Sertraline decreases serum level of interleukin-6 (IL-6) in hemodialysis patients with depression: Results of a randomized double-blind, placebo-controlled clinical trial

Background: This study was designed to assess the effect of sertraline on serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), IL-10 and high-sensitivity C-reactive protein (hs-CRP) of depressed hemodialysis (HD) patients. Methods: During a randomized, double-blind, placebo-controlled trial, fifty depressed HD patients were allocated to receive sertraline or placebo for 12 weeks. Patients' depression was assessed using Beck Depression Inventory-second edition (BDI-II). Biochemical parameters (hemoglobin, serum albumin, iron stores, etc.) and serum IL-6, IL-10, TNF-alpha, and hs-CRP levels were measured at baseline and at weeks 6 and 12 of the study. Results: Sertraline significantly improved depression symptoms in 47.5% of the patients. Compared with placebo, serum levels of IL-6 significantly decreased (P<0.01) in the sertraline group at week 12 of the study. Although serum level of TNF-alpha decreased and serum level of IL-10 increased in sertraline group at week 12 versus initiation of the study, no significant differences were found between sertraline and placebo groups. Serum hs-CRP did not display differences neither for inter- nor intra-group comparisons. Hemoglobin and serum albumin concentrations were significantly lower at week 12 in the placebo versus sertraline group (P=0.012 and P=0.006, respectively). No significant differences were observed in the inflammatory mediators between responders and nonresponders to sertraline. Conclusions: Compared with placebo, sertraline significantly decreased serum level of IL-6. The anti-inflammatory effect of sertraline was independent to its efficacy for depression treatment. Sertraline could be a promising strategy to reduce the systemic inflammation and to treat depression in HD patients. (C) 2013 Elsevier B.V. All rights reserved.