Association between B cell activating factor (BAFF) and future depressive symptoms in hemodialysis patients

Abstract

Objective: B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) are cytokines that play critical roles in maturation, homeostasis, and differentiation of B cells, and are associated with mental disorders. The link between inflammation and depression is well-established. Patients undergoing hemodialysis (HD), who commonly experience depression, exhibit a state of immune dysfunction. We hypothesize that BAFF and APRIL may influence future depressive symptoms in HD patients.

Methods: We enrolled 72 HD patients without baseline depressive symptoms. Participants' depressive symptoms were assessed annually over two years using the BDI-II. The participants were measured for plasma BAFF, APRIL, and tumor necrosis factor (TNF)-α levels. To evaluate their impact on the development of depressive symptoms, we performed Cox regression and Kaplan-Meier analysis.

Results: Depressive symptoms were observed in 31 (43.1%) subjects. In both univariate and multivariate Cox regression analyses, a 1 SD increase in BAFF was significantly associated with increased risk of future depressive symptoms with hazard ratio of 1.44 (95%CI 1.03-2.00) and 1.70 (95%CI 1.04-2.78), respectively. Higher BAFF groups exhibited a significantly greater incidence of depressive symptoms over two years (p = 0.048).

Conclusion: Elevated plasma BAFF levels were significantly associated with the development of depressive symptoms in HD patients.

Keywords: APRIL; BAFF; TNF-α; cytokines; depression; hemodialysis.