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Huang Q, Wang D, Chen S, Tang L, Ma C. Association of METS-IR index with depressive symptoms in US adults: A cross-sectional study. J Affect Disord 2024; 355:355-362. [PMID: 38554881 DOI: 10.1016/j.jad.2024.03.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/04/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND An association between insulin resistance (IR) and depression has been identified in recent years. The purpose of this study was to examine the relationship between IR and depression in the general population. METHODS The population for this cross-sectional study consisted of adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. Insulin sensitivity was assessed using the Metabolic Score for IR (METS-IR) index, while depression was evaluated using the Patient Health Questionnaire (PHQ)-9. Logistic regression analyses, subgroup analyses, and dose-response curves were conducted to assess the association between the METS-IR index and depression. RESULTS A total of 13,157 adults aged over 20 years were included in this study. After adjusting for potential confounders, it was observed that each unit increase in the METS-IR index was associated with a 1.1 percentage point increase in the prevalence of depression (OR = 1.011; 95 % CI: 1.008, 1.014). Patients in the 4th quartile of the METS-IR index had a higher likelihood of depression compared to those in the 1st quartile (OR = 1.386, 95 % CI: 1.239, 1.549). Stratified analyses demonstrated consistent results in all subgroups, except for men, patients under 40 years of age, and those with a history of cancer. Dose-response curves indicated a nonlinear relationship between the METS-IR index and the risk of depression, with an inflection point value of 32.443 according to threshold effect analysis. CONCLUSIONS Our findings suggest that higher METS-IR scores are associated with an increased likelihood of experiencing depressive symptoms among U.S. adults.
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Affiliation(s)
- Qi Huang
- Department of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
| | - Denghong Wang
- Department of Traditional Chinese Medicine and Rehabilitation, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan 430311, China
| | - Shanshan Chen
- Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
| | - Lei Tang
- Department of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China.
| | - Chaoyang Ma
- Department of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China.
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Lorenz TI, Schreuders E, Stuldreher IV, Thammasan N, Brouwer AM, Giletta M. The Interplay of Peer Victimization and Parasympathetic Nervous System Activity on Acute Inflammatory Stress Responses in Adolescence. Res Child Adolesc Psychopathol 2024; 52:757-771. [PMID: 38008787 DOI: 10.1007/s10802-023-01156-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 11/28/2023]
Abstract
This study examined the extent to which adolescent peer victimization predicted acute inflammatory responses to stress, and whether both resting parasympathetic nervous system (PNS) activity and PNS stress reactivity moderated this association. 83 adolescents (Mage = 14.89, SDage = 0.52, 48% female) reported their history of peer victimization and were exposed to a standardized social stress task before and after which dried blood spot samples were collected to assay inflammatory markers. Inflammatory responses to the stress task were assessed with a latent inflammatory change factor using the cytokines interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α). PNS functioning, indexed by high-frequency heart rate variability, was measured at rest and during the stressor. Contrary to hypotheses, analyses revealed no direct relation between peer victimization and acute inflammatory responses, and resting PNS activity did not moderate this association. However, peer victimization predicted stronger inflammatory responses among adolescents with weaker PNS reactivity to the stress task (b = 0.63, p = .02). This association was not observed among adolescents with stronger PNS reactivity, for whom a negative but non-significant trend was found. Weaker PNS reactivity may thus indicate victimized adolescents' vulnerability for acute inflammatory responses, whereas stronger PNS reactivity may indicate adolescents' resilience to a social stressor.
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Affiliation(s)
- Tamara I Lorenz
- Department of Developmental, Personality, and Social Psychology, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium.
| | - Elisabeth Schreuders
- Department of Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - Ivo V Stuldreher
- The Netherlands Organization for Applied Scientific Research (TNO), Soesterberg, The Netherlands
| | - Nattapong Thammasan
- OnePlanet Research Center, Imec- The Netherlands, Wageningen, The Netherlands
| | - Anne-Marie Brouwer
- The Netherlands Organization for Applied Scientific Research (TNO), Soesterberg, The Netherlands
- Department of Artificial Intelligence, Radboud University, Nijmegen, Netherlands
| | - Matteo Giletta
- Department of Developmental, Personality, and Social Psychology, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
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Mengelkoch S, Slavich GM. Sex Differences in Stress Susceptibility as a Key Mechanism Underlying Depression Risk. Curr Psychiatry Rep 2024; 26:157-165. [PMID: 38470558 PMCID: PMC10978685 DOI: 10.1007/s11920-024-01490-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE OF REVIEW Although females are at relatively greater risk for a variety of disorders, including depression, the biological mechanisms underlying this striking health disparity remain unclear. To address this issue, we highlight sex differences in stress susceptibility as a key mechanism potentially driving this effect and describe the interacting inflammatory, hormonal, epigenomic, and social-environmental mechanisms involved. RECENT FINDINGS Using the Social Signal Transduction Theory of Depression as a theoretical framework, women's elevated risk for depression may stem from a tight link between life stress, inflammation, and depression in women. Further, research finds hormonal contraceptive use alters cortisol and inflammatory reactivity to acute stress in ways that may increase depression risk in females. Finally, beyond established epigenetic mechanisms, mothers may transfer risk for depression to their female offspring through stressful family environments, which influence stress generation and stress-related gene expression. Together, these findings provide initial, biologically plausible clues that may help explain the relatively greater risk for depression in females vs. males. Looking forward, much more research is needed to address the longstanding underrepresentation of females in biomedical research on the biology of stress and depression.
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Affiliation(s)
- Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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4
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Beydoun HA, Beydoun MA, Wassertheil-Smoller S, Saquib N, Manson JE, Snetselaar L, Weiss J, Zonderman AB, Brunner R. Depressive symptoms and antidepressant use in relation to white blood cell count among postmenopausal women from the Women's Health Initiative. Transl Psychiatry 2024; 14:157. [PMID: 38514652 PMCID: PMC10958010 DOI: 10.1038/s41398-024-02872-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 03/05/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
Inflammation can play a role in the pathophysiology of depression, and specific types of antidepressants may have inflammatory or anti-inflammatory properties. Furthermore, depression and antidepressant use has been linked to white blood cell (WBC) count, a routinely measured inflammatory marker. We examined the cross-sectional and longitudinal relationships of depressive symptoms and/or antidepressant use with WBC count among postmenopausal women. Analyses of cross-sectional data at enrollment were performed on 125,307 participants, 50-79 years of age, from the Women's Health Initiative Clinical Trials and Observational Studies who met eligibility criteria, and a subset of those with 3-year follow-up data were examined for longitudinal relationships. Depressive symptoms were defined using the Burnam Algorithm whereas antidepressant use was defined using therapeutic class codes. WBC count (Kcell/ml) was obtained through laboratory evaluations of fasting blood samples. Multivariable regression modeling was performed taking sociodemographic, lifestyle and health characteristics into consideration. At enrollment, nearly 85% were non-users of antidepressants with no depressive symptoms, 5% were antidepressant users with no depressive symptoms, 9% were non-users of antidepressants with depressive symptoms, and 2% were users of antidepressants with depressive symptoms. In fully-adjusted models, cross-sectional relationships were observed whereby women in the 2nd (OR = 1.06, 95% CI: 1.01, 1.13), 3rd (OR = 1.06, 95% CI: 1.00, 1.12) or 4th (OR = 1.10, 95% CI: 1.05, 1.17) quartiles of WBC count were more likely to exhibit depressive symptoms, and women in the 4th quartile were more likely to be users of antidepressants (OR = 1.07, 95% CI: 1.00, 1.15), compared to women in the 1st quartile. Compared to women who exhibited no depressive symptoms at either visit, those with consistent depressive symptoms at enrollment and at 3-year follow-up had faster decline in WBC count (β = -0.73, 95% CI: -1.33, -0.14) over time. No significant bidirectional relationships were observed between changes in depressive symptoms score and WBC count over time. In conclusion, depressive symptoms and/or antidepressant use were cross-sectionally related to higher WBC counts among postmenopausal women. Further evaluation of observed relationships is needed in the context of prospective cohort studies involving older adult men and women, with repeated measures of depression, antidepressant use, and WBC count.
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Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | | | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Linda Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Jordan Weiss
- Department of Demography, UC Berkeley, Berkeley, CA, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - Robert Brunner
- Department of Family and Community Medicine (Emeritus), School of Medicine, University of Nevada (Reno), Reno, NV, USA
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Schaeff VLK, Sperber PS, Piper SK, Giesers NK, Gertz K, Heuschmann PU, Endres M, Liman TG. Associations of C-reactive protein with depressive symptoms over time after mild to moderate ischemic stroke in the PROSCIS-B cohort. J Neurol 2024; 271:909-917. [PMID: 37848651 PMCID: PMC10828033 DOI: 10.1007/s00415-023-12038-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND AND PURPOSE C-reactive protein serves as a marker of inflammation and is linked to depression in the general population. We aimed to assess whether elevated baseline levels of high-sensitivity C-reactive protein (hs-CRP) are associated with depressive symptoms over time in a prospective cohort of mild-to-moderate first-ever ischemic stroke patients. METHODS Data were obtained from the Prospective Cohort with Incident Stroke Berlin (NCT01363856). Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) at three annual follow-up points. We assessed the association of elevated levels of hs-CRP with CES-D scores over time via linear mixed models. In a subgroup analysis, we explored an interaction effect with sex. RESULTS We included 585 ischemic stroke patients with baseline data on CRP levels. The mean age was 67 (13 SD), 39% (n = 226) were female, and the median National Institutes of Health Stroke Scale (NIHSS) was 3 (IQR 1-4). Twenty percent of survivors showed evidence for depressive symptoms one year after stroke with CES-D ≥ 16, 21% at year two, and 17% at year three. Higher log-transformed baseline hs-CRP levels were associated with higher CES-D Scores over time in the adjusted linear mixed model (β = 1.28; (95% CI 0.22-2.34)). The subgroup analysis revealed an interaction effect of hs-CRP on depressive symptoms in women (β = 2.33; (95% CI 0.71-3.95)). CONCLUSION In our cohort with mild-to-moderate first-ever ischemic stroke patients, hs-CRP levels were associated with more depressive symptoms over time, with an interaction effect for the female sex. STUDY REGISTRATION https://clinicaltrials.gov ; Unique identifier: NCT01363856.
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Affiliation(s)
- Viktoria L K Schaeff
- Charité-Universitätsmedizin Berlin, Center for Stroke Research Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Pia S Sperber
- Charité-Universitätsmedizin Berlin, Center for Stroke Research Berlin, Charitéplatz 1, 10117, Berlin, Germany
- German Centre for Cardiovascular Research DZHK, Berlin, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Department of Neurology With Experimental Neurology, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Experimental and Clinical Research Center, Berlin, Germany
| | - Sophie K Piper
- Charité-Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Institute of Medical Informatics, Berlin, Germany
| | - Naomi K Giesers
- Department of Neurology, Carl Von Ossietzky University, Oldenburg, Germany
| | - Karen Gertz
- Charité-Universitätsmedizin Berlin, Center for Stroke Research Berlin, Charitéplatz 1, 10117, Berlin, Germany
- German Centre for Cardiovascular Research DZHK, Berlin, Berlin, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Matthias Endres
- Charité-Universitätsmedizin Berlin, Center for Stroke Research Berlin, Charitéplatz 1, 10117, Berlin, Germany
- German Centre for Cardiovascular Research DZHK, Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- German Center for Neurodegenerative Disease DZNE, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Neurocure Cluster of Excellence, Berlin, Germany
| | - Thomas G Liman
- Charité-Universitätsmedizin Berlin, Center for Stroke Research Berlin, Charitéplatz 1, 10117, Berlin, Germany
- German Centre for Cardiovascular Research DZHK, Berlin, Berlin, Germany
- Department of Neurology, Carl Von Ossietzky University, Oldenburg, Germany
- German Center for Neurodegenerative Disease DZNE, Berlin, Germany
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6
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Sabião TDS, Oliveira FCD, Bressan J, Pimenta AM, Hermsdorff HHM, Oliveira FLPD, Mendonça RDD, Carraro JCC. Fatty acid intake and prevalence of depression among Brazilian graduates and postgraduates (CUME Study). J Affect Disord 2024; 346:182-191. [PMID: 37949241 DOI: 10.1016/j.jad.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Dietary fatty acids are related to the development of several inflammatory-related diseases, which may include depression. So, the association between fatty acids, culinary oils and fat intake and depression in highly educated Brazilians was evaluated. METHODS Multicenter cross-sectional study using baseline data from the Cohort of Universities of Minas Gerais. The diagnosis of depression was self-reported, and the daily intake of fatty acids was assessed using a 144-item food frequency questionnaire (FFQ). RESULTS A total of 7157 participants (68.83 % women) with a median age of 33 years were included. The prevalence of depression was 12.60 % (N = 902). In the adjusted analyses, it was observed that individuals with the highest intake of omega-6 fatty acids (n-6) (OR: 1.36, 95 % CI 1.11-1.67) had a higher prevalence of depression. This increased n-6 intake was identified as a risk factor for depression only among male participants, while among overweight participants, higher n-6 intake was also positively associated with depression. Conversely, a higher ratio of polyunsaturated to monounsaturated and saturated fatty acids (PM/S) was also found to be positively associated with depression, but this association was observed only among non-overweight participants. No associations were found between the consumption of culinary oils or fats and depression. LIMITATIONS Cross-sectional design limits the assessment of causality. The use of the FFQ can make estimates more difficult. CONCLUSION Higher consumption of n-6, and higher PM/S ratios were associated with depression, and individual factors can interfere. The mental health care policies should include specific nutritional strategies.
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Christian LM, Wilson SJ, Madison AA, Prakash RS, Burd CE, Rosko AE, Kiecolt-Glaser JK. Understanding the health effects of caregiving stress: New directions in molecular aging. Ageing Res Rev 2023; 92:102096. [PMID: 37898293 PMCID: PMC10824392 DOI: 10.1016/j.arr.2023.102096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 10/30/2023]
Abstract
Dementia caregiving has been linked to multiple health risks, including infectious illness, depression, anxiety, immune dysregulation, weakened vaccine responses, slow wound healing, hypertension, cardiovascular disease, metabolic syndrome, diabetes, frailty, cognitive decline, and reduced structural and functional integrity of the brain. The sustained overproduction of proinflammatory cytokines is a key pathway behind many of these risks. However, contrasting findings suggest that some forms of caregiving may have beneficial effects, such as maintaining caregivers' health and providing a sense of meaning and purpose which, in turn, may contribute to lower rates of functional decline and mortality. The current review synthesizes these disparate literatures, identifies methodological sources of discrepancy, and integrates caregiver research with work on aging biomarkers to propose a research agenda that traces the mechanistic pathways of caregivers' health trajectories with a focus on the unique stressors facing spousal caregivers as compared to other informal caregivers. Combined with a focus on psychosocial moderators and mechanisms, studies using state-of-the-art molecular aging biomarkers such as telomere length, p16INK4a, and epigenetic age could help to reconcile mixed literature on caregiving's sequelae by determining whether and under what conditions caregiving-related experiences contribute to faster aging, in part through inflammatory biology. The biomarkers predict morbidity and mortality, and each contributes non-redundant information about age-related molecular changes -together painting a more complete picture of biological aging. Indeed, assessing changes in these biopsychosocial mechanisms over time would help to clarify the dynamic relationships between caregiving experiences, psychological states, immune function, and aging.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Stephanie J Wilson
- Department of Psychology, Southern Methodist University, University Park, TX, USA
| | - Annelise A Madison
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Ruchika S Prakash
- Department of Psychology, The Ohio State University, Columbus, OH, USA; Center for Cognitive and Behavioral Brain Imaging, Ohio State University, Columbus, OH, USA
| | - Christin E Burd
- Departments of Molecular Genetics, Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA
| | - Ashley E Rosko
- Division of Hematology, The Ohio State University, Columbus, OH, USA
| | - Janice K Kiecolt-Glaser
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Paolini M, Harrington Y, Raffaelli L, Poletti S, Zanardi R, Colombo C, Benedetti F. Neutrophil to lymphocyte ratio and antidepressant treatment response in patients with major depressive disorder: Effect of sex and hippocampal volume. Eur Neuropsychopharmacol 2023; 76:52-60. [PMID: 37544076 DOI: 10.1016/j.euroneuro.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Several factors may affect response to treatment in Major Depressive Disorder (MDD) including immune/inflammatory alterations and regional brain volumes, particularly in hippocampal regions which have shown to be influenced by inflammatory status. Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker found to be elevated in depressed women in large population studies. Here we investigate the effect of NLR on treatment response in MDD patients, and the role of sex and hippocampal volume on influencing this relationship. A sample of 124 MDD depressed inpatients (F = 80) underwent MRI acquisition, admission NLR was calculated by dividing absolute neutrophil by absolute lymphocyte counts and depression severity was assessed at admission and discharge via the Hamilton Depression Rating Scale (HDRS). As a measure of treatment response, delta HDRS was calculated. We found a significant moderation effect of sex on the relationship between NLR and Delta HDRS: a negative relation was found in females and a positive one in males. NLR was found to negatively affect hippocampal volumes in females. Both left and right hippocampal volume positively associated with Delta HDRS. Finally, left hippocampal volume mediated the effect of NLR on Delta HDRS in females. Sex moderated the relation between inflammation and treatment response in line with previous reports linking inflammation to hampered antidepressant effect in females. Further, this effect is partially mediated by hippocampal volume, suggesting that antidepressant response may be hampered by the detrimental effect of inflammation on the brain.
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Affiliation(s)
- Marco Paolini
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Yasmin Harrington
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy.
| | - Laura Raffaelli
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Sara Poletti
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Mood Disorders Unit, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy; Mood Disorders Unit, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
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Souza APDE, Carvalho LOT, Pedroso AP, Moraes ADES, Cipullo MAT, Dâmaso AR, Telles MM, Oyama LM, Tashima AK, Caranti DA, Ribeiro EB. An interdisciplinary therapy for lifestyle change is effective in improving psychological and inflammatory parameters in women with grade I obesity. AN ACAD BRAS CIENC 2023; 95:e20230365. [PMID: 37909611 DOI: 10.1590/0001-3765202320230365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/03/2023] [Indexed: 11/03/2023] Open
Abstract
Obesity and depression, disorders associated with inflammation, have high incidences in women. Understanding the derangements present in the initial phase of obesity may point to factors that could help avoiding disease aggravation. The present study aimed at investigating the effects of a 6-months interdisciplinary therapy for weight loss in women with grade I obesity. Before and after the therapy, 37 middle-aged women donated blood and responded to questionnaires for depression and anxiety symptoms. Inflammatory parameters were evaluated in serum and a preliminary screening of the plasma proteome was performed. The therapy decreased anthropometric, psychological scores, and serum levels of inflammatory parameters. Depression and anxiety scores correlated positively with some inflammatory parameters. The proteomic analysis showed changes in proteins related to cholesterol metabolism and inflammatory response. Interdisciplinary therapy improves anthropometric and inflammatory statuses and ameliorating psychological symptoms. The decrease of MCP-1 levels after interdisciplinary therapy has not been reported so far, at the best of our knowledge. The present demonstration of positive associations of inflammatory markers and psychological scores indicate that these mediators may be useful to monitor psychological status in obesity. The present proteome data, although preliminary, pointed to plasma alterations indicative of improvement of inflammation after interdisciplinary therapy.
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Affiliation(s)
- Adriana P DE Souza
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fisiologia, Rua Botucatu, 862, 2° andar, Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Lorenza Oliveira T Carvalho
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fisiologia, Rua Botucatu, 862, 2° andar, Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Amanda Paula Pedroso
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fisiologia, Rua Botucatu, 862, 2° andar, Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Amanda DE Santos Moraes
- Universidade Federal de São Paulo (UNIFESP), Departamento de Biociências, Grupo de Estudo de Obesidade (GEO), Av. Dr. Epitácio Pessoa, 741, 11045-301 Santos, SP, Brazil
| | - Marcos Alberto Taddeo Cipullo
- Universidade Federal de São Paulo (UNIFESP), Departamento de Biociências, Grupo de Estudo de Obesidade (GEO), Av. Dr. Epitácio Pessoa, 741, 11045-301 Santos, SP, Brazil
| | - Ana Raimunda Dâmaso
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fisiologia, Rua Botucatu, 862, 2° andar, Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Mônica M Telles
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fisiologia, Rua Botucatu, 862, 2° andar, Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Lila M Oyama
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fisiologia, Rua Botucatu, 862, 2° andar, Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Alexandre K Tashima
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Bioquímica, Rua Botucatu, 862, Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Danielle A Caranti
- Universidade Federal de São Paulo (UNIFESP), Departamento de Biociências, Grupo de Estudo de Obesidade (GEO), Av. Dr. Epitácio Pessoa, 741, 11045-301 Santos, SP, Brazil
| | - Eliane B Ribeiro
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fisiologia, Rua Botucatu, 862, 2° andar, Vila Clementino, 04023-062 São Paulo, SP, Brazil
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10
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Madison AA, Andridge R, Kantaras AH, Renna ME, Bennett JM, Alfano CM, Povoski SP, Agnese DM, Lustberg M, Wesolowski R, Carson WE, Williams NO, Reinbolt RE, Sardesai SD, Noonan AM, Stover DG, Cherian MA, Malarkey WB, Kiecolt-Glaser JK. Depression, Inflammation, and Intestinal Permeability: Associations with Subjective and Objective Cognitive Functioning throughout Breast Cancer Survivorship. Cancers (Basel) 2023; 15:4414. [PMID: 37686689 PMCID: PMC10487080 DOI: 10.3390/cancers15174414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
About one-in-three breast cancer survivors have lingering cognitive complaints and objective cognitive impairment. Chronic inflammation and intestinal permeability (i.e., leaky gut), two risk factors for cognitive decline, can also fuel depression-another vulnerability for cognitive decline. The current study tested whether depression accompanied by high levels of inflammation or intestinal permeability predicted lower subjective and objective cognitive function in breast cancer survivors. We combined data from four breast cancer survivor studies (n = 613); some had repeated measurements for a total of 1015 study visits. All participants had a blood draw to obtain baseline measures of lipopolysaccharide binding protein-a measure of intestinal permeability, as well as three inflammatory markers that were incorporated into an inflammatory index: C-reactive protein, interleukin-6, and tumor necrosis factor-α. They reported depressive symptoms on the Center for Epidemiological Studies depression scale (CES-D), and a binary variable indicated clinically significant depressive symptoms (CES-D ≥ 16). The Kohli (749 observations) and the Breast Cancer Prevention Trial (591 observations) scales assessed subjective cognitive function. Objective cognitive function tests included the trail-making test, Hopkins verbal learning test, Conners continuous performance test, n-back test, FAS test, and animal-naming test (239-246 observations). Adjusting for education, age, BMI, cancer treatment type, time since treatment, study visit, and fatigue, women who had clinically elevated depressive symptoms accompanied by heightened inflammation or intestinal permeability reported poorer focus and marginally poorer memory. However, poorer performance across objective cognitive measures was not specific to inflammation-associated depression. Rather, there was some evidence of lower verbal fluency; poorer attention, verbal learning and memory, and working memory; and difficulties with visuospatial search among depressed survivors, regardless of inflammation. By themselves, inflammation and intestinal permeability less consistently predicted subjective or objective cognitive function. Breast cancer survivors with clinically significant depressive symptoms accompanied by either elevated inflammation or intestinal permeability may perceive greater cognitive difficulty, even though depression-related objective cognitive deficits may not be specific to inflammation- or leaky-gut-associated depression.
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Affiliation(s)
- Annelise A Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Psychology, The Ohio State University, Columbus, OH 43210, USA
| | - Rebecca Andridge
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Division of Biostatistics, The Ohio State University, Columbus, OH 43210, USA
| | - Anthony H Kantaras
- Department of Neuroscience, The Ohio State University, Columbus, OH 43210, USA
| | - Megan E Renna
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Jeanette M Bennett
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC 28213, USA
| | | | - Stephen P Povoski
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Division of Surgical Oncology, Department of Surgery, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Doreen M Agnese
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Division of Surgical Oncology, Department of Surgery, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Maryam Lustberg
- Center for Breast Cancer, Yale Cancer Center, Yale University, New Haven, CT 06519, USA
| | - Robert Wesolowski
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - William E Carson
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Division of Surgical Oncology, Department of Surgery, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Nicole O Williams
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Raquel E Reinbolt
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Sagar D Sardesai
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Anne M Noonan
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Daniel G Stover
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Mathew A Cherian
- The Ohio State University Comprehensive Cancer Center, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - William B Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA
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11
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Bruse N, Jansen A, Gerretsen J, Rijbroek D, Wienholts K, Arron M, van Goor H, Ederveen THA, Pickkers P, Kox M. The gut microbiota composition has no predictive value for the endotoxin-induced immune response or development of endotoxin tolerance in humans invivo. Microbes Infect 2023; 25:105174. [PMID: 37348752 DOI: 10.1016/j.micinf.2023.105174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/23/2023] [Accepted: 06/16/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND It is largely unknown whether the gut microbiome regulates immune responses in humans. We determined relationships between the microbiota composition and immunological phenotypes in 108 healthy volunteers, using 16S sequencing, an ex vivo monocyte challenge model, and an in vivo challenge model of systemic inflammation induced by lipopolysaccharide (LPS). RESULTS Significant associations were observed between the microbiota composition and ex vivo monocytic cytokine responses induced by several stimuli, most notably IL-10 production induced by Pam3Cys, Pseudomonas aeruginosa and Candida albicans, although the explained variance was rather low (0.3-4.8%). Furthermore, a number of pairwise correlations between Blautia, Bacteroides and Prevotella genera and cytokine production induced by these stimuli were identified. LPS administration induced a profound transient in vivo inflammatory response. A second LPS challenge one week after the first resulted in a severely blunted response, reflecting endotoxin tolerance. However, no significant relationships between microbiota composition and in vivo parameters of inflammation or tolerance were found (explained variance ranging from 0.4 to 1.5%, ns). CONCLUSIONS The gut microbiota composition explains a limited degree of variance in ex vivo monocytic cytokine responses to several pathogenic stimuli, but no relationships with the LPS-induced in vivo immune response or tolerance was observed.
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Affiliation(s)
- Niklas Bruse
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Aron Jansen
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Jelle Gerretsen
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Danielle Rijbroek
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Kiedo Wienholts
- Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Amsterdam UMC Location University of Amsterdam, Surgery, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Cancer Center Amsterdam, Imaging and Therapy, De Boelelaan 1118, 1081 HV Amsterdam, the Netherlands
| | - Melissa Arron
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Harry van Goor
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Thomas H A Ederveen
- Center for Molecular and Biomolecular Informatics (CMBI), Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Peter Pickkers
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Matthijs Kox
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands; Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands.
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12
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Madison AA, Renna M, Andridge R, Peng J, Shrout MR, Sheridan J, Lustberg M, Ramaswamy B, Wesolowski R, Williams NO, Noonan AM, Reinbolt RE, Stover DG, Cherian MA, Malarkey WB, Kiecolt-Glaser JK. Conflicts hurt: social stress predicts elevated pain and sadness after mild inflammatory increases. Pain 2023; 164:1985-1994. [PMID: 36943254 PMCID: PMC10440304 DOI: 10.1097/j.pain.0000000000002894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/07/2023] [Indexed: 03/23/2023]
Abstract
ABSTRACT Individuals respond differently to inflammation. Pain, sadness, and fatigue are common correlates of inflammation among breast cancer survivors. Stress may predict response intensity. This study tested whether breast cancer survivors with greater exposure to acute or chronic social or nonsocial stress had larger increases in pain, sadness, and fatigue during an acute inflammatory response. In total, 156 postmenopausal breast cancer survivors (ages 36-78 years, stage I-IIIA, 1-9 years posttreatment) were randomized to either a typhoid vaccine/saline placebo or the placebo/vaccine sequence, which they received at 2 separate visits at least 1 month apart. Survivors had their blood drawn every 90 minutes for the next 8 hours postinjection to assess levels of interleukin-6 and interleukin-1 receptor antagonist (IL-1Ra). Shortly after each blood draw, they rated their current levels of pain, sadness, and fatigue. Women also completed the Test of Negative Social Exchange to assess chronic social stress and the Trier Inventory of Chronic Stressors screen to index chronic general stress. At each visit, a trained experimenter administered the Daily Inventory of Stressful Events to assess social and nonsocial stress exposure within the past 24 hours. After statistical adjustment for relevant demographic and behavioral covariates, the most consistent results were that survivors who reported more chronic social stress reported more pain and sadness in response to IL-1Ra increases. Frequent and ongoing social stress may sensitize the nervous system to the effects of inflammation, with potential implications for chronic pain and depression risk among breast cancer survivors.
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Affiliation(s)
- Annelise A Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, United States
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Megan Renna
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Rebecca Andridge
- Division of Biostatistics, The Ohio State University, Columbus, OH, United States
| | - Juan Peng
- Division of Biostatistics, The Ohio State University, Columbus, OH, United States
| | - M Rosie Shrout
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - John Sheridan
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, United States
- Division of Biosciences, The Ohio State University College of Dentistry, Columbus, OH, United States
| | | | - Bhuvaneswari Ramaswamy
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Robert Wesolowski
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Nicole O Williams
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Anne M Noonan
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Raquel E Reinbolt
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Daniel G Stover
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Mathew A Cherian
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - William B Malarkey
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, United States
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, United States
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13
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Abdulla H, Maalouf M, Jelinek HF. Machine Learning for the Prediction of Depression Progression from Inflammation Markers. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38082683 DOI: 10.1109/embc40787.2023.10340436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Major depressive disorder is one of the major contributors to disability worldwide with an estimated prevalence of 4%. Depression is a heterogeneous disease often characterized by an undefined pathogenesis and multifactorial phenotype that complicate diagnosis and follow-up. Translational research and identification of objective biomarkers including inflammation can assist clinicians in diagnosing depression and disease progression. Investigating inflammation markers using machine learning methods combines recent understanding of the pathogenesis of depression associated with inflammatory changes as part of chronic disease progression that aims to highlight complex interactions. In this paper, 721 patients attending a diabetes health screening clinic (DiabHealth) were classified into no depression (none) to minimal depression (none-minimal), mild depression, and moderate to severe depression (moderate-severe) based on the Patient Health Questionnaire (PHQ-9). Logistic Regression, K-nearest Neighbors, Support Vector Machine, Random Forest, Multi-layer Perceptron, and Extreme Gradient Boosting were applied and compared to predict depression level from inflammatory marker data that included C-reactive protein (CRP), Interleukin (IL)-6, IL-1β, IL-10, Complement Component 5a (C5a), D-Dimer, Monocyte Chemoattractant Protein (MCP)-1, and Insulin-like Growth Factor (IGF)-1. MCP-1 and IL-1β were the most significant inflammatory markers for the classification performance of depression level. Extreme Gradient Boosting outperformed the models achieving the highest accuracy and Area Under the Receiver Operator Curve (AUC) of 0.89 and 0.95, respectively.Clinical Relevance- The findings of this study show the potential of machine learning models to aid in clinical practice, leading to a more objective assessment of depression level based on the involvement of MCP-1 and IL-1β inflammatory markers with disease progression.
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14
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Yin J, Gong R, Zhang M, Ding L, Shen T, Cai Y, He S, Peng D. Associations between sleep disturbance, inflammatory markers and depressive symptoms: Mediation analyses in a large NHANES community sample. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110786. [PMID: 37178815 DOI: 10.1016/j.pnpbp.2023.110786] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/16/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
Both depression and sleep disturbance have been linked to inflammation. However, the role that inflammation plays in the relationship between sleep disturbance and depression remains unclear. We examined pairwise associations between inflammatory markers (neutrophil-to-lymphocyte ratio [NLR] and C-reactive protein level [CRP]), sleep disturbance, and depressive symptoms in a robust, ethnically diverse sample (n = 32,749) from the National Health and Nutrition Examination Survey (NHANES). We found higher levels of inflammatory markers in participants with depression and/or sleep disturbance compared to those without depression or sleep disturbance. Sleep disturbance was positively associated with inflammatory markers and depressive symptoms even after considering a wide range of potential confounders (e.g., age, sex, body mass index). Inflammatory marker levels were nonlinearly associated with depressive symptoms and were positively associated with depressive symptoms after reaching the inflection point (NLR, 1.67; CRP, 0.22 mg/dL). Inflammatory markers mediated a marginal portion (NLR, 0.0362%, p = 0.026; CRP, 0.0678%; p = 0.018) of the potential effects of sleep disturbance on depressive symptoms. Our research showed that inflammatory markers, sleep disturbance, and depression are pairwise correlated. Increased inflammatory markers levels slightly mediate the association between sleep disturbance and depression.
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Affiliation(s)
- Jiahui Yin
- College of traditional Chinese medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Rongpeng Gong
- Medical College of Qinghai University, Xining, China
| | - Min Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Ding
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Shen
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiyun Cai
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shen He
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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15
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Ma S, Wang W, Gong Q, Xiang D, Yao L, Xu S, Xie X, Wang H, Wang G, Yang J, Liu Z. Inflammatory bowel disease and the long-term risk of depression: A prospective cohort study of the UK biobank. Gen Hosp Psychiatry 2023; 82:26-32. [PMID: 36924701 DOI: 10.1016/j.genhosppsych.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Depression is more common in patients with chronic inflammatory diseases, but whether inflammatory bowel disease (IBD), a chronic, relapsing immune-mediated disease, is associated with a higher risk of depression remains uncertain. METHOD We studied 497,134 participants in the UK Biobank, including 3561 IBD patients. Multivariate Cox proportional risk models were constructed to investigate the risk associated with IBD and depression adjusting for potential confounding factors including sociodemographic, lifestyle, and family history variables. RESULTS The average age of participants was 56.54 ± 8.09 years; 54.3% were female and 90.4% were white. Over a mean follow-up period of 13.3 years, the cumulative incidence of depression was 8.2% (95% CI: 7.3%-9.1%) in IBD patients compared with 4.9% (95% CI: 4.9%-5.0%) in individuals without IBD. Compared with non-IBD participants, the adjusted hazard ratio (HR) for depression among IBD patients was 1.56 (95% CI: 1.39-1.76), with an adjusted HR of 1.54 (95% CI: 1.25-1.90) in Crohn's disease and 1.52 (95% CI: 1.30-1.78) in ulcerative colitis, respectively. CONCLUSION IBD patients had a significantly higher risk of depression than non-IBD participants after adjusting for multiple confounding factors. We recommend screening for depression in middle-aged adults with IBD and no established history of depression.
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Affiliation(s)
- Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dan Xiang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lihua Yao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuxian Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xinhui Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jun Yang
- School of Information Engineering, Wuhan University of Technology, Wuhan, China.
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China; Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China.
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16
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Senders ML, Calcagno C, Tawakol A, Nahrendorf M, Mulder WJM, Fayad ZA. PET/MR imaging of inflammation in atherosclerosis. Nat Biomed Eng 2023; 7:202-220. [PMID: 36522465 DOI: 10.1038/s41551-022-00970-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/25/2022] [Indexed: 12/23/2022]
Abstract
Myocardial infarction, stroke, mental disorders, neurodegenerative processes, autoimmune diseases, cancer and the human immunodeficiency virus impact the haematopoietic system, which through immunity and inflammation may aggravate pre-existing atherosclerosis. The interplay between the haematopoietic system and its modulation of atherosclerosis has been studied by imaging the cardiovascular system and the activation of haematopoietic organs via scanners integrating positron emission tomography and resonance imaging (PET/MRI). In this Perspective, we review the applicability of integrated whole-body PET/MRI for the study of immune-mediated phenomena associated with haematopoietic activity and cardiovascular disease, and discuss the translational opportunities and challenges of the technology.
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Affiliation(s)
- Max L Senders
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Claudia Calcagno
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ahmed Tawakol
- Cardiology Division and Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthias Nahrendorf
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Willem J M Mulder
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
- Department of Internal Medicine, Radboud Institute of Molecular Life Sciences (RIMLS) and Radboud Center for Infectious Diseases (RCI), Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
- Laboratory of Chemical Biology, Department of Biochemical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - Zahi A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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17
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Exploring Associations between C-Reactive Protein and Self-Reported Interoception in Major Depressive Disorder: A Bayesian Analysis. Brain Sci 2023; 13:brainsci13020353. [PMID: 36831896 PMCID: PMC9954036 DOI: 10.3390/brainsci13020353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Major depressive disorder (MDD) is associated with dysfunctional self-reported interoception (i.e., abnormal perception of the body's physiological state) and systemic inflammation, both of which adversely affect treatment response. In this study, we explored associations between C-reactive protein (CRP) and self-reported interoception, to gain more insight into the pathophysiology of interoceptive impairments in MDD. We also aimed to replicate previous findings on the associations of depression and fatigue severity with CRP. The study included 97 depressed individuals, who completed self-administered questionnaires (Multidimensional Assessment of Interoceptive Awareness (MAIA-2); Beck Depression Inventory-II, Multidimensional Fatigue Inventory). CRP concentrations were analyzed in the serum using a particle-enhanced turbidimetric immunoassay. We applied Bayesian inference to estimate robust effect parameters from posterior distributions based on MCMC sampling, and computed Bayes factors (BF10) as indices of relative evidence. The bivariate analysis supported evidence against associations between CRP and self-reported interoception (BF10 ≤ 0.32), except for one dimension (Not-Distracting: r = 0.11, BF10 > 0.43, absence of evidence). Positive correlations with overall depression (r = 0.21, BF10 = 3.19), physical fatigue (r = 0.28, BF10 = 20.64), and reduced activity (r = 0.22, BF10 = 4.67) were found. The multivariate analysis showed moderate evidence that low-grade inflammation predicted higher scores on the MAIA-2 Not-Worrying scale (β = 0.28, BF10 = 3.97), after controlling for relevant confounders. Inflammatory responses, as measured by CRP, may not be involved in the pathophysiology of dysfunctional self-reported interoception. However, systemic low-grade inflammation could potentially exert a protective effect against worries about pain or discomfort sensations. An immunological involvement in interoceptive impairments cannot be ruled out until future studies considering additional biomarkers of inflammation replicate our findings.
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18
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The effect of chronic stress on behaviors, inflammation and lymphocyte subtypes in male and female rats. Behav Brain Res 2023; 439:114220. [PMID: 36414104 DOI: 10.1016/j.bbr.2022.114220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/05/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022]
Abstract
Excessively released proinflammatory mediators from activated macrophages and lymphocytes may contribute to the etiology of depression. However, the relationship between lymphocytes and depression is not fully understood. Although women have higher depression risk than men, sex/gender differences in psychoneuroimmunological mechanisms are still unclear. To explore these two questions, chronic unpredictable mild stress (CUMS) was used to evaluate the changes in behaviors, inflammation and lymphocyte subtypes in adult male and female Wistar rats. Results show that CUMS increased anhedonia and anxiety-like behaviors, along with increased serum corticosterone, hippocampal pro-inflammatory factors, CD11b, IFN-γ, IL-6 and IL-17, but decreased CD4, CD25, CD4/CD8 ratio, GFAP, 5-hydroxytryptamine (5-HT) and NE concentrations, regardless of sex. There was no positive correlation between sucrose preference and blood CD4/CD8 ratio, but a positive correlation between sucrose preference and spleen CD25, sucrose preference and neurotransmitters (NE and 5-HT), spleen CD25 and serum TGF-β1/IL-6 ratio were found, regardless of sex. Females presented higher basal locomotion, blood CD4, CD4/CD8 ratio, serum corticosteroid and IL-6 concentrations, but lower hippocampal norepinephrine (NE) than males. Although CUMS didn't induce significant sex differences, females presented more changes in CD4 and CD8 lymphocytes than male rats. CUMS caused abnormalities in corticosteroid, lymphocytes, cytokines and neurotransmitters, which might be the precursors for inducing depression-like behaviors in both sexes.
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Chen F, Liu L, Wang Y, Hu K, Ma B, Chi J. Prevalence of Depression and Anxiety in Patients With Chronic Rhinosinusitis: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 168:143-153. [PMID: 35230890 DOI: 10.1177/01945998221082538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We performed a meta-analysis and estimated the prevalence of depression and anxiety and their related factors among patients with chronic rhinosinusitis (CRS). DATA SOURCES PubMed, Embase, Web of Science, Cochrane Library, CINAHL, PsycINFO, and CBM databases. REVIEW METHODS A systematic search was performed for relevant studies published before August 17, 2021. A random effects model was used to estimate the prevalence of depression and anxiety. Subgroup analysis was performed by continent or region, study setting, sex, sample size, diagnosis, and assessment method. RESULTS Twenty-two articles covering 40,956 patients were included in the meta-analysis. The pooled crude prevalence estimates of depression and anxiety were 25.2% (95% CI, 20.9%-29.6%) and 28.9% (95% CI, 16.1%-41.6%), respectively. Subgroup analyses revealed the following: (1) continent or region, study setting, sex, sample size, depression assessment method, and CRS diagnosis were significantly correlated with the prevalence of depression, and (2) continent or region, study setting, sample size, anxiety assessment method, and CRS diagnosis were significantly correlated with the prevalence of anxiety. Meta-regression analysis revealed that study setting and sample size were negatively associated with the pooled prevalence of depression. In contrast, CRS diagnosis and anxiety assessment method were positively associated with the pooled prevalence of anxiety. CONCLUSION Depression and anxiety are common in patients with CRS, especially among clinics. Therefore, in patients with CRS, screening and early diagnosis of depression and anxiety are necessary for prevention and treatment.
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Affiliation(s)
- Fei Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Libo Liu
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yetong Wang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Ke Hu
- Department of Hepatobiliary and Pancreatic Surgery, The First People's Hospital of Kunming, Kunming, China
| | - Bin Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Junting Chi
- Department of Nursing, The First People's Hospital of Yunnan Province, Kunming, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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Hughes FM, Odom MR, Cervantes A, Livingston AJ, Purves JT. Why Are Some People with Lower Urinary Tract Symptoms (LUTS) Depressed? New Evidence That Peripheral Inflammation in the Bladder Causes Central Inflammation and Mood Disorders. Int J Mol Sci 2023; 24:2821. [PMID: 36769140 PMCID: PMC9917564 DOI: 10.3390/ijms24032821] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Anecdotal evidence has long suggested that patients with lower urinary tract symptoms (LUTS) develop mood disorders, such as depression and anxiety, at a higher rate than the general population and recent prospective studies have confirmed this link. Breakthroughs in our understanding of the diseases underlying LUTS have shown that many have a substantial inflammatory component and great strides have been made recently in our understanding of how this inflammation is triggered. Meanwhile, studies on mood disorders have found that many are associated with central neuroinflammation, most notably in the hippocampus. Excitingly, work on other diseases characterized by peripheral inflammation has shown that they can trigger central neuroinflammation and mood disorders. In this review, we discuss the current evidence tying LUTS to mood disorders, its possible bidirectionally, and inflammation as a common mechanism. We also review modern theories of inflammation and depression. Finally, we discuss exciting new animal studies that directly tie two bladder conditions characterized by extensive bladder inflammation (cyclophosphamide-induced hemorrhagic cystitis and bladder outlet obstruction) to neuroinflammation and depression. We conclude with a discussion of possible mechanisms by which peripheral inflammation is translated into central neuroinflammation with the resulting psychiatric concerns.
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Affiliation(s)
- Francis M. Hughes
- Department Urology, Duke University Medical Center, P.O. Box 3831, Durham, NC 27710, USA
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21
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Koohi M, Moloud R, Leyla A, Reza KH. Effect of nursing home care on the quality of life of patients with major depressive in Iranian patients: A randomized controlled trial. Arch Psychiatr Nurs 2023; 42:25-32. [PMID: 36842824 DOI: 10.1016/j.apnu.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/13/2022] [Accepted: 10/01/2022] [Indexed: 11/02/2022]
Abstract
AIMS AND BACKGROUND continuous and effective care is needed to improve the quality of life of patients with depression. The present study aimed to determine the effect of nursing home care on the quality of life of patients with Major Depressive Disorder. DESIGN This is a clinical trial study in which a total of 50 patients with Major Depressive Disorder were recruited using convenience sampling and then randomly assigned to two groups of control and intervention. METHODS Data were collected using a demographic questionnaire and the McGill Quality of Life Questionnaire at three time-points of before, three months, and six months after the intervention. Patients in the intervention group received nursing home care in accordance with nursing process (5-6 training sessions of 1.5 to 2 h, one session every two weeks over three months). They also received telephone follow-up. Data were analyzed with SPSS software version 16.0 using independent-samples t-test, chi square and repeated measures Analysis of Variance. RESULTS The results of the present study indicated there was a significant difference in the mean score of the overall quality of life and its domains between the intervention and the control group at three and six months after the intervention. CONCLUSION Based on the results of the present study, it was concluded that the nursing home care program can improve the quality of life and its domains in patients with Major Depressive Disorder. RELEVANCE TO CLINICAL PRACTICE According to this study, by follow up of patients with major depression disorder after discharge and performing care and counseling interventions at home besides routine treatment plan, it is possible to prevent re-hospitalization and decrease hospitalization costs.
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Affiliation(s)
- Mahsa Koohi
- Nursing and Midwifery Faculty,Urmia University of Medical Sciences, UMSU Central Site, Orjhans Street, Resalat BLvd., Urmia 571478334, Iran
| | - Radfar Moloud
- Nursing and Midwifery Faculty,Urmia University of Medical Sciences, UMSU Central Site, Orjhans Street, Resalat BLvd., Urmia 571478334, Iran.
| | - Alilu Leyla
- Nursing and Midwifery Faculty,Urmia University of Medical Sciences, UMSU Central Site, Orjhans Street, Resalat BLvd., Urmia 571478334, Iran
| | - Khalkhali Hamid Reza
- Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, UMSU Central Site, Orjhans Street, Resalat BLvd., Urmia 571478334, Iran
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22
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Shaikh NF, Shen C, LeMasters T, Dwibedi N, Ladani A, Sambamoorthi U. Prescription Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Incidence of Depression Among Older Cancer Survivors With Osteoarthritis: A Machine Learning Analysis. Cancer Inform 2023; 22:11769351231165161. [PMID: 37101728 PMCID: PMC10123903 DOI: 10.1177/11769351231165161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 03/05/2023] [Indexed: 04/28/2023] Open
Abstract
ObjectiveS This study examined prescription NSAIDs as one of the leading predictors of incident depression and assessed the direction of the association among older cancer survivors with osteoarthritis. Methods This study used a retrospective cohort (N = 14, 992) of older adults with incident cancer (breast, prostate, colorectal cancers, or non-Hodgkin's lymphoma) and osteoarthritis. We used the longitudinal data from the linked Surveillance, Epidemiology, and End Results -Medicare data for the study period from 2006 through 2016, with a 12-month baseline and 12-month follow-up period. Cumulative NSAIDs days was assessed during the baseline period and incident depression was assessed during the follow-up period. An eXtreme Gradient Boosting (XGBoost) model was built with 10-fold repeated stratified cross-validation and hyperparameter tuning using the training dataset. The final model selected from the training data demonstrated high performance (Accuracy: 0.82, Recall: 0.75, Precision: 0.75) when applied to the test data. SHapley Additive exPlanations (SHAP) was used to interpret the output from the XGBoost model. Results Over 50% of the study cohort had at least one prescption of NSAIDs. Nearly 13% of the cohort were diagnosed with incident depression, with the rates ranging between 7.4% for prostate cancer and 17.0% for colorectal cancer. The highest incident depression rate of 25% was observed at 90 and 120 cumulative NSAIDs days thresholds. Cumulative NSAIDs days was the sixth leading predictor of incident depression among older adults with OA and cancer. Age, education, care fragmentation, polypharmacy, and zip code level poverty were the top 5 predictors of incident depression. Conclusion Overall, 1 in 8 older adults with cancer and OA were diagnosed with incident depression. Cumulative NSAIDs days was the sixth leading predictor with an overall positive association with incident depression. However, the association was complex and varied by the cumulative NSAIDs days.
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Affiliation(s)
- Nazneen Fatima Shaikh
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Chan Shen
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
- Chan Shen, Department of Surgery, College of Medicine, The Pennsylvania State University, 700 HMC Crescent Road, Hershey, PA 17033-2360, USA.
| | - Traci LeMasters
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USA
| | | | - Amit Ladani
- Department of Medicine, Section of Rheumatology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Usha Sambamoorthi
- Pharmacotherapy Department College of Pharmacy, “Vashisht” Professor of Health Disparities, HEARD Scholar, Institute for Health Disparities, University of North Texas Health Sciences Center, Fort Worth, TX, USA
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23
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Mehrabani S, Khorvash F, Heidari Z, Tajabadi-Ebrahimi M, Amani R. The effects of synbiotic supplementation on oxidative stress markers, mental status, and quality of life in patients with Parkinson’s disease: A double-blind, placebo-controlled, randomized controlled trial. J Funct Foods 2023. [DOI: 10.1016/j.jff.2022.105397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Mehta ND, Stevens JS, Li Z, Fani N, Gillespie CF, Ravi M, Michopoulos V, Felger JC. Inflammation, amygdala-ventromedial prefrontal functional connectivity and symptoms of anxiety and PTSD in African American women recruited from an inner-city hospital: Preliminary results. Brain Behav Immun 2022; 105:122-130. [PMID: 35772683 PMCID: PMC11041384 DOI: 10.1016/j.bbi.2022.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 01/28/2023] Open
Abstract
Inflammatory stimuli have been shown to impact brain regions involved in threat detection and emotional processing including amygdala and ventromedial prefrontal cortex (vmPFC), and to increase anxiety. Biomarkers of endogenous inflammation, including inflammatory cytokines and C-reactive protein (CRP), are reliably elevated in a subset of patients with depression and anxiety-related disorders such as post-traumatic stress disorder (PTSD), and have been associated with high anxiety in population studies. We previously reported that plasma CRP and cytokines in patients with depression were negatively correlated with resting-state functional connectivity (FC) between right amygdala and vmPFC, as assessed using both ROI to voxel-wise and targeted FC approaches, in association with symptoms of anxiety, particularly in patients with comorbid anxiety disorders or PTSD. To determine whether relationships between inflammation, right amygdala-vmPFC FC, and anxiety are reproducible across patient samples and research settings, we employed an a priori, hypothesis-driven approach to examine relationships between inflammation, targeted right amygdala-vmPFC FC and anxiety in a cohort of African American (AA) women (n = 54) recruited from an inner-city hospital population reliably found to have higher levels of inflammation (median CRP ∼ 4 mg/L) as well as symptoms of anxiety, depression and PTSD. Higher concentrations of plasma CRP were associated with lower right amygdala-vmPFC FC (r = -0.32, p = 0.017), and this relationship remained significant when controlling for age, body mass index and number of lifetime trauma events experienced, as well as severity of PTSD and depression symptoms (all p < 0.05). This amygdala-vmPFC FC was similarly associated with a composite score of three inflammatory cytokines in a subset of women where plasma was available for analysis (n = 33, r = -0.33, p = 0.058; adjusted r = -0.43, p = 0.026 when controlling for covariates including PTSD and depression symptom severity). Lower right amygdala-vmPFC FC was in turn associated with higher levels of anxiety reported to be generally experienced on the State-Trait Anxiety Inventory, trait component (adjusted r = -0.32, p = 0.039 when controlling for covariates). Exploratory analyses also revealed a negative correlation between severity of childhood maltreatment and right amygdala-vmPFC FC (r = -0.32, p = 0.018) that was independent of CRP and its association with FC, as well as an association between low amygdala-vmPFC FC and severity of PTSD symptoms, specifically the re-experiencing/intrusive symptom subscale (adjusted r = -0.32, p = 0.028 when controlling for covariates). While CRP was not linearly associated with either anxiety or PTSD symptoms, CRP concentrations were higher in women reporting clinically significant anxiety or PTSD symptom severity when these symptoms were considered together (both p < 0.05), but with no interaction. These results support our primary hypothesis that higher inflammation was associated with lower amygdala-vmPFC FC, a relationship that was detected using a hypothesis-driven, targeted approach. Findings also support that this phenotype of high CRP and low vmPFC FC was observed in association with anxiety in primary analyses, as well as symptoms of PTSD in exploratory analyses, in a cohort recruited from an inner-city population of AA women enriched for high inflammation, history of trauma exposure, and symptom severity. Larger, longitudinal samples are required to fully tease apart causal relationships between inflammatory biomarkers, FC and PTSD-related symptoms in future studies.
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Affiliation(s)
- Neeti D Mehta
- Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA 30322, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States
| | - Zhihao Li
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States; School of Psychology and Sociology, Shenzhen University, Shenzhen, Guangdong Sheng, 518060, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, Guangdong Sheng, 518060, China
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States
| | - Charles F Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States
| | - Meghna Ravi
- Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA 30322, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States; Yerkes National Primate Research Center, Atlanta, GA 30322, United States.
| | - Jennifer C Felger
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States; Winship Cancer Institute, Emory University, Atlanta, GA 30322, United States.
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Brown CM, Wong Q, Thakur A, Singh K, Singh RS. Origin of Sex-Biased Mental Disorders: Do Males and Females Experience Different Selective Regimes? J Mol Evol 2022; 90:401-417. [PMID: 36097083 DOI: 10.1007/s00239-022-10072-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/26/2022] [Indexed: 12/24/2022]
Abstract
The origins of sex-biased differences in disease and health are of growing interest to both medical researchers and health professionals. Several major factors have been identified that affect sex differences in incidence of diseases and mental disorders. These are: sex chromosomes, sex hormones and female immunity, sexual selection and antagonistic evolution, and differential susceptibility of sexes to environmental factors. These factors work on different time scales and are not exclusive of each other. Recently, a combined Sexual Selection-Sex Hormones (SS-SH) Theory was presented as an evolutionary mechanism to explain sex-biased differences in diseases and mental disorders (Singh in J Mol Evol 89:195-213, 2021). In that paper disease prevalence trends were investigated, and non-sex-specific diseases were hypothesized to be more common in males than in females in general. They showed signs of exceptions to this trend with inflammatory diseases and stress-related mental disorders that were more common in females. We believe that the SS-SH theory requires the consideration of psycho-social stress (PSS) to explain the predominance of female-biased mental disorders and some other exceptions in their findings. Here we present a theory of sex-differential experience of PSS and provide quantitative support for the combined SS-SH-PSS Theory using age-standardized incidence rates (ASIRs) recording the levels of male- and female-bias in data obtained from different countries. The grand theory provides an evolutionary framework for explaining patterns of sex-biased trends in the prevalence of disease and health. Further exploration of women's vulnerability to social factors may help to facilitate new treatments for female-biased diseases.
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Affiliation(s)
| | - Queenie Wong
- Department of Biology, McMaster University, Hamilton, Canada
| | - Aditi Thakur
- Department of Biology, McMaster University, Hamilton, Canada
| | - Karun Singh
- Krembil Research Institute, University Health Network and Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Rama S Singh
- Department of Biology, McMaster University, Hamilton, Canada.
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Atasoy S, Hausteiner-Wiehle C, Sattel H, Johar H, Roenneberg C, Peters A, Ladwig KH, Henningsen P. Gender specific somatic symptom burden and mortality risk in the general population. Sci Rep 2022; 12:15049. [PMID: 36065007 PMCID: PMC9445038 DOI: 10.1038/s41598-022-18814-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/19/2022] [Indexed: 11/21/2022] Open
Abstract
Gender specific all-cause mortality risk associated with a high somatic symptom burden (SSB) in a population-based cohort was investigated. The study population included 5679 women and 5861 men aged 25-74 years from the population-based MONICA/KORA Cohort. SSB was assessed following the Somatic Symptom Scale-8 and categorized as very high (≥ 95th percentile), high (60-95th percentile), moderate (30-60th percentile), and low (≤ 30th percentile). The impact of SSB on all-cause mortality risk within a mean follow-up period of 22.6 years (SD 7.1; 267,278 person years) was estimated by gender-specific Cox regression models adjusted for sociodemographic, lifestyle, somatic and psychosocial risk factors, as well as pre-existing medical conditions. Approximately 5.7% of men and 7.3% of women had very high SSB. During follow-up, 3638 (30.6%) mortality cases were observed. Men with a very-high SSB had 48% increased relative risk of mortality in comparison to men with a low SSB after adjustment for concurrent risk factors (1.48, 95% CI 1.20-1.81, p < .0001), corresponding to 2% increased risk of mortality for each 1-point increment in SSB (1.02; 95% CI 1.01-1.03; p = 0.03). In contrast, women with a very high SSB had a 22% lower risk of mortality (0.78, 95% CI 0.61-1.00, p = 0.05) and women with high SSB had an 18% lower risk of mortality (0.82; 95% CI 0.68-0.98, p = 0.03) following adjustment for concurrent risk factors. The current findings indicate that an increasing SSB is an independent risk factor for mortality in men but not in women, pointing in the direction of critical gender differences in the management of SSB, including women's earlier health care utilization than men.
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Affiliation(s)
- Seryan Atasoy
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts Der Isar, University Hospital Rechts Der Isar, Technische Universität München, Langerstr. 3, 81676, Munich, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, University of Giessen and Marburg, Marburg, Germany.
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
| | - Constanze Hausteiner-Wiehle
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts Der Isar, University Hospital Rechts Der Isar, Technische Universität München, Langerstr. 3, 81676, Munich, Germany
- Department of Neurology, BG Trauma Center, Murnau, Germany
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts Der Isar, University Hospital Rechts Der Isar, Technische Universität München, Langerstr. 3, 81676, Munich, Germany
| | - Hamimatunnisa Johar
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Casper Roenneberg
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts Der Isar, University Hospital Rechts Der Isar, Technische Universität München, Langerstr. 3, 81676, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Karl-Heinz Ladwig
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts Der Isar, University Hospital Rechts Der Isar, Technische Universität München, Langerstr. 3, 81676, Munich, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts Der Isar, University Hospital Rechts Der Isar, Technische Universität München, Langerstr. 3, 81676, Munich, Germany
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Sivasankari R, Usha B. Reshaping the Gut Microbiota Through Lifestyle Interventions in Women with PCOS: A Review. Indian J Microbiol 2022; 62:351-363. [PMID: 35974920 PMCID: PMC9375820 DOI: 10.1007/s12088-022-01019-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/30/2022] [Indexed: 11/05/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder evolving as a global threat to women's health. However, its multifactorial etiology causes difficulty in eliminating it. The interrelation between the gut microbiota and metabolic disorders has been trending recently, giving rise to new opportunities on the etiology and pathogenesis of PCOS. Lifestyle interventions such as healthy diet, physical exercises, and behavioral interventions such as regulation of stress and sleep cycles have been identified to improve the symptoms of PCOS across the endocrinological, metabolic and psychological scales and are recommended as the first line of treatment for PCOS. The impact of the unhealthy lifestyle factors on intestinal dysbiosis that cause PCOS is summarized in this review. This review also provides an insight on the therapeutic approaches that primarily target the gut microbiota and offers novel gut microflora-associated treatment strategies for PCOS. Further, this survey also highlights the need for the implementation of lifestyle management strategies and strongly recommends a healthy and stress-free lifestyle to promote gut health and manage PCOS.
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Affiliation(s)
- Ramadurai Sivasankari
- Department of Genetic Engineering, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Tamil Nadu 603 203 India
| | - Balasundaram Usha
- Department of Genetic Engineering, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Tamil Nadu 603 203 India
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O'Shields J, Patel D, Mowbray OP. Childhood maltreatment and inflammation: Leveraging structural equation modeling to test the social signal transduction theory of depression. J Affect Disord 2022; 311:173-180. [PMID: 35594973 DOI: 10.1016/j.jad.2022.05.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 05/03/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The experience of childhood maltreatment has long been understood to increase the risk for experiencing depressive symptoms and is often associated with an overall worse course of illness when these symptoms are elevated to a major depressive episode. Despite this, current treatments for depression continue to require a need for a greater understanding of the underlying mechanisms. METHOD We utilized structural equation modeling to test the effects of childhood maltreatment on inflammation and depressive symptoms. Inflammation was conceptualized as a latent variable, estimated by CRP, fibrinogen, IL-6, sICAM-1, sE-selectin, and TNF- α; whereas depressive symptoms were estimated using the subscales for the Center for Epidemiological Studies-Depression scale and childhood maltreatment was estimated using the subscales for the Childhood Trauma Questionnaire. RESULTS Multivariate results identified that childhood maltreatment had a significant positive relationship with inflammation as well as depressive symptoms, and inflammation had a significant positive relationship with depressive symptoms. Notably, childhood maltreatment also had a significant positive relationship with perceived stress over the last month and this perceived stress had a positive relationship with depressive symptoms; however perceived stress had no relationship with inflammation. LIMITATIONS Data from the present study is cross-sectional, requiring replication with longitudinal data. Some measures such as childhood maltreatment were measured by self-report and should be replicated with verified reports. CONCLUSIONS These results provide support for the Social Signal Transduction Theory of Depression, emphasizing the importance of the immune system and inflammation as a relevant mediator between early social treats and adulthood depressive symptoms.
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Affiliation(s)
- Jay O'Shields
- University of Georgia, School of Social Work, United States of America.
| | - Dipali Patel
- University of Georgia, School of Social Work, United States of America
| | - Orion P Mowbray
- University of Georgia, School of Social Work, United States of America
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Yu X, Baillargeon J, Berenson AB, Westra JR, Giordano TP, Kuo YF. Incident depression among Medicare beneficiaries with disabilities and HIV. AIDS 2022; 36:1295-1304. [PMID: 35608114 PMCID: PMC9283374 DOI: 10.1097/qad.0000000000003268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Despite disproportionally high prevalence of HIV and depression in persons with disabilities, no data have been published on the incidence and correlates of depression in Medicare beneficiaries with disabilities. We assessed the effect of HIV infection on developing depression in this population. DESIGN We conducted a retrospective matched cohort study using a 5% sample of Medicare beneficiaries who qualified for disability coverage (1996-2015). METHODS Beneficiaries with incident ( n = 2438) and prevalent ( n = 5758) HIV were individually matched with beneficiaries without HIV (HIV-, n = 20 778). Fine-Gray models with death as a competing risk were used to assess the effect of HIV status, age, and cohort period on developing depression by sex strata. RESULTS Beneficiaries with HIV had a higher risk of developing depression within 5 years ( P < 0.0001). Sex differences were observed ( P < 0.0001), with higher subdistribution hazard ratios (sHR) in males with HIV compared with controls. The risk decreased with age ( P < 0.0001) and increased in recent years ( P < 0.0001). There were significant age-HIV ( P = 0.004) and period-HIV ( P = 0.006) interactions among male individuals, but not female individuals. The sHR was also higher within the first year of follow-up among male individuals, especially those with incident HIV. CONCLUSION Medicare enrollees with disabilities and HIV had an increased risk of developing depression compared to those without HIV, especially among males and within the first year of HIV diagnosis. The HIV-depression association varied by sex, age, and cohort period. Our findings may help guide screening and comprehensive management of depression among subgroups in this vulnerable population.
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Affiliation(s)
- Xiaoying Yu
- Department of Preventive Medicine and Population Health
- Center for Interdisciplinary Research in Women's Health
| | | | - Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health
- Department of Obstetrics & Gynecology, University of Texas Medical Branch at Galveston
| | | | - Thomas P Giordano
- Department of Medicine, Baylor College of Medicine
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Population Health
- Center for Interdisciplinary Research in Women's Health
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Preuss HG, Kaats GR, Mrvichin N, Bagchi D, Scheckenbach R, Preuss JM. Assessing Genders Separately in Nondiabetic Persons Regarding Links Between Insulin Resistance and Fat Mass With Elements Related to the Metabolic Syndrome. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022; 41:435-443. [PMID: 35584266 DOI: 10.1080/07315724.2021.1911718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Initial results gathered from previously published observations dealing with nondiabetic volunteers reveal that both the fasting blood glucose (FBG) level employed as a surrogate for insulin resistance (IR) and the amount of body fat mass (FM) correlate significantly with the strength and pathological direction of many harmful elements making up the metabolic syndrome (MS). These initial results were obtained using combined data from both females and males. How the two markers correlate with specific metabolic parameters in each gender separately was not established. METHOD Baseline data from more than 700 volunteers were examined mainly using correlations to compare whether the breadth of IR estimated by FBG levels and/or the accumulation of body FM on the early development and progression of many chronic metabolic derangements differ to any meaningful extent between nondiabetic females and males. RESULTS The following significant positive correlations were found in the data on females employing either FBG or FM as independent variables regarding development of elements associated with MS: in body composition (scale weight, fat free mass [FFM]); in blood chemistries (triglycerides, high-sensitivity C-reactive protein [hsCRP], alanine aminotransferase [ALT]); and in blood counts (white blood cells [WBC], neutrophils). Also consistent with MS, high-density lipoprotein cholesterol levels declined significantly. In males, findings with FBG as the independent variable differ from females in some respects. These major exceptions are lack of significant correlations with FFM and high-density lipoprotein cholesterol as well as a weaker link with ALT. Despite a positive hsCRP linkage, a poorer response of WBC and neutrophils appeared in males when correlations were made. The latter disassociations disappeared when FM replaced FBG as the independent variable. CONCLUSIONS Progression of many chronic metabolic derangements differ only slightly in females and males.
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Affiliation(s)
- Harry G Preuss
- Department of Biochemistry, Georgetown University Medical Center, Washington, DC, USA
| | | | - Nate Mrvichin
- Integrative Health Technologies, San Antonio, Texas, USA
| | - Debasis Bagchi
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, Texas, USA
| | | | - Jeffrey M Preuss
- Emergency Department, Veterans Administration Medical Center, Salem, Virginia, USA
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Song S, DeMeo NN, Almeida DM, Majd M, Engeland CG, Graham-Engeland JE. The longitudinal connection between depressive symptoms and inflammation: Mediation by sleep quality. PLoS One 2022; 17:e0269033. [PMID: 35617264 PMCID: PMC9135207 DOI: 10.1371/journal.pone.0269033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/12/2022] [Indexed: 11/19/2022] Open
Abstract
Although there is a strong association between depressive symptoms and markers of inflammation, it remains unclear whether depressive symptoms at one point in life may predict inflammation later in life. Moreover, despite extant literature linking sleep with both depressive symptoms and inflammation, there is little research investigating poor sleep as a mechanism linking depressive symptoms with later inflammation. The links between depression and physical health can also vary by gender. In longitudinal analyses with data from the Midlife in the United States (MIDUS) study, we examined whether depressive symptoms were associated with inflammatory markers 11 years later and whether these associations were mediated by sleep disturbances or moderated by gender. Participants reported depressive symptoms and demographic information at baseline. At 11-year follow-up, the same participants (n = 968) reported depressive symptoms, sleep quality and duration using validated scale items, and provided a blood sample from which inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) were quantified. Actigraphy assessment of sleep was obtained in a subsample (n = 276). After adjusting for concurrent depressive symptoms and other relevant covariates, baseline depressive symptoms were associated with CRP 11 years later in the full sample, and with IL-6 among women. Subjective sleep quality mediated the association between depressive symptoms and CRP. Results suggest that depressive symptoms may be longitudinally associated with inflammation; however, directionality issues cannot be determined from the present work, particularly as inflammation markers (which might have been associated with baseline depressive symptoms) were not available at baseline. Findings further suggest that longitudinal associations between depressive symptoms and inflammation may potentially be explained by sleep and may reflect gender specific patterns.
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Affiliation(s)
- Sunmi Song
- Department of Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
| | - Natasha N. DeMeo
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States of America
| | - Marzieh Majd
- Department of Psychological Sciences, Rice University, Houston, TX, United States of America
| | - Christopher G. Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
- The College of Nursing, The Pennsylvania State University, University Park, PA, United States of America
| | - Jennifer E. Graham-Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
- * E-mail:
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Hazeltine DB, Polokowski AR, Reigada LC. Inflammatory Cytokines, but Not Dietary Patterns, Are Related to Somatic Symptoms of Depression in a Sample of Women. Front Psychiatry 2022; 13:822466. [PMID: 35651828 PMCID: PMC9149097 DOI: 10.3389/fpsyt.2022.822466] [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: 11/25/2021] [Accepted: 03/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background Depression is a heterogenous disorder with both cognitive and somatic symptom dimensions that may differentially relate to systemic inflammation. Diet, which has the potential to modulate both inflammation levels and mood, is yet to be studied within the context of individual depression dimensions. This study examined the associations between inflammatory cytokines and dietary patterns with depressive symptom dimension profiles among a sample of women recruited in a non-clinical setting. Methods Inflammatory cytokines (IL-6 and TNF-α), inflammatory diet (Diet Inflammatory Index; DII), and depressive symptoms (Beck Depression Inventory-II; BDI-II) were measured in 136 females (M age = 22.01 ± 4.02, range 18-59 years). Multiple linear regressions were used to investigate the relationships between inflammatory cytokines and diet with self-reported cognitive, somatic, and total depressive symptoms, adjusting for demographic factors. Results Findings showed that increased somatic dimension scores were positively associated with IL-6 (ß = 0.273, p = 0.002) and TNF-α (ß = 0.215, p = 0.017), but not inflammatory diet (p = 0.300). Total BDI-II scores were only positively associated with IL-6 (ß = 0.221, p = 0.012), and cognitive dimension scores were not associated with any inflammation measures. Conclusions These findings contribute to existing evidence that inflammatory cytokines are associated with the somatic symptoms of depression. Inflammatory diet index was not associated with depression measures.
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Affiliation(s)
- Danielle Belden Hazeltine
- Department of Psychology, Brooklyn College, City University of New York, New York, NY, United States
- Program in Psychology, The Graduate Center, City University of New York, New York, NY, United States
| | - Ashley Rose Polokowski
- Department of Psychology, Brooklyn College, City University of New York, New York, NY, United States
- Program in Psychology, The Graduate Center, City University of New York, New York, NY, United States
- Psycho-Oncology, Monter Cancer Center, Northwell Health Cancer Institute, New York, NY, United States
| | - Laura Christine Reigada
- Department of Psychology, Brooklyn College, City University of New York, New York, NY, United States
- Program in Psychology, The Graduate Center, City University of New York, New York, NY, United States
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Zhang Y, Li X, Chan VKY, Luo H, Chan SSM, Wong GHY, Wong ICK, Lum TYS. Depression duration and risk of incident cardiovascular disease: A population-based six-year cohort study. J Affect Disord 2022; 305:188-195. [PMID: 35283180 DOI: 10.1016/j.jad.2022.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depression symptoms are significantly associated with an increased risk of cardiovascular disease (CVD). However, understanding of the magnitude of the association between depression duration and risk of CVD is limited. Therefore, we aimed to assess whether a longer duration of exposure to depression is associated with a higher risk of new-onset CVD. METHODS We conducted a territory-wide retrospective cohort study among patients (≥ 10 years old) with depression diagnosed between January and December 2014 in Hong Kong. The observation period spanned January 1, 2014, to December 31, 2019, and all participants had no CVD at baseline. Incidence of CVD was calculated. We used Cox proportional hazard regression to adjust confounders and estimate hazard ratios of CVD risk. RESULTS Among 11,651 participants with depression, 1306 (11.2%) individuals developed CVD. Multi-adjusted models showed individuals with depression duration of 2-5 years (Hazard Ratios [HRs]: 1.38 [95% confidence interval (CI): 1.19-1.60]) and ≥6 years (1.45 [1.25-1.68]) had a significantly escalated risk of developing CVD, compared to those with depression within one year. Stratified analyses indicated that the association was prominent in women and those under 65 years old. LIMITATIONS Lack of depression severity information and the small sample size in some subgroup analyses. CONCLUSIONS Longer exposure to depression is associated with significant increased risk of CVD. The interplay between mental and vascular health emphasizes the need for CVD prevention in patients with long-term depression.
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Affiliation(s)
- Yingyang Zhang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Xue Li
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Center for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science Park, Hong Kong, China; The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
| | - Vivien K Y Chan
- Center for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Hao Luo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
| | - Sandra S M Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Gloria H Y Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
| | - Ian C K Wong
- Center for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science Park, Hong Kong, China; Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
| | - Terry Y S Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
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Association of the Dietary Inflammatory Index with Depressive Symptoms among Pre- and Post-Menopausal Women: Findings from the National Health and Nutrition Examination Survey (NHANES) 2005-2010. Nutrients 2022; 14:nu14091980. [PMID: 35565951 PMCID: PMC9105364 DOI: 10.3390/nu14091980] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 12/19/2022] Open
Abstract
During their lifetime, 20% of US women experience depression. Studies have indicated that a high Dietary Inflammatory Index (DII) score is associated with high C-reactive protein (CRP) levels and depression. No previous study has compared the association of the DII with different measures of depression (e.g., somatic, cognitive) among pre- and post-menopausal women. We used data from 2512 pre-menopausal and 2392 post-menopausal women from the National Health and Nutrition Examination Survey (NHANES) 2005−2010 database. We ran linear and logistic regression models to compare the association of the DII with survey-measured depression among pre- and post-menopausal women. We further assessed the mediation effect of CRP on the association of the DII and depression, using structural equation modeling. The odds of experiencing depression among pre-menopausal women was higher for all DII quartiles compared to the reference group (i.e., DII Q1), with an odds ratio (OR) of 3.2, 5.0, and 6.3 for Q2, Q3, and Q4, respectively (p < 0.05). Among post-menopausal women, only Q4 had 110% higher odds of experiencing depression compared to Q1 (p = 0.027). No mediation effect of CRP was found between DII and any of our depression outcome measures. Our findings suggest that lifestyle habits, such as diet, may have a stronger influence on mental health among pre-menopausal women than post-menopausal women.
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Jóźwik S, Wrzeciono A, Cieślik B, Kiper P, Szczepańska-Gieracha J, Gajda R. The Use of Virtual Therapy in Cardiac Rehabilitation of Male Patients with Coronary Heart Disease: A Randomized Pilot Study. Healthcare (Basel) 2022; 10:745. [PMID: 35455922 PMCID: PMC9031657 DOI: 10.3390/healthcare10040745] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
The study aimed to evaluate the effectiveness of virtual reality therapy (VRT) in the treatment of anxiety-depressive disorders and in reducing stress levels in a group of men with coronary heart disease (CHD) participating in cardiac rehabilitation (CR). The study included 34 men with CHD who were assigned to the experimental group (EG) or the control group (CG). CR in the EG was supported by 8 VRT sessions, while CR in the CG was supplemented with 8 SAT sessions. Anxiety-depressive disorders were assessed using the Hospital Anxiety and Depression Scale (HADS). Perceived stress was assessed using the Perception of Stress Questionnaire (PSQ). In the EG, all measured parameters improved after the intervention. Significant reductions in HADS total score, the HADS-A, general stress score, emotional tension, and the external stress were obtained. In the CG, a deterioration in all measured parameters was observed. Significant changes were obtained in the general stress score and intrapsychic stress. The analysis between groups showed that the effectiveness of psychological interventions significantly differed between groups. The study results confirmed that supplementing standard CR with VRT leads to an improvement in the mental state of the patients and thus has a positive effect on the course of CR. However, the small sample size and high withdrawal rate prompt cautious interpretation of the results.
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Affiliation(s)
- Sandra Jóźwik
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (S.J.); (A.W.); (J.S.-G.)
| | - Adam Wrzeciono
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (S.J.); (A.W.); (J.S.-G.)
| | - Błażej Cieślik
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland;
| | - Paweł Kiper
- Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, 30126 Venice, Italy;
| | - Joanna Szczepańska-Gieracha
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (S.J.); (A.W.); (J.S.-G.)
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland;
- Center for Sports Cardiology at the Gajda-Med Medical Center in Pultusk, 06-102 Pultusk, Poland
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Spencer HF, Berman RY, Boese M, Zhang M, Kim SY, Radford KD, Choi KH. Effects of an intravenous ketamine infusion on inflammatory cytokine levels in male and female Sprague-Dawley rats. J Neuroinflammation 2022; 19:75. [PMID: 35379262 PMCID: PMC8981848 DOI: 10.1186/s12974-022-02434-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/20/2022] [Indexed: 12/29/2022] Open
Abstract
Background Ketamine, a multimodal dissociative anesthetic drug, is widely used as an analgesic following traumatic injury. Although ketamine may produce anti-inflammatory effects when administered after injury, the immunomodulatory properties of intravenous (IV) ketamine in a non-inflammatory condition are unclear. In addition, most preclinical studies use an intraperitoneal (IP) injection of ketamine, which limits its clinical translation as patients usually receive an IV ketamine infusion after injury. Methods Here, we administered sub-anesthetic doses of a single IV ketamine infusion (0, 10, or 40 mg/kg) to male and female Sprague–Dawley rats over a 2-h period. We collected blood samples at 2- and 4-h post-ketamine infusion to determine plasma inflammatory cytokine levels using multiplex immunoassays. Results The 10 mg/kg ketamine infusion reduced spontaneous locomotor activity in male and female rats, while the 40 mg/kg infusion stimulated activity in female, but not male, rats. The IV ketamine infusion produced dose-dependent and sex-specific effects on plasma inflammatory cytokine levels. A ketamine infusion reduced KC/GRO and tumor necrosis factor alpha (TNF-α) levels in both male and female rats, interleukin-6 (IL-6) levels in female rats, and interleukin-10 (IL-10) levels in male rats. However, most cytokine levels returned to control levels at 4-h post-infusion, except for IL-6 levels in male rats and TNF-α levels in female rats, indicating a different trajectory of certain cytokine changes over time following ketamine administration. Conclusions The current findings suggest that sub-anesthetic doses of an IV ketamine infusion may produce sex-related differences in the effects on peripheral inflammatory markers in rodents, and further research is warranted to determine potential therapeutic effects of an IV ketamine infusion in an inflammatory condition.
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Affiliation(s)
- Haley F Spencer
- Program in Neuroscience, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Rina Y Berman
- Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Martin Boese
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Michael Zhang
- Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Sharon Y Kim
- Program in Neuroscience, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Kennett D Radford
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Kwang H Choi
- Program in Neuroscience, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. .,Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. .,Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. .,Department of Psychiatry, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Pusceddu MM, Hernandez-Baixauli J, Puiggrós F, Arola L, Caimari A, Del Bas JM, Baselga L. Mediterranean natural extracts improved cognitive behavior in zebrafish and healthy rats and ameliorated lps-induced cognitive impairment in a sex dependent manner. Behav Brain Funct 2022; 18:5. [PMID: 35216588 PMCID: PMC8876132 DOI: 10.1186/s12993-022-00190-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/12/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Several findings suggest neuroinflammation as a contributing factor for the onset of psychiatric disorders such as Alzheimer's disease, depression, and anxiety. There is increasing evidence pointing out that the Mediterranean diet influences brain and behavior. Mediterranean herbs and spices have been shown to be within those components of the Mediterranean diet involved in cognitive enhancement. Thus, we investigated the influence of Mediterranean natural extracts (MNE), Rosemary extract (RE) and Glycyrrhiza glabra root extract (GGRE), on cognitive behavior. RESULTS Adult zebrafish were exposed to RE or GGRE (100 and 250 mg/L) treatments. Both MNE improved memory retention during the T-maze test, although no improvements were observed during the novel object preference. Similarly, chronic administration of RE (150 mg/Kg) and GGRE (150 mg/Kg) improved, respectively, spatial and retention memory, as assessed by the Morris Water Maze (MWM), and the Elevated Plus Maze (EPM) in healthy male rats. However, no improvements were observed during the novel object recognition. Finally, male, and female rats were chronically treated with lipopolysaccharide [(LPS) 300 ug/kg] and orally administered with RE. Interestingly, RE reversed LPS-induced cognitive deficit during the MWM and EPM in female rats. CONCLUSIONS We found that MNE improved cognition in both zebrafish and rats. Moreover, MNE rescued LPS-induced cognitive impairment in a gender-specific manner. Therefore, our study supports the view that zebrafish represent a valuable preclinical model for drug discovery in neuroscience. These findings contribute to an exciting and growing body of research suggesting that MNE may play an important role in the prevention of cognitive impairment.
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Affiliation(s)
- Matteo M Pusceddu
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició I Salut, Reus, Spain.
| | | | - Francesc Puiggrós
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició I Salut, Reus, Spain
| | - Lluis Arola
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició I Salut, Reus, Spain.,Departament de Bioquímica I Biotecnologia, Grup de Recerca en Nutrigenòmica, Universitat Rovira I Virgili, Tarragona, Spain
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició I Salut, Reus, Spain.
| | - Josep M Del Bas
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició I Salut, Reus, Spain.
| | - Laura Baselga
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició I Salut, Reus, Spain
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Stress induced microglial activation contributes to depression. Pharmacol Res 2022; 179:106145. [DOI: 10.1016/j.phrs.2022.106145] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
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Porter GA, O’Connor JC. Brain-derived neurotrophic factor and inflammation in depression: Pathogenic partners in crime? World J Psychiatry 2022; 12:77-97. [PMID: 35111580 PMCID: PMC8783167 DOI: 10.5498/wjp.v12.i1.77] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/21/2021] [Accepted: 12/02/2021] [Indexed: 02/06/2023] Open
Abstract
Major depressive disorder is a debilitating disorder affecting millions of people each year. Brain-derived neurotrophic factor (BDNF) and inflammation are two prominent biologic risk factors in the pathogenesis of depression that have received considerable attention. Many clinical and animal studies have highlighted associations between low levels of BDNF or high levels of inflammatory markers and the development of behavioral symptoms of depression. However, less is known about potential interaction between BDNF and inflammation, particularly within the central nervous system. Emerging evidence suggests that there is bidirectional regulation between these factors with important implications for the development of depressive symptoms and anti-depressant response. Elevated levels of inflammatory mediators have been shown to reduce expression of BDNF, and BDNF may play an important negative regulatory role on inflammation within the brain. Understanding this interaction more fully within the context of neuropsychiatric disease is important for both developing a fuller understanding of biological pathogenesis of depression and for identifying novel therapeutic opportunities. Here we review these two prominent risk factors for depression with a particular focus on pathogenic implications of their interaction.
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Affiliation(s)
- Grace A Porter
- Department of Pharmacology, UT Health San Antonio, San Antonio, TX 78229, United States
| | - Jason C O’Connor
- Department of Pharmacology, University of Texas Health San Antonio, San Antonio, TX 78229, United States
- Audie L. Murphy VA Hospital, South Texas Veterans Health System, San Antonio, TX 78229, United States
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Abstract
ABSTRACT Inflammatory phenomena are found in many psychiatric disorders-notably, depression, schizophrenia, and posttraumatic stress disorder. Inflammation has been linked to severity and treatment resistance, and may both contribute to, and result from, the pathophysiology of some psychiatric illnesses. Emerging research suggests that inflammation may contribute to symptom domains of reward, motor processing, and threat reactivity across different psychiatric diagnoses. Reward-processing deficits contribute to motivational impairments in depression and schizophrenia, and motor-processing deficits contribute to psychomotor slowing in both depression and schizophrenia. A number of experimental models and clinical trials suggest that inflammation produces deficits in reward and motor processing through common pathways connecting the cortex and the striatum, which includes the nucleus accumbens, caudate nucleus, and putamen.The observed effects of inflammation on psychiatric disorders may cut across traditional conceptualizations of psychiatric diagnoses. Further study may lead to targeted immunomodulating treatments that address difficult-to-treat symptoms in a number of psychiatric disorders. In this review, we use a Research Domain Criteria framework to discuss proposed mechanisms for inflammation and its effects on the domains of reward processing, psychomotor slowing, and threat reactivity. We also discuss data that support contributing roles of metabolic dysregulation and sex differences on the behavioral outcomes of inflammation. Finally, we discuss ways that future studies can help disentangle this complex topic to yield fruitful results that will help advance the field of psychoneuroimmunology.
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Affiliation(s)
- David S Thylur
- From the Department of Psychiatry and Behavioral Sciences, Emory University
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The dietary inflammatory index is inversely associated with depression, which is minimally mediated by C-reactive protein. Nutr Res 2021; 97:11-21. [PMID: 34922121 DOI: 10.1016/j.nutres.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022]
Abstract
Depression affects 8% of adults in America and is one of the leading causes of disability in Western countries. The dietary inflammatory index (DII) has previously been reported to be associated with inflammation and depression. However, no study to date has looked at the potential mediating effect of inflammation on the association of DII and depression. We hypothesized that the association of DII and depression would be both statistically and clinically mediated substantially by inflammation. We assessed these associations using the cross-sectional National Health and Nutrition Examination Survey (NHANES) 2005-2010 database. Our analysis included 10,022 participants aged 20 years and older. Inflammation was assessed with C-reactive protein (CRP) levels. Diet was measured using two 24 hour dietary recalls. Depression was assessed using the 9-item Patient Health Questionnaire (PHQ-9), which has a score range of 0 to 27, with the higher score showing more severe depressive symptoms. Comparing the highest to lowest DII quartiles, the mean score difference for depression was 0.47 units (95% CI 0.24-0.70, P-trend <.001) in the multivariable adjusted model. In the sex-stratified models, the results remained significant only among females, with the mean score difference of 0.72 (95% CI 0.34-1.10, P-trend <.001). CRP mediated 3.6% of the association between DII and depression in the total population in the fully adjusted model, which was statistically significant (P-trend <.001) but not clinically significant. No mediation association was found in the sex-stratified models. Further studies are needed to assess the associations with various inflammatory biomarkers in larger and more diverse populations.
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Zainal NH, Newman MG. Increased inflammation predicts nine-year change in major depressive disorder diagnostic status. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:829-840. [PMID: 34618490 PMCID: PMC8629837 DOI: 10.1037/abn0000716] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cytokine theory of depression proposes that increased baseline inflammatory activity may accumulate over time and lead to future major depressive disorder (MDD). However, most research conducted on this topic has been cross-sectional and examined between- (vs. within-) persons and symptom severity (vs. diagnosis). Therefore, we tested if elevated inflammatory activity at Time 1 (T1) would predict future within-person 9-year change in MDD diagnosis. Community-dwelling adults (n = 945) participated in the Midlife Development in the United States (MIDUS) study. T1 and Time 2 (T2) MDD status was assessed using the Composite International Diagnostic Interview-Short Form, and markers of inflammatory activity at T1 were measured (e.g., levels of serum interleukin-6 [IL-6], C-reactive protein [CRP], fibrinogen). Latent change score modeling was conducted. Higher T1 IL-6, CRP, and fibrinogen levels of inflammatory activity predicted T1-T2 development/relapse of MDD within persons. This effect occurred more strongly among women (vs. men; d = .149 vs. .042), younger (vs. older) adults (d = .137 vs. .119), persons with more (vs. less) chronic health issues (d = .133 vs. .065), low- (vs. middle- or high-) income earners (d = .161 vs. .050), and persons with more (vs. less) frequent childhood trauma (d = .156 vs. .017). Findings aligned with expanded cytokine theories, which posit that the impact of increased T1 inflammatory activity on future change in MDD status will be larger for subgroups vulnerable to increased stress exposure. Cognitive-behavioral or pharmacological approaches to reduce markers of inflammatory activity may prevent development/relapse of MDD. General Scientific Summary: Increased C-reactive protein (CRP), fibrinogen, and interleukin-6 (IL-6) levels predicted 9-year major depressive disorder (MDD) diagnostic status change more strongly in younger than older adults, women but not men, those with low (vs. high) income, as well as persons with high (vs. low) childhood trauma frequency and number of chronic illnesses. Findings aligned with expanded cytokine theories (e.g., social signal transduction theory of depression), which posit that markers of inflammatory activity predict future change in MDD status especially for populations vulnerable to heightened, chronic, and long-term exposure to environmental stressors. Continued efforts to empirically test expanded cytokine theories of depression may improve delineation of patterns of health disparities and facilitate effective measures to prevent the onset or recurrence of MDD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Campesi I, Montella A, Seghieri G, Franconi F. The Person's Care Requires a Sex and Gender Approach. J Clin Med 2021; 10:4770. [PMID: 34682891 PMCID: PMC8541070 DOI: 10.3390/jcm10204770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 12/15/2022] Open
Abstract
There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex-gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global health, avoiding systematic errors that generate results with low validity. Care for people should consider the single individual and his or her past and present life experiences, as well as his or her relationship with care providers. Therefore, intersectoral and interdisciplinary studies are urgently required. It is desirable to create teams made up of men and women to meet the needs of both. Finally, it is also necessary to build an alliance among regulatory and ethic authorities, statistics, informatics, the healthcare system and providers, researchers, the pharmaceutical and diagnostic industries, decision makers, and patients to overcome the gender gap in medicine and to take real care of a person in an appropriate manner.
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Affiliation(s)
- Ilaria Campesi
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy;
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Andrea Montella
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giuseppe Seghieri
- Department of Epidemiology, Regional Health Agency of Tuscany, 50124 Florence, Italy;
| | - Flavia Franconi
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy;
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Gender Differences in Lifestyle and Mental Health among Senior High School Students in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010746. [PMID: 34682487 PMCID: PMC8535804 DOI: 10.3390/ijerph182010746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/30/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022]
Abstract
Gender differences in health outcomes have long been a concern worldwide. We investigated the gender differences in the lifestyle and mental health status of senior students in general high schools who were preparing for college entrance exams. This secondary analysis was based on data from the 14th Korea Youth Risk Behavior Web-Based Survey (2018). The data of 8476 students in the third year (12th grade) of general high school, among a total of 60,040 middle and high school students nationwide, were analyzed. Mean and standard error (SE) and weighted percentage data were obtained, and the Rao-Scott χ2 test was performed. Boys reported more risky behaviors related to drinking and smoking, while girls had more negative perceptions of their bodies and overall health. In addition, girls showed unhealthier lifestyle-related behaviors (breakfast, physical activity, weight control) and greater vulnerability to poor mental health, including lower sleep satisfaction, stress, depression, and suicidal thoughts. Our results suggest that education and health institutions should consider the needs of each gender separately. A gender-specific approach to maintaining healthy lifestyles and good health status among senior high school students is highly recommended.
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Gialluisi A, Santonastaso F, Bonaccio M, Bracone F, Shivappa N, Hebert JR, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Circulating Inflammation Markers Partly Explain the Link Between the Dietary Inflammatory Index and Depressive Symptoms. J Inflamm Res 2021; 14:4955-4968. [PMID: 34611421 PMCID: PMC8487281 DOI: 10.2147/jir.s312925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/23/2021] [Indexed: 12/12/2022] Open
Abstract
Background Depression is a mood disorder characterized by a high rate of resistance to pharmacological treatments, which has often been linked to chronic inflammation. This can be influenced by different environmental factors, in particular pro-inflammatory diets. However, a mediating role of circulating inflammation has never been observed. Aim To test the association between a dietary inflammatory index (DII®) and continuous depressive symptoms (adapted version of PHQ9) in an Italian population cohort (N=13,301), along with potential explanatory effect of a composite index (INFLA-score) based on four circulating inflammatory biomarkers: C-reactive protein, granulocyte-to-lymphocyte ratio, platelet and white blood cell counts. Results Significant positive associations were observed between DII and total depressive symptoms (standardized β (SE) = 0.038 (0.005), p < 0.001), and with two factors tagging somatic (0.012 (0.003), p < 0.001) and cognitive symptoms (0.012 (0.003), p < 0.001), after adjustment for different potential confounders (socioeconomic status, chronic health conditions and lifestyles). These associations were about twice as strong in women than in men. INFLA-score explained a small but significant proportion of the association with total depressive symptoms (0.90–2.30%, p < 0.05), which was mainly driven by granulocyte-to-lymphocyte ratio (1.18–1.65%). This effect was even stronger for the somatic (2.66–4.66%) but not for the cognitive factor (0%). Conclusion These findings support a strong link between inflammatory diet and depression, especially with somatic symptoms and within women. Moreover, they provide novel evidence for a potential explanatory role of circulating inflammation in this association, suggesting new paths for prevention and treatment of major and atypical depression.
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Affiliation(s)
| | | | | | - Francesca Bracone
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | | | | | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Piantella S, Dragano N, McDonald SJ, Wright BJ. Depression symptoms mediate the association between workplace stress and interleukin 6 in women, but not men: The Whitehall II study. Brain Behav Immun Health 2021; 12:100215. [PMID: 34589736 PMCID: PMC8474445 DOI: 10.1016/j.bbih.2021.100215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 02/08/2023] Open
Abstract
Workplace stress and depression are positively related with inflammation, and each other. Low-grade inflammation and concurrent high levels of workplace stress or depression has been related with future morbidity. The potential pathway between constructs however, remains elusive. For the first time, this study explored the concurrent relationship between workplace stress, depressive symptomology and low-grade inflammation, and considered the role of gender in these relationships. Data from the Whitehall II cohort study (N = 2528, Mage = 57.01, 23.7% females) provided measures of workplace stress (job demand-control; JDC), depressive symptomology (Centre for Epidemiological Studies Depression scale; CES-D) and circulating inflammatory markers, interleukin-6 (IL-6) and C-reactive protein (CRP) collected on the same day from a single time point. Females had higher workplace stress, depressive symptoms and lower serum IL-6 concentrations. For males, higher workplace stress was associated with higher depressive symptoms. For females, higher depressive symptoms were related with elevated IL-6 levels, and both higher workplace stress and IL-6 levels were associated with higher depressive symptoms. Higher depressive symptoms were related with higher CRP levels in men only. Higher depressive symptoms statistically mediated the relationship between higher workplace stress and IL-6 levels in females only, b = 0.016, CI [0.002, 0.039]. Females in this large cohort had higher levels of job strain, depression and lower IL-6 concentrations than males. In females, higher depressive symptoms were associated with higher serum IL-6 levels and workplace stress was not. Considered together, these findings suggest that low job control may be more apparent in females than males, but it is primarily negative affect that drives the positive relationship between work stress and serum IL-6 concentrations in females. Replicating the current design with a suitably proximal follow-up is required to determine if the associations identified are causal. Females had higher workplace stress, depressive symptoms and lower IL-6. Association between stress, depression and inflammation was stronger in women. Among females, depressive symptoms and not stress associated with serum IL-6. .
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Key Words
- CES-D, Centre for Epidemiological Studies Depression scale
- CESgrp, CES-D group
- CRP
- CRP, C-reactive protein
- Demand-control model
- ERI, Effort-reward imbalance
- Gender
- IL-6, interleukin-6
- Inflammation
- JC, Job control
- JD, Job demand
- JDC, Job demand control ratio
- JDR, Job demand-resources
- JSgrp, Job strain group
- Job strain
- OJ, Organisational Justice
- Stress and coping model
- TMSC, Transactional model of stress and coping
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Affiliation(s)
- Stefan Piantella
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Nico Dragano
- Institute of Medical Sociology, Medical Faculty, University of Duesseldorf, Universitaetstrasse 1, Duesseldorf, 40255, Germany
| | - Stuart J McDonald
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Bradley J Wright
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
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Jones BDM, Levitan RD, Wang W, Uher R, Rotzinger S, Foster JA, Kennedy SH, Farzan F, Quilty LC, Kloiber S. Metabolic variables associated with response to cognitive behavioural therapy for depression in females: A Canadian biomarker integration network for depression (CAN-BIND) study. J Psychiatr Res 2021; 142:321-327. [PMID: 34419752 DOI: 10.1016/j.jpsychires.2021.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/13/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Cognitive behavioural therapy (CBT) is an established first-line treatment for depression; however, it remains unclear which factors predict a positive outcome with this approach. Prior work suggests that co-morbid obesity predicts a poorer response to antidepressant medication. The current study examined whether there is an association between weight parameters and improvement of depressive symptoms with CBT. METHODS This was a secondary analysis of data from the "Clinical and Biological Markers of Response to Cognitive Behavioural Therapy for Depression - 6" (CANBIND-6; https://clinicaltrials.gov/ct2/show/NCT02883257) study. Adult participants (n = 41) with a diagnosis of Major Depressive Disorder (MDD) or Persistent Depressive Disorder (PDD) were recruited from an outpatient tertiary psychiatric centre in Canada. Participants completed 20 individual sessions of CBT over 16 weeks. The primary measure for treatment outcome was the Montgomery-Åsberg Depression Rating Scale (MADRS) total score at week 16. RESULTS Thirty-seven participants completed assessments pre and post CBT. Baseline weight parameters were not correlated with treatment response to CBT in the entire group. There was a significant sex*waist circumference (WC) (B:-1.34; p = 0.004) and sex*body mass index (BMI) interaction (B:-2.03; p:0.009). In female participants, baseline waist circumference, but not BMI, significantly predicted week 16 MADRS after controlling for age and baseline MADRS (B:0.422 p:0.049). LIMITATIONS The major limitation of our preliminary finding is the small sample size. CONCLUSION Our preliminary findings suggest that higher waist circumference may be associated with a better treatment response to CBT for depression in females. This result could be of clinical relevance and warrants further investigation in larger and independent samples.
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Affiliation(s)
- Brett D M Jones
- Centre for Addiction and Mental Health and Campbell Family Mental Health Research Institute, 1000 Queen St West, Toronto, Canada; Department of Psychiatry, University of Toronto, 250 College St, Toronto, Canada
| | - Robert D Levitan
- Centre for Addiction and Mental Health and Campbell Family Mental Health Research Institute, 1000 Queen St West, Toronto, Canada; Department of Psychiatry, University of Toronto, 250 College St, Toronto, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health and Campbell Family Mental Health Research Institute, 1000 Queen St West, Toronto, Canada; Department of Psychiatry, University of Toronto, 250 College St, Toronto, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, 5909 Veteran Memorial Lane, Halifax, NS, Canada
| | - Susan Rotzinger
- Department of Psychiatry, University Health Network, University of Toronto, 200 Elizabeth St, Toronto, Ontario, Canada
| | - Jane A Foster
- Psychiatry and Behavioural Neuroscience, McMaster University, 1280 Main St West, Hamilton, Ontario, Canada; Department of Psychiatry, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, University of Toronto, 200 Elizabeth St, Toronto, Ontario, Canada
| | - Faranak Farzan
- Brain Lab, School of Mechatronic Systems Engineering, Simon Fraser University, 250-13450, 102 Avenue, Surrey, BC, Canada
| | - Lena C Quilty
- Centre for Addiction and Mental Health and Campbell Family Mental Health Research Institute, 1000 Queen St West, Toronto, Canada; Department of Psychiatry, University of Toronto, 250 College St, Toronto, Canada
| | - Stefan Kloiber
- Centre for Addiction and Mental Health and Campbell Family Mental Health Research Institute, 1000 Queen St West, Toronto, Canada; Department of Psychiatry, University of Toronto, 250 College St, Toronto, Canada.
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Koelman L, Reichmann R, Börnhorst C, Schulze MB, Weikert C, Biemann R, Isermann B, Fritsche A, Aleksandrova K. Determinants of elevated chemerin as a novel biomarker of immunometabolism: data from a large population-based cohort. Endocr Connect 2021; 10:1200-1211. [PMID: 34431786 PMCID: PMC8494416 DOI: 10.1530/ec-21-0273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/25/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Chemerin is a novel inflammatory biomarker suggested to play a role in the development of metabolic disorders, providing new avenues for treatment and prevention. Little is known about the factors that predispose elevated chemerin concentrations. We therefore aimed to explore a range of lifestyle-associated, dietary, and metabolic factors as potential determinants of elevated chemerin concentrations in asymptomatic adults. DESIGN We used cross-sectional data from a random subsample of 2433 participants (1494 women and 939 men) aged 42-58 years of the European Prospective Investigation into Cancer and Nutrition-Potsdam cohort. METHODS Random forest regression (RFR) was applied to explore the relative importance of 32 variables as statistical predictors of elevated chemerin concentrations overall and by sex. Multivariable-adjusted linear regression was applied to evaluate associations between selected predictors and chemerin concentrations. RESULTS Results from RFR suggested BMI, waist circumference, C-reactive protein, fatty liver index, and estimated glomerular filtration rate as the strongest predictors of chemerin concentrations. Additional predictors included sleeping duration, alcohol, red and processed meat, fruits, sugar-sweetened beverages (SSB), vegetables, dairy, and refined grains. Collectively, these factors explained 32.9% variation of circulating chemerin. Multivariable-adjusted analyses revealed linear associations of elevated chemerin with metabolic parameters, obesity, longer sleep, higher intakes of red meat and SSB, and lower intakes of dairy. CONCLUSIONS These findings come in support of the role of chemerin as a biomarker characterizing inflammatory and metabolic phenotypes in asymptomatic adults. Modifiable dietary and lifestyle-associated determinants of elevated chemerin concentrations require further evaluation in a prospective study setting.
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Affiliation(s)
- Liselot Koelman
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Robin Reichmann
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Claudia Börnhorst
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Cornelia Weikert
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Ronald Biemann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Berend Isermann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Andreas Fritsche
- Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany
| | - Krasimira Aleksandrova
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
- Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
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Pezzato S, Bonetto C, Caimmi C, Tomassi S, Montanari I, Gnatta MG, Fracassi E, Cristofalo D, Rossini M, Carletto A, Tosato S. Depression is associated with increased disease activity and higher disability in a large Italian cohort of patients with rheumatoid arthritis. Adv Rheumatol 2021; 61:57. [PMID: 34526144 DOI: 10.1186/s42358-021-00214-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/28/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Depression is a quite common comorbidity in patients with rheumatoid arthritis (RA) and is thought to influence its severity. This study aims to estimate, in a large cohort of Italian patients with RA, the prevalence of depression and to investigate the clinical correlates of depression in terms of disease activity and disability. METHODS This is a cross-sectional study enrolling 490 outpatients with RA (80% female, mean age 59.5). The Hospital Anxiety and Depression Scale (HADS) was used to assess the presence of depression with a cut-off of 11. We collected data about disease activity and disability with DAS28, TJC-68, PhGA, PGA, VAS, DAS28, SDAI, CDAI and HAQ. RESULTS Prevalence of depression was 14.3% (95% CI: 11-17%). Depressed patients, when compared with not depressed ones, were found to have higher scores for TJC-68 (p = 0.011), PhGA (p = 0.001), PGA (p = 0.001), VAS (p = 0.001), DAS28 (p = 0.007), SDAI (p = 0.001), CDAI (p = 0.001) and HAQ (p = 0.001). Out of the 70 depressed patients, 30 subjects, already known to be depressed in the past, were still depressed at the time of the assessment, with only 11 (15.7%) under antidepressants. A multivariate analysis showed that male sex, higher PGA score, use of antidepressants and higher HAQ score were significantly associated with an increased risk of depression. CONCLUSIONS Our study shows that depression is common in RA and may affect its activity mainly via an alteration in the perception of the disease. Although its important implications, depression is still under-diagnosed and its management is inadequate.
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Affiliation(s)
- Sara Pezzato
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134, Verona, VR, Italy
| | - Chiara Bonetto
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Cristian Caimmi
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134, Verona, VR, Italy
| | - Simona Tomassi
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Ilaria Montanari
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134, Verona, VR, Italy
| | - Maria Giulia Gnatta
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Elena Fracassi
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134, Verona, VR, Italy
| | - Doriana Cristofalo
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134, Verona, VR, Italy
| | - Antonio Carletto
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134, Verona, VR, Italy.
| | - Sarah Tosato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
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de Oliveira Neto L, Tavares VDDO, Agrícola PMD, de Oliveira LP, Sales MC, de Sena-Evangelista KCM, Gomes IC, Galvão-Coelho NL, Pedrosa LFC, Lima KC. Factors associated with inflamm-aging in institutionalized older people. Sci Rep 2021; 11:18333. [PMID: 34526542 PMCID: PMC8443661 DOI: 10.1038/s41598-021-97225-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/13/2021] [Indexed: 02/08/2023] Open
Abstract
The increase in inflammatory cytokines associated with a reduction in the bioavailability of zinc has been used as a marker for inflammation. Despite the high inflammatory state found in institutionalized older individuals, few studies have proposed verifying the factors associated with this condition in this population. To verify the factors associated with inflamm-aging in institutionalized older people. A total of 178 older people (≥ 60 years old) living in nursing homes in Natal/RN were included in the study. Cluster analysis was used to identify three groups according to their inflammatory state. Analysis anthropometric, biochemical, sociodemographic, and health-related variables was carried out. In sequence, an ordinal logistic regression was performed for a confidence level of 95% in those variables with p < 0.20 in the bivariate analysis. IL-6, TNF-α, zinc, low-density lipids (LDL), high-density lipids (HDL), and triglycerides were associated with inflamm-aging. The increase of 1 unit of measurement of LDL, HDL, and triglycerides increased the chance of inflammation-aging by 1.5%, 4.1%, and 0.9%, respectively, while the oldest old (≥ 80 years old) had an 84.9% chance of presenting inflamm-aging in relation to non-long-lived older people (< 80 years). The association between biochemical markers and inflamm-aging demonstrates a relationship between endothelial injury and the inflammatory state. In addition, the presence of a greater amount of fat in the blood may present a higher relative risk of death.
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Affiliation(s)
- Leônidas de Oliveira Neto
- Department of Arts, Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 3000-Lagoa Nova, Natal, RN, 59078-970, Brazil.
| | | | | | | | - Márcia Cristina Sales
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | - Igor Conterato Gomes
- Department of Epidemiology, School of Public Health, University of São Paulo, Brazil, São Paulo, SP, Brazil
| | | | | | - Kenio Costa Lima
- Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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