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Wang W, Wang R, Jiang Z, Li H, Zhu Z, Khalid A, Liu D, Pan F. Inhibiting Brd4 alleviated PTSD-like behaviors and fear memory through regulating immediate early genes expression and neuroinflammation in rats. J Neurochem 2021; 158:912-927. [PMID: 34050937 DOI: 10.1111/jnc.15439] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/11/2021] [Accepted: 05/18/2021] [Indexed: 12/30/2022]
Abstract
Post-traumatic stress disorder (PTSD) is characterized by depression/anxiety and memory failure, primarily fear memory. According to the reports, neuroinflammation and synaptic plasticity can play a role in the neurophysiological mechanisms underlying PTSD. Bromodomain-containing protein 4 (Brd4) intriguingly affects regulating of inflammatory responses and learning and memory. This study aimed to explore the effect of inhibiting Brd4 on depression/anxiety-like behaviors, spatial and fear memory, and underlying mechanisms in a model of PTSD. Inescapable foot shocks (IFS) with a sound reminder in 6 days were used to induce PTSD-like behaviors which were tested using contextual and cue fear tests, sucrose preference test, open-field test, elevated plus maze test, and Y-maze test. Meanwhile, the Brd4 inhibitor JQ1 was used as an intervention. The results found that IFS induced PTSD-like behaviors and indicated obvious Brd4 expression in microglia of the prefrontal cortex (PFC), hippocampus, and amygdala, pro-inflammatory cytokines over-expression, microglial activation, and nuclear factor-kappa B over-expression in PFC and hippocampus but not in amygdala. Meanwhile, the alterations of immediate early genes (IEGs) were found in PFC, hippocampus, and amygdala. Besides, dendritic spine density was reduced in PFC and hippocampus but was elevated in amygdala of rats with IFS. In addition, treatment with JQ1 significantly reduced freezing time in the contextual and cue fear test, reversed the behavioral impairment, decreased the elevated neuroinflammation, and normalized the alteration in IEGs and dendritic spine densities. The results suggested that Brd4 was involved in IFS-induced PTSD-like behaviors through regulating neuroinflammation, dynamics of IEGs, and synaptic plasticity.
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Affiliation(s)
- Wei Wang
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Rui Wang
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Zhijun Jiang
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Haonan Li
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Zemeng Zhu
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Arslan Khalid
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Dexiang Liu
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Fang Pan
- Department of Medical Psychology and Ethics, School of Basic Medical Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
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152
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Taft TH, Quinton S, Jedel S, Simons M, Mutlu EA, Hanauer SB. Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes. Inflamm Bowel Dis 2021; 28:710-719. [PMID: 34137449 PMCID: PMC8344426 DOI: 10.1093/ibd/izab152] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with chronic illness are at increased risk for traumatic stress because of medical trauma. Initial studies of posttraumatic stress (PTS) in patients with inflammatory bowel disease (IBD) have found that approximately one-third of patients may experience significant PTS symptoms including flashbacks, nightmares, hypervigilance, disrupted sleep, and low mood. We aim to better characterize PTS in IBD and its relationship with patient outcomes in a large cohort of patients with IBD. METHODS Adult patients registered with the Crohn's & Colitis Foundation/University of North Carolina IBD Partners database were invited to complete a supplementary survey between February and July 2020. The Post Traumatic Stress Disorder Checklist-5th edition was administered as a supplemental survey. Additional data from IBD Partners included disease severity, surgery and hospital history, demographics, and health care utilization. RESULTS A total of 797 patients participated (452 with Crohn disease, 345 with ulcerative colitis). No impacts on response patterns because of the COVID-19 pandemic were found. Although 5.6% of the sample reported an existing PTS diagnosis because of IBD experiences, 9.6% of participants met the full IBD-related PTS diagnostic criteria per the Post Traumatic Stress Disorder Checklist-5th edition. Female patients, younger patients, those with less educational attainment, non-White patients, and Hispanic patients reported higher levels of PTS symptoms. Patients with higher PTS symptoms were more likely to have been hospitalized, have had surgery, have more severe symptoms, and not be in remission. Increased PTS was also associated with increased anxiety, depression, pain interference, fatigue, and health care utilization. CONCLUSIONS The present findings support prior research that approximately one-quarter to one-third of patients with IBD report significant symptoms of PTS directly from their disease experiences, and certain demographic groups are at higher risk. In addition, PTS is associated with several IBD outcomes. Patients with higher PTS symptoms are less likely to be in remission and may utilize more outpatient gastrointestinal services. Intervention trials to mitigate PTS symptoms in patients with IBD are warranted.
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Affiliation(s)
- Tiffany H Taft
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA,Address correspondence to: Tiffany Taft, PsyD, MIS, 676 North Saint Clair Street, Suite 1400, Chicago, IL 60611 ()
| | - Sarah Quinton
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA
| | - Sharon Jedel
- Rush University, Department of Digestive Disease and Nutrition, Chicago, Illinois, USA
| | - Madison Simons
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA
| | - Ece A Mutlu
- Rush University, Department of Digestive Disease and Nutrition, Chicago, Illinois, USA
| | - Stephen B Hanauer
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA
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153
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Weggen JB, Darling AM, Autler AS, Hogwood AC, Decker KP, Imthurn B, Tuzzolo GM, Garten RS. Impact of acute antioxidant supplementation on vascular function and autonomic nervous system modulation in young adults with PTSD. Am J Physiol Regul Integr Comp Physiol 2021; 321:R49-R61. [PMID: 34075811 DOI: 10.1152/ajpregu.00054.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Posttraumatic stress disorder (PTSD) has been associated with an increase in risk of cardiovascular disease (CVD). The goal of this study was to determine if peripheral vascular dysfunction, a precursor to CVD, was present in young adults with PTSD, and if an acute antioxidant (AO) supplementation could modify this potential PTSD-induced vascular dysfunction. Thirteen individuals with PTSD were recruited for this investigation and were compared with 35 age- and sex-matched controls (CTRL). The PTSD group participated in two visits, consuming either a placebo (PTSD-PL) or antioxidants (PTSD-AO; vitamins C and E; α-lipoic acid) before their visits, whereas the CTRL subjects only participated in one visit. Upper and lower limb vascular functions were assessed via flow-mediated dilation and passive leg movement technique. Heart rate variability was utilized to assess autonomic nervous system modulation. The PTSD-PL condition, when compared with the CTRL group, reported lower arm and leg microvascular function as well as sympathetic nervous system (SNS) predominance. After acute AO supplementation, arm, but not leg, microvascular function was improved and SNS predominance was lowered to which the prior difference between PTSD group and CTRL was no longer significant. Young individuals with PTSD demonstrated lower arm and leg microvascular function as well as greater SNS predominance when compared with age- and sex-matched controls. Furthermore, this lower vascular/autonomic function was augmented by an acute AO supplementation to the level of the healthy controls, potentially implicating oxidative stress as a contributor to this blunted vascular/autonomic function.
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Affiliation(s)
- Jennifer B Weggen
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Ashley M Darling
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Aaron S Autler
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Austin C Hogwood
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| | - Kevin P Decker
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Brandon Imthurn
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Gina M Tuzzolo
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Ryan S Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
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154
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Pantazopoulos H, Katsel P, Haroutunian V, Chelini G, Klengel T, Berretta S. Molecular signature of extracellular matrix pathology in schizophrenia. Eur J Neurosci 2021; 53:3960-3987. [PMID: 33070392 PMCID: PMC8359380 DOI: 10.1111/ejn.15009] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/04/2020] [Indexed: 02/06/2023]
Abstract
Growing evidence points to a critical involvement of the extracellular matrix (ECM) in the pathophysiology of schizophrenia (SZ). Decreases of perineuronal nets (PNNs) and altered expression of chondroitin sulphate proteoglycans (CSPGs) in glial cells have been identified in several brain regions. GWAS data have identified several SZ vulnerability variants of genes encoding for ECM molecules. Given the potential relevance of ECM functions to the pathophysiology of this disorder, it is necessary to understand the extent of ECM changes across brain regions, their region- and sex-specificity and which ECM components contribute to these changes. We tested the hypothesis that the expression of genes encoding for ECM molecules may be broadly disrupted in SZ across several cortical and subcortical brain regions and include key ECM components as well as factors such as ECM posttranslational modifications and regulator factors. Gene expression profiling of 14 neocortical brain regions, caudate, putamen and hippocampus from control subjects (n = 14/region) and subjects with SZ (n = 16/region) was conducted using Affymetrix microarray analysis. Analysis across brain regions revealed widespread dysregulation of ECM gene expression in cortical and subcortical brain regions in SZ, impacting several ECM functional key components. SRGN, CD44, ADAMTS1, ADAM10, BCAN, NCAN and SEMA4G showed some of the most robust changes. Region-, sex- and age-specific gene expression patterns and correlation with cognitive scores were also detected. Taken together, these findings contribute to emerging evidence for large-scale ECM dysregulation in SZ and point to molecular pathways involved in PNN decreases, glial cell dysfunction and cognitive impairment in SZ.
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Affiliation(s)
- Harry Pantazopoulos
- Department of Neurobiology and Anatomical SciencesUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Pavel Katsel
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkNYUSA
- Department of NeuroscienceThe Icahn School of Medicine at Mount SinaiNew YorkNYUSA
- Mental Illness Research Education ClinicalCenters of Excellence (MIRECC)JJ Peters VA Medical CenterBronxNYUSA
| | - Vahram Haroutunian
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkNYUSA
- Department of NeuroscienceThe Icahn School of Medicine at Mount SinaiNew YorkNYUSA
- Mental Illness Research Education ClinicalCenters of Excellence (MIRECC)JJ Peters VA Medical CenterBronxNYUSA
| | - Gabriele Chelini
- Translational Neuroscience LaboratoryMclean HospitalBelmontMAUSA
- Department of PsychiatryHarvard Medical SchoolBostonMAUSA
| | - Torsten Klengel
- Department of PsychiatryHarvard Medical SchoolBostonMAUSA
- Translational Molecular Genomics LaboratoryMclean HospitalBelmontMAUSA
- Department of PsychiatryUniversity Medical Center GöttingenGöttingenGermany
| | - Sabina Berretta
- Translational Neuroscience LaboratoryMclean HospitalBelmontMAUSA
- Department of PsychiatryHarvard Medical SchoolBostonMAUSA
- Program in NeuroscienceHarvard Medical SchoolBostonMAUSA
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155
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Parekh SV, Paniccia JE, Adams LO, Lysle DT. Hippocampal TNF-α Signaling Mediates Heroin Withdrawal-Enhanced Fear Learning and Withdrawal-Induced Weight Loss. Mol Neurobiol 2021; 58:2963-2973. [PMID: 33580871 PMCID: PMC8128733 DOI: 10.1007/s12035-021-02322-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/04/2021] [Indexed: 12/25/2022]
Abstract
There is significant comorbidity of opioid use disorder (OUD) and post-traumatic stress disorder (PTSD) in clinical populations. However, the neurobiological mechanisms underlying the relationship between chronic opioid use and withdrawal and development of PTSD are poorly understood. Our previous work identified that chronic escalating heroin administration and withdrawal can produce enhanced fear learning, an animal model of hyperarousal, and is associated with an increase in dorsal hippocampal (DH) interleukin-1β (IL-1β). However, other cytokines, such as TNF-α, work synergistically with IL-1β and may have a role in the development of enhanced fear learning. Based on both translational rodent and clinical studies, TNF-α has been implicated in hyperarousal states of PTSD, and has an established role in hippocampal-dependent learning and memory. The first set of experiments tested the hypothesis that chronic heroin administration followed by withdrawal is capable of inducing alterations in DH TNF-α expression. The second set of experiments examined whether DH TNF-α expression is functionally relevant to the development of enhanced fear learning. We identified an increase of TNF-α immunoreactivity and positive cells at 0, 24, and 48 h into withdrawal in the dentate gyrus DH subregion. Interestingly, intra-DH infusions of etanercept (TNF-α inhibitor) 0, 24, and 48 h into heroin withdrawal prevented the development of enhanced fear learning and mitigated withdrawal-induced weight loss. Overall, these findings provide insight into the role of TNF-α in opioid withdrawal and the development of anxiety disorders such as PTSD.
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Affiliation(s)
- Shveta V Parekh
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3270, Chapel Hill, NC, 27599-3270, USA
| | - Jacqueline E Paniccia
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3270, Chapel Hill, NC, 27599-3270, USA
| | - Lydia O Adams
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3270, Chapel Hill, NC, 27599-3270, USA
| | - Donald T Lysle
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3270, Chapel Hill, NC, 27599-3270, USA.
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156
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Rackova L, Mach M, Brnoliakova Z. An update in toxicology of ageing. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 84:103611. [PMID: 33581363 DOI: 10.1016/j.etap.2021.103611] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
The field of ageing research has been rapidly advancing in recent decades and it had provided insight into the complexity of ageing phenomenon. However, as the organism-environment interaction appears to significantly affect the organismal pace of ageing, the systematic approach for gerontogenic risk assessment of environmental factors has yet to be established. This puts demand on development of effective biomarker of ageing, as a relevant tool to quantify effects of gerontogenic exposures, contingent on multidisciplinary research approach. Here we review the current knowledge regarding the main endogenous gerontogenic pathways involved in acceleration of ageing through environmental exposures. These include inflammatory and oxidative stress-triggered processes, dysregulation of maintenance of cellular anabolism and catabolism and loss of protein homeostasis. The most effective biomarkers showing specificity and relevancy to ageing phenotypes are summarized, as well. The crucial part of this review was dedicated to the comprehensive overview of environmental gerontogens including various types of radiation, certain types of pesticides, heavy metals, drugs and addictive substances, unhealthy dietary patterns, and sedentary life as well as psychosocial stress. The reported effects in vitro and in vivo of both recognized and potential gerontogens are described with respect to the up-to-date knowledge in geroscience. Finally, hormetic and ageing decelerating effects of environmental factors are briefly discussed, as well.
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Affiliation(s)
- Lucia Rackova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia.
| | - Mojmir Mach
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
| | - Zuzana Brnoliakova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
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157
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Kalungi A, Womersley JS, Kinyanda E, Joloba ML, Ssembajjwe W, Nsubuga RN, Seedat S, Hemmings SMJ. The 5-HTTLPR-rs25531 S-A-S-A Haplotype and Chronic Stress Moderate the Association Between Acute Stress and Internalizing Mental Disorders Among HIV+ Children and Adolescents in Uganda. Front Genet 2021; 12:649055. [PMID: 33968131 PMCID: PMC8104030 DOI: 10.3389/fgene.2021.649055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 03/26/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Internalizing mental disorders (IMDs) among HIV-positive (HIV+) children and adolescents are associated with poor disease outcomes, such as faster HIV disease progression. Although it has been suggested that the development of IMDs is moderated by interaction of stressful life events and vulnerability factors, the underlying etiology is largely unknown. Serotonin transporter gene [solute carrier family 6 member A4 (SLC6A4)] and human tryptophan hydroxylase 2 gene (TPH2) polymorphisms have been implicated in the development of IMDs. This study investigated the association between acute stress and IMDs, and moderation by chronic stress and genetic variants in SLC6A4 and TPH2. Hypothesis: Acute stress acts through genetic and environmental vulnerability factors to increase the risk of developing IMDs. Methods: Polymorphisms in SLC6A4 (5-HTTLPR, rs25531, 5-HTTLPR-rs25531, and STin2 VNTR) and TPH2 (rs1843809, rs1386494, rs4570625, and rs34517220) were genotyped in 368 HIV+ children and adolescents (aged 5-17 years) with any internalizing mental disorder (depression, anxiety disorders, or posttraumatic stress disorder), and 368 age- and sex-matched controls, who were also HIV+. Chronic and acute stress categories were derived by hierarchical cluster analysis. Logistic regression analysis was used to assess the independent moderating effect of chronic stress and each selected polymorphism on the association between acute stress and IMDs. Results: We observed a statistically significant association between severe acute stress and IMDs (p = 0.001). Children and adolescents who experienced severe acute stress were twice as likely to develop IMDs, compared to children and adolescents who experienced mild acute stress (p = 0.001). Chronic stress interacted with severe acute stress to increase the risk of IMDs (p = 0.033). Acute stress was found to interact with 5-HTTLPR-rs25531 S-A-S-A haplotype to increase the risk for IMDs among Ugandan HIV+ children and adolescents (p = 0.049). We found no evidence for a combined interaction of acute stress, chronic stress, and 5-HTTLPR-rs25531 on IMDs. Conclusion: The odds of having an internalizing mental disorder (IMD) were higher among HIV+ children and adolescents who experienced severe acute stress compared to HIV+ children and adolescents who experienced mild acute stress. Chronic stress and 5-HTTLPR-rs25531 independently moderated the association between acute stress and IMDs.
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Affiliation(s)
- Allan Kalungi
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, Makerere University, Kampala, Uganda
- Department of Medical Microbiology, Makerere University, Kampala, Uganda
| | - Jacqueline S. Womersley
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Cape Town, South Africa
| | - Eugene Kinyanda
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Moses L. Joloba
- Department of Medical Microbiology, Makerere University, Kampala, Uganda
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Wilber Ssembajjwe
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- MRC/UVRI and LSHTM Uganda Research Unit, Statistics and Data Science Section, Entebbe, Uganda
| | - Rebecca N. Nsubuga
- MRC/UVRI and LSHTM Uganda Research Unit, Statistics and Data Science Section, Entebbe, Uganda
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Cape Town, South Africa
| | - Sian M. J. Hemmings
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Cape Town, South Africa
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158
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Liu L, Wen L, Gao C, Piao H, Zhao H, Yu D, Zhu L, Li S. Effects of Non-directional Mechanical Trauma on Gastrointestinal Tract Injury in Rats. Front Physiol 2021; 12:649554. [PMID: 33935802 PMCID: PMC8081863 DOI: 10.3389/fphys.2021.649554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/26/2021] [Indexed: 12/04/2022] Open
Abstract
Mechanical trauma can (MT) cause secondary injury, such as cardiomyocyte apoptosis and cardiac dysfunction has been reported. However, the effects of mechanical trauma on gastrointestinal tract is unclear. This study aims to observe the main location and time of gastrointestinal tract injury caused by non-directional trauma and explain the reason of the increase of LPS in blood caused by mechanical injury. Morphological changes in the stomach, ileum and cecum at different time points after MT were observed in this experiment. The results reveal that the injury to the cecal mucosa in the rats was more obvious than that in the ileum and the stomach. The cecal epithelial cell junction was significantly widened at 20 min after MT, and the plasma LPS and D-lactic acid concentrations increased significantly at the same time point. In addition, some bacterial structures in the widened intercellular space and near the capillary wall of the cecal mucosa were detected at 12 h after MT. This finding suggests that the main reason for the increase in LPS in plasma after MT is cecal mucosal injury. This study is important for the early intervention of the gastrointestinal tract to prevent secondary injury after MT.
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Affiliation(s)
- Lihong Liu
- Department of Physiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Lianpu Wen
- Department of Physiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Chuanzhou Gao
- Central Laboratory, Dalian Medical University, Dalian, China
| | - Hua Piao
- Department of Physiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Hui Zhao
- Department of Physiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Deqin Yu
- Department of Physiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Liang Zhu
- Department of Physiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Shuzhuang Li
- Department of Physiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
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159
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Namba MD, Leyrer-Jackson JM, Nagy EK, Olive MF, Neisewander JL. Neuroimmune Mechanisms as Novel Treatment Targets for Substance Use Disorders and Associated Comorbidities. Front Neurosci 2021; 15:650785. [PMID: 33935636 PMCID: PMC8082184 DOI: 10.3389/fnins.2021.650785] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
Recent studies examining the neurobiology of substance abuse have revealed a significant role of neuroimmune signaling as a mechanism through which drugs of abuse induce aberrant changes in synaptic plasticity and contribute to substance abuse-related behaviors. Immune signaling within the brain and the periphery critically regulates homeostasis of the nervous system. Perturbations in immune signaling can induce neuroinflammation or immunosuppression, which dysregulate nervous system function including neural processes associated with substance use disorders (SUDs). In this review, we discuss the literature that demonstrates a role of neuroimmune signaling in regulating learning, memory, and synaptic plasticity, emphasizing specific cytokine signaling within the central nervous system. We then highlight recent preclinical studies, within the last 5 years when possible, that have identified immune mechanisms within the brain and the periphery associated with addiction-related behaviors. Findings thus far underscore the need for future investigations into the clinical potential of immunopharmacology as a novel approach toward treating SUDs. Considering the high prevalence rate of comorbidities among those with SUDs, we also discuss neuroimmune mechanisms of common comorbidities associated with SUDs and highlight potentially novel treatment targets for these comorbid conditions. We argue that immunopharmacology represents a novel frontier in the development of new pharmacotherapies that promote long-term abstinence from drug use and minimize the detrimental impact of SUD comorbidities on patient health and treatment outcomes.
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Affiliation(s)
- Mark D. Namba
- School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | | | - Erin K. Nagy
- Department of Psychology, Arizona State University, Tempe, AZ, United States
| | - M. Foster Olive
- Department of Psychology, Arizona State University, Tempe, AZ, United States
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160
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Astill Wright L, Roberts NP, Barawi K, Simon N, Zammit S, McElroy E, Bisson JI. Disturbed Sleep Connects Symptoms of Posttraumatic Stress Disorder and Somatization: A Network Analysis Approach. J Trauma Stress 2021; 34:375-383. [PMID: 33170989 PMCID: PMC9943267 DOI: 10.1002/jts.22619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/04/2020] [Accepted: 10/10/2020] [Indexed: 12/13/2022]
Abstract
Posttraumatic stress disorder (PTSD) and physical health problems, particularly somatic symptom disorder, are highly comorbid. Studies have only examined this co-occurrence at the disorder level rather than assessing the associations between specific symptoms. Using network analysis to identify symptoms that act as bridges between these disorders may allow for the development of interventions to specifically target this comorbidity. We examined the association between somatization and PTSD symptoms via network analysis. This included 349 trauma-exposed individuals recruited through the National Centre for Mental Health PTSD cohort who completed the Clinician-Administered PTSD Scale for DSM-5 and the Patient Health Questionnaire-15. A total of 215 (61.6%) individuals met the DSM-5 diagnostic criteria for PTSD. An exploratory graph analysis identified four clusters of densely connected symptoms within the overall network: PTSD, chronic pain, gastrointestinal issues, and more general somatic complaints. Sleep difficulties played a key role in bridging PTSD and somatic symptoms. Our network analysis demonstrates the distinct nature of PTSD and somatization symptoms, with this association connected by disturbed sleep.
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Affiliation(s)
- Laurence Astill Wright
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Neil P. Roberts
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom,Directorate of Psychology and Psychological TherapiesCardiff & Vale University Health BoardCardiffUnited Kingdom
| | - Kali Barawi
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Natalie Simon
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Stanley Zammit
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom,Centre for Academic Mental HealthPopulation Health SciencesUniversity of BristolBristolUnited Kingdom
| | - Eoin McElroy
- Department of NeurosciencePsychology and BehaviourUniversity of LeicesterLeicesterUnited Kingdom
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
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Lionetti V, Bollini S, Coppini R, Gerbino A, Ghigo A, Iaccarino G, Madonna R, Mangiacapra F, Miragoli M, Moccia F, Munaron L, Pagliaro P, Parenti A, Pasqua T, Penna C, Quaini F, Rocca C, Samaja M, Sartiani L, Soda T, Tocchetti CG, Angelone T. Understanding the heart-brain axis response in COVID-19 patients: A suggestive perspective for therapeutic development. Pharmacol Res 2021; 168:105581. [PMID: 33781873 PMCID: PMC7997688 DOI: 10.1016/j.phrs.2021.105581] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/19/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022]
Abstract
In-depth characterization of heart-brain communication in critically ill patients with severe acute respiratory failure is attracting significant interest in the COronaVIrus Disease 19 (COVID-19) pandemic era during intensive care unit (ICU) stay and after ICU or hospital discharge. Emerging research has provided new insights into pathogenic role of the deregulation of the heart-brain axis (HBA), a bidirectional flow of information, in leading to severe multiorgan disease syndrome (MODS) in patients with confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Noteworthy, HBA dysfunction may worsen the outcome of the COVID-19 patients. In this review, we discuss the critical role HBA plays in both promoting and limiting MODS in COVID-19. We also highlight the role of HBA as new target for novel therapeutic strategies in COVID-19 in order to open new translational frontiers of care. This is a translational perspective from the Italian Society of Cardiovascular Researches.
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Affiliation(s)
- Vincenzo Lionetti
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; UOSVD Anesthesia and Intensive Care, Fondazione Toscana G. Monasterio, Pisa, Italy.
| | - Sveva Bollini
- Regenerative Medicine Laboratory, Department of Experimental Medicine, University of Genova, Genova, Italy
| | - Raffaele Coppini
- Department of NEUROFARBA, Center of Molecular Medicine, University of Firenze, 50139 Firenze, Italy
| | - Andrea Gerbino
- Department of Bioscience, Biotechnology and Biopharmaceuticals, University of Bari, Bari, Italy
| | - Alessandra Ghigo
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, Federico II University, Italy
| | - Rosalinda Madonna
- Institute of Cardiology, University of Pisa, Pisa, Italy; Center for Cardiovascular Biology and Atherosclerosis Research, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Fabio Mangiacapra
- Unit of Cardiovascular Science, Campus Bio-Medico University, Rome, Italy
| | - Michele Miragoli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesco Moccia
- Department of Biology and Biotechnology, Laboratory of General Physiology, University of Pavia, Pavia, Italy.
| | - Luca Munaron
- Department of Life Sciences and Systems Biology, University of Turin, Turin, Italy
| | - Pasquale Pagliaro
- Clinical and Biological Sciences Department, University of Turin, Orbassano, Turin, Italy
| | - Astrid Parenti
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Teresa Pasqua
- Department of Health Science, University of Magna Graecia, Catanzaro, Italy
| | - Claudia Penna
- Clinical and Biological Sciences Department, University of Turin, Orbassano, Turin, Italy
| | - Federico Quaini
- Department of Medicine and Surgery, Hematology and Bone Marrow Transplantation, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Carmine Rocca
- Laboratory of Cellular and Molecular Cardiovascular Patho-Physiology, Department of Biology, E. and E.S., University of Calabria, Arcavacata di Rende, CS, Italy
| | - Michele Samaja
- Department of Health Science, University of Milano, Milan, Italy
| | - Laura Sartiani
- Department of NEUROFARBA, Center of Molecular Medicine, University of Firenze, 50139 Firenze, Italy
| | - Teresa Soda
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Carlo Gabriele Tocchetti
- Interdepartmental Center of Clinical and Translational Research, Federico II University, Naples, Italy
| | - Tommaso Angelone
- Laboratory of Cellular and Molecular Cardiovascular Patho-Physiology, Department of Biology, E. and E.S., University of Calabria, Arcavacata di Rende, CS, Italy
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162
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Ertle CM, Rommel FR, Tumala S, Moriwaki Y, Klein J, Kruse J, Gieler U, Peters EMJ. New Pathways for the Skin's Stress Response: The Cholinergic Neuropeptide SLURP-1 Can Activate Mast Cells and Alter Cytokine Production in Mice. Front Immunol 2021; 12:631881. [PMID: 33815383 PMCID: PMC8012551 DOI: 10.3389/fimmu.2021.631881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/24/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The alpha7 nicotinic acetylcholine receptor (Chrna7) plays an essential anti-inflammatory role in immune homeostasis and was recently found on mast cells (MC). Psychosocial stress can trigger MC hyperactivation and increases pro-inflammatory cytokines in target tissues such as the skin. If the cholinergic system (CS) and Chrna7 ligands play a role in these cascades is largely unknown. Objective: To elucidate the role of the CS in the response to psychosocial stress using a mouse-model for stress-triggered cutaneous inflammatory circuits. Methods: Key CS markers (ACh, Ch, SLURP-1, SLURP-2, Lynx1, Chrm3, Chrna7, Chrna9, ChAT, VAChT, Oct3, AChE, and BChE) in skin and its MC (sMC), MC activation, immune parameters (TNFα, IL1β, IL10, TGFβ, HIF1α, and STAT3) and oxidative stress were analyzed in skin from 24 h noise-stressed mice and in cultured MC (cMC) from C57BL/6 or Chrna7-Knockout mice. Results: First, Chrna7 and SLURP-1 mRNA were exclusively upregulated in stressed skin. Second, histomorphometry located Chrna7 and SLURP-1 in nerves and sMC and demonstrated upregulated contacts and increased Chrna7+ sMC in stressed skin, while 5 ng/mL SLURP-1 degranulated cMC. Third, IL1β+ sMC were high in stressed skin, and while SLURP-1 alone had no significant effect on cMC cytokines, it upregulated IL1β in cMC from Chrna7-KO and in IL1β-treated wildtype cMC. In addition, HIF1α+ sMC were high in stressed skin and Chrna7-agonist AR-R 17779 induced ROS in cMC while SLURP-1 upregulated TNFα and IL1β in cMC when HIF1α was blocked. Conclusions: These data infer that the CS plays a role in the regulation of stress-sensitive inflammatory responses but may have a surprising pro-inflammatory effect in healthy skin, driving IL1β expression if SLURP-1 is involved.
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Affiliation(s)
- Christoph M Ertle
- Psychoneuroimmunology Laboratory, Clinic for Psychosomatic Medicine and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany
| | - Frank R Rommel
- Psychoneuroimmunology Laboratory, Clinic for Psychosomatic Medicine and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany
| | - Susanne Tumala
- Psychoneuroimmunology Laboratory, Clinic for Psychosomatic Medicine and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany
| | - Yasuhiro Moriwaki
- Department of Pharmacology, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Jochen Klein
- Department of Pharmacology, Biocenter N260, Goethe University Frankfurt, Frankfurt, Germany
| | - Johannes Kruse
- Clinic for Psychosomatic Medicine and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany.,Clinic for Psychosomatic Medicine and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Uwe Gieler
- Department of Dermatology, University Hospital Giessen, Giessen, Germany
| | - Eva M J Peters
- Psychoneuroimmunology Laboratory, Clinic for Psychosomatic Medicine and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany.,Charité Center 12 for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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163
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Tang H, Li K, Zhang S, Lan H, Liang L, Huang C, Li T. Inhibitory Effect of Paeonol on Apoptosis, Oxidative Stress, and Inflammatory Response in Human Umbilical Vein Endothelial Cells Induced by High Glucose and Palmitic Acid Induced Through Regulating SIRT1/FOXO3a/NF-κB Pathway. J Interferon Cytokine Res 2021; 41:111-124. [PMID: 33750217 DOI: 10.1089/jir.2019.0236] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Reactive oxygen species (ROS) induced by high glucose and high fat of diabetes mellitus (DM) finally caused the occurrence and progression of atherosclerosis and other macrovascular complications. Paeonol (Pae) exhibits anti-inflammation, antioxidation, and antiatherosclerosis activities. However, the role of Pae in diabetic cardiopathy has not been fully understood. Therefore, we aimed to investigate the role of Pae in diabetic cardiovascular diseases. Human umbilical vein endothelial cells (HUVECs) were exposed to high glucose and palmitic acid (HG/HP), a model DM environment and different doses of Pae. The viability and apoptotic rate of HUVECs were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and flow cytometry assay, respectively. Oxidative indicators (ROS, malondiadehyde [MDA], superoxide dismutase [SOD]), and inflammatory cytokines (tumor necrosis factor-α, interleukin-1β, and interleukin-6) were detected by 2,7-dichlorodihydrofluorescein diacetate, colorimetry, and enzyme-linked immunosorbent assay. The protein levels of Sirtuin type 1 (SIRT1), Bcl-2, Bax, Cleaved caspase-3, p-p65, and p-65 were detected by Western blot. The mRNA levels of Bcl-2 and Bax were detected by quantitative real-time polymerase chain reaction. The acetylation and protein levels of forkhead box O3a (FOXO3a) were detected by immunoprecipitation assay. SIRT1 silencing was used to confirm the role of Pae in the resistance to apoptosis, oxidative stress, and inflammatory response. Pae increased SIRT1 expression, cell viability, and SOD activity and suppressed apoptosis, the levels of p-p65/p-65, ROS, MDA, and inflammatory cytokines, and the expression of acetylated-FOXO3a induced by HG/HP in HUVECs. SIRT1 silencing abrogated the effect of Pae on HG/HP-mediated HUVECs. Inhibitory effect of Pae on apoptosis, oxidative stress, and inflammatory response in HUVECs induced by HG/HP induced through regulating SIRT1/FOXO3a/NF-κB pathway.
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Affiliation(s)
- Hanqing Tang
- Department of Research, School of Basic Medicine, Youjiang Medical University for Nationalities, Baise, China
| | - Keming Li
- Department of Research, School of Basic Medicine, Youjiang Medical University for Nationalities, Baise, China
| | - Shitian Zhang
- Department of Research, School of Basic Medicine, Youjiang Medical University for Nationalities, Baise, China
| | - Huangqi Lan
- Department of Research, School of Basic Medicine, Youjiang Medical University for Nationalities, Baise, China
| | - Lingling Liang
- Department of Research, School of Basic Medicine, Youjiang Medical University for Nationalities, Baise, China
| | - Cenhan Huang
- Department of Research, School of Basic Medicine, Youjiang Medical University for Nationalities, Baise, China
| | - Tianzi Li
- Department of Research, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
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164
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Roohi E, Jaafari N, Hashemian F. On inflammatory hypothesis of depression: what is the role of IL-6 in the middle of the chaos? J Neuroinflammation 2021; 18:45. [PMID: 33593388 PMCID: PMC7884972 DOI: 10.1186/s12974-021-02100-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/02/2021] [Indexed: 12/13/2022] Open
Abstract
Many patients with major depressive disorder (MDD) are reported to have higher levels of multiple inflammatory cytokines including interleukin 6 (IL-6). Recent studies both pre-clinical and clinical have advocated for the functional role of IL-6 in development of MDD and suggested a great potential for targeting this cytokine to open new avenues in pharmacotherapy of depression. The purpose of the present narrative review was to provide an integrated account of how IL-6 may contribute to development of depression. All peer-reviewed journal articles published before July 2020 for each area discussed were searched by WOS, PubMed, MEDLINE, Scopus, Google Scholar, for original research, review articles, and book chapters. Publications between 1980 and July 2020 were included. Alterations in IL-6 levels, both within the periphery and the brain, most probably contribute to depression symptomatology in numerous ways. As IL-6 acts on multiple differing target tissues throughout the body, dysregulation of this particular cytokine can precipitate a multitude of events relevant to depression and blocking its effects can prevent further escalation of inflammatory responses, and potentially pave the way for opening new avenues in diagnosis, treatment, and prevention of this debilitating disorder.
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Affiliation(s)
- Elnaz Roohi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, No. 99 Yakhchal Street, Shariati Avenue, Tehran, 1941933111, Iran
| | - Nematollah Jaafari
- Université de Poitiers, Unité de recherche clinique intersectorielle Pierre Deniker du Centre Hospitalier Henri Laborit F-86022 France, Groupement De Recherche CNRS 3557, Poitiers, France
| | - Farshad Hashemian
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, No. 99 Yakhchal Street, Shariati Avenue, Tehran, 1941933111, Iran.
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165
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Hori H, Itoh M, Lin M, Yoshida F, Niwa M, Hakamata Y, Matsui M, Kunugi H, Kim Y. Childhood maltreatment history and attention bias variability in healthy adult women: role of inflammation and the BDNF Val66Met genotype. Transl Psychiatry 2021; 11:122. [PMID: 33574220 PMCID: PMC7878504 DOI: 10.1038/s41398-021-01247-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/09/2021] [Accepted: 01/25/2021] [Indexed: 01/31/2023] Open
Abstract
Childhood maltreatment has been associated with greater attention bias to emotional information, but the findings are controversial. Recently, a novel index of attention bias, i.e., attention bias variability (ABV), has been developed to better capture trauma-related attentional dysfunction. However, ABV in relation to childhood trauma has not been studied. Here, we examined the association of childhood maltreatment history with attention bias/ABV in 128 healthy adult women. Different types of childhood maltreatment were assessed with the Childhood Trauma Questionnaire. Attention bias/ABV was measured by the dot-probe task. Possible mechanisms whereby childhood maltreatment affects attention bias/ABV were also explored, focusing on blood proinflammatory markers and the BDNF Val66Met polymorphism. We observed a significant positive correlation between childhood emotional abuse and ABV (P = 0.002). Serum high-sensitivity tumor necrosis factor-α levels were significantly positively correlated with ABV (P < 0.001), but not with childhood maltreatment. Jonckheere-Terpstra trend test showed a significant tendency toward greater ABV with increasing numbers of the BDNF Met alleles (P = 0.021). A two-way analysis of variance further revealed that the genotype-by-emotional abuse interaction for ABV was significant (P = 0.022); individuals with the Val/Met and Met/Met genotypes exhibited even greater ABV when childhood emotional abuse was present. These results indicate that childhood emotional abuse can have a long-term negative impact on emotional attention control. Increased inflammation may be involved in the mechanism of ABV, possibly independently of childhood maltreatment. The BDNF Met allele may dose-dependently increase ABV by interacting with childhood emotional abuse.
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Affiliation(s)
- Hiroaki Hori
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Mariko Itoh
- grid.419280.60000 0004 1763 8916Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan ,grid.39158.360000 0001 2173 7691Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mingming Lin
- grid.419280.60000 0004 1763 8916Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Fuyuko Yoshida
- grid.419280.60000 0004 1763 8916Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Madoka Niwa
- grid.419280.60000 0004 1763 8916Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuko Hakamata
- grid.419280.60000 0004 1763 8916Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan ,grid.411731.10000 0004 0531 3030Department of Clinical Psychology, International University of Health and Welfare, Tokyo, Japan
| | - Mie Matsui
- grid.9707.90000 0001 2308 3329Department of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
| | - Hiroshi Kunugi
- grid.419280.60000 0004 1763 8916Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan ,grid.264706.10000 0000 9239 9995Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshiharu Kim
- grid.419280.60000 0004 1763 8916Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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166
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Lin JE, Asfour A, Sewell TB, Hooe B, Pryce P, Earley C, Shen MY, Kerner-Rossi M, Thakur KT, Vargas WS, Silver WG, Geneslaw AS. Neurological issues in children with COVID-19. Neurosci Lett 2021; 743:135567. [PMID: 33352286 PMCID: PMC7831718 DOI: 10.1016/j.neulet.2020.135567] [Citation(s) in RCA: 144] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022]
Abstract
Coronavirus disease 2019 (COVID-19) usually leads to a mild infectious disease course in children, but serious complications may occur in conjunction with both acute infection and associated phenomena such as the multisystem inflammatory syndrome in children (MIS-C). Neurological symptoms, which have been predominantly reported in adults, range from mild headache to seizure, peripheral neuropathy, stroke, demyelinating disorders, and encephalopathy. Similar to respiratory and cardiac manifestations of COVID-19, neurological complications present differently based on age and underlying comorbidities. This review provides a concise overview of the neurological conditions seen in the context of COVID-19, as well as potential mechanisms and long-term implications of COVID-19 in the pediatric population from literature reviews and primary data collected at NewYork-Presbyterian Morgan Stanley Children's Hospital.
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Affiliation(s)
- Jieru E Lin
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States; Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children's Hospital, New York, NY 10032, United States
| | - Arsenoi Asfour
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States; Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children's Hospital, New York, NY 10032, United States
| | - Taylor B Sewell
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Benjamin Hooe
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Patrice Pryce
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Chelsea Earley
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States; Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children's Hospital, New York, NY 10032, United States
| | - Min Ye Shen
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States; Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children's Hospital, New York, NY 10032, United States
| | - Mallory Kerner-Rossi
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States; Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children's Hospital, New York, NY 10032, United States
| | - Kiran T Thakur
- Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Wendy S Vargas
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Wendy G Silver
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Andrew S Geneslaw
- Department of Pediatrics, Division of Pediatric Critical Care and Hospital Medicine, Columbia University Irving Medical Center, New York, NY 10032, United States.
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167
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Otsuka T, Hori H, Yoshida F, Itoh M, Lin M, Niwa M, Ino K, Imai R, Ogawa S, Matsui M, Kamo T, Kunugi H, Kim Y. Association of CRP genetic variation with symptomatology, cognitive function, and circulating proinflammatory markers in civilian women with PTSD. J Affect Disord 2021; 279:640-649. [PMID: 33190115 DOI: 10.1016/j.jad.2020.10.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/08/2020] [Accepted: 10/25/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with increased inflammation. C-reactive protein (CRP) is a marker of systemic inflammation, and recently, single nucleotide polymorphisms (SNPs) in the CRP gene have been associated with increased blood CRP protein levels and illness severity in PTSD patients. However, the mechanism by which the CRP SNPs are involved in PTSD remains unclear. Here we investigated the association of CRP genetic variation with blood proinflammatory protein levels, symptomatology, and cognitive function, and further explored the moderating effect of childhood maltreatment history, in adult patients with PTSD. METHODS Fifty-seven Japanese civilian women with PTSD and 73 healthy control women were enrolled. Three SNPs in the CRP gene, namely rs2794520, rs1130864, and rs3093059, were genotyped, and analyses focused on rs2794520 (T/C). Serum levels of high-sensitivity CRP (hsCRP), high-sensitivity tumor necrosis factor-α (hsTNF-α), and interleukin-6 were measured. PTSD symptoms were evaluated by the Posttraumatic Diagnostic Scale. Cognitive function was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status. Childhood maltreatment history was assessed by the Childhood Trauma Questionnaire. RESULTS Patients with the rs2794520 CC/CT genotype, compared to those with the TT genotype, showed significantly higher levels of hsCRP (p=0.009) and hsTNF-α (p=0.001), more severe PTSD symptoms (p=0.036), and poorer cognitive function (p=0.018). A two-way analysis of variance revealed a significant genotype-by-maltreatment interaction for more severe PTSD avoidance symptom (p=0.012). LIMITATIONS The relatively small sample size limited our findings. CONCLUSIONS These findings may provide an insight into the etiology of PTSD from the inflammatory perspective.
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Affiliation(s)
- Takeshi Otsuka
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroaki Hori
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Fuyuko Yoshida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mariko Itoh
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mingming Lin
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Madoka Niwa
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Keiko Ino
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Risa Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sei Ogawa
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mie Matsui
- Department of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
| | - Toshiko Kamo
- Wakamatsu-cho Mental and Skin Clinic, Tokyo, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshiharu Kim
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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168
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Manukhina EB, Tseilikman VE, Komelkova MV, Lapshin MS, Goryacheva AV, Kondashevskaya MV, Mkhitarov VA, Lazuko SS, Tseilikman OB, Sarapultsev AP, Dmitrieva YA, Strizhikov VK, Kuzhel OP, Downey HF. Сardiac injury in rats with experimental posttraumatic stress disorder and mechanisms of its limitation in experimental posttraumatic stress disorder-resistant rats. J Appl Physiol (1985) 2021; 130:759-771. [PMID: 33411642 DOI: 10.1152/japplphysiol.00694.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Traumatic stress causes posttraumatic stress disorder (PTSD). PTSD is associated with cardiovascular diseases and risk of sudden cardiac death in some subjects. We compared effects of predator stress (PS, cat urine scent, 10 days) on mechanisms of cardiac injury and protection in experimental PTSD-vulnerable (PTSD) and -resistant (PTSDr) rats. Fourteen days post-stress, rats were evaluated with an elevated plus-maze test, and assigned to PTSD and PTSDr groups according to an anxiety index calculated from the test results. Cardiac injury was evaluated by: 1) exercise tolerance; 2) ECG; 3) myocardial histomorphology; 4) oxidative stress; 5) pro- and anti-inflammatory cytokines. Myocardial heat shock protein 70 (HSP70) was also measured. Experimental PTSD developed in 40% of rats exposed to PS. Exercise tolerance of PTSD rats was 25% less than control rats and 21% less than PTSDr rats. ECG QRS, QT, and OTc intervals were significantly longer in PTSD rats than in control and PTSDr rats. Only cardiomyocytes of PTSD rats had histomorphological signs of metabolic and hypoxic injury and impaired contractility. Oxidative stress markers were higher in PTSD than in PTSDr rats. Pro-inflammatory IL-6 was higher in PTSD rats than in control and PTSDr rats, and anti-inflammatory IL-4 was lower in PTSD than in control and PTSDr rats. Myocardial HSP70 was lower in PTSD rats than in PTSDr and control rats. Our conclusion was that rats with PTSD developed multiple signs of cardiac injury. PTSDr rats were resistant also to cardiac injury. Factors that limit cardiac damage in PS rats include reduced inflammation and oxidative stress and increased protective HSP70.NEW & NOTEWORTHY For the first time, rats exposed to stress were segregated into experimental PTSD (ePTSD)-susceptible and ePTSD-resistant rats. Cardiac injury, ECG changes, and impaired exercise tolerance were more pronounced in ePTSD-susceptible rats. Resistance to ePTSD was associated with decreased inflammation and oxidative stress and with increased protective heat shock protein 70. Results may help identify individuals at high risk of PTSD and also provide a foundation for developing preventive and therapeutic means to restrict PTSD-associated cardiac morbidity.
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Affiliation(s)
- Eugenia B Manukhina
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation.,Laboratory for Regulatory Mechanisms of Stress and Adaptation, Institute of General Pathology and Pathophysiology, Moscow, Russian Federation.,Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Vadim E Tseilikman
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation
| | - Maria V Komelkova
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation
| | - Maxim S Lapshin
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation
| | - Anna V Goryacheva
- Laboratory for Regulatory Mechanisms of Stress and Adaptation, Institute of General Pathology and Pathophysiology, Moscow, Russian Federation
| | - Marina V Kondashevskaya
- Laboratory for Immunomorphology of Inflammation, Research Institute of Human Morphology, Moscow, Russian Federation
| | - Vladimir A Mkhitarov
- Laboratory for Immunomorphology of Inflammation, Research Institute of Human Morphology, Moscow, Russian Federation
| | - Svetlana S Lazuko
- Department of Normal Physiology, Vitebsk State Medical University, Vitebsk, Republic of Belarus
| | - Olga B Tseilikman
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation.,School of Basic Medicine, Chelyabinsk State University, Chelyabinsk, Russian Federation
| | - Alexey P Sarapultsev
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation.,Laboratory of Immunopathophysiology, Institute of Immunology and Physiology of RAS, Ekaterinburg, Russian Federation
| | - Yulia A Dmitrieva
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation
| | - Viktor K Strizhikov
- Department of Morphology and Histology, South Ural State Agricultural University, Troitsk, Russian Federation
| | - Olga P Kuzhel
- Department of Normal Physiology, Vitebsk State Medical University, Vitebsk, Republic of Belarus
| | - H Fred Downey
- School of Medical Biology, South Ural State University, Chelyabinsk, Russian Federation.,Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
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169
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Nie PY, Tong L, Li MD, Fu CH, Peng JB, Ji LL. miR-142 downregulation alleviates rat PTSD-like behaviors, reduces the level of inflammatory cytokine expression and apoptosis in hippocampus, and upregulates the expression of fragile X mental retardation protein. J Neuroinflammation 2021; 18:17. [PMID: 33407653 PMCID: PMC7788709 DOI: 10.1186/s12974-020-02064-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background FMRP is a selective mRNA-binding protein that regulates protein synthesis at synapses, and its loss may lead to the impairment of trace fear memory. Previously, we found that FMRP levels in the hippocampus of rats with post-traumatic stress disorder (PTSD) were decreased. However, the mechanism underlying these changes remains unclear. Methods Forty-eight male Sprague-Dawley rats were randomly divided into four groups. The experimental groups were treated with the single-prolonged stress (SPS) procedure and injected with a lentivirus-mediated inhibitor of miR-142-5p. Behavior test as well as morphology and molecular biology experiments were performed to detect the effect of miR-142 downregulation on PTSD, which was further verified by in vitro experiments. Results We found that silence of miRNA-142 (miR-142), an upstream regulator of FMRP, could alleviate PTSD-like behaviors of rats exposed to the SPS paradigm. MiR-142 silence not only decreased the levels of proinflammatory mediators, such as interleukin-1β, interleukin-6, and tumor necrosis factor-α, but also increased the expressive levels of synaptic proteins including PSD95 and synapsin I in the hippocampus, which was one of the key brain regions associated with PTSD. We further detected that miR-142 silence also downregulated the transportation of nuclear factor kappa-B (NF-κB) into the nuclei of neurons and might further affect the morphology of neurons. Conclusions The results revealed miR-142 downregulation could alleviate PTSD-like behaviors through attenuating neuroinflammation in the hippocampus of SPS rats by binding to FMRP.
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Affiliation(s)
- Peng-Yin Nie
- Department of Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Lei Tong
- Department of Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Ming-Da Li
- Department of 1st Clinical Medicine, China Medical University, Shenyang, China
| | - Chang-Hai Fu
- Department of Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Jun-Bo Peng
- Department of Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Li-Li Ji
- Department of Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang, China.
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170
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Maffioletti E, Bocchio-Chiavetto L, Perusi G, Carvalho Silva R, Sacco C, Bazzanella R, Zampieri E, Bortolomasi M, Gennarelli M, Minelli A. Inflammation-related microRNAs are involved in stressful life events exposure and in trauma-focused psychotherapy in treatment-resistant depressed patients. Eur J Psychotraumatol 2021; 12:1987655. [PMID: 35070159 PMCID: PMC8772504 DOI: 10.1080/20008198.2021.1987655] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND About 30% of major depressive disorder (MDD) patients are classified as resistant to treatment (treatment-resistant depression, TRD). Among the factors associated with unfavourable treatment outcomes, stressful life events play a relevant role, and trauma-focused psychotherapy has been successfully proposed for the treatment of patients with a history of such events. Stressful experiences are related to enhanced inflammation and, recently, microRNAs (miRNAs) have emerged as potential mediators of the association between these experiences and psychiatric disorders. To date, no study has explored the effects of stressful life events on miRNAs in MDD patients. OBJECTIVE The objective of the present study was to assess possible miRNA blood expression alterations in TRD patients induced by the exposure to stressful life events and to investigate the effects of trauma-focused psychotherapy on the expression profiles of the same miRNAs, as well as their possible predictivity in relation to therapy outcome. METHOD The basal levels (T0) of seven candidate miRNAs (miR-15a/miR-29a/miR-125b/miR-126/miR-146a/miR-195/let-7f) were measured in the whole blood of 41 TRD patients. A subgroup of patients (n = 21) underwent trauma-focused psychotherapy; for all of them, miRNA levels were also longitudinally assessed (T4: after 4 weeks of treatment; T8: end of treatment; T12: follow-up visit), contextually to clinical evaluations. RESULTS miR-146a levels negatively correlated with recent stressful life event scores (p = .001), whereas the levels of miR-15a, miR-29a, miR-126, miR-195, and let-7f changed during the psychotherapy (best p = 1.98*10-9). miR-29a was also identified as a response predictor, with lower baseline levels predicting non-response (p = .019) or worse improvement in mood symptoms (p = .032). CONCLUSIONS The study results could contribute to clarify the underlying molecular mechanisms and to identify novel biomarkers of stressful experiences and response to targeted treatments.
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Affiliation(s)
- Elisabetta Maffioletti
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Luisella Bocchio-Chiavetto
- Genetics Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Psychiatric Unit, IRCCS Istituto Centro S. Giovanni di Dio, Brescia, Italy.,Department of Theoretical and Applied Sciences, eCampus University, Como, Novedrate, Italy
| | - Giulia Perusi
- Psychiatric Hospital "Villa Santa Chiara", Verona, Italy
| | - Rosana Carvalho Silva
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Chiara Sacco
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | | | - Elisa Zampieri
- Psychiatric Hospital "Villa Santa Chiara", Verona, Italy
| | | | - Massimo Gennarelli
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Psychiatric Unit, IRCCS Istituto Centro S. Giovanni di Dio, Brescia, Italy
| | - Alessandra Minelli
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Psychiatric Unit, IRCCS Istituto Centro S. Giovanni di Dio, Brescia, Italy
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171
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Street ME, Sartori C, Catellani C, Righi B. Precocious Puberty and Covid-19 Into Perspective: Potential Increased Frequency, Possible Causes, and a Potential Emergency to Be Addressed. Front Pediatr 2021; 9:734899. [PMID: 34616700 PMCID: PMC8488256 DOI: 10.3389/fped.2021.734899] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/20/2021] [Indexed: 01/01/2023] Open
Abstract
A significant increase in precocious puberty, rapidly progressive puberty and precocious menarche has been reported in Italy since the initial lockdown because of the pandemic, and this could represent a new emergency to be addressed during this pandemic. There is a need, therefore, for further understanding and research. Many causes could account for this. Initially, it was thought that the changes in life-style, in screen time, and sleeping habits could be the cause but if considered individually these are insufficient to explain this phenomenon. Likely, changes in central nervous mediators, and an increase in catecholamines could contribute as a trigger, however, these aspects are poorly studied and understood as well as the real perceptions of these children. Finally, staying more indoors has certainly exposed these children to specific contaminants working as endocrine disruptors which could also have had an effect. It would be of utmost importance to compare this phenomenon worldwide with appropriate studies in order to verify what is happening, and gain a new insight into the consequences of the covid-19 pandemic and into precocious puberty and for future prevention.
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Affiliation(s)
- Maria E Street
- Division of Pediatric Endocrinology and Diabetology, Unit of Pediatrics, Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Sartori
- Division of Pediatric Endocrinology and Diabetology, Unit of Pediatrics, Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cecilia Catellani
- Division of Pediatric Endocrinology and Diabetology, Unit of Pediatrics, Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Beatrice Righi
- Division of Pediatric Endocrinology and Diabetology, Unit of Pediatrics, Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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172
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Dadabayev AR, Joshi SA, Reda MH, Lake T, Hausman MS, Domino E, Liberzon I. Low Dose Ketamine Infusion for Comorbid Posttraumatic Stress Disorder and Chronic Pain: A Randomized Double-Blind Clinical Trial. ACTA ACUST UNITED AC 2020; 4:2470547020981670. [PMID: 33426410 PMCID: PMC7758557 DOI: 10.1177/2470547020981670] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/24/2020] [Indexed: 11/15/2022]
Abstract
Objective To date, treatment options (i.e. psychotherapy, antidepressant medications) for patients with posttraumatic stress disorder (PTSD), are relatively few, and considering their limited efficacy, novel therapies have gained interest among researchers and treatment providers alike. Among patients with chronic pain (CP) about one third experience comorbid PTSD, which further complicates their already challenging pharmacological regimens. Low dose ketamine infusion has shown promise in PTSD, and in treatment of CP, however they have not been studied in comorbid population and under rigorous control conditions. Methods We compared the effects of a single dose of either ketamine (0.5 mg/kg) or ketorolac (15 mg) over a 40-minute of IV infusion in CP patients with and without PTSD, in double blind, randomized study. Measures were collected before, during, one day and seven days after the infusion. A planned sample size of 40 patients randomly assigned to treatment order was estimated to provide 80% power to detect a hypothesized treatment difference after the infusion. Main Outcome and Measures: The primary outcome measures were change in PTSD symptom severity assessed with the Impact of Event Scale–Revised (IES-R) and Visual Analogue Scale (VAS) for pain administered by a study clinician 24 hours post infusion. Secondary outcome measures included Impact of Event Scale–Revised (IES-R), VAS and Brief Pain Inventory (Short Form) for pain 1 week after the infusion. Results Both treatments offered comparable improvement of PTSD and CP symptoms that persisted for 7 days after the infusion. Patients with comorbid PTSD and CP experienced less dissociative side effects compared to the CP group. Surprisingly, ketorolac infusion resulted in dissociative symptoms in CP patients only. Conclusions This first prospective study comparing effects of subanesthetic ketamine versus ketorolac infusions for comorbid PTSD and CP, suggests that both ketamine and ketorolac might offer meaningful and durable response for both PTSD and CP symptoms.
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Affiliation(s)
- Alisher R Dadabayev
- Department of Anesthesiology, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Sonalee A Joshi
- Department of Psychology, The University of Michigan, Ann Arbor, MI, USA
| | - Mariam H Reda
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tamar Lake
- Department of Anesthesiology, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Mark S Hausman
- Department of Anesthesiology, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Edward Domino
- Department of Pharmacology, The University of Michigan, Ann Arbor, MI, USA
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M University, College Station, TX, USA
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173
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Yamanashi T, Iwata M, Shibushita M, Tsunetomi K, Nagata M, Kajitani N, Miura A, Matsuo R, Nishiguchi T, Kato TA, Setoyama D, Shirayama Y, Watanabe K, Shinozaki G, Kaneko K. Beta-hydroxybutyrate, an endogenous NLRP3 inflammasome inhibitor, attenuates anxiety-related behavior in a rodent post-traumatic stress disorder model. Sci Rep 2020; 10:21629. [PMID: 33303808 PMCID: PMC7728809 DOI: 10.1038/s41598-020-78410-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/24/2020] [Indexed: 12/21/2022] Open
Abstract
Accumulating evidence suggests that elevated inflammation contributes to the pathophysiology of post-traumatic stress disorder (PTSD) and that anti-inflammatory drugs might be a new treatment strategy for PTSD. It has been reported that beta-hydroxybutyrate (BHB), one of the main ketone bodies produced, can have an anti-inflammatory and antidepressant effect. Here, we investigated the potential anti-anxiety and anti-inflammatory effects of BHB using a rodent PTSD model, induced by single prolonged stress (SPS). Male, Sprague–Dawley rats were employed in this study. Repeated administration of BHB attenuated SPS-induced anxiety-related behaviors evaluated by the elevated plus maze test. SPS increased the serum levels of TNF-α and IL-1β. In contrast, BHB administration partially attenuated the increase of serum TNF-α. These findings demonstrate that BHB exerts its anxiolytic effects, possibly by inhibiting systemic TNF-α. Hence, BHB may be a novel therapeutic candidate for the treatment of PTSD.
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Affiliation(s)
- Takehiko Yamanashi
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan.,Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Masaaki Iwata
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan.
| | - Midori Shibushita
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Kyohei Tsunetomi
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Mayu Nagata
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Naofumi Kajitani
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Akihiko Miura
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Ryoichi Matsuo
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Tsuyoshi Nishiguchi
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daiki Setoyama
- Clinical Laboratories, Kyushu University Hospital, Fukuoka, Japan
| | - Yukihiko Shirayama
- Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara, Japan
| | | | - Gen Shinozaki
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Koichi Kaneko
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
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174
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Bordoni L, Petracci I, Calleja-Agius J, Lalor JG, Gabbianelli R. NURR1 Alterations in Perinatal Stress: A First Step towards Late-Onset Diseases? A Narrative Review. Biomedicines 2020; 8:E584. [PMID: 33302583 PMCID: PMC7764589 DOI: 10.3390/biomedicines8120584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
Perinatal life represents a delicate phase of development where stimuli of all sorts, coming to or from the mother, can influence the programming of the future baby's health. These stimuli may have consequences that persist throughout adulthood. Nuclear receptor related 1 protein (NURR1), a transcription factor with a critical role in the development of the dopaminergic neurons in the midbrain, mediates the response to stressful environmental stimuli in the perinatal period. During pregnancy, low-grade inflammation triggered by maternal obesity, hyperinsulinemia or vaginal infections alters NURR1 expression in human gestational tissues. A similar scenario is triggered by exposure to neurotoxic compounds, which are associated with NURR1 epigenetic deregulation in the offspring, with potential intergenerational effects. Since these alterations have been associated with an increased risk of developing late-onset diseases in children, NURR1, alone, or in combination with other molecular markers, has been proposed as a new prognostic tool and a potential therapeutic target for several pathological conditions. This narrative review describes perinatal stress associated with NURR1 gene deregulation, which is proposed here as a mediator of late-onset consequences of early life events.
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Affiliation(s)
- Laura Bordoni
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, 62032 Camerino, Italy;
| | - Irene Petracci
- School of Advanced Studies, University of Camerino, 62032 Camerino, Italy;
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta;
| | - Joan G. Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier Street, Dublin 2, Ireland;
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, 62032 Camerino, Italy;
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175
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Jiang Y, Huang Z, Mi L, Zhou Y. The potential role of inflammation reaction in COVID-19 related posttraumatic stress disorder. Asian J Psychiatr 2020; 54:102405. [PMID: 33271701 PMCID: PMC7455808 DOI: 10.1016/j.ajp.2020.102405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Yufeng Jiang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, PR China
| | - Ziyin Huang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, PR China
| | - Lijie Mi
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, PR China
| | - Yafeng Zhou
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, PR China.
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176
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Enomoto S, Kato TA. Involvement of microglia in disturbed fear memory regulation: Possible microglial contribution to the pathophysiology of posttraumatic stress disorder. Neurochem Int 2020; 142:104921. [PMID: 33232758 DOI: 10.1016/j.neuint.2020.104921] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 02/07/2023]
Abstract
Microglia, immune cells in the brain, play a crucial role in brain inflammation and synaptic plasticity by releasing inflammatory mediators and neurotrophic factors as well as, phagocytosing synaptic elements. Recent studies have shown peripheral inflammation, immune alteration in the brain are associated with post-traumatic stress disorder (PTSD) in humans. Several preclinical studies using Pavlovian fear conditioning have suggested that microglia are involved in fear memory dysregulation and altered fear neuronal networks. Microglial priming resulting from previous stressful experiences may also have an effect. This review will introduce the current knowledge of microglial contribution to disturbed fear memory regulation, a fundamental feature of PTSD.
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Affiliation(s)
- Shingo Enomoto
- Self Defense Force, Fukuoka Hospital, 1-61 Kokura Higashi, Kasuga-Si, Fukuoka, 816-0826, Japan; Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-Ku, Fukuoka, 812-8582, Japan.
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177
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Affiliation(s)
- Tobias Bertsch
- Földi Clinic, Hinterzarten-European Center of Lymphology, Germany
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178
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Sarapultsev A, Sarapultsev P, Dremencov E, Komelkova M, Tseilikman O, Tseilikman V. Low glucocorticoids in stress-related disorders: the role of inflammation. Stress 2020; 23:651-661. [PMID: 32401103 DOI: 10.1080/10253890.2020.1766020] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
There is evidence that plasma cortisol concentration can be either increased or decreased in patients with depression and related anxiety and stress-related disorders; the exact pathophysiological mechanisms of this state are not almost clear. Several distinct theories were proposed and mechanisms, which could lead to decreased glucocorticoid signaling and/or levels, were described. However, there is a possible drawback in almost all the theories proposed: insufficient attention to the inflammatory process, which is undoubtedly present in several stress-related disorders, including post-traumatic stress disorder (PTSD). Previous studies only briefly mentioned the presence of an inflammatory reaction's signs in PTSD, without giving it due importance, although recognizing that it can affect the course of the disease. With that, the state of biochemical changes, characterized by the low glucocorticoids, glucocorticoid receptor's resistance and the signs of the persistent inflammation (with the high levels of circulating cytokines) might be observed not only in PTSD but in coronary heart diseases and systemic chronic inflammatory diseases (rheumatoid arthritis) as well. That is why the present review aims to depict the pathophysiological mechanisms, which lead to a decrease in glucocorticoids in PTSD due to the action of inflammatory stimuli. We described changes in the glucocorticoid system and inflammatory reaction as parts of an integral system, where glucocorticoids and the glucocorticoid receptor reside at the apex of a regulatory network that blocks several inflammatory pathways, while decreased glucocorticoid signaling and/or level leads to unchecked inflammatory reactions to promote pathologies such as PTSD. LAY SUMMARY This review emphasizes the importance of inflammatory reaction in the development of puzzling conditions sometimes observed in severe diseases including post-traumatic stress disorder - the decreased levels of glucocorticoids in the blood. Following the classical concepts, one would expect an increase in glucocorticoid hormones, since they are part of the feedback mechanism in the immune system, which reduces stress and inflammation. However, low levels of glucocorticoid hormones are also observed. Thus, this review describes potential mechanisms, which can lead to the development of such a state.
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Affiliation(s)
- Alexey Sarapultsev
- Institute of Immunology and Physiology, Ural Division of the Russian Academy of Sciences, Ekaterinburg, Russia
| | - Petr Sarapultsev
- Institute of Immunology and Physiology, Ural Division of the Russian Academy of Sciences, Ekaterinburg, Russia
| | - Eliyahu Dremencov
- Institute of Molecular Physiology and Genetics, Centre for Biosciences, Slovak Academy of Sciences, Bratislava, Slovakia
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Maria Komelkova
- Institute of Immunology and Physiology, Ural Division of the Russian Academy of Sciences, Ekaterinburg, Russia
- School of Medical Biology, South Ural State University, Chelyabinsk, Russia
| | - Olga Tseilikman
- School of Medical Biology, South Ural State University, Chelyabinsk, Russia
| | - Vadim Tseilikman
- School of Medical Biology, South Ural State University, Chelyabinsk, Russia
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179
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Wisnivesky JP, Markowitz SB, James S, Stone K, Dickens B, Busse P, Crowley L, Federman A, Katz C, Gonzalez A. Comorbid posttraumatic stress disorder and major depressive disorder are associated with asthma morbidity among World Trade Center workers. Ann Allergy Asthma Immunol 2020; 126:278-283. [PMID: 33098982 DOI: 10.1016/j.anai.2020.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/21/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND World Trade Center (WTC) rescue and recovery workers have a high burden of asthma, comorbid posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). PTSD is associated with worse asthma outcomes. OBJECTIVE In this study, we evaluated whether the relationship between PTSD and asthma morbidity is modified by the presence of MDD. METHODS We used data from a cohort of WTC workers with asthma. Asthma control (asthma control questionnaire), resource utilization, and quality of life (asthma quality of life questionnaire) were evaluated. We used regression analyses to evaluate the adjusted association of PTSD and MDD with asthma control, resource utilization, and quality of life. RESULTS Of the study cohort of 293 WTC workers with asthma, 19% had PTSD alone, 2% had MDD alone, and 12% had PTSD and MDD. Adjusted mean differences (95% confidence interval) in asthma control questionnaire scores were 1.32 (0.85-1.80) for WTC workers with PTSD and MDD, 0.44 (0.03-0.84) for those with PTSD alone, and 0.50 (-0.38 to 1.38) for workers with MDD alone compared with those without MDD or PTSD. WTC workers with PTSD and MDD, PTSD alone, and MDD alone had mean (95% confidence interval) adjusted differences in asthma quality of life questionnaire scores of -1.67 (-2.22 to -1.12), -0.56 (-2.23 to -1.12), and -1.21 (-2.23 to -0.18), respectively, compared with workers without MDD or PTSD. Similar patterns were observed for acute resource utilization. CONCLUSION PTSD and MDD seem to have a synergistic effect that worsens asthma control and quality of life. Efforts to improve asthma outcomes in this population should address the negative impacts of these common mental health conditions.
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Affiliation(s)
- Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Steven B Markowitz
- Occupational-Environmental Medicine, Queens College, City University of New York, Flushing, New York
| | - Shynah James
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kim Stone
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brittany Dickens
- Occupational-Environmental Medicine, Queens College, City University of New York, Flushing, New York
| | - Paula Busse
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Laura Crowley
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alex Federman
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Craig Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adam Gonzalez
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
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180
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Bersani FS, Mellon SH, Lindqvist D, Kang JI, Rampersaud R, Somvanshi PR, Doyle FJ, Hammamieh R, Jett M, Yehuda R, Marmar CR, Wolkowitz OM. Novel Pharmacological Targets for Combat PTSD-Metabolism, Inflammation, The Gut Microbiome, and Mitochondrial Dysfunction. Mil Med 2020; 185:311-318. [PMID: 32074311 DOI: 10.1093/milmed/usz260] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 07/15/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Current pharmacological treatments of post-traumatic stress disorder (PTSD) have limited efficacy. Although the diagnosis is based on psychopathological criteria, it is frequently accompanied by somatic comorbidities and perhaps "accelerated biological aging," suggesting widespread physical concomitants. Such physiological comorbidities may affect core PTSD symptoms but are rarely the focus of therapeutic trials. METHODS To elucidate the potential involvement of metabolism, inflammation, and mitochondrial function in PTSD, we integrate findings and mechanistic models from the DOD-sponsored "Systems Biology of PTSD Study" with previous data on these topics. RESULTS Data implicate inter-linked dysregulations in metabolism, inflammation, mitochondrial function, and perhaps the gut microbiome in PTSD. Several inadequately tested targets of pharmacological intervention are proposed, including insulin sensitizers, lipid regulators, anti-inflammatories, and mitochondrial biogenesis modulators. CONCLUSIONS Systemic pathologies that are intricately involved in brain functioning and behavior may not only contribute to somatic comorbidities in PTSD, but may represent novel targets for treating core psychiatric symptoms.
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Affiliation(s)
- F Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy.,Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, 401 Parnassus Ave, San Francisco, CA 94143
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Sciences, UCSF School of Medicine, 513 Parnassus Ave, 1464G, San Francisco, CA 94143
| | - Daniel Lindqvist
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, 401 Parnassus Ave, San Francisco, CA 94143.,Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
| | - Jee In Kang
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, 401 Parnassus Ave, San Francisco, CA 94143.,Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul 03722, South Korea
| | - Ryan Rampersaud
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, 401 Parnassus Ave, San Francisco, CA 94143
| | - Pramod Rajaram Somvanshi
- Harvard John A. Paulson School of Engineering and Applied Sciences, 29 Oxford St., Harvard University, Cambridge, MA 02138
| | - Francis J Doyle
- Harvard John A. Paulson School of Engineering and Applied Sciences, 29 Oxford St., Harvard University, Cambridge, MA 02138
| | - Rasha Hammamieh
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, 568 Doughten Drive, Fort Detrick, MD 21702-5010
| | - Marti Jett
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, 568 Doughten Drive, Fort Detrick, MD 21702-5010
| | - Rachel Yehuda
- James J. Peters Veterans Administration Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468.,Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029-6574
| | - Charles R Marmar
- Center for Alcohol Use Disorder and PTSD, New York University, 1 Park Ave., Room 8-214, New York NY 10016.,Department of Psychiatry, New York University, 1 Park Ave., Room 8-214, New York, NY 10016
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, 401 Parnassus Ave, San Francisco, CA 94143
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181
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Neurophysiology and Psychopathology Underlying PTSD and Recent Insights into the PTSD Therapies-A Comprehensive Review. J Clin Med 2020; 9:jcm9092951. [PMID: 32932645 PMCID: PMC7565106 DOI: 10.3390/jcm9092951] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a well-known psychiatric disorder that affects millions of people worldwide. Pharmacodynamic and cognitive-behavioral therapies (CBT) have been used to treat patients with PTSD. However, it remains unclear whether there are concurrent changes in psychopathological and neurophysiological factors associated with PTSD patients. Past reports described those PTSD patients with efficient fatty acid metabolism, neurogenesis, mitochondrial energy balance could improve ability to cope against the conditioned fear responses and traumatic memories. Furthermore, cognitive, behavioral, cellular, and molecular evidence can be combined to create personalized therapies for PTSD sufferers either with or without comorbidities such as depression or memory impairment. Unfortunately, there is still evidence lacking to establish a full understanding of the underlying neurophysiological and psychopathological aspects associated with PTSD. This review has extensively discussed the single nucleotide polymorphism (SNPs) of genetic factors to cause PTSD, the implications of inflammation, neurotransmitter genomics, metabolic alterations, neuroendocrine disturbance (hypothalamus-pituitary-adrenal (HPA) axis), mitochondrial dynamics, neurogenesis, and premature aging related to PTSD-induced psychopathology and neurophysiology. In addition, the review delineated the importance of CBT and several pharmacodynamic therapies to mitigate symptomatology of PTSD.
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182
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Goodwin L, Leightley D, Chui ZE, Landau S, McCrone P, Hayes RD, Jones M, Wessely S, Fear NT. Hospital admissions for non-communicable disease in the UK military and associations with alcohol use and mental health: a data linkage study. BMC Public Health 2020; 20:1236. [PMID: 32912179 PMCID: PMC7488237 DOI: 10.1186/s12889-020-09300-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/26/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since the recent conflicts in Iraq and Afghanistan, the short-term focus of military healthcare research has been on the consequences of deployment for mental health and on those wounded or injured in combat. Now that these conflicts have ended for the UK Armed Forces, it is important to consider the longer term physical and mental health consequences, and just as importantly, the links between these. The aims of this study were to determine the most common physical conditions requiring a hospital admission in UK military personnel and whether they were more common in personnel with a mental health condition, smokers, and/or those misusing alcohol compared to those without. METHODS Data linkage of a prospective UK military cohort study to electronic admitted patient care records for England, Wales and Scotland. Nine thousand nine hundred ninety military personnel completed phase 2 of a military cohort study (56% response rate, data collected from 2007 to 2009), with analyses restricted to 86% of whom provided consent for linkage to healthcare records (n = 8602). Ninety percent were male and the mean age at phase 2 was 36 years. The outcome was physical non communicable diseases (NCDs) requiring a hospital admission which occurred after phase 2 of the cohort when the mental health, smoking and alcohol use exposure variables had been assessed until the end of March 2014. RESULTS The most common NCDs requiring a hospital admission were gastrointestinal disorders 5.62% (95% Confidence Intervals (CI) 5.04, 6.19) and joint disorders 5.60% (95% CI 5.02, 6.18). Number of NCDs requiring a hospital admission was significantly higher in those with a common mental disorder (Hazard ratio (HR) 1.40 (95% CI 1.16-1.68), post-traumatic stress disorder (HR 1.78 (95% CI 1.32-2.40)) and in current smokers (HR 1.35 (95% CI 1.12-1.64) compared to those without the disorder, and non-smokers, respectively. CONCLUSIONS Military personnel with a mental health problem are more likely to have an inpatient hospital admission for NCDs compared to those without, evidencing the clear links between physical and mental health in this population.
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Affiliation(s)
- L Goodwin
- Department of Psychology, University of Liverpool, Room 2.31 Eleanor Rathbone Building, Liverpool, L69 7ZA, UK.
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, UK.
| | - D Leightley
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Z E Chui
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - S Landau
- Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - P McCrone
- Institute for Lifecourse Development, University of Greenwich, London, UK
| | - R D Hayes
- Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Jones
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - S Wessely
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - N T Fear
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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183
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The Link between Chronic Stress and Accelerated Aging. Biomedicines 2020; 8:biomedicines8070198. [PMID: 32645916 PMCID: PMC7400286 DOI: 10.3390/biomedicines8070198] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 12/11/2022] Open
Abstract
People exposed to chronic stress age rapidly. The telomeres in their cells of all types shorten faster. Inflammation is another important feature of stress that, along with aging, accounts for the phenomenon of inflammaging. In addition to aging itself, inflammaging can contribute to the development of several pathologies, including atherosclerosis, diabetes, hypertension, and others. Oxidative stress is one of the main mechanisms related to stress. Oxidative stress is caused by the over-production of reactive oxygen species (ROS) that can damage various tissues. The main source of ROS is mitochondria. Being suppressed by mitochondrial mutations, mitophagy can aggravate the situation. In this case, the aging-specific pro-inflammatory changes are amplified. It happens because of the inability of cells to maintain the normal state of mitochondria. Macrophages are the crucial element of the innate immunity associated with the chronic inflammation and, subsequently, with the inflammaging. In this review, we focus on the therapy approaches potentially reducing the deleterious effects of oxidative stress. These include stimulation of mitophagy, activation of mitochondrial uncoupling, induction of the expression of the telomerase catalytic component gene, and use of antioxidants. Any method reducing oxidative stress should improve post-traumatic stress disorder.
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184
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Quinones MM, Gallegos AM, Lin FV, Heffner K. Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:455-480. [PMID: 32170605 PMCID: PMC7682894 DOI: 10.3758/s13415-020-00782-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.
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Affiliation(s)
- Maria M Quinones
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Autumn M Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Feng Vankee Lin
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Kathi Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Division of Geriatrics & Aging, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
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185
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Sumner JA, Nishimi KM, Koenen KC, Roberts AL, Kubzansky LD. Posttraumatic Stress Disorder and Inflammation: Untangling Issues of Bidirectionality. Biol Psychiatry 2020; 87:885-897. [PMID: 31932029 PMCID: PMC7211139 DOI: 10.1016/j.biopsych.2019.11.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/21/2019] [Accepted: 11/04/2019] [Indexed: 12/27/2022]
Abstract
Posttraumatic stress disorder (PTSD) has increasingly been linked to heightened systemic inflammation. It matters whether this association is causal (and either bidirectional or unidirectional) or correlational. Investigators have hypothesized that chronic systemic low-grade inflammation may contribute to greater risk of developing PTSD after experiencing trauma and/or serve as a mechanism linking PTSD to adverse physical health outcomes. However, if the PTSD-inflammation relation is correlational, it may not warrant further research aimed at understanding inflammation as a PTSD risk factor or as a pathway linking PTSD with poor health. In this review, we first assess the longitudinal evidence related to PTSD and inflammation to understand more clearly the directionality and causal nature of this relation. Overall, few longitudinal studies rigorously assess the direction of the PTSD-inflammation relation. Some of the evidence indicates that elevated inflammation assessed pretrauma or in the acute aftermath of trauma increases risk for developing PTSD. Fewer studies evaluate the influence of PTSD on subsequent inflammation levels, and findings are mixed. Sample characteristics and study designs, and also the type of inflammation-related measure, vary widely across studies. Based on current evidence, we then recommend several statistical and study design approaches that may help untangle issues of bidirectionality and aid in determining the direction of causality between PTSD and inflammation. Last, we conclude with future research directions and consider potential implications for interventions or treatment approaches based on this growing body of literature.
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Affiliation(s)
- Jennifer A. Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA,Correspondence to: Jennifer A. Sumner, University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095. Telephone: 1 (310) 794-9860;
| | - Kristen M. Nishimi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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186
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Smith ML, Farkas DK, Sumner JA, Jiang T, Lash TL, Galea S, Sørensen HT, Gradus JL. Associations between adjustment disorder and hospital-based infections in the Danish population. J Psychosom Res 2020; 132:109976. [PMID: 32142971 DOI: 10.1016/j.jpsychores.2020.109976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There is some evidence that posttraumatic stress disorder (PTSD) is associated with increased risk of infections, and it is unknown whether adjustment disorder is as well. We assessed the association between adjustment disorder and subsequent infections, and assessed additive interaction with sex. METHODS The study population included a nationwide cohort of all Danish-born residents of Denmark diagnosed with adjustment disorder between 1995 and 2011, and an age- and sex-matched general population comparison cohort. We compared rates of infections requiring inpatient or outpatient hospitalization in the two cohorts. We fit Cox proportional hazards models to compute adjusted hazard ratios (aHR) for the associations between adjustment disorder and 32 types of infections, and calculated interaction contrasts to assess interaction between adjustment disorder and sex. RESULTS Adjustment disorder was associated with increased rates of infections overall (n = 19,838 infections, aHR = 1.8, 95% confidence interval = 1.8. 1.9), and increased rates of each individual infection type (aHRs for 30 infections ranged from 1.5 to 2.3), adjusting for baseline psychiatric and somatic comorbidities and marital status. For many infection types (e.g., skin infections, pneumonia), interaction contrasts indicated rate differences were greater among men than women, while for two (urinary tract infections and sexually transmitted infections), rate differences were greater for women. CONCLUSIONS These findings are consistent with studies examining the relationship between psychological stress and infections, and between PTSD and infections. They may be explained by a combination of the triggering of unhealthy behaviors as well as immune responses to stress.
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Affiliation(s)
- Meghan L Smith
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | | | - Jennifer A Sumner
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Tammy Jiang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Sanchis-Soler G, Tortosa-Martínez J, Manchado-Lopez C, Cortell-Tormo JM. The effects of stress on cardiovascular disease and Alzheimer's disease: Physical exercise as a counteract measure. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 152:157-193. [PMID: 32450995 DOI: 10.1016/bs.irn.2020.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AD is a complicated multi-systemic neurological disorder that involves different biological pathways. Several risk factors have been identified, including chronic stress. Chronic stress produces an alteration in the activity of the hypothalamic pituitary adrenal (HPA) system, and the autonomic nervous system (ANS), which over time increase the risk of AD and also the incidence of cardiovascular disease (CVD) and risk factors, such as hypertension, obesity and type 2 diabetes, associated with cognitive impairment and AD. Considering the multi-factorial etiology of AD, understanding the complex interrelationships between different risk factors is of potential interest for designing adequate strategies for preventing, delaying the onset or slowing down the progression of this devastating disease. Thus, in this review we will explore the general mechanisms and evidence linking stress, cardiovascular disease and AD, and discuss the potential benefits of physical activity for AD by counteracting the negative effects of chronic stress, CVD and risk factors.
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188
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Inflammation in Post-Traumatic Stress Disorder (PTSD): A Review of Potential Correlates of PTSD with a Neurological Perspective. Antioxidants (Basel) 2020; 9:antiox9020107. [PMID: 31991875 PMCID: PMC7070581 DOI: 10.3390/antiox9020107] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 12/18/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a chronic condition characterized by symptoms of physiological and psychosocial burden. While growing research demonstrated signs of inflammation in PTSD, specific biomarkers that may be representative of PTSD such as the detailed neural correlates underlying the inflammatory responses in relation to trauma exposure are seldom discussed. Here, we review recent studies that explored alterations in key inflammatory markers in PTSD, as well as neuroimaging-based studies that further investigated signs of inflammation within the brain in PTSD, as to provide a comprehensive summary of recent literature with a neurological perspective. A search was conducted on studies published from 2009 through 2019 in PubMed and Web of Science. Fifty original articles were selected. Major findings included elevated levels of serum proinflammatory cytokines in individuals with PTSD across various trauma types, as compared with those without PTSD. Furthermore, neuroimaging-based studies demonstrated that altered inflammatory markers are associated with structural and functional alterations in brain regions that are responsible for the regulation of stress and emotion, including the amygdala, hippocampus, and frontal cortex. Future studies that utilize both central and peripheral inflammatory markers are warranted to elucidate the underlying neurological pathway of the pathophysiology of PTSD.
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189
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Microglia, Lifestyle Stress, and Neurodegeneration. Immunity 2020; 52:222-240. [PMID: 31924476 DOI: 10.1016/j.immuni.2019.12.003] [Citation(s) in RCA: 184] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/26/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
Abstract
Recent years have witnessed a revolution in our understanding of microglia biology, including their major role in the etiology and pathogenesis of neurodegenerative diseases. Technological advances have enabled the identification of microglial signatures in health and disease, including the development of new models to investigate and manipulate human microglia in vivo in the context of disease. In parallel, genetic association studies have identified several gene risk factors associated with Alzheimer's disease that are specifically or highly expressed by microglia in the central nervous system (CNS). Here, we discuss evidence for the effect of stress, diet, sleep patterns, physical activity, and microbiota composition on microglia biology and consider how lifestyle might influence an individual's predisposition to neurodegenerative diseases. We discuss how different lifestyles and environmental factors might regulate microglia, potentially leading to increased susceptibility to neurodegenerative disease, and we highlight the need to investigate the contribution of modern environmental factors on microglia modulation in neurodegeneration.
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190
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Hori H, Yoshida F, Itoh M, Lin M, Niwa M, Ino K, Imai R, Ogawa S, Matsui M, Kamo T, Kunugi H, Kim Y. Proinflammatory status-stratified blood transcriptome profiling of civilian women with PTSD. Psychoneuroendocrinology 2020; 111:104491. [PMID: 31698278 DOI: 10.1016/j.psyneuen.2019.104491] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 10/13/2019] [Accepted: 10/18/2019] [Indexed: 02/07/2023]
Abstract
Etiology of posttraumatic stress disorder (PTSD) remains largely unknown. Studies have shown that a significant subset of patients with PTSD exhibit increased inflammation, suggesting that the understanding of this disorder could be facilitated by classifying these patients by inflammatory status. Here we performed a microarray-based blood transcriptome analysis on proinflammatory status-stratified Japanese civilian women with PTSD most of whom developed the disorder after experiencing interpersonal violence. By utilizing our previously identified cut-off serum interleukin-6 (IL-6) level that approximately corresponded to the median IL-6 level of our PTSD patients, we classified patients into those with high IL-6 levels and those with normal IL-6 levels (n = 16 for each). Transcriptome profiles of these 2 groups were compared with the profile of 16 age-matched healthy control women. Differentially expressed genes between high IL-6 patients and controls showed significant enrichment in a number of gene ontology terms and pathways primarily involved in immune/inflammatory responses, and their protein-protein interaction network was significantly enriched. In contrast, differentially expressed genes between normal IL-6 patients and controls showed significant enrichment in several gene ontology terms related to ion transport and neural function. The microarray data were confirmed by reverse transcription quantitative PCR. These findings illustrate the heterogeneous molecular mechanisms of PTSD within this relatively homogeneous sample in terms of sex, trauma type, and ethnicity, suggesting that peripheral proinflammatory status such as IL-6 levels could be a useful subtyping marker for this disorder. With further research, it is hoped that our findings will be translated into personalized medicine.
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Affiliation(s)
- Hiroaki Hori
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Fuyuko Yoshida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mariko Itoh
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mingming Lin
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Madoka Niwa
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Keiko Ino
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Risa Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sei Ogawa
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mie Matsui
- Department of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
| | - Toshiko Kamo
- Wakamatsu-cho Mental and Skin Clinic, Tokyo, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshiharu Kim
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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191
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Peters EMJ, Neusetzer M, Akinci S, Murat A, Treuherz S, Rose M, Leweke F, Leichsenring F, Conrad ML, Kruse J. Multimodal Psychotherapeutic Inpatient Therapy of Depression Is Successful in Patients With High Cytokine Production. Front Psychiatry 2020; 11:571636. [PMID: 33240126 PMCID: PMC7667045 DOI: 10.3389/fpsyt.2020.571636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/05/2020] [Indexed: 12/27/2022] Open
Abstract
Objective: In experimental settings, systemically elevated inflammation markers interfere with major depression treatment. In German healthcare, compulsory national health insurance covers treatment of a wide variety of depressive disorders, if it follows evidence-based medicine guidelines combining recommended therapies. To date, little is known about the relevance of immune system cytokine production with regard to real-world clinical care for patients with moderate depression. Methods: Seventy three patients with moderate depression subjected to multimodal psychotherapeutic inpatient therapy (mPT) following a psychodynamic concept at a German university hospital were included. As a primary outcome, mPT success, evidenced by delta HADS "depression," was analyzed according to tumor necrosis factor alpha (TNFα) production by peripheral blood mononuclear cells (PBMC) after phytohemagglutinin (PHA) challenge at baseline. Secondary outcomes addressed the inflammatory response and mental health comparing high and low TNFα-producers. Results: First, higher PBMC TNFα production at baseline predicted a better mPT-outcome (R 2 0.162, p = 0.014). Second, patients with high TNFα (hTNF) at baseline produced significantly more acute inflammatory cytokines [interleukin (IL)1β, IL6), TH1/TH2 cytokines [interferon gamma (IFNγ), IL4] as well as eotaxin and IL2 compared to low TNFα producers (lTNF) (Cohen's ds between -0.532 and -1.013). Demographic data, diagnosis subtype-distribution, medication, systemic inflammation markers [C-reactive protein (CRP), high mobility group box 1 (HMGB1), leptin], anxiety and depression (HADS) did not differ. From baseline to mPT-discharge, HADS "depression" decreased in both hTNF (11.31 to 5.47, p = 0.001, d = 1.184) and lTNF patients (11.50-7.92, p = 0.001, d = -0.765), while PBMC cytokine production decreased significantly in hTNF (Cohen's ds between -0.304 and -0.345) with a significant group by time interaction for TH1/TH2 ratio. At the end of therapy, comparison of TNF groups revealed significantly lower depression-scores in hTNF compared to lTNF patients (5.47 compared to 7.92, p = 0.035, d = 0.504). Conclusions: Our study demonstrates successful treatment of depression in a clinical care setting using multimodal psychotherapy based on a psychodynamic concept following guideline recommendation. The greatest improvement in patient depression was linked to the highest production of TNFα by PBMCs at baseline. Our study contributes to the definition of patient subpopulations with differing cytokine responses that are related to succesful treatment of depression.
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Affiliation(s)
- Eva M J Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany.,Division for General Internal Medicine, Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Melanie Neusetzer
- Psychoneuroimmunology Laboratory, Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Secil Akinci
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Aysenur Murat
- Psychoneuroimmunology Laboratory, Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Sabine Treuherz
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Matthias Rose
- Division for General Internal Medicine, Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Leweke
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Falk Leichsenring
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Melanie L Conrad
- Division for General Internal Medicine, Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Charité Center 5 Laboratory and Preventive Medicine, Institute of Microbiology, Infectious Diseases and Immunology, Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Kruse
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
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192
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Belrose C, Duffaud A, Rakotoarison E, Faget C, Raynaud P, Dutheil F, Boyer L, Billaud JB, Trousselard M. Neurological Soft Signs and Post-Traumatic Stress Disorder: A Biomarker of Severity? Front Psychiatry 2020; 11:533662. [PMID: 33192652 PMCID: PMC7606651 DOI: 10.3389/fpsyt.2020.533662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/03/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The psychophysiological changes for individual suffering from chronic post-traumatic stress disorder (PTSD) raise to the questions of how facilitate recovery and return to work. Negative alterations in neuro-cognition remain a complaint for patients and participate to long-term functional impairments. Neurological soft signs (NSSs) appear as a candidate for better understanding these complaints. They have been reported in several mental disorders. They are found in several behavioral and/or neurocognitive disorders and are taken into account by psychiatric rehabilitation programs to support recovery. As few studies evaluate NSSs in PTSD, our exploratory study aims to assess NSSs in chronic PTSD and their relationships with PTSD severity. METHOD Twenty-two patients with a clinical diagnosis of chronic PTSD were evaluated in terms of PTSD severity (post-traumatic checklist scale, PCL5), NSSs (NSSs psychomotor skills scale, PASS), and well-being upon arrival to the hospital and compared with 15 healthy subjects. Statistical non-parametric analyses assessed the relationships between these variables. RESULTS PTSD subjects exhibited higher NSSs compared with healthy subjects. NSSs were positively associated with PTSD severity, with negative alterations in cognition and mood, and with impairment in well-being. They were higher in women compared with men. No impact of age was found. Three groups were identified based on the severity of the PTSD. Severe PTSD exhibited NSSs characterized by motor integration alterations. CONCLUSIONS This pilot study suggests that NSSs might be a biomarker of PTSD severity. This proof of concept highlights the need for further research for better evaluating the clinical neuro-functional impairment. This will be helping for defining neurological remediation for promoting PTSD recovery.
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Affiliation(s)
- Célia Belrose
- Département de Neurosciences et Sciences Cognitives, Unité de Neurophysiologie du Stress, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France.,Réseau ABC des Psychotraumas, Montpellier, France.,APEMAC, EA 4360, Université de Lorraine, Nancy, France
| | - Anais Duffaud
- Département de Neurosciences et Sciences Cognitives, Unité de Neurophysiologie du Stress, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France.,Réseau ABC des Psychotraumas, Montpellier, France
| | | | | | - Philippe Raynaud
- APEMAC, EA 4360, Université de Lorraine, Nancy, France.,Centre Hospitalier Léon Jean Grégory, Thuir, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Clermont-Ferrand, France.,Faculty of Health, School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia
| | - Léa Boyer
- Département de Neurosciences et Sciences Cognitives, Unité de Neurophysiologie du Stress, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France
| | - Jean-Baptiste Billaud
- Département de Neurosciences et Sciences Cognitives, Unité de Neurophysiologie du Stress, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France
| | - Marion Trousselard
- Département de Neurosciences et Sciences Cognitives, Unité de Neurophysiologie du Stress, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France.,Réseau ABC des Psychotraumas, Montpellier, France.,APEMAC, EA 4360, Université de Lorraine, Nancy, France
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193
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Relationships of blood proinflammatory markers with psychological resilience and quality of life in civilian women with posttraumatic stress disorder. Sci Rep 2019; 9:17905. [PMID: 31784695 PMCID: PMC6884570 DOI: 10.1038/s41598-019-54508-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/15/2019] [Indexed: 02/06/2023] Open
Abstract
Individuals with posttraumatic stress disorder (PTSD) show low resilience and impaired quality of life (QOL). Accumulating evidence shows that PTSD is associated with increased inflammation. Studies suggest that inflammation can be a key mechanism underlying low resilience/QOL, but this relationship has been understudied in individuals with PTSD. Here, we investigated the association of blood proinflammatory markers with self-reported resilience and QOL in civilian women with PTSD. Fifty-six women with PTSD and 73 healthy control women participated in this study. Resilience was assessed using the Connor-Davidson Resilience Scale. QOL was assessed using the World Health Organization Quality of Life-BREF. Blood samples were collected for the measurement of three proinflammatory markers including interleukin-6 (IL-6), high-sensitivity tumor necrosis factor-α, and high-sensitivity C-reactive protein (hsCRP). Compared to controls, patients showed significantly higher IL-6 levels and lower resilience and QOL. In patients, IL-6 levels were significantly negatively correlated with resilience, and hsCRP levels were significantly negatively correlated with psychological QOL. These results show that increased levels of proinflammatory markers including IL-6 and hsCRP are associated with lower psychological resilience and QOL in PTSD patients. Our findings suggest that interventions and treatments targeting inflammation may aid in the recovery from PTSD and lead to better prognosis.
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194
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van der Velden PG, Oudejans M, Das M, Bosmans MWG, Maercker A. The longitudinal effect of social recognition on PTSD symptomatology and vice versa: Evidence from a population-based study. Psychiatry Res 2019; 279:287-294. [PMID: 31262536 DOI: 10.1016/j.psychres.2019.05.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 01/20/2023]
Abstract
A specific type of social support after potentially traumatic events is called "social recognition". It is the acknowledgement or validation of event-related thoughts, behavior, and feelings by the individual or others. It consists of positive individual or societal reactions that recognize and acknowledge victims' traumatic experiences and difficulties. Current studies suggest that social recognition protects against the development of PTSD symptomatology, but there is a lack of population-based studies assessing the longitudinal interplay between PTSD symptomatology and social recognition. For this purpose, we conducted a longitudinal study using the Dutch LISS panel, based on a random sample of the Dutch population. Structural equation modeling showed that among recently affected adults (0-2 months ago), those with relatively higher levels of social recognition had lower levels of PTSD symptomatology 6 months later. Victims with high levels of PTSD symptomatology at baseline received less social recognition 6 months later. On the intermediate term (affected 5-12 months ago), baseline social recognition was no longer predictive of PTSD symptoms 6 months later, in contrast to PTSD symptomatology predicting lack of social recognition. In sum, PTSD symptom levels eroded social recognition on the short and intermediate term, while the protective role of social recognition was limited to the short term.
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Affiliation(s)
- Peter G van der Velden
- CentERdata and Tilburg University's Network on Health and Behavior (Nethlab), Tilburg, the Netherlands.
| | | | - Marcel Das
- CentERdata and Tilburg University's Network on Health and Behavior (Nethlab), Tilburg, the Netherlands
| | - Mark W G Bosmans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Andreas Maercker
- Department of Psychology Psychopathology and Clinical Intervention, University of Zurich, Switzerland
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195
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Abizaid A, Merali Z, Anisman H. Cannabis: A potential efficacious intervention for PTSD or simply snake oil? J Psychiatry Neurosci 2019; 44:75-78. [PMID: 30810022 PMCID: PMC6397040 DOI: 10.1503/jpn.190021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Alfonso Abizaid
- From the Department of Neuroscience, Carleton University (Abizaid, Anisman); and the Royal’s Institute of Mental Health (Merali), Ottawa, Ont., Canada
| | - Zul Merali
- From the Department of Neuroscience, Carleton University (Abizaid, Anisman); and the Royal’s Institute of Mental Health (Merali), Ottawa, Ont., Canada
| | - Hymie Anisman
- From the Department of Neuroscience, Carleton University (Abizaid, Anisman); and the Royal’s Institute of Mental Health (Merali), Ottawa, Ont., Canada
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196
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Règue M, Poilbout C, Martin V, Franc B, Lanfumey L, Mongeau R. Increased 5-HT2C receptor editing predisposes to PTSD-like behaviors and alters BDNF and cytokines signaling. Transl Psychiatry 2019; 9:100. [PMID: 30792491 PMCID: PMC6384909 DOI: 10.1038/s41398-019-0431-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/24/2019] [Accepted: 01/27/2019] [Indexed: 12/16/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a trauma- and stress-related disorder with dysregulated fear responses and neurobiological impairments, notably at neurotrophic and inflammation levels. Understanding the mechanisms underlying this disease is crucial to develop PTSD models that meet behavioral and neurobiological validity criteria as well as innovative therapeutic approaches. Serotonin 2C receptors (5-HT2CR) are known for their important role in anxiety, and mice having only the fully edited VGV isoform of 5-HT2CR, which thereby overexpressed brain 5-HT2CR, are of special interest to study PTSD predisposition. Innate and conditioned fear-related behaviors were assessed in VGV and wild-type mice. mRNA expression of brain-derived neurotrophic factor (BDNF), tissue-plasminogen activator (tPA), and pro-inflammatory cytokines (IL-6, IL-1β, and calcineurin) were measured by qRT-PCR. The effect of acute and chronic paroxetine was evaluated on both behavior and gene expression. VGV mice displayed greater fear expression, extensive fear extinction deficits, and fear generalization. Paroxetine restored fear extinction in VGV mice when administered acutely and decreased innate fear and fear generalization when administered chronically. In parallel, Bdnf, tPA, and pro-inflammatory cytokines mRNA levels were dysregulated in VGV mice. Bdnf and tPA mRNA expression was decreased in the hippocampus but increased in the amygdala, and chronic paroxetine normalized Bdnf mRNA levels both in the amygdala and the hippocampus. Amygdalar calcineurin mRNA level in VGV mice was also normalized by chronic paroxetine. VGV-transgenic mice displayed behavioral and neurobiological features that could be accessory to the investigation of PTSD and its treatment. Furthermore, these data point out to the role of 5-HT2CR in neuroplasticity and neuroinflammation.
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MESH Headings
- Amygdala/metabolism
- Animals
- Anxiety/genetics
- Behavior, Animal/drug effects
- Brain-Derived Neurotrophic Factor/genetics
- Brain-Derived Neurotrophic Factor/metabolism
- Cytokines/metabolism
- Disease Models, Animal
- Fear
- Hippocampus/metabolism
- Male
- Maze Learning
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Paroxetine/pharmacology
- RNA Editing
- RNA, Messenger/genetics
- Receptor, Serotonin, 5-HT2C/genetics
- Receptor, Serotonin, 5-HT2C/metabolism
- Signal Transduction
- Stress Disorders, Post-Traumatic/drug therapy
- Stress Disorders, Post-Traumatic/metabolism
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Affiliation(s)
- Mathilde Règue
- Inserm UMR S894, Centre de Psychiatrie et Neuroscience, Université Paris Descartes, 75014, Paris, France
| | - Corinne Poilbout
- Inserm UMR S894, Centre de Psychiatrie et Neuroscience, Université Paris Descartes, 75014, Paris, France
| | - Vincent Martin
- Inserm UMR S894, Centre de Psychiatrie et Neuroscience, Université Paris Descartes, 75014, Paris, France
| | - Bernard Franc
- Inserm UMR S894, Centre de Psychiatrie et Neuroscience, Université Paris Descartes, 75014, Paris, France
| | - Laurence Lanfumey
- Inserm UMR S894, Centre de Psychiatrie et Neuroscience, Université Paris Descartes, 75014, Paris, France
| | - Raymond Mongeau
- EA 4475, Pharmacologie de la circulation cérébrale, Université Paris Descartes, 75006, Paris, France.
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