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Maza-Quiroga R, García-Marchena N, Romero-Sanchiz P, Barrios V, Pedraz M, Serrano A, Nogueira-Arjona R, Ruiz JJ, Soria M, Campos R, Chowen JA, Argente J, Torrens M, López-Gallardo M, Marco EM, Rodríguez de Fonseca F, Pavón FJ, Araos P. Evaluation of plasma cytokines in patients with cocaine use disorders in abstinence identifies transforming growth factor alpha (TGFα) as a potential biomarker of consumption and dual diagnosis. PeerJ 2017; 5:e3926. [PMID: 29038767 PMCID: PMC5641428 DOI: 10.7717/peerj.3926] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/24/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cocaine use disorder (CUD) is a complex health condition, especially when it is accompanied by comorbid psychiatric disorders (dual diagnosis). Dual diagnosis is associated with difficulties in the stratification and treatment of patients. One of the major challenges in clinical practice of addiction psychiatry is the lack of objective biological markers that indicate the degree of consumption, severity of addiction, level of toxicity and response to treatment in patients with CUD. These potential biomarkers would be fundamental players in the diagnosis, stratification, prognosis and therapeutic orientation in addiction. Due to growing evidence of the involvement of the immune system in addiction and psychiatric disorders, we tested the hypothesis that patients with CUD in abstinence might have altered circulating levels of signaling proteins related to systemic inflammation. METHODS The study was designed as a cross-sectional study of CUD treatment-seeking patients. These patients were recruited from outpatient programs in the province of Malaga (Spain). The study was performed with a total of 160 white Caucasian subjects, who were divided into the following groups: patients diagnosed with CUD in abstinence (N = 79, cocaine group) and matched control subjects (N = 81, control group). Participants were clinically evaluated with the diagnostic interview PRISM according to the DSM-IV-TR, and blood samples were collected for the determination of chemokine C-C motif ligand 11 (CCL11, eotaxin-1), interferon gamma (IFNγ), interleukin-4 (IL-4), interleukin-8 (IL-8), interleukin-17α (IL-17α), macrophage inflammatory protein 1α (MIP-1α) and transforming growth factor α (TGFα) levels in the plasma. Clinical and biochemical data were analyzed in order to find relationships between variables. RESULTS While 57% of patients with CUD were diagnosed with dual diagnosis, approximately 73% of patients had other substance use disorders. Cocaine patients displayed greater cocaine symptom severity when they were diagnosed with psychiatric comorbidity. Regarding inflammatory factors, we observed significantly lower plasma levels of IL-17α (p < 0.001), MIP-1α (p < 0.001) and TGFα (p < 0.05) in the cocaine group compared with the levels in the control group. Finally, there was a significant primary effect of dual diagnosis on the plasma concentrations of TGFα (p < 0.05) in the cocaine group, and these levels were lower in patients with dual diagnoses. DISCUSSION IL-17α, MIP-1α and TGFα levels are different between the cocaine and control groups, and TGFα levels facilitate the identification of patients with dual diagnosis. Because TGFα reduction is associated with enhanced responses to cocaine in preclinical models, we propose TGFα as a potential biomarker of complex CUD in humans.
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Affiliation(s)
- Rosa Maza-Quiroga
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Nuria García-Marchena
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Pablo Romero-Sanchiz
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Vicente Barrios
- Department of Endocrinology, Hospital Universitario Niño Jesús, Madrid, Spain
| | - María Pedraz
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Antonia Serrano
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Raquel Nogueira-Arjona
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Juan Jesus Ruiz
- Diputación de Málaga, Centro Provincial de Drogodependencias, Málaga, Spain
| | - Maribel Soria
- Diputación de Málaga, Centro Provincial de Drogodependencias, Málaga, Spain
| | - Rafael Campos
- Diputación de Málaga, Centro Provincial de Drogodependencias, Málaga, Spain
| | - Julie Ann Chowen
- Department of Endocrinology, Hospital Universitario Niño Jesús, Madrid, Spain
| | - Jesus Argente
- Department of Endocrinology, Hospital Universitario Niño Jesús, Madrid, Spain
| | - Marta Torrens
- Institut de Neuropsiquiatria i Addiccions (INAD) del Parc de Salut Mar, Barcelona, Spain
| | | | - Eva María Marco
- Department of Physiology II Faculty of Biology, Universidad Complutense de Madrid, Madrid, Spain
| | - Fernando Rodríguez de Fonseca
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Francisco Javier Pavón
- Hospital Regional Universitario de Málaga, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Pedro Araos
- Department of Physiology II Faculty of Biology, Universidad Complutense de Madrid, Madrid, Spain
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Garland EL, Hanley AW, Baker AK, Howard MO. Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective. CHRONIC STRESS 2017; 1. [PMID: 28840198 PMCID: PMC5565157 DOI: 10.1177/2470547017711912] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Mindfulness-based interventions have been heralded as promising means of alleviating
chronic stress. While meta-analyses indicate that mindfulness-based interventions
significantly reduce global measures of stress, how mindfulness-based interventions
modulate the specific mechanisms underpinning chronic stress as operationalized by the
National Institute of Mental Health research domain criteria (RDoC) of sustained threat
has not yet been detailed in the literature. To address this knowledge gap, this article
aims to (1) review evidence that mindfulness-based interventions ameliorate each of the 10
elements of behavioral dysregulation characterizing sustained threat via an array of
mindful counter-regulatory strategies; (2) review evidence that mindfulness-based
interventions modify biological domains implicated in sustained threat, such as the
hypothalamic–pituitary–adrenal axis, as well as brain circuits involved in attentional
function, limbic reactivity, habit behavior, and the default mode network; and (3)
integrate these findings into a novel conceptual framework of mindful self-regulation in
the face of stress—the Mindfulness-to-Meaning Theory. Taken together, the extant body of
scientific evidence suggests that the practice of mindfulness enhances a range
biobehavioral factors implicated in adaptive stress coping and induces self-referential
plasticity, leading to the ability to find meaning in adversity. These mechanistic
findings can inform the treatment development process to optimize the next generation of
mindfulness-based interventions for greater therapeutic efficacy.
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Affiliation(s)
- Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND) College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Adam W Hanley
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND) College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Anne K Baker
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND) College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Matthew O Howard
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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