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Saleki K, Alijanizadeh P, Javanmehr N, Rezaei N. The role of Toll-like receptors in neuropsychiatric disorders: Immunopathology, treatment, and management. Med Res Rev 2024; 44:1267-1325. [PMID: 38226452 DOI: 10.1002/med.22012] [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: 04/08/2022] [Revised: 10/20/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024]
Abstract
Neuropsychiatric disorders denote a broad range of illnesses involving neurology and psychiatry. These disorders include depressive disorders, anxiety, schizophrenia, bipolar disorder, attention deficit hyperactivity disorder, autism spectrum disorders, headaches, and epilepsy. In addition to their main neuropathology that lies in the central nervous system (CNS), lately, studies have highlighted the role of immunity and neuroinflammation in neuropsychiatric disorders. Toll-like receptors (TLRs) are innate receptors that act as a bridge between the innate and adaptive immune systems via adaptor proteins (e.g., MYD88) and downstream elements; TLRs are classified into 13 families that are involved in normal function and illnesses of the CNS. TLRs expression affects the course of neuropsychiatric disorders, and is influenced during their pharmacotherapy; For example, the expression of multiple TLRs is normalized during the major depressive disorder pharmacotherapy. Here, the role of TLRs in neuroimmunology, treatment, and management of neuropsychiatric disorders is discussed. We recommend longitudinal studies to comparatively assess the cell-type-specific expression of TLRs during treatment, illness progression, and remission. Also, further research should explore molecular insights into TLRs regulation and related pathways.
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Affiliation(s)
- Kiarash Saleki
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
- Department of e-Learning, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Parsa Alijanizadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
| | - Nima Javanmehr
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Taylor JH, Bermudez-Gomez J, Zhou M, Gómez O, Ganz-Leary C, Palacios-Ordonez C, Huque ZM, Barzilay R, Goldsmith DR, Gur RE. Immune and oxidative stress biomarkers in pediatric psychosis and psychosis-risk: Meta-analyses and systematic review. Brain Behav Immun 2024; 117:1-11. [PMID: 38141839 DOI: 10.1016/j.bbi.2023.12.019] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 10/08/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE While genetic and cohort studies suggest immune and reduction/oxidation (redox) alterations occur in psychosis, less is known about potential alterations in children and adolescents. METHODS We conducted a systematic review to identify immune and redox biomarker studies in children and adolescents (mean age ≤ 18 years old) across the psychosis spectrum: from psychotic like experiences, which are common in children, to threshold psychotic disorders like schizophrenia. We conducted meta-analyses when at least three studies measured the same biomarker. RESULTS The systematic review includes 38 pediatric psychosis studies. The meta-analyses found that youth with threshold psychotic disorders had higher neutrophil/lymphocyte ratio (Hedge's g = 0.40, 95 % CI 0.17 - 0.64), tumor necrosis factor (Hedge's g = 0.38, 95 % CI 0.06 - 0.69), C-reactive protein (Hedge's g = 0.38, 95 % CI 0.05 - 0.70), interleukin-6 (Hedge's g = 0.35; 95 % CI 0.11 - 0.64), and total white blood cell count (Hedge's g = 0.29, 95 % CI 0.12 - 0.46) compared to youth without psychosis. Other immune and oxidative stress meta-analytic findings were very heterogeneous. CONCLUSION Results from several studies are consistent with the hypothesis that signals often classified as "proinflammatory" are elevated in threshold pediatric psychotic disorders. Data are less clear for immune markers in subthreshold psychosis and redox markers across the subthreshold and threshold psychosis spectrum. Immune and redox biomarker intervention studies are lacking, and research investigating interventions targeting the immune system in threshold pediatric psychosis is especially warranted.
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Affiliation(s)
- Jerome Henry Taylor
- Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, PA, USA.
| | - Julieta Bermudez-Gomez
- National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico; Statiscripts, LLC, USA
| | - Marina Zhou
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Oscar Gómez
- Statiscripts, LLC, USA; Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Casey Ganz-Leary
- Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, PA, USA
| | - Cesar Palacios-Ordonez
- Statiscripts, LLC, USA; Monterrey Institute of Technology and Higher Education, Monterrey, Mexico
| | - Zeeshan M Huque
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, PA, USA; Temple University, Philadelphia, PA, USA
| | - Ran Barzilay
- Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, PA, USA
| | | | - Raquel E Gur
- Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, PA, USA
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Kuang N, Liu Z, Yu G, Wu X, Becker B, Fan H, Peng S, Zhang K, Zhao J, Kang J, Dong G, Zhao X, Sahakian BJ, Robbins TW, Cheng W, Feng J, Schumann G, Palaniyappan L, Zhang J. Neurodevelopmental risk and adaptation as a model for comorbidity among internalizing and externalizing disorders: genomics and cell-specific expression enriched morphometric study. BMC Med 2023; 21:291. [PMID: 37542243 PMCID: PMC10403847 DOI: 10.1186/s12916-023-02920-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/01/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Comorbidity is the rule rather than the exception for childhood and adolescent onset mental disorders, but we cannot predict its occurrence and do not know the neural mechanisms underlying comorbidity. We investigate if the effects of comorbid internalizing and externalizing disorders on anatomical differences represent a simple aggregate of the effects on each disorder and if these comorbidity-associated cortical surface differences relate to a distinct genetic underpinning. METHODS We studied the cortical surface area (SA) and thickness (CT) of 11,878 preadolescents (9-10 years) from the Adolescent Brain and Cognitive Development Study. Linear mixed models were implemented in comparative and association analyses among internalizing (dysthymia, major depressive disorder, disruptive mood dysregulation disorder, agoraphobia, panic disorder, specific phobia, separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder), externalizing (attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder) diagnostic groups, a group with comorbidity of the two and a healthy control group. Genome-wide association analysis (GWAS) and cell type specificity analysis were performed on 4468 unrelated European participants from this cohort. RESULTS Smaller cortical surface area but higher thickness was noted across patient groups when compared to controls. Children with comorbid internalizing and externalizing disorders had more pronounced areal reduction than those without comorbidity, indicating an additive burden. In contrast, cortical thickness had a non-linear effect with comorbidity: the comorbid group had no significant CT differences, while those patient groups without comorbidity had significantly higher thickness compare to healthy controls. Distinct biological pathways were implicated in regional SA and CT differences. Specifically, CT differences were associated with immune-related processes implicating astrocytes and oligodendrocytes, while SA-related differences related mainly to inhibitory neurons. CONCLUSION The emergence of comorbidity across distinct clusters of psychopathology is unlikely to be due to a simple additive neurobiological effect alone. Distinct developmental risk moderated by immune-related adaptation processes, with unique genetic and cell-specific factors, may contribute to underlying SA and CT differences. Children with the highest risk but lowest resilience, both captured in their developmental morphometry, may develop a comorbid illness pattern.
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Affiliation(s)
- Nanyu Kuang
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
| | - Zhaowen Liu
- School of Computer Science, Northwestern Polytechnical University, Xi'an, Shanxin, People's Republic of China
| | - Gechang Yu
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
| | - Xinran Wu
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
| | - Benjamin Becker
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Huaxin Fan
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
| | - Songjun Peng
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
| | - Kai Zhang
- Institute of Computer Science and Technology, East China Normal University, Shanghai, People's Republic of China
| | - Jiajia Zhao
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
| | - Jujiao Kang
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Shanghai Center for Mathematical Sciences, Fudan University, Shanghai, People's Republic of China
| | - Guiying Dong
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
| | - Xingming Zhao
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
- Zhangjiang Fudan International Innovation Center, Shanghai, 200433, People's Republic of China
| | - Barbara J Sahakian
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Trevor W Robbins
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Wei Cheng
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, 321004, China
- Shanghai Medical College and Zhongshan Hospital Immunotherapy Technology Transfer Center, Shanghai, 200032, China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China
- Shanghai Center for Mathematical Sciences, Shanghai, 200433, People's Republic of China
- Department of Computer Science, University of Warwick, Coventry, CV4 7AL, UK
- Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200433, People's Republic of China
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, People's Republic of China
| | - Gunter Schumann
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China.
- PONS Research Group, Department of Psychiatry and 20 Psychotherapy, Humboldt University, Berlin and Leibniz Institute for Neurobiology, Campus Charite Mitte, Magdeburg, Germany.
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
- Robarts Research Institute, University of Western Ontario, London, ON, Canada.
- Department of Medical Biophysica, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Jie Zhang
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, People's Republic of China.
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Ministry of Education, Fudan University, Beijing, People's Republic of China.
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Bodnar TS, Chao A, Holman PJ, Ellis L, Raineki C, Weinberg J. Impact of the COVID-19 pandemic on adults with Fetal Alcohol Spectrum Disorder: linking immune function to mental health status. Front Neurosci 2023; 17:1214100. [PMID: 37539379 PMCID: PMC10394466 DOI: 10.3389/fnins.2023.1214100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/14/2023] [Indexed: 08/05/2023] Open
Abstract
Prenatal alcohol exposure (PAE) is known to cause a variety of cognitive, behavioral, and neurological changes. Importantly, mental health problems are also overrepresented in individuals with Fetal Alcohol Spectrum Disorder (FASD), the group of neurodevelopmental conditions that can occur following PAE. Approximately 90% of individuals with FASD report experiencing mental health problems over their lifespan, compared to approximately 30% in the overall population. Individuals with FASD also display impairments in coping skills and increased vulnerability to stress. Here, we investigated whether the COVID-19 pandemic would have a differential impact on mental health and inflammation-to-mood associations in adults with FASD, compared to unexposed controls (no PAE). We capitalized on our pre-pandemic study examining health and immune function and invited past-participants to enroll in the current study. Participants completed mental health assessments and COVID-related questionnaires by phone. In addition, blood samples collected at baseline (pre-pandemic) were used to probe for inflammation-to-mood associations. Overall, our results indicate that lower SES was predictive of higher coronavirus anxiety scores, with no differences between adults with FASD and controls. In addition, while there were no differences in depression or anxiety measures at baseline (pre-pandemic) or during the pandemic, examination of inflammation-to-mood associations identified differential relationships in adults with FASD compared to unexposed controls. Specifically, there was a positive association between baseline neutrophil counts and both baseline and pandemic mental health scores in unexposed controls only. In addition, for unexposed controls there was also a negative association between baseline interferon-ɣ (IFN-ɣ) and pandemic mental health scores. By contrast, only adults with FASD showed positive associations between baseline interleukin-12p70 (IL-12p70), IL-8, soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) and pandemic mental health scores. Taken together, to our knowledge, this study is the first to examine the impact of the pandemic in adults with FASD. And while it may be too soon to predict the long-term effects of the pandemic on mental health, our data suggest that it will be important that future work also takes into account how immune function may be modulating mental health outcomes in this population.
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Affiliation(s)
- Tamara S. Bodnar
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amanda Chao
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Parker J. Holman
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Linda Ellis
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Charlis Raineki
- Department of Psychology, Brock University, St. Catharines, ON, Canada
| | - Joanne Weinberg
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Nian HY, Zhang RX, Ding SS, Wang YL, Li JF, Liu HG, Li JH, Li X, Bao J. Emotional responses of piglets under long-term exposure to negative and positive auditory stimuli. Domest Anim Endocrinol 2023; 82:106771. [PMID: 36332459 DOI: 10.1016/j.domaniend.2022.106771] [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: 04/18/2022] [Revised: 09/21/2022] [Accepted: 10/10/2022] [Indexed: 11/20/2022]
Abstract
The stress caused by sound is inevitable. The stress caused by noise and the positive effects of music can affect the endocrine of animals and their welfare. In this study, a total of 72 hybrid piglets (Large White × Duroc × Min pig) were randomly divided into 3 groups, including music (Mozart K.448, 60-70 dB), noise (recorded mechanical noise, 80-85 dB), and control (natural background sound, <40 dB) groups. S-IgA (secretory immunoglobulin A), IL-6 (interleukin-6), IL-8 (interleukin-8), and positive emotion-related behaviors were used as indicators to discuss whether noise induced stress and inflammation in piglets or whether music could have positive effects. Six hours of auditory exposure were given daily (10:00-16:00), which lasted for 56 days. Behavioral responses of the piglets were observed, and the concentrations of salivary S-IgA and serum IL-6 and IL-8 were measured. The results showed that the concentration of S-IgA increased in the noise and control groups on the 57th day (P < 0.05); S-IgA concentration in the music group was unchanged after long-term music exposure. The concentrations of IL-6 and IL-8 showed that long-term noise exposure might lead to stress and inflammation in piglets. Tail-wagging and play behaviors of the piglets in the music group were significantly greater than those in the noise and control groups, which implied that long-term music exposure improved the emotional state of the piglets in a restricted and barren environment.
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Affiliation(s)
- H-Y Nian
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China; Key Laboratory of Swine Facilities Engineering, Ministry of Agriculture and Rural Affairs, Changjiang Road No. 150030 Harbin, Heilongjiang, P.R. China
| | - R-X Zhang
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China
| | - S-S Ding
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China; Key Laboratory of Swine Facilities Engineering, Ministry of Agriculture and Rural Affairs, Changjiang Road No. 150030 Harbin, Heilongjiang, P.R. China
| | - Y-L Wang
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China; Key Laboratory of Swine Facilities Engineering, Ministry of Agriculture and Rural Affairs, Changjiang Road No. 150030 Harbin, Heilongjiang, P.R. China
| | - J-F Li
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China; Key Laboratory of Swine Facilities Engineering, Ministry of Agriculture and Rural Affairs, Changjiang Road No. 150030 Harbin, Heilongjiang, P.R. China
| | - H-G Liu
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China; Key Laboratory of Swine Facilities Engineering, Ministry of Agriculture and Rural Affairs, Changjiang Road No. 150030 Harbin, Heilongjiang, P.R. China
| | - J-H Li
- College of Life Science, Northeast Agricultural University, 150030 Harbin, Heilongjiang, P.R. China
| | - X Li
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China; Key Laboratory of Swine Facilities Engineering, Ministry of Agriculture and Rural Affairs, Changjiang Road No. 150030 Harbin, Heilongjiang, P.R. China
| | - J Bao
- College of Animal Science and Technology, Northeast Agricultural University,150030 Harbin, Heilongjiang, P.R. China; Key Laboratory of Swine Facilities Engineering, Ministry of Agriculture and Rural Affairs, Changjiang Road No. 150030 Harbin, Heilongjiang, P.R. China.
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Drapisz A, Avrahami M, Ben Dor DH, Bustan Y, Mekori–Domachevski E, Weizman A, Barzilay R. Association between neutrophil to lymphocyte ratio and mood polarity in adolescents admitted to an inpatient psychiatric ward. Int Clin Psychopharmacol 2022; 37:242-246. [PMID: 35833290 PMCID: PMC9547949 DOI: 10.1097/yic.0000000000000412] [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] [Indexed: 02/04/2023]
Abstract
Inflammatory processes are associated with mood disorders, but data on pediatric patients are scarce. The aim of this study was to investigate a possible association between elevated neutrophil/lymphocyte ratio (NLR) - a marker of inflammation and mood polarity (manic/depressed) in adolescents, admitted between 2010 and 2015 due to a mood disorder episode and to an adolescent inpatient ward. Electronic medical records of 305 patients (aged 10-19 years, 60.6% males) admitted during the study period due to a mood disorder episode were reviewed. Of these, 63 were diagnosed with manic episodes and 242 with depressive episodes. Multivariate analyses were used to compare NLR between and within the two groups, covarying for age, sex, and antipsychotic use. NLR was significantly higher in the manic episode group compared with the depression one. Moreover, in inpatients with multiple hospitalizations, the NLR was higher during their manic episodes than that during their nonmanic states. These results suggest that, as has been reported in adults with bipolar disorder, inflammatory mechanisms may be involved in adolescents' mood disorders as well, particularly in the manic episodes. Thus, clinicians may consider adding anti-inflammatories as part of the treatment of these patients.
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Affiliation(s)
- Adi Drapisz
- Child & Adolescent Division, Geha Mental Health Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Matan Avrahami
- Child & Adolescent Division, Geha Mental Health Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David H. Ben Dor
- Child & Adolescent Division, Geha Mental Health Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Bustan
- Child & Adolescent Division, Geha Mental Health Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ehud Mekori–Domachevski
- Child & Adolescent Division, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Child & Adolescent Division, Geha Mental Health Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Laboratory of Molecular Psychiatry, Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, , Philadelphia, PA, USA
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Cytokine alterations in pediatric internalizing disorders: Systematic review and exploratory multi-variate meta-analysis. Brain Behav Immun Health 2022; 24:100490. [PMID: 35880170 PMCID: PMC9307453 DOI: 10.1016/j.bbih.2022.100490] [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: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 12/16/2022] Open
Abstract
Pediatric internalizing disorders are prevalent and characterized by a maladaptive cognitive, emotional response to a perceived stressor. The hypothesized effect of this response is observable changes in behavior mediated by homeostatic inflammatory cytokines. The aim of this study was to synthesize the literature and analyze the effect of cytokines on pediatric internalizing disorders. Influential moderating variables, including mean body mass index, fasting status at blood collection, participant sex, cytokine type, mean age, percentage of sample medicated, and diagnosis, were also assessed. A systematic literature search was performed in electronic databases (Medline, PubMed, and PsycINFO) from January 1, 1980 to June 15, 2022. Case-control studies of pediatric internalizing disorders, specifically anxiety and depression, were reviewed for their association with peripheral cytokine levels. Meta-analyses were performed using a random effects multi-variate model and effect sizes were calculated using Hedge's g for IL-2, CRP, IL-6, TNF-α, IL-1β, IFN-γ, and IL-10. Thirty-three studies were reviewed and 28 studies were included in the meta-analysis (n = 1322 cases and n = 3617 controls). Peripheral cytokine levels were elevated in pediatric internalizing disorders compared to controls (Hedge's g = 0.19, p < 0.001). In the moderator analyses, depression diagnosis (Hedge's g = 0.18, p = 0.009) and non-fasting blood collection (Hedge's g = 0.20, p = 0.006) were significant. The meta-analytic findings are limited by methodological variation between studies, high heterogeneity, and low statistical power. Despite this, the findings suggest that elevated peripheral cytokine levels may play a role in the etiology and/or symptom maintenance of pediatric internalizing disorders. Depression diagnosis and non-fasting blood collection were observed to significantly influenced peripheral cytokine levels. No individual peripheral cytokines tested were associated with pediatric internalizing disorders. Overall, elevated peripheral cytokines were observed in pediatric internalizing disorders compared to controls.
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Ghandour M, Yamin JB, Arnetz JE, Lumley MA, Stemmer PM, Burghardt P, Jamil H, Arnetz BB. Association Between Inflammatory Biomarkers and Mental Health Symptoms in Middle Eastern Refugees in the US. Cureus 2022; 14:e28246. [PMID: 36158450 PMCID: PMC9498960 DOI: 10.7759/cureus.28246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: Refugees are at increased risk for trauma-related mental health disorders, including anxiety, depression, and post-traumatic stress disorder (PTSD). The underlying biological mechanisms linking trauma to mental disorders need additional study, and the possible pathophysiological role of the immune system is attracting increasing interest. In this study, we investigated whether two well-known pro-inflammatory cytokines (interleukin (IL-8) and IL-6) are associated with mental health symptoms in Middle Eastern refugees displaced to the United States. Methods: Refugees (n=64, mean age=37.6 years) ages ranged from 21 to 74 years (mean=37.62, SD=11.84) were interviewed one month after arrival in Michigan, United States, using a validated survey in Arabic. Questions covered pre-displacement trauma, current anxiety, depression, and PTSD symptoms. Blood, collected immediately following the interview, was analyzed for the levels of interleukins. Multivariate linear regression was used to determine the association between mental health symptoms and IL-6 and IL-8. Results: In multivariate modeling, older age (β=0.37; p<0.01) and anxiety (β=0.31; p<0.05) were positively associated with IL-8. Age (β=0.28; p<0.05) and pre-displacement trauma (β=0.40; p<0.05) were positively associated with IL-6. Depression (β=-0.38) was negatively associated with IL-6. Conclusion/relevance: This study of inflammatory biomarkers suggests the possibility of differential associations between mental health symptoms (anxiety and depression) and pro-inflammatory markers (IL-6 and IL-8). To enhance our ability to prevent and more effectively treat trauma-exposed refugees, we need to better understand the neuroinflammatory mechanisms contributing to mental disorders.
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Fabricius RA, Sørensen CB, Skov L, Debes NM. Cytokine profile of pediatric patients with obsessive-compulsive and/or movement disorder symptoms: A review. Front Pediatr 2022; 10:893815. [PMID: 36061386 PMCID: PMC9437446 DOI: 10.3389/fped.2022.893815] [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: 03/10/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Cytokines are an important modulator of the immune system and have been found to be altered significantly in many neurological and psychiatric disorders, like obsessive compulsive disorder (OCD) and movement disorders. Also, in pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infections (PANDAS), which are characterized by abrupt debut of symptoms of OCD and /or movement disorder symptoms, alterations in the immune system have been suggested. The aim of this paper was to review the current literature on the cytokine profile of pediatric patients with symptoms of OCD and/or movement disorder symptoms. A search of PubMed and Medline was performed with specific keywords to review studies measuring cytokines in pediatric patients with symptoms of OCD and/or movement disorders. Nineteen studies were found, twelve of which included a healthy control group, while four studies had control groups of children with other disorders, primarily neurological or psychiatric. One study compared cytokines measurements to reference intervals, and two studies had a longitudinal design. Many cytokines were found to have significant changes in patients with symptoms of OCD and/or movement disorders compared to both healthy controls and other control groups. Furthermore, differences were found when comparing cytokines in periods of exacerbation with periods of remission of symptoms in study participants. The cytokines that most studies with healthy control groups found to be significantly altered were TNF-α, IL-1β and IL-17. Although the exact role of these cytokines in OCD and movement disorder symptoms remains unclear, the available literature suggests a proinflammatory cytokine profile. This offers interesting perspectives on the pathogenesis of OCD and/or movement disorder symptoms in children, and further research into the implications of cytokines in neuropsychiatric disorders is warranted.
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Affiliation(s)
- Rebecca Alison Fabricius
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev, Denmark
| | | | - Liselotte Skov
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev, Denmark
| | - Nanette Mol Debes
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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10
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Lee J, Chi S, Lee MS. Molecular Biomarkers for Pediatric Depressive Disorders: A Narrative Review. Int J Mol Sci 2021; 22:ijms221810051. [PMID: 34576215 PMCID: PMC8464852 DOI: 10.3390/ijms221810051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/05/2021] [Accepted: 09/14/2021] [Indexed: 01/31/2023] Open
Abstract
Depressive disorder in childhood and adolescence is a highly prevalent mood disorder that tends to recur throughout life. Untreated mood disorders can adversely impact a patient’s quality of life and cause socioeconomic loss. Thus, an accurate diagnosis and appropriate treatment is crucial. However, until now, diagnoses and treatments were conducted according to clinical symptoms. Objective and biological validation is lacking. This may result in a poor outcome for patients with depressive disorder. Research has been conducted to identify the biomarkers that are related to depressive disorder. Cumulative evidence has revealed that certain immunologic biomarkers including brain-derived neurotrophic factor (BDNF) and cytokines, gastrointestinal biomarkers, hormones, oxidative stress, and certain hypothalamus-pituitary axis biomarkers are associated with depressive disorder. This article reviews the biomarkers related to the diagnosis and treatment of pediatric depressive disorders. To date, clinical biomarker tests are not yet available for diagnosis or for the prediction of treatment prognosis. However, cytokines such as Interleukin-2, interferon-gamma, tumor necrosis factor-alpha, and BDNF have shown significant results in previous studies of pediatric depressive disorder. These biomarkers have the potential to be used for diagnosis, prognostic assessment, and group screening for those at high risk.
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Affiliation(s)
- Jongha Lee
- Department of Psychiatry, Korea University Ansan Hospital, Ansan 15355, Korea;
| | - Suhyuk Chi
- Department of Psychiatry, Korea University Guro Hospital, Seoul 08308, Korea;
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University Guro Hospital, Seoul 08308, Korea;
- Correspondence: ; Tel.: +82-2-2626-3163; Fax: +82-2-852-1937
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11
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Wunram HL, Oberste M, Hamacher S, Neufang S, Grote N, Krischer MK, Bloch W, Schönau E, Bender S, Fricke O. Immunological Effects of an Add-On Physical Exercise Therapy in Depressed Adolescents and Its Interplay with Depression Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6527. [PMID: 34204400 PMCID: PMC8296386 DOI: 10.3390/ijerph18126527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pro-inflammatory cytokines (PICs) have gained attention in the pathophysiology and treatment of depressive disorders. At the same time, the therapeutic effect of physical activity seems to work via immunomodulatory pathways. The interventional study "Mood Vibes" analyzed the influence of exercise on depression severity (primary endpoint) in depressive adolescents; the influence of PICs on the clinical outcome was analyzed as a secondary endpoint. METHODS Clinically diagnosed depressed adolescents (N = 64; 28.1% male; mean age = 15.9; mean BMI = 24.6) were included and participated either in Whole Body Vibration (WBV) (n = 21) or bicycle ergometer training (n = 20) in addition to treatment-as-usual (TAU). Patients in the control treatment group received TAU only (n = 23). The PICs (interleukin-6-IL-6 and tumor necrosis factor-α-TNF-α) were analyzed before intervention, after 6 weeks of training (t1), and 8 weeks post-intervention (t2). The effects of the treatment on depression severity were rated by self-rating "Depression Inventory for Children and Adolescents" (DIKJ). RESULTS Basal IL-6 decreased in all groups from t0 to t1, but it increased again in WBV and controls at t2. TNF-α diminished in ergometer and controls from baseline to t1. PIC levels showed no correlation with depression severity at baseline. The influence on DIKJ scores over time was significant for IL-6 in the WBV group (p = 0.008). Sex had an impact on TNF-α (p < 0.001), with higher concentrations in male patients. Higher body mass index was associated with higher IL-6 concentrations over all measurement points (p < 0.001). CONCLUSIONS The positive effects of an intensive add-on exercise therapy on adolescent depression seem to be partly influenced by immunomodulation. A small sample size and non-randomized controls are limitations of this study.
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Affiliation(s)
- Heidrun Lioba Wunram
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Max Oberste
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, 50937 Cologne, Germany; (M.O.); (S.H.)
- Department for Molecular and Cellular Sports Medicine, German Sport University Cologne, 50933 Cologne, Germany
| | - Stefanie Hamacher
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, 50937 Cologne, Germany; (M.O.); (S.H.)
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty Heinrich-Heine University, 40225 Düsseldorf, Germany;
| | - Nils Grote
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Maya Kristina Krischer
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Wilhelm Bloch
- Institute of Movement and Neuroscience, German Sport University Cologne, 50933 Cologne, Germany;
| | - Eckhard Schönau
- Children’s Hospital, University Hospital of Cologne & UniReha, University Hospital of Cologne, 50933 Cologne, Germany;
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Oliver Fricke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke & Chair of Child and Adolescent Psychiatry, Witten/Herdecke University, 58313 Witten/Herdecke, Germany;
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12
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Parsons C, Roberts R, Mills NT. Review: Inflammation and anxiety-based disorders in children and adolescents - a systematic review and meta-analysis. Child Adolesc Ment Health 2021; 26:143-156. [PMID: 33200498 DOI: 10.1111/camh.12434] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Anxiety-based disorders are common and are often chronic with an onset during childhood or adolescence. An emerging literature has examined the role of inflammation in these disorders by measuring blood concentrations of inflammatory markers such as cytokines, C-reactive protein (CRP) and immune markers such as white blood cell counts. However, existing results are inconsistent, with available meta-analyses only including adult populations. We believe this is the first systematic review and meta-analysis to investigate these inconsistencies among the population of children and adolescents. METHODS A systematic search of five electronic databases was conducted to identify studies which compared inflammatory markers between individuals with an anxiety-based disorder and healthy controls. Study quality was assessed, and pooled effect sizes (Hedges' g) were calculated using random-effects meta-analyses. RESULTS Nine independent studies were identified. The combined meta-analysis of 16 cytokines and CRP was approaching significance; however, no significant between-group difference was observed for meta-analyses of individual inflammatory or immune markers. Heterogeneity was high, and quality assessments identified important limitations; primarily, small sample sizes and a lack of control over confounding variables. CONCLUSIONS Although no significant effects were observed, the small number of included studies and limitations in study or reporting quality render these findings provisional. Research in this area has the potential for important clinical implications in relation to therapeutic interventions. Important recommendations for further research are put forth.
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Affiliation(s)
- Chelsea Parsons
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Rachel Roberts
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Natalie T Mills
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
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Hsu CJ, Wong LC, Lee WT. Immunological Dysfunction in Tourette Syndrome and Related Disorders. Int J Mol Sci 2021; 22:ijms22020853. [PMID: 33467014 PMCID: PMC7839977 DOI: 10.3390/ijms22020853] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/28/2022] Open
Abstract
Chronic tic disorder and Tourette syndrome are common childhood-onset neurological diseases. However, the pathophysiology underlying these disorders is unclear, and most studies have focused on the disinhibition of the corticostriatal–thalamocortical circuit. An autoimmune dysfunction has been proposed in the pathogenetic mechanism of Tourette syndrome and related neuropsychiatric disorders such as obsessive–compulsive disorder, autism, and attention-deficit/hyperactivity disorder. This is based on evidence from animal model studies and clinical findings. Herein, we review and give an update on the clinical characteristics, clinical evidence, and genetic studies in vitro as well as animal studies regarding immune dysfunction in Tourette syndrome.
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Affiliation(s)
- Chia-Jui Hsu
- Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan;
| | - Lee-Chin Wong
- Department of Pediatrics, Cathay General Hospital, Taipei 106, Taiwan;
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Wang-Tso Lee
- Department of Pediatric Neurology, National Taiwan University Children’s Hospital, Taipei 100, Taiwan
- Department of Pediatrics, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-2-2312-3456 (ext. 71545); Fax: +886-2-2314-7450
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Martino D, Johnson I, Leckman JF. What Does Immunology Have to Do With Normal Brain Development and the Pathophysiology Underlying Tourette Syndrome and Related Neuropsychiatric Disorders? Front Neurol 2020; 11:567407. [PMID: 33041996 PMCID: PMC7525089 DOI: 10.3389/fneur.2020.567407] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/20/2020] [Indexed: 12/20/2022] Open
Abstract
Objective: The goal of this article is to review the past decade's literature and provide a critical commentary on the involvement of immunological mechanisms in normal brain development, as well as its role in the pathophysiology of Tourette syndrome, other Chronic tic disorders (CTD), and related neuropsychiatric disorders including Obsessive-compulsive disorder (OCD) and Attention deficit hyperactivity disorder (ADHD). Methods: We conducted a literature search using the Medline/PubMed and EMBASE electronic databases to locate relevant articles and abstracts published between 2009 and 2020, using a comprehensive list of search terms related to immune mechanisms and the diseases of interest, including both clinical and animal model studies. Results: The cellular and molecular processes that constitute our "immune system" are crucial to normal brain development and the formation and maintenance of neural circuits. It is also increasingly evident that innate and adaptive systemic immune pathways, as well as neuroinflammatory mechanisms, play an important role in the pathobiology of at least a subset of individuals with Tourette syndrome and related neuropsychiatric disorders In the conceptual framework of the holobiont theory, emerging evidence points also to the importance of the "microbiota-gut-brain axis" in the pathobiology of these neurodevelopmental disorders. Conclusions: Neural development is an enormously complex and dynamic process. Immunological pathways are implicated in several early neurodevelopmental processes including the formation and refinement of neural circuits. Hyper-reactivity of systemic immune pathways and neuroinflammation may contribute to the natural fluctuations of the core behavioral features of CTD, OCD, and ADHD. There is still limited knowledge of the efficacy of direct and indirect (i.e., through environmental modifications) immune-modulatory interventions in the treatment of these disorders. Future research also needs to focus on the key molecular pathways through which dysbiosis of different tissue microbiota influence neuroimmune interactions in these disorders, and how microbiota modification could modify their natural history. It is also possible that valid biomarkers will emerge that will guide a more personalized approach to the treatment of these disorders.
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Affiliation(s)
- Davide Martino
- Department of Clinical Neurosciences & Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Isaac Johnson
- Child Study Center, Yale University, New Haven, CT, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - James F. Leckman
- Child Study Center, Yale University, New Haven, CT, United States
- Departments of Psychiatry, Pediatrics and Psychology, Yale University, New Haven, CT, United States
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15
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Novel Insight into Neuroimmune Regulatory Mechanisms and Biomarkers Linking Major Depression and Vascular Diseases: The Dilemma Continues. Int J Mol Sci 2020; 21:ijms21072317. [PMID: 32230840 PMCID: PMC7177743 DOI: 10.3390/ijms21072317] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 02/07/2023] Open
Abstract
Major depressive disorder (MDD) represents a serious health problem estimated to affect 350 million people globally. Importantly, MDD has repeatedly emerged as an etiological or prognostic factor in cardiovascular disease (CVD) development, including vascular pathology. Several linking pathomechanisms between MDD and CVD involve abnormal autonomic regulation, inflammation, and endothelial dysfunction as an early preclinical stage of atherosclerosis. However, the cause of accelerated atherosclerosis in MDD patients remains unclear. Recently, the causal relationships between MDD and mediator (e.g., inflammation and/or endothelial dysfunction), as well as the causal pathways from the mediator to atherosclerosis, were discussed. Specifically, MDD is accompanied by immune dysregulation, resulting in increased production of proinflammatory cytokines (e.g., interleukin (IL)-6 and tumor necrosis factor (TNF)-α), which could lead to depression-linked abnormalities in brain function. Further, MDD has an adverse effect on endothelial function; for example, circulating markers of endothelial dysfunction (e.g., soluble adhesion molecules, von Willebrand factor) have been linked with depression. Additionally, MDD-linked autonomic dysregulation, which is characterized by disrupted sympathovagal balance associated with excessive circulating catecholamines, can contribute to CVD. Taken together, activated inflammatory response, endothelial dysfunction, and autonomic dysregulation could affect gradual atherosclerosis progression, resulting in a higher risk of developing CVD in MDD. This review focused on the pathomechanisms linking MDD and CVD with respect to neuroimmune regulation, and the description of promising biomarkers, which is important for the early diagnosis and personalized prevention of CVD in major depression.
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16
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Hockenberry MJ, Pan W, Scheurer ME, Hooke MC, Taylor O, Koerner K, Montgomery D, Whitman S, Mitby P, Moore I. Influence of Inflammatory and Oxidative Stress Pathways on Longitudinal Symptom Experiences in Children With Leukemia. Biol Res Nurs 2019; 21:458-465. [PMID: 31315444 DOI: 10.1177/1099800419863160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to explore the influence of oxidative stress (F2-isoprostanes) and inflammatory (interleukin [IL]-8) biomarkers on symptom trajectories during the first 18 months of childhood leukemia treatment. METHOD A repeated-measures design was used to evaluate symptoms experienced by 218 children during treatment. A symptom cluster (fatigue, pain, and nausea) was explored over four time periods: initiation of post-induction therapy, 4 and 8 months into post-induction therapy, and the beginning of maintenance therapy (12 months postinduction). F2-isoprostanes and IL-8 were evaluated in cerebrospinal fluid (CSF) samples collected at baseline (diagnosis) and then at the four time periods. The longitudinal relationships of these biomarkers with the symptom cluster were examined using the longitudinal parallel process. RESULTS Pain and fatigue levels were highest during the post-induction phases of treatment and decreased slightly during maintenance therapy, while nausea scores were relatively stable. Even in the later phases of treatment, children continued to experience symptoms. CSF levels of the biomarkers increased during the post-induction phases of treatment. Early increases in the biomarkers were associated with more severe symptoms during the same period; patients who had increased biomarkers over time also experienced more severe symptoms over time. CONCLUSIONS Findings reveal that children experienced symptoms throughout the course of leukemia treatment and support hypothesized longitudinal relationships of oxidative stress and inflammatory biomarkers with symptom severity. Activation of the biomarker pathways during treatment may explain underlying mechanisms of symptom experiences and identify which children are at risk for severe symptoms.
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Affiliation(s)
| | - Wei Pan
- 1 School of Nursing, Duke University, Durham, NC, USA
| | - Michael E Scheurer
- 2 Baylor College of Medicine, Houston, TX, USA.,3 Texas Children's Cancer and Hematology Centers, Houston, TX, USA
| | - Mary C Hooke
- 4 School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Olga Taylor
- 2 Baylor College of Medicine, Houston, TX, USA.,3 Texas Children's Cancer and Hematology Centers, Houston, TX, USA
| | - Kari Koerner
- 5 College of Nursing, University of Arizona, Tucson, AZ, USA
| | | | - Susan Whitman
- 5 College of Nursing, University of Arizona, Tucson, AZ, USA
| | | | - Ida Moore
- 5 College of Nursing, University of Arizona, Tucson, AZ, USA
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17
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Baumgaertel C, Skripuletz T, Kronenberg J, Stangel M, Schwenkenbecher P, Sinke C, Müller-Vahl KR, Sühs KW. Immunity in Gilles de la Tourette-Syndrome: Results From a Cerebrospinal Fluid Study. Front Neurol 2019; 10:732. [PMID: 31333575 PMCID: PMC6621640 DOI: 10.3389/fneur.2019.00732] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Several lines of evidence support the hypothesis of an autoimmune origin of Gilles de la Tourette-Syndrome (GTS). Accordingly, in a recent study we detected positive oligoclonal bands (OCB) in cerebrospinal fluid (CSF) in >30% of adult patients indicating an intrathecal antibody synthesis. However, until today no corresponding antibodies could be identified. The aims of this study were to replicate our findings of positive OCB in an independent sample and to detect CSF autoantibodies. Methods: In this prospective study, 20 adult patients with GTS (male: female = 18:2, median age 36.1 years ± 14.34 SD) were included. All patients were thoroughly clinically characterized. Magnetic Resonance Imaging (MRI) and CSF standard measurements were performed. Isoelectric focusing on polyacrylamide gels with silver staining was used to detect OCB. To examine specific and unspecified autoantibodies, we used transfected Human Embryonic Kidney (HEK) cells expressing different surface antigens (NMDA-, CASPR2-, LGI1-, AMPA-, or GABAB1/B), indirect immunofluorescence on different brain tissue sections, and enzyme-linked visualization. Additionally, we differentiated Glioma stem cells SY5Y (human neuroblastoma) using retinoic acid and astrocytes (rat). Results: CSF analyses showed positive OCB (type 2) in 4/20 patients (20%). Using transfected HEK cells we did not find specific surface-autoantibodies. Immunohistochemistry on tissue-sections, SY5Y Glioma stem-cells, and astrocytes showed no specific binding patterns either. Conclusions: Our results corroborate previous findings and demonstrate positive OCB in a substantial number of patients with GTS (prevalence in healthy controls: 5%). Although this is the largest study investigating CSF autoantibodies in GTS using several techniques, we failed to detect any specific or unspecified autoantibodies.
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Affiliation(s)
- Charlotte Baumgaertel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | | | - Jessica Kronenberg
- Department of Neurology, Hannover Medical School, Hanover, Germany.,Center for Systems Neuroscience, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Martin Stangel
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | | | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Kirsten R Müller-Vahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
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18
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The Relationship between Anxiety and Immunity in Pediatric Oncology Patients. JOURNAL OF INTERDISCIPLINARY MEDICINE 2019. [DOI: 10.2478/jim-2019-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background: Pediatric onco-hematology is not a frequently encountered medical specialty, and it influences everyday life, basic activities, and the immune system, mostly through psychosocial changes, which may affect every individual and their families differently. Anxiety is the most frequently encountered mental health disorder occurring during childhood and adolescence. The effect of stress and anxiety on the immune system is suggested by the fact that stress hormones elevate proinflammatory cytokines and subsequently lower the anti-inflammatory response.
Objective: Our main objective was to analyze the relationship between anxiety disturbance and cytokine levels in oncologic pediatric patients from Târgu Mureș in order to answer the following question: does anxiety influence immunity?
Material and methods: After testing pediatric oncology patients from the Pediatrics Clinic no. 2 of Târgu Mureș, Romania with the SCARED child test, we took blood samples from each participant. IL-6, IL-10, IL-1β, IL-12p40 and TNF-α levels were evaluated with a Human Cytokine Magnetic Panel using the xMAP technique on Flexmap 3D platform (Luminex Corporation, Austin, USA). C-reactive protein levels were determined with the BN Pro Spec nephelometer with CardioPhase hsCRP (Siemens Healthcare Diagnostics, GmbH, Marburg, Germany) reagent.
Results: The 46 pediatric oncology patients had 6 main diagnostic groups, the most frequent pathology was acute leukemia (58.7%) followed by malignant solid tumors (21.74%) and lymphomas (6.52%). In the anxious group (45.65%) we observed 4 of the 5 studied anxiety types: panic disorder, separation, social, and generalized anxiety. We measured the cytokine levels of all the participants from the two main groups: anxious/non-anxious. Statistical analysis (linear regression) showed statistically significant positive correlations in the anxious group related to the IL-1β and IL-6, a moderate/weak correlation related to IL-12p40, as well as a negative moderate correlation between IL-10 values in the anxious group and a positive trend in the non-anxious group.
Conclusions: Psycho-oncology is a relatively young specialty with few studies in the last two decades. IL-1β, IL-6, and TNF-α present high levels in anxious patients, while IL-10 and IL-12p40 have low serum levels in mental disorders. C-reactive protein levels are not influenced by anxiety.
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D'Acunto G, Nageye F, Zhang J, Masi G, Cortese S. Inflammatory Cytokines in Children and Adolescents with Depressive Disorders: A Systematic Review and Meta-Analysis. J Child Adolesc Psychopharmacol 2019; 29:362-369. [PMID: 30939048 DOI: 10.1089/cap.2019.0015] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: Meta-analytic evidence shows alterations of peripheral inflammatory cytokines in adults with depressive disorders. By contrast, no evidence synthesis on alterations of peripheral inflammatory cytokines in children/adolescents with depressive disorders is available to date. To fill this gap, we conducted a systematic review and meta-analysis of case-control studies comparing serum cytokine levels in children/adolescents with depressive disorders and healthy controls. Methods: Based on a preregistered protocol (PROSPERO-CRD42018095418), we searched PubMed, Ovid, and Web of Knowledge from inception through July 21, 2018, with no language restrictions, and contacted study authors for unpublished data/information. Random-effects model was used to compute effect size for each cytokine. The Newcastle-Ottawa Scale was used to asses study bias. Results: From a pool of 4231 nonduplicate, potentially relevant references, 8 studies were retained for the qualitative synthesis and 5 for the meta-analysis. TNF-α was higher in participants with depressive disorders versus controls, falling short of statistical significance. Conclusions: Overall, due to the small number of studies, in contrast to the literature in adults, further evidence is needed to confirm possible inflammatory alterations associated with depression in youth.
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Affiliation(s)
- Giulia D'Acunto
- 1 IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy
| | - Fatuma Nageye
- 2 School of Medicine, University of Southampton, Southampton, United Kingdom
| | - Junhua Zhang
- 3 School of Education, Jiangsu Key Laboratory for Big Data of Psychology and Cognitive Science, Yancheng Teachers University, Yancheng, China
| | - Gabriele Masi
- 1 IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy
| | - Samuele Cortese
- 4 Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, United Kingdom.,5 School of Psychology, Life and Environmental Sciences, and Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry), University of Southampton, United Kingdom.,6 Solent NHS Trust, Southampton, United Kingdom.,7 New York University Child Study Center, New York, New York.,8 Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Autoantibodies, elevated cytokines, and neurocognitive abnormalities in offspring of women with systemic lupus erythematosus: comparison with healthy controls. Clin Rheumatol 2019; 38:2529-2539. [DOI: 10.1007/s10067-019-04495-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/04/2019] [Accepted: 02/24/2019] [Indexed: 12/25/2022]
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21
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Sathyanarayanan G, Thippeswamy H, Mani R, Venkataswamy M, Kumar M, Philip M, Chandra PS. Cytokine alterations in first-onset postpartum psychosis-clues for underlying immune dysregulation. Asian J Psychiatr 2019; 42:74-78. [PMID: 30974307 DOI: 10.1016/j.ajp.2019.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 02/16/2019] [Accepted: 03/25/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Emerging evidence suggests a possible role for immune system dysregulation in the pathogenesis of postpartum psychosis (PP) but the evidence is limited. The current study sought to determine the serum cytokines/ chemokine changes associated with first-onset PP. METHODS Women with first onset PP were recruited as cases and the cytokines/ chemokine changes were compared against healthy postpartum (HP) and healthy non-postpartum (HNP) women.There were 20 subjects in each of the three groups. Levels of serum cytokines and Monocyte Chemoattractant Protein-1 (MCP-1) were estimated with a cytometric beadarray assay. RESULTS HP group showed significantly elevated levels of interleukin (IL)-6 as compared to HNP group. Whereas, the first onset PP group showed significantly elevated levels of both IL-6 and IL-8 as compared to HNP group. CONCLUSION Postpartum period appears to be a state of altered immune functioning considering the elevated level of IL-6 in both HP and PP group. Additionally, IL-8 appears to play a role in the manifestation of PP. Our study highlights the immune alterations associated with first-onset PP.
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Affiliation(s)
- Gopinath Sathyanarayanan
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, 560029, Bengaluru, Karnataka, India
| | - Harish Thippeswamy
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, 560029, Bengaluru, Karnataka, India.
| | - Reeta Mani
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, 560029, Bengaluru, Karnataka, India
| | - Manjunatha Venkataswamy
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, 560029, Bengaluru, Karnataka, India
| | - Mahesh Kumar
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, 560029, Bengaluru, Karnataka, India
| | - Mariamma Philip
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, 560029, Bengaluru, Karnataka, India
| | - Prabha S Chandra
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, 560029, Bengaluru, Karnataka, India
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22
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Kozłowska E, Agier J, Wysokiński A, Łucka A, Sobierajska K, Brzezińska-Błaszczyk E. The expression of toll-like receptors in peripheral blood mononuclear cells is altered in schizophrenia. Psychiatry Res 2019; 272:540-550. [PMID: 30616121 DOI: 10.1016/j.psychres.2018.12.138] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/19/2018] [Accepted: 12/26/2018] [Indexed: 01/30/2023]
Abstract
Increasing evidence suggests that in addition to neurochemical abnormalities, various immunological alterations are related to the pathogenesis of schizophrenia. Toll-like receptors (TLRs) actively mediate immune/inflammatory processes and play a pivotal role in damage/danger recognizing. Therefore, the aim of this study was to compare the expression of TLRs in peripheral blood mononuclear cells (PBMCs) in schizophrenic patients with those of healthy subjects. It also measures the metabolic status of the study subjects. Twenty-seven adult European Caucasian patients with paranoid schizophrenia and twenty-nine healthy volunteers were included in this prospective study. qRT-PCR assessed TLR mRNA expression levels. Body composition was measured using two methods: bioimpedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). The TLR1, TLR2, TLR4, TLR6, and TLR9 expression were down-regulated, in opposite to TLR3 and TLR7 which manifested higher expression in patients with schizophrenia. TLR5 and TLR8 mRNAs did not differ between groups. TLR mRNA expression was highly correlated. Decreased TLR expression may protect against excessive cell stimulation via exogenous and/or endogenous ligands, and may be recognized as a counterbalancing mechanism limiting the excessive development of inflammation.
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Affiliation(s)
- Elżbieta Kozłowska
- Department of Experimental Immunology, Medical University of Lodz, Pomorska 251, 92-213, Lodz, Poland
| | - Justyna Agier
- Department of Experimental Immunology, Medical University of Lodz, Pomorska 251, 92-213, Lodz, Poland
| | - Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Anna Łucka
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | | | - Ewa Brzezińska-Błaszczyk
- Department of Experimental Immunology, Medical University of Lodz, Pomorska 251, 92-213, Lodz, Poland.
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23
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Inflammatory Profiles in Depressed Adolescents Treated with Fluoxetine: An 8-Week Follow-up Open Study. Mediators Inflamm 2018; 2018:4074051. [PMID: 30662368 PMCID: PMC6312587 DOI: 10.1155/2018/4074051] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/30/2018] [Accepted: 08/28/2018] [Indexed: 12/17/2022] Open
Abstract
Changes in cytokine levels in major depression and during treatment have been reported in adults. However, few studies have examined cytokine levels in an adolescent sample despite this being a common age of onset. Methods. We measured proinflammatory (IL-2, IFN-γ, IL-1β, TNF-α, IL-6, IL-12, and IL-15) and anti-inflammatory (IL-4, IL-5, IL-13, IL-1Ra, and IL-10) cytokine serum levels in 22 adolescents with major depression and 18 healthy volunteers. Cytokines were measured by multiplex bead-based immunoassays at baseline, and 4 and 8 weeks after commencement of fluoxetine administration in the clinical group. Results. Compared to healthy volunteers, adolescents with major depression at baseline showed significant increases in all pro- and anti-inflammatory cytokines, except IL-1Ra and IL-10. Significant changes were observed in fluoxetine treatment compared to baseline: proinflammatory cytokines IFN-γ, IL-1β, TNF-α, IL-6, IL-12, and IL-15 were decreased only at week 4 whereas IL-2 was increased only at week 8; anti-inflammatory cytokines IL-4 and IL-5 were increased at week 8 while IL-1Ra was reduced only at week 4. There were no significant correlations between cytokine levels and symptomatic improvement in HDRS. Discussion. The results suggest a significant interplay between cytokine levels, the depressive state, and the stage of treatment with an SSRI. To the best of our knowledge, this is the first report in depressed adolescents with elevated IL-12, IL-13, and IL-15 levels. Further studies are necessary to clarify the role and mechanisms of altered cytokine levels in the pathogenesis and physiopathology of major depressive disorder.
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24
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Condon EM. Chronic Stress in Children and Adolescents: A Review of Biomarkers for Use in Pediatric Research. Biol Res Nurs 2018; 20:473-496. [PMID: 29865855 DOI: 10.1177/1099800418779214] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PROBLEM Incorporating biomarkers of chronic stress into pediatric research studies may help to explicate the links between exposure to adversity and lifelong health, but there are currently very few parameters to guide nurse researchers in choosing appropriate biomarkers of chronic stress for use in research with children and adolescents. METHODS Biomarkers of chronic stress are described, including primary mediators (glucocorticoids, catecholamines, and cytokines) and secondary outcomes (neurologic, immune, metabolic, cardiovascular, respiratory, and anthropometric) of the chronic stress response. RESULTS Evidence of the use of each biomarker in pediatric research studies is reviewed. Recommendations for pediatric researchers, including selection of appropriate biomarkers, measurement considerations, potential moderators, and future directions for research, are presented. DISCUSSION A wide range of biomarkers is available for use in research studies with children. While primary mediators of chronic stress have been frequently measured in studies of children, measurement of secondary outcomes, particularly immune and metabolic biomarkers, has been limited. With thoughtful and theoretically based approaches to selection and measurement, these biomarkers present an important opportunity to further explore the physiologic pathways linking exposure to chronic stress with later health and disease. CONCLUSION The incorporation of chronic stress biomarkers into pediatric research studies may provide valuable insight into the mechanisms through which stressful environments "get under the skin" and ultimately inform efforts to promote health and reduce inequities among children exposed to adversity.
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Affiliation(s)
- Eileen M Condon
- 1 Yale School of Nursing, West Campus Drive, Orange, CT, USA
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25
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Bocchio-Chiavetto L, Zanardini R, Tosato S, Ventriglia M, Ferrari C, Bonetto C, Lasalvia A, Giubilini F, Fioritti A, Pileggi F, Pratelli M, Pavanati M, Favaro A, De Girolamo G, Frisoni GB, Ruggeri M, Gennarelli M. Immune and metabolic alterations in first episode psychosis (FEP) patients. Brain Behav Immun 2018; 70:315-324. [PMID: 29548996 DOI: 10.1016/j.bbi.2018.03.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/09/2018] [Accepted: 03/11/2018] [Indexed: 12/14/2022] Open
Abstract
The molecular underpinnings associated to first episode psychosis (FEP) remains to be elucidated, but compelling evidence supported an association of FEP with blood alterations in biomarkers related to immune system, growth factors and metabolism regulators. Many of these studies have not been already confirmed in larger samples or have not considered the FEP diagnostic subgroups. In order to identify biochemical signatures of FEP, the serum levels of the growth factors BDNF and VEGF, the immune regulators IL-1RA, IL-6, IL-10 and IL-17, RANTES/CCL5, MIP-1b/CCL4, IL-8 and the metabolic regulators C-peptide, ghrelin, GIP, GLP-1, glucagon, insulin, leptin, PAI-1, resistin and visfatin were analysed in 260 subjects collected in the GET UP project. The results indicated an increase of MIP-1b/CCL4, VEGF, IL-6 and PAI-1, while IL-17, ghrelin, glucagon and GLP-1 were decreased in the whole sample of FEP patients (p < 0.01 for all markers except for PAI-1 p < 0.05). No differences were evidenced for these markers among the diagnostic groups that constitute the FEP sample, whereas IL-8 is increased only in patients with a diagnosis of affective psychosis. The principal component analysis (PCA) and variable importance analysis (VIA) indicated that MIP-1b/CCL4, ghrelin, glucagon, VEGF and GLP-1 were the variables mostly altered in FEP patients. On the contrary, none of the analysed markers nor a combination of them can discriminate between FEP diagnostic subgroups. These data evidence a profile of immune and metabolic alterations in FEP patients, providing new information on the molecular mechanism associated to the psychosis onset for the development of preventive strategies and innovative treatment targets.
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Affiliation(s)
- Luisella Bocchio-Chiavetto
- IRCCS Centro S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy; Faculty of Psychology, eCampus University, Novedrate (Como), Italy.
| | | | - Sarah Tosato
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mariacarla Ventriglia
- Fatebenefratelli Foundation, AFaR Division, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Clarissa Ferrari
- IRCCS Centro S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Antonio Lasalvia
- Unit of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | | | | | | | | | - Michele Pavanati
- Department of Medical Sciences of Communication and Behavior, Section of Psychiatry, The Consultation-Liaison Psychiatric Service and Psychiatric Unit, University of Ferrara, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua and Azienda Ospedaliera, Padua, Italy
| | | | - Giovanni Battista Frisoni
- IRCCS Centro S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy; Geneva University Hospital and University of Geneva, Switzerland
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Massimo Gennarelli
- IRCCS Centro S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy; Dept. of Molecular and Translational Medicine, Division of Biology and Genetics, University of Brescia, Italy
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26
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Tengeler AC, Kozicz T, Kiliaan AJ. Relationship between diet, the gut microbiota, and brain function. Nutr Rev 2018; 76:603-617. [DOI: 10.1093/nutrit/nuy016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Anouk C Tengeler
- Department of Anatomy, Radboud university medical center, Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, the Netherlands
| | - Tamas Kozicz
- Department of Anatomy, Radboud university medical center, Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, the Netherlands
- Department of Pedriatrics, Hayward Genetics Center, Tulane University School of Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Amanda J Kiliaan
- Department of Anatomy, Radboud university medical center, Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, the Netherlands
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27
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Bustan Y, Drapisz A, Ben Dor DH, Avrahami M, Schwartz-Lifshitz M, Weizman A, Barzilay R. Elevated neutrophil to lymphocyte ratio in non-affective psychotic adolescent inpatients: Evidence for early association between inflammation and psychosis. Psychiatry Res 2018; 262:149-153. [PMID: 29448179 DOI: 10.1016/j.psychres.2018.02.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 01/17/2018] [Accepted: 02/01/2018] [Indexed: 12/12/2022]
Abstract
Accumulating data suggest an association between inflammation and schizophrenia and related psychosis. While several studies have established this immune-psychosis association in adult schizophrenia patients, there is very limited data associating inflammation with acute psychosis in children and adolescents. The ratio between neutrophils and lymphocyte, computed from routine blood counts, has been shown to correlate with traditional markers of inflammation, and is therefore considered a proxy-marker for inflammation. Here we report elevated neutrophil to lymphocyte ratio and total leukocyte count in psychotic adolescent inpatients (n = 81, mean age 14.7 years, 52% males) compared to non-psychotic adolescent inpatient (n = 285, mean age 15.9 years, 58% males), in a population of adolescent inpatients with no affective symptomatology. The elevated neutrophil to lymphocyte ratio remained significant after controlling for confounders such as age, BMI, smoking and antipsychotic medication. In a subset of psychotic adolescent inpatients (n = 20, mean duration between blood test 157 days), we found significant decrease in neutrophil to lymphocyte ratio at clinical remission compared with the acute psychotic state. The results suggest that psychosis is associated with peripheral markers of inflammation early in the course of psychiatric pathology, and that inflammation may represent a state that accompanies psychosis and decreases during clinical remission.
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Affiliation(s)
- Yael Bustan
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Adi Drapisz
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - David H Ben Dor
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Matan Avrahami
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Maya Schwartz-Lifshitz
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Abraham Weizman
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ran Barzilay
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel; Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; the Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, United States.
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28
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Voltas N, Arija V, Hernández-Martínez C, Jiménez-Feijoo R, Ferré N, Canals J. Are there early inflammatory biomarkers that affect neurodevelopment in infancy? J Neuroimmunol 2017; 305:42-50. [DOI: 10.1016/j.jneuroim.2017.01.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/31/2016] [Accepted: 01/11/2017] [Indexed: 12/21/2022]
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29
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Lopizzo N, Tosato S, Begni V, Tomassi S, Cattane N, Barcella M, Turco G, Ruggeri M, Riva MA, Pariante CM, Cattaneo A. Transcriptomic analyses and leukocyte telomere length measurement in subjects exposed to severe recent stressful life events. Transl Psychiatry 2017; 7:e1042. [PMID: 28221367 PMCID: PMC5438034 DOI: 10.1038/tp.2017.5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/23/2016] [Accepted: 12/08/2016] [Indexed: 02/07/2023] Open
Abstract
Stressful life events occurring in adulthood have been found able to affect mood and behavior, thus increasing the vulnerability for several stress-related psychiatric disorders. However, although there is plenty of clinical data supporting an association between stressful life events in adulthood and an enhanced vulnerability for psychopathology, the underlying molecular mechanisms are still poorly investigated. Thus, in this study we performed peripheral/whole-genome transcriptomic analyses in blood samples obtained from 53 adult subjects characterized for recent stressful life events occurred within the previous 6 months. Transcriptomic data were analyzed using Partek Genomics Suite; pathway and network analyses were performed using Ingenuity Pathway Analysis and GeneMANIA Software. We found 207 genes significantly differentially expressed in adult subjects who reported recent stressful life experiences (n=21) compared with those without such experiences (n=32). Moreover, the same subjects exposed to such stressful experiences showed a reduction in leukocyte telomere length. A correlation analyses between telomere length and transcriptomic data indicated an association between the exposures to recent stressful life events and the modulation of several pathways, mainly involved in immune-inflammatory-related processes and oxidative stress, such as natural killer cell signaling, interleukin-1 (IL-1) signaling, MIF regulation of innate immunity and IL-6 signaling. Our data suggest an association between exposures to recent stressful life events in adulthood and alterations in the immune, inflammatory and oxidative stress pathways, which could be also involved in the negative effect of stressful life events on leukocyte telomere length. The modulation of these mechanisms may underlie the clinical association between the exposure to recent Stressful life events in adulthood and an enhanced vulnerability to develop psychiatric diseases in adulthood.
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Affiliation(s)
- N Lopizzo
- Biological Psychiatry Unit, IRCCS Fatebenefratelli S. Giovanni di Dio, Brescia, Italy
| | - S Tosato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - V Begni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - S Tomassi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - N Cattane
- Biological Psychiatry Unit, IRCCS Fatebenefratelli S. Giovanni di Dio, Brescia, Italy
| | - M Barcella
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - G Turco
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - M Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - M A Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - C M Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, London, UK
| | - A Cattaneo
- Biological Psychiatry Unit, IRCCS Fatebenefratelli S. Giovanni di Dio, Brescia, Italy,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, London, UK,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 125 Coldharbour Lane, London SE5 9NU, UK. E-mail:
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30
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31
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Schiavone S, Trabace L. Inflammation, Stress Response, and Redox Dysregulation Biomarkers: Clinical Outcomes and Pharmacological Implications for Psychosis. Front Psychiatry 2017; 8:203. [PMID: 29118723 PMCID: PMC5660996 DOI: 10.3389/fpsyt.2017.00203] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/27/2017] [Indexed: 12/31/2022] Open
Abstract
In recent years, several studies claiming the finding of a specific biomarker for the identification of the "high-risk state" to develop psychosis, first psychotic episode, as well as the prediction of the individual response to antipsychotics have been published. Together with genetic reports, numerous publications in this field have been focused on inflammation and stress response blood biomarkers, as well as on indicators of redox dysregulation. In this review, we focus on human studies found in PubMed from January 1st 2010 to January 31st 2017, describing the clinical use of these biomarkers to detect the "premorbid" psychotic state and early phases of the disease. Their pharmacological implications in predicting and monitoring the individual response to antipsychotic medication is also discussed.
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Affiliation(s)
- Stefania Schiavone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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32
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Garcia-Delgar B, Morer A, Luber MJ, Coffey BJ. Obsessive-Compulsive Disorder, Tics, and Autoinflammatory Diseases: Beyond PANDAS. J Child Adolesc Psychopharmacol 2016; 26:847-850. [PMID: 27854543 PMCID: PMC6445174 DOI: 10.1089/cap.2016.29118.bjc] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Blanca Garcia-Delgar
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Maxwell J. Luber
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Barbara J. Coffey
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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