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Boyle CC, Cole SW, Eisenberger NI, Olmstead R, Breen EC, Irwin MR. Sex differences in the transcriptional response to acute inflammatory challenge: A randomized controlled trial of endotoxin. Brain Behav Immun Health 2024; 40:100840. [PMID: 39252981 PMCID: PMC11381881 DOI: 10.1016/j.bbih.2024.100840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 09/11/2024] Open
Abstract
Background Sex differences in immune-based disorders are well-established, with female sex associated with a markedly heightened risk of autoimmune disease. Female sex is also overrepresented in other conditions associated with elevated inflammation, including depression, chronic pain, and chronic fatigue. The mechanisms underlying these disparities are unclear. This study used an experimental model of inflammatory challenge to interrogate molecular mechanisms that may contribute to female vulnerability to disorders with an inflammatory basis. Method In this analysis of a secondary outcome from a randomized controlled trial, 111 participants (67 female) received either a bolus injection of endotoxin (n = 59) or placebo (n = 52). Participants provided blood samples before and 0.5 h post-injection for assessment of differential activation of key pro-inflammatory (i.e., activator protein (AP)-1; nuclear factor (NF)-κB) and immunoregulatory (i.e., glucocorticoid receptor (GR); cAMP response element binding protein (CREB)) signaling pathways via genome-wide expression profiling and promoter-based bioinformatics analyses. Results Relative to males, females exhibited greater endotoxin-induced increases in bioinformatic measures of CREB transcription factor activity (p's < 0.01). However, contrary to hypotheses, female vs. male sex was not associated with greater increases in activation of NF-κB, AP-1, or GR in response to endotoxin vs. placebo administration. Conclusions This work suggests CREB signaling as a critical upstream biological pathway that should be further interrogated as a mechanism of female vulnerability to immune-related disorders. Future work should clarify whether increased CREB signaling indicates sex differences in activity of the sympathetic nervous system or other physiological pathways that signal through CREB, such as prostaglandin release.
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Affiliation(s)
- Chloe C Boyle
- Norman Cousins Center for Psychoneuroimmunology, UCLA, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, USA
| | - Steve W Cole
- Norman Cousins Center for Psychoneuroimmunology, UCLA, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, USA
- Division of Hematology-Oncology, Department of Medicine, UCLA School of Medicine, USA
| | | | - Richard Olmstead
- Norman Cousins Center for Psychoneuroimmunology, UCLA, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, USA
| | - Elizabeth C Breen
- Norman Cousins Center for Psychoneuroimmunology, UCLA, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, USA
| | - Michael R Irwin
- Norman Cousins Center for Psychoneuroimmunology, UCLA, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, USA
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de Carlo Forest TE, Gill Z, Lisker-Cervantes A, Gnanaraj R, Grove N, Patnaik JL, Lynch AM, Palestine AG, Mathias M, Manoharan N, Mandava N. Association Between Quantitative and Qualitative Imaging Biomarkers and Geographic Atrophy Growth Rate. Am J Ophthalmol 2024; 264:168-177. [PMID: 38552931 PMCID: PMC11257804 DOI: 10.1016/j.ajo.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE Investigate associations between geographic atrophy (GA) growth rate and multimodal imaging biomarkers and patient demographics in patients with advanced non-neovascular age-related macular degeneration (nnAMD). DESIGN Prospective cohort study. METHODS One hundred twenty-one eyes of 66 patients with advanced nnAMD with GA enrolled in the University of Colorado AMD Registry from August 2014 to June 2021, with follow-up through June 2023. Multimodal images were reviewed by two graders for imaging biomarkers at enrollment. GA growth rate and square-root transformed (SQRT) GA growth rate were measured between enrollment and final visit. Associations between the outcome SQRT GA growth rate and imaging biomarkers, baseline GA lesions characteristics, and patient demographics were evaluated. RESULTS Average GA growth rate was 1.430 mm2/year and SQRT GA growth rate was 0.268 mm/year over a mean of 3.7 years. SQRT GA growth rate was positively associated with patient age (P = .010) and female sex (0.035), and negatively associated with body mass index (0.041). After adjustment for these demographic factors, SQRT GA growth rate was positively associated with presence of non-exudative subretinal fluid (P < .001), non-exudative subretinal hyperreflective material (P = .037), and incomplete retinal pigment epithelium and outer retina atrophy (P = .022), and negatively associated with subfoveal choroidal thickness (P = .031) and presence of retinal pseudocysts (P = .030). Larger baseline GA size at enrollment was associated with faster GA growth rate (P = .002) but not SQRT GA growth rate. CONCLUSIONS Select patient demographic factors and basic clinically-relevant imaging biomarkers were associated with GA growth rate. These biomarkers may guide patient selection when considering treating GA patients with novel therapeutics.
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Affiliation(s)
- Talisa E de Carlo Forest
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
| | - Zafar Gill
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Andres Lisker-Cervantes
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ramya Gnanaraj
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Nathan Grove
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jennifer L Patnaik
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Anne M Lynch
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alan G Palestine
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marc Mathias
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Niranjan Manoharan
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Naresh Mandava
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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3
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Keck J, Honekamp C, Gebhardt K, Nolte S, Linka M, de Haas B, Munzert J, Krüger K, Krüger B. Exercise-induced inflammation alters the perception and visual exploration of emotional interactions. Brain Behav Immun Health 2024; 39:100806. [PMID: 38974339 PMCID: PMC11225855 DOI: 10.1016/j.bbih.2024.100806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/08/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction The study aimed to investigate whether an exercise-induced pro-inflammatory response alters the perception as well as visual exploration of emotional body language in social interactions. Methods In a within-subject design, 19 male, healthy adults aged between 19 and 33 years performed a downhill run for 45 min at 70% of their VO2max on a treadmill to induce maximal myokine blood elevations, leading to a pro-inflammatory status. Two control conditions were selected: a control run with no decline and a rest condition without physical exercise. Blood samples were taken before (T0), directly after (T1), 3 h after (T3), and 24 h after (T24) each exercise for analyzing the inflammatory response. 3 h after exercise, participants observed point-light displays (PLDs) of human interactions portraying four emotions (happiness, affection, sadness, and anger). Participants categorized the emotional content, assessed the emotional intensity of the stimuli, and indicated their confidence in their ratings. Eye movements during the entire paradigm and self-reported current mood were also recorded. Results The downhill exercise condition resulted in significant elevations of measured cytokines (IL6, CRP, MCP-1) and markers for muscle damage (Myoglobin) compared to the control running condition, indicating a pro-inflammatory state after the downhill run. Emotion recognition rates decreased significantly after the downhill run, whereas no such effect was observed after control running. Participants' sensitivity to emotion-specific cues also declined. However, the downhill run had no effect on the perceived emotional intensity or the subjective confidence in the given ratings. Visual scanning behavior was affected after the downhill run, with participants fixating more on sad stimuli, in contrast to the control conditions, where participants exhibited more fixations while observing happy stimuli. Conclusion Our study demonstrates that inflammation, induced through a downhill running model, impairs perception and emotional recognition abilities. Specifically, inflammation leads to decreased recognition rates of emotional content of social interactions, attributable to diminished discrimination capabilities across all emotional categories. Additionally, we observed alterations in visual exploration behavior. This confirms that inflammation significantly affects an individual's responsiveness to social and affective stimuli.
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Affiliation(s)
- Johannes Keck
- Neuromotor Behavior Lab, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips University of Marburg and Justus-Liebig-University Giessen, Germany
| | - Celine Honekamp
- Sensorimotor Control and Learning, Centre for Cognitive Science, Technical University of Darmstadt, Germany
| | - Kristina Gebhardt
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Svenja Nolte
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Marcel Linka
- Department of Experimental Psychology, Justus-Liebig-University Giessen, Germany
| | - Benjamin de Haas
- Department of Experimental Psychology, Justus-Liebig-University Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips University of Marburg and Justus-Liebig-University Giessen, Germany
| | - Jörn Munzert
- Neuromotor Behavior Lab, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips University of Marburg and Justus-Liebig-University Giessen, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Britta Krüger
- Neuromotor Behavior Lab, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
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Jolink TA, West TN, Alvarez GM, Cardenas MN, Feldman MJ, Algoe SB, Muscatell KA. Higher interleukin-6 is associated with greater momentary social connection in close relationships in daily life. Psychoneuroendocrinology 2024; 164:107020. [PMID: 38520887 DOI: 10.1016/j.psyneuen.2024.107020] [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: 08/15/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
Recent evidence has documented associations between higher levels of inflammation and social approach behaviors toward close others in laboratory-based tasks. Yet it is unknown if this translates to interactions with close others in daily life. Given that momentary experiences of social connection have both relational and health consequences, this is a critical gap in our knowledge. To address the association between inflammation and momentary social connection experiences in close relationships, 55 participants provided blood samples on two consecutive days, which were assayed for circulating levels of the inflammatory marker interleukin-6 (IL-6). After providing the first blood sample, participants received the annual influenza vaccine as a mild inflammatory challenge. Participants also reported on cognitive, affective, and behavioral indicators of social connection with a specific close other multiple times across the two study days. Results indicated that levels of IL-6 were positively associated with temporally-proximal indicators of momentary social connection with a close other. Specifically, higher levels of IL-6 were associated with greater feelings of comfort from the close other, greater desire to be near them, and higher reported relationship quality. Greater IL-6 reactivity to the vaccine was only associated with increased reported relationship quality. These data add to the existing literature suggesting that higher levels of IL-6 may motivate social approach toward a close other, extending evidence to now include momentary social connection experiences in daily life.
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Affiliation(s)
- Tatum A Jolink
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Taylor N West
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gabriella M Alvarez
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megan N Cardenas
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mallory J Feldman
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sara B Algoe
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Keely A Muscatell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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5
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Burns C, Hejl C, Z. Szabo Y. Childhood Adversity and Adult Inflammation: Exploring the Mediating Role of Emotion Regulation in the MIDUS II Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:319-334. [PMID: 38938945 PMCID: PMC11199436 DOI: 10.1007/s40653-023-00594-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 06/29/2024]
Abstract
The present study furthers understanding of how childhood adversity connects to inflammation and, in turn, poor health. Using the publicly available Midlife in the United States II (MIDUS II) dataset, we test a recent theoretical model that suggests emotion regulation is a potential mechanism of associations between adversity and inflammation. We examined the indirect effects of various types of adversity (e.g., stressful events, maltreatment, threat, and deprivation) on inflammation via two emotion regulation strategies (i.e., expressive suppression and reappraisal). Participants included 1096 adults without a history of cancer or HIV/AIDS who had completed the initial MIDUS II follow up and a sub-study examining biomarkers. Participants completed self-report measures inquiring about psychosocial factors including stressful life events, childhood trauma, and emotion regulation as well as provided blood samples. Bivariate correlation indicated that multiple forms of childhood adversity were associated with both C-reactive protein and fibrinogen. Deprivation, as measured by a stressful life events scale, was positively associated with both reappraisal and suppression. Tests of indirect effects indicated that deprivation was positively associated with fibrinogen through both emotion regulation strategies, particularly for female participants. Our findings partially support recent theory positing emotion regulation as a pathway through which childhood adversity may impact inflammation in adulthood. Further, deprivation may be particularly critical in understanding how adversity is connected to maladaptive emotion regulation and inflammation. Emotion regulation may be an important treatment target to mitigate the negative impact of childhood adversity on health and well-being. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-023-00594-2.
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Affiliation(s)
- Christina Burns
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX USA
- Department of Education, Health, & Behavior, University of North Dakota, Grand Forks, ND USA
| | - Christina Hejl
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX USA
| | - Yvette Z. Szabo
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX USA
- Department of Psychology, California State University, Los Angeles, Los Angeles, CA USA
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6
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Alhamawi RM, Almutawif YA, Aloufi BH, Alotaibi JF, Alharbi MF, Alsrani NM, Alinizy RM, Almutairi WS, Alaswad WA, Eid HMA, Mumena WA. Free sugar intake is associated with reduced proportion of circulating invariant natural killer T cells among women experiencing overweight and obesity. Front Immunol 2024; 15:1358341. [PMID: 38807605 PMCID: PMC11131101 DOI: 10.3389/fimmu.2024.1358341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/29/2024] [Indexed: 05/30/2024] Open
Abstract
Background Higher prevalence of obesity has been observed among women compared to men, which can be explained partly by the higher consumption of sweets and physical inactivity. Obesity can alter immune cell infiltration, and therefore increase the susceptibility to develop chronic inflammation and metabolic disorders. In this study, we aimed to explore the association between free sugar intake and other unhealthy lifestyle habits in relation to the proportion of circulating iNKT cells among women with healthy weight and women experiencing overweight and obesity. Methods A cross-sectional study was conducted on 51 Saudi women > 18 years, wherein their daily free sugar intake was assessed using the validated Food Frequency Questionnaire. Data on smoking status, physical activity, and supplement use were also collected. Anthropometric data including height, weight, waist circumference were objectively measured from each participants. The proportion of circulating iNKT cells was determined using flow cytometry. Results Smoking, physical activity, supplement use, and weight status were not associated with proportion of circulating iNKT cells. Significant association was found between proportion of circulating iNKT cells and total free sugar intake and free sugar intake coming from solid food sources only among women experiencing overweight and obesity (Beta: -0.10: Standard Error: 0.04 [95% Confidence Interval: -0.18 to -0.01], p= 0.034) and (Beta: -0.15: Standard Error: 0.05 [95% Confidence Interval: -0.25 to -0.05], p= 0.005), respectively. Conclusion Excessive free sugar consumption may alter iNKT cells and consequently increase the risk for chronic inflammation and metabolic disorders.
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Affiliation(s)
- Renad M. Alhamawi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Yahya A. Almutawif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Bushra H. Aloufi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Jory F. Alotaibi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Manar F. Alharbi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Nura M. Alsrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Razan M. Alinizy
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Waad S. Almutairi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Wed A. Alaswad
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Hamza M. A. Eid
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Walaa A. Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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7
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Liu C, Liu T, Zhang Q, Song M, Zhang Q, Shi J, Deng L, Chen Y, Zheng X, Lin S, Wang Z, Xie H, Chen S, Wu S, Shi H. Temporal relationship between inflammation and metabolic disorders and their impact on cancer risk. J Glob Health 2024; 14:04041. [PMID: 38386717 PMCID: PMC10869135 DOI: 10.7189/jogh.14.04041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Background Inflammation and metabolic disorders are closely associated with cancer. Whether inflammation leads to metabolic disorders or vice versa during cancer initiation remains unclear. In this study, we explored this temporal relationship and the co-exposure effect on cancer risk. Methods This prospective study had two phases. Initially, we examined the temporal relationship between inflammation (high-sensitivity C-reactive protein (CRP)) and metabolic disorders (metabolic syndrome severity Z-score (MetS-Z)) using a 3.98-year survey and cross-lagged analysis. Subsequently, we assessed the connection of co-exposure to inflammation and metabolic disorders, and the risks of overall cancer, as well as specific obesity-related, non-obesity-related, digestive system, lung, and other cancers using an 11.04-year survey and Cox proportional hazard models. Results The cross-lagged analysis revealed that the path coefficient from baseline CRP to follow-up MetS-Z (β2 = 0.032; 95% confidence interval (CI) = 0.026, 0.046) was more significant than the path coefficient from baseline MetS-Z to follow-up CRP (β1 = 0.009; 95% CI = -0.001, 0.019). During the follow-up, 2304 cases of cancer occurred. Compared with the risk of cancer of patients with low average cumulative CRP and MetS-Z, patients with high value had a significantly increased risk (hazard ratio = 1.54, 95% CI = 1.30, 1.83). The mediation analysis showed that MetS-Z mediated the association between CRP levels and overall cancer (12.67%), digestive system cancer (10.16%), and obesity-related cancer risk (13.87%). Conclusions Inflammation had a greater impact on metabolic disorders than vice versa. Co-exposure to inflammation and metabolic disorders significantly increased the risk of cancer, particularly digestive system and obesity-related cancers. Registration Chinese Clinical Trial Registry: ChiCTR-TNRC-11001489.
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Affiliation(s)
- Chenan Liu
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Tong Liu
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Qingsong Zhang
- Department of General Surgery, Kailuan General Hospital, Tangshan, China
| | - Mengmeng Song
- Cardiovascular Research Institute, University of California, San Francisco, California, USA
| | - Qi Zhang
- Department of Genetics, Yale University School of Medicine, New Haven, USA
| | - Jinyu Shi
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Li Deng
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Yue Chen
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Xin Zheng
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Shiqi Lin
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Ziwen Wang
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Hailun Xie
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine Capital Medical University, Beijing, China
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Kim YJ, Lee SG, Lee JS, Choi YJ, Son CG. Comparative characteristics of fatigue in irritable bowel syndrome and inflammatory bowel disease: A systematic review and meta-analysis. J Psychosom Res 2024; 177:111589. [PMID: 38199049 DOI: 10.1016/j.jpsychores.2024.111589] [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: 10/24/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Fatigue is a common symptom in both irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). This study aimed to distinguish fatigue characteristics in IBS and IBD, two functional and organic disorders. METHODS We systematically searched the PubMed and Cochrane Library databases from inception to June 30, 2023, and conducted a meta-analysis to generate precise estimates and 95% confidence intervals. The analyses were stratified by fatigue type, severity, sex, disease phase, and comorbidities, and study quality was assessed using Newcastle-Ottawa Scale (NOS). RESULTS Our analysis included 74 data (13 IBS, 31 CD, 30 UC) encompassing 16,689 participants (6484 males, 7402 females, and 2803 unknown). Overall, fatigue prevalence trended higher in IBS (54.5% [95%CI, 44.5-64.6]), followed by CD (49.8% [95%CI, 44.0-55.5]) and UC (43.6% [95%CI, 38.5-48.7]). This pattern persisted across sub-analyses, including general fatigue (63.4% vs. 51.3% vs. 45.3%) and moderate to severe fatigue (73.8% vs. 59.5% vs. 52.7%) for IBS, CD, and UC, respectively. Female predominance was observed in all three diseases (odds ratio: 1.5 in IBS and CD, 1.8 in UC). Fatigue prevalence significantly varied between disease phases (active vs. remission) in CD (61.3% vs. 36.3%) and UC (53.8% vs. 32.6%). Anemia, anxiety/depression, and/or IBS-like symptoms also contributed to fatigue in CD and UC. CONCLUSIONS This study is the first extensive comparison of fatigue prevalence and features in IBS, CD, and UC. The findings offer valuable insights for treatment and management, aiding our understanding of functional and organic diseases.
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Affiliation(s)
- Yeon-Jae Kim
- Korean Medical College of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Seul-Gi Lee
- Korean Medical College of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Jin-Seok Lee
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, 176 Daedeokdae-ro, Seo-gu, Daejeon 35235, Republic of Korea
| | - Yu-Jin Choi
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, 176 Daedeokdae-ro, Seo-gu, Daejeon 35235, Republic of Korea
| | - Chang-Gue Son
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, 176 Daedeokdae-ro, Seo-gu, Daejeon 35235, Republic of Korea; Institute of Bioscience and Integrative Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea.
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Martucci KT, Karshikoff B, Mackey SC. Links between brain neuroimaging and blood inflammatory markers in urological chronic pelvic pain syndrome. Physiol Behav 2023; 271:114358. [PMID: 37769862 PMCID: PMC10599305 DOI: 10.1016/j.physbeh.2023.114358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
Urological chronic pelvic pain syndrome (UCPPS) is a debilitating painful condition with unclear etiology. Prior researchers have indicated that compared to healthy controls, patients with UCPPS demonstrated altered brain activity. Researchers have also shown that in UCPPS, several blood inflammatory markers relate to clinical variables of pain, fatigue, and pain widespreadness. However, how altered brain function in patients with UCPPS relates to blood inflammation remains unknown. To extend and connect prior findings of altered brain function and inflammatory factors in UCPPS, we conducted a secondary analysis of data from a cohort of UCPPS patients (N = 29) and healthy controls (N = 31) who provided both neuroimaging and blood data (National Institute of Health MAPP Research Network publicly available dataset). In our present study, we aimed to evaluate relationships between a priori-defined brain neuroimaging markers and inflammatory factors of interest and their relationships to pain-psychological variables. We hypothesized that two brain alterations of interest (i.e., PCC - left hippocampus functional connectivity and PCC - bilateral amygdala functional connectivity) would be correlated with four cytokine markers of interest: interleukin (IL) - 6, tumor necrosis factor-alpha (TNF-a), IL-8, and granulocyte-macrophage colony-stimulating factor (GM-CSF). In the UCPPS cohort, we identified a significant PCC - left hippocampus functional connectivity relationship with IL-6 (p = 0.0044). Additionally, in the UCPPS cohort, we identified a PCC - amygdala functional connectivity relationship with GM-CSF which did not meet our model's threshold for statistical significance (p = 0.0665). While these data are preliminary and cross-sectional, our findings suggest connections between brain function and levels of low-grade systemic inflammation in UCPPS. Thus, while further study is needed, our data indicate the potential for advancing the understanding of how brain functional circuits may relate to clinical symptoms and systemic inflammation.
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Affiliation(s)
- Katherine T Martucci
- Human Affect and Pain Neuroscience Laboratory, Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
| | - Bianka Karshikoff
- UiS Biopsychology Research Group, Department of Social Studies, Stavanger University, Stavanger, Norway; Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Sean C Mackey
- Stanford Neuroscience and Pain Laboratory, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA
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Paolini M, Harrington Y, Raffaelli L, Poletti S, Zanardi R, Colombo C, Benedetti F. Neutrophil to lymphocyte ratio and antidepressant treatment response in patients with major depressive disorder: Effect of sex and hippocampal volume. Eur Neuropsychopharmacol 2023; 76:52-60. [PMID: 37544076 DOI: 10.1016/j.euroneuro.2023.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Several factors may affect response to treatment in Major Depressive Disorder (MDD) including immune/inflammatory alterations and regional brain volumes, particularly in hippocampal regions which have shown to be influenced by inflammatory status. Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker found to be elevated in depressed women in large population studies. Here we investigate the effect of NLR on treatment response in MDD patients, and the role of sex and hippocampal volume on influencing this relationship. A sample of 124 MDD depressed inpatients (F = 80) underwent MRI acquisition, admission NLR was calculated by dividing absolute neutrophil by absolute lymphocyte counts and depression severity was assessed at admission and discharge via the Hamilton Depression Rating Scale (HDRS). As a measure of treatment response, delta HDRS was calculated. We found a significant moderation effect of sex on the relationship between NLR and Delta HDRS: a negative relation was found in females and a positive one in males. NLR was found to negatively affect hippocampal volumes in females. Both left and right hippocampal volume positively associated with Delta HDRS. Finally, left hippocampal volume mediated the effect of NLR on Delta HDRS in females. Sex moderated the relation between inflammation and treatment response in line with previous reports linking inflammation to hampered antidepressant effect in females. Further, this effect is partially mediated by hippocampal volume, suggesting that antidepressant response may be hampered by the detrimental effect of inflammation on the brain.
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Affiliation(s)
- Marco Paolini
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Yasmin Harrington
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy.
| | - Laura Raffaelli
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Sara Poletti
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Mood Disorders Unit, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy; Mood Disorders Unit, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
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11
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Benson S, Karshikoff B. How Can Experimental Endotoxemia Contribute to Our Understanding of Pain? A Narrative Review. Neuroimmunomodulation 2023; 30:250-267. [PMID: 37797598 PMCID: PMC10619593 DOI: 10.1159/000534467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/02/2023] [Indexed: 10/07/2023] Open
Abstract
The immune system and the central nervous system exchange information continuously. This communication is a prerequisite for adaptive responses to physiological and psychological stressors. While the implicate relationship between inflammation and pain is increasingly recognized in clinical cohorts, the underlying mechanisms and the possibilities for pharmacological and psychological approaches aimed at neuro-immune communication in pain are not fully understood yet. This calls for preclinical models which build a bridge from clinical research to laboratory research. Experimental models of systemic inflammation (experimental endotoxemia) in humans have been increasingly recognized as an approach to study the direct and causal effects of inflammation on pain perception. This narrative review provides an overview of what experimental endotoxemia studies on pain have been able to clarify so far. We report that experimental endotoxemia results in a reproducible increase in pain sensitivity, particularly for pressure and visceral pain (deep pain), which is reflected in responses of brain areas involved in pain processing. Increased levels of blood inflammatory cytokines are required for this effect, but cytokine levels do not always predict pain intensity. We address sex-dependent differences in immunological responses to endotoxin and discuss why these differences do not necessarily translate to differences in behavioral measures. We summarize psychological and cognitive factors that may moderate pain sensitization driven by immune activation. Together, studying the immune-driven changes in pain during endotoxemia offers a deeper mechanistic understanding of the role of inflammation in chronic pain. Experimental endotoxemia models can specifically help to tease out inflammatory mechanisms underlying individual differences, vulnerabilities, and comorbid psychological problems in pain syndromes. The model offers the opportunity to test the efficacy of interventions, increasing their translational applicability for personalized medical approaches.
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Affiliation(s)
- Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Medical Education, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Bianka Karshikoff
- Department of Social Studies, University of Stavanger, Stavanger, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Koop MA, Sleijser-Koehorst MLS, Hooijmans CR, Tdlohreg PQ, Lutke Schipholt IJ, Scholten-Peeters GGM, Coppieters MW. The potential protective effects of pre-injury exercise on neuroimmune responses following experimentally-induced traumatic neuropathy: a systematic review with meta-analysis. Front Immunol 2023; 14:1215566. [PMID: 37767095 PMCID: PMC10520553 DOI: 10.3389/fimmu.2023.1215566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Pre-clinical evidence shows that neuropathy is associated with complex neuroimmune responses, which in turn are associated with increased intensity and persistence of neuropathic pain. Routine exercise has the potential to mitigate complications of future nerve damage and persistence of pain through neuroimmune regulation. This systematic review aimed to explore the effect of pre-injury exercise on neuroimmune responses, and other physiological and behavioural reactions following peripheral neuropathy in animals. Three electronic databases were searched from inception to July 2022. All controlled animal studies assessing the influence of an active exercise program prior to experimentally-induced traumatic peripheral neuropathy compared to a non-exercise control group on neuroimmune, physiological and behavioural outcomes were selected. The search identified 17,431 records. After screening, 11 articles were included. Meta-analyses showed that pre-injury exercise significantly reduced levels of IL-1β (SMD: -1.06, 95% CI: -1.99 to -0.13, n=40), but not iNOS (SMD: -0.71 95% CI: -1.66 to 0.25, n=82). From 72 comparisons of different neuroimmune outcomes at different anatomical locations, vote counting revealed reductions in 23 pro-inflammatory and increases in 6 anti-inflammatory neuroimmune outcomes. For physiological outcomes, meta-analyses revealed that pre-injury exercise improved one out of six nerve morphometric related outcomes (G-ratio; SMD: 1.95, 95%CI: 0.77 to 3.12, n=20) and one out of two muscle morphometric outcomes (muscle fibre cross-sectional area; SMD: 0.91, 95%CI: 0.27 to 1.54, n=48). For behavioural outcomes, mechanical allodynia was significantly less in the pre-injury exercise group (SMD -1.24, 95%CI: -1.87 to -0.61) whereas no overall effect was seen for sciatic function index. Post hoc subgroup analysis suggests that timing of outcome measurement may influence the effect of pre-injury exercise on mechanical allodynia. Risk of bias was unclear in most studies, as the design and conduct of the included experiments were poorly reported. Preventative exercise may have potential neuroprotective and immunoregulatory effects limiting the sequalae of nerve injury, but more research in this field is urgently needed.
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Affiliation(s)
- Meghan A. Koop
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Marije L. S. Sleijser-Koehorst
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Carlijn R. Hooijmans
- Meta Research Team, Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Paul Q. Tdlohreg
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Ivo J. Lutke Schipholt
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, Netherlands
| | | | - Michel W. Coppieters
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
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13
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Madison AA, Renna M, Andridge R, Peng J, Shrout MR, Sheridan J, Lustberg M, Ramaswamy B, Wesolowski R, Williams NO, Noonan AM, Reinbolt RE, Stover DG, Cherian MA, Malarkey WB, Kiecolt-Glaser JK. Conflicts hurt: social stress predicts elevated pain and sadness after mild inflammatory increases. Pain 2023; 164:1985-1994. [PMID: 36943254 PMCID: PMC10440304 DOI: 10.1097/j.pain.0000000000002894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/07/2023] [Indexed: 03/23/2023]
Abstract
ABSTRACT Individuals respond differently to inflammation. Pain, sadness, and fatigue are common correlates of inflammation among breast cancer survivors. Stress may predict response intensity. This study tested whether breast cancer survivors with greater exposure to acute or chronic social or nonsocial stress had larger increases in pain, sadness, and fatigue during an acute inflammatory response. In total, 156 postmenopausal breast cancer survivors (ages 36-78 years, stage I-IIIA, 1-9 years posttreatment) were randomized to either a typhoid vaccine/saline placebo or the placebo/vaccine sequence, which they received at 2 separate visits at least 1 month apart. Survivors had their blood drawn every 90 minutes for the next 8 hours postinjection to assess levels of interleukin-6 and interleukin-1 receptor antagonist (IL-1Ra). Shortly after each blood draw, they rated their current levels of pain, sadness, and fatigue. Women also completed the Test of Negative Social Exchange to assess chronic social stress and the Trier Inventory of Chronic Stressors screen to index chronic general stress. At each visit, a trained experimenter administered the Daily Inventory of Stressful Events to assess social and nonsocial stress exposure within the past 24 hours. After statistical adjustment for relevant demographic and behavioral covariates, the most consistent results were that survivors who reported more chronic social stress reported more pain and sadness in response to IL-1Ra increases. Frequent and ongoing social stress may sensitize the nervous system to the effects of inflammation, with potential implications for chronic pain and depression risk among breast cancer survivors.
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Affiliation(s)
- Annelise A Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, United States
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Megan Renna
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Rebecca Andridge
- Division of Biostatistics, The Ohio State University, Columbus, OH, United States
| | - Juan Peng
- Division of Biostatistics, The Ohio State University, Columbus, OH, United States
| | - M Rosie Shrout
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - John Sheridan
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, United States
- Division of Biosciences, The Ohio State University College of Dentistry, Columbus, OH, United States
| | | | - Bhuvaneswari Ramaswamy
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Robert Wesolowski
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Nicole O Williams
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Anne M Noonan
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Raquel E Reinbolt
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Daniel G Stover
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Mathew A Cherian
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, United States
| | - William B Malarkey
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, United States
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, United States
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14
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Yoon JH, Park NH, Kang YE, Ahn YC, Lee EJ, Son CG. The demographic features of fatigue in the general population worldwide: a systematic review and meta-analysis. Front Public Health 2023; 11:1192121. [PMID: 37575103 PMCID: PMC10416797 DOI: 10.3389/fpubh.2023.1192121] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Background Fatigue is one of the most common subjective symptoms that impairs daily life and predict health-related events. This study aimed to estimate the prevalence of fatigue in the global population. Methods PubMed and the Cochrane Library were used to search for relevant articles from inception to December 31, 2021. Studies with prevalence data of fatigue in the general population were selected and reviewed by three authors independently and cross-checked. Regarding subgroups, adults (≥18 years), minors (<18 years), and specific occupation population (participants in each study being limited to a specific occupational group), and fatigue types and severity, meta-analysis was conducted to produce point estimates and 95% confidence intervals (95% CI). Results From the initial 3,432 studies, 91 studies accounting for 115 prevalence data points (623,624 participants) were finally selected. The prevalence of general fatigue (fatigue lasting < 6 months, or fatigue of unspecified duration) was 20.4% (95% CI, 16.7-25.0) in adults, 11.7% (95% CI, 5.2-26.6) in minors, and 42.3% (95% CI, 33.0-54.2) in specific occupations. Chronic fatigue (fatigue lasting more than 6 months) affected 10.1% (95% CI, 8.2-12.5) of adults, 1.5% (95% CI, 0.5-4.7) of minors, and 5.5% (95% CI, 1.4-21.6) of subjects in specific occupations. There was an overall female-predominant prevalence for all subgroup analyses, with a total odds ratio of 1.4 (95% CI, 1.3-1.6). Regarding the severity and presence of medical causes, the total prevalence of moderate fatigue [14.6% (95% CI, 9.8-21.8)] was 2.4-fold that of severe fatigue [6.1% (95% CI, 3.4-11.0)], while unexplained fatigue (fatigue experienced by individuals without any underlying medical condition that can explain the fatigue) was ~2.7-fold that of explained fatigue (fatigue experienced by individuals with a medical condition that can explain the fatigue); as proportion of 40.0% of physical, 8.6% of mental, and 28.4% of mixed cause. Conclusions This study has produced the first comprehensive picture of global fatigue prevalence in the general population, which will provide vital reference data contributing to fatigue-related research, including the prevention of diseases. Systematic review registration Identifier: CRD42021270498.
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Affiliation(s)
- Ji-Hae Yoon
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Na-Hyun Park
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Ye-Eun Kang
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
- Institute of Bioscience and Integrative Medicine, Daejeon University, Daejeon, Republic of Korea
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Lambregts BIHM, Vassena E, Jansen A, Stremmelaar DE, Pickkers P, Kox M, Aarts E, van der Schaaf ME. Fatigue during acute systemic inflammation is associated with reduced mental effort expenditure while task accuracy is preserved. Brain Behav Immun 2023:S0889-1591(23)00131-9. [PMID: 37257522 DOI: 10.1016/j.bbi.2023.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/12/2023] [Accepted: 05/25/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Earlier work within the physical domain showed that acute inflammation changes motivational prioritization and effort allocation rather than physical abilities. It is currently unclear whether a similar motivational framework accounts for the mental fatigue and cognitive symptoms of acute sickness. Accordingly, this study aimed to assess the relationship between fatigue, cytokines and mental effort-based decision making during acute systemic inflammation. METHODS Eighty-five participants (41 males; 18-30 years (M=23.0, SD=2.4)) performed a mental effort-based decision-making task before, 2 hours after, and 5 hours after intravenous administration of 1 ng/kg bacterial lipopolysaccharide (LPS) to induce systemic inflammation. Plasma concentrations of cytokines (interleukin (IL)-6, IL-8 and tumor necrosis factor (TNF)) and fatigue levels were assessed at similar timepoints. In the task, participants decided whether they wanted to perform (i.e., 'accepted') arithmetic calculations of varying difficulty (3 levels: easy, medium, hard) in order to obtain rewards (3 levels: 5, 6 or 7 points). Acceptance rates were analyzed using a binomial generalized estimated equation (GEE) approach with effort, reward and time as independent variables. Arithmetic performance was measured per effort level prior to the decisions and included as a covariate. Associations between acceptance rates, fatigue (self-reported) and cytokine concentrations levels were analyzed using partial correlation analyses. RESULTS Plasma cytokine concentrations and fatigue were increased at 2 hours post-LPS compared to baseline and 5 hours post-LPS administration. Acceptance rates decreased for medium, but not for easy or hard effort levels at 2 hours post-LPS versus baseline and 5 hours post-LPS administration, irrespective of reward level. This reduction in acceptance rates occurred despite improved accuracy on the arithmetic calculations itself. Reduced acceptance rates for medium effort were associated with increased fatigue, but not with increased cytokines. CONCLUSION Fatigue during acute systemic inflammation is associated with alterations in mental effort allocation, similarly as observed previously for physical effort-based choice. Specifically, willingness to exert mental effort depended on effort and not reward information, while task accuracy was preserved. These results extend the motivational account of inflammation to the mental domain and suggest that inflammation may not necessarily affect domain-specific mental abilities, but rather affects domain-general effort-allocation processes.
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Affiliation(s)
- B I H M Lambregts
- Department of Psychiatry, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Postbus 9104, HE Nijmegen, The Netherlands.
| | - E Vassena
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Postbus 9104, HE Nijmegen, The Netherlands; Experimental Psychopathology and Treatment, Behavioural Science Institute Radboud University Nijmegen Postbus 9104, 6500 HE Nijmegen, The Netherlands.
| | - A Jansen
- Department of Intensive Care Medicine, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands; Radboud Center for Infectious Diseases, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands.
| | - D E Stremmelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Postbus 9104, HE Nijmegen, The Netherlands.
| | - P Pickkers
- Department of Intensive Care Medicine, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands; Radboud Center for Infectious Diseases, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands.
| | - M Kox
- Department of Intensive Care Medicine, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands; Radboud Center for Infectious Diseases, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands.
| | - E Aarts
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Postbus 9104, HE Nijmegen, The Netherlands.
| | - M E van der Schaaf
- Department of Psychiatry, Radboud University Medical Center Postbus 9101, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Postbus 9104, HE Nijmegen, The Netherlands; Department of Cognitive Neuropsychology, Tilburg University Postbus 90153, 5000 LE Tilburg, The Netherlands.
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16
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Johnston JN, Greenwald MS, Henter ID, Kraus C, Mkrtchian A, Clark NG, Park LT, Gold P, Zarate CA, Kadriu B. Inflammation, stress and depression: An exploration of ketamine's therapeutic profile. Drug Discov Today 2023; 28:103518. [PMID: 36758932 PMCID: PMC10050119 DOI: 10.1016/j.drudis.2023.103518] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/13/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023]
Abstract
Well-established animal models of depression have described a proximal relationship between stress and central nervous system (CNS) inflammation - a relationship mirrored in the peripheral inflammatory biomarkers of individuals with depression. Evidence also suggests that stress-induced proinflammatory states can contribute to the neurobiology of treatment-resistant depression. Interestingly, ketamine, a rapid-acting antidepressant, can partially exert its therapeutic effects via anti-inflammatory actions on the hypothalamic-pituitary adrenal (HPA) axis, the kynurenine pathway or by cytokine suppression. Further investigations into the relationship between ketamine, inflammation and stress could provide insight into ketamine's unique therapeutic mechanisms and stimulate efforts to develop rapid-acting, anti-inflammatory-based antidepressants.
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Affiliation(s)
- Jenessa N Johnston
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
| | - Maximillian S Greenwald
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Ioline D Henter
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Christoph Kraus
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Anahit Mkrtchian
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Neil G Clark
- US School of Medicine, Uniformed Services University, Bethesda, MD, USA
| | - Lawrence T Park
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Philip Gold
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Bashkim Kadriu
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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17
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Inflammatory Blood Signature Related to Common Psychological Comorbidity in Chronic Pain. Biomedicines 2023; 11:biomedicines11030713. [PMID: 36979692 PMCID: PMC10045222 DOI: 10.3390/biomedicines11030713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023] Open
Abstract
Chronic pain is characterized by high psychological comorbidity, and diagnoses are symptom-based due to a lack of clear pathophysiological factors and valid biomarkers. We investigate if inflammatory blood biomarker signatures are associated with pain intensity and psychological comorbidity in a mixed chronic pain population. Eighty-one patients (72% women) with chronic pain (>6 months) were included. Patient reported outcomes were collected, and blood was analyzed with the Proseek Multiplex Olink Inflammation Panel (Bioscience Uppsala, Uppsala, Sweden), resulting in 77 inflammatory markers included for multivariate data analysis. Three subgroups of chronic pain patients were identified using an unsupervised principal component analysis. No difference between the subgroups was seen in pain intensity, but differences were seen in mental health and inflammatory profiles. Ten inflammatory proteins were significantly associated with anxiety and depression (using the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire (PHQ-9): STAMBP, SIRT2, AXIN1, CASP-8, ADA, IL-7, CD40, CXCL1, CXCL5, and CD244. No markers were related to pain intensity. Fifteen proteins could differentiate between patients with moderate/high (GAD-7/PHQ-9 > 10) or mild/no (GAD-7/PHQ-9 < 10) psychological comorbidity. This study further contributes to the increasing knowledge of the importance of inflammation in chronic pain conditions and indicates that specific inflammatory proteins may be related to psychological comorbidity.
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Typhoid vaccine does not impact feelings of social connection or social behavior in a randomized crossover trial among middle-aged female breast cancer survivors. Brain Behav Immun 2023; 107:124-131. [PMID: 36208853 DOI: 10.1016/j.bbi.2022.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Inflammation can have social consequences, which may be relevant to inflammation's link with depression. The current study tests whether a typhoid vaccine increases feelings of social disconnection and avoidance behavior. METHOD In two full-day visits at least three weeks apart, 172 postmenopausal breast cancer survivors (Stage I-IIIA) each received a typhoid capsular polysaccharide vaccination and a saline placebo injection in a random sequence. Blood was drawn prior to the injection, as well as every 90 min thereafter for 8 h to assess the inflammatory response (interleukin-6, IL-6; interleukin-1 receptor antagonist, IL-1Ra). At both visits, women completed the Social Connection Scale at 0 and 8.5 h post-vaccination as well as implicit and explicit social avoidance tasks at 7 h post-vaccination. RESULTS The typhoid vaccine triggered rises in both inflammatory markers (ps < 0.01), but it did not impact feelings of social connection (p = .32), or performance on the implicit (p = .34) or explicit tasks (p = .37). Inflammatory rises did not predict feelings of social connection (ps > 0.64) or performance on explicit (ps > 0.73) or implicit (ps > 0.88) social avoidance tasks. CONCLUSION Milder inflammatory stimuli may not affect social processes. Higher levels of inflammation or, relatedly, more sickness symptoms may be necessary to recapitulate prior findings of social avoidance.
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Helman TJ, Headrick JP, Stapelberg NJC, Braidy N. The sex-dependent response to psychosocial stress and ischaemic heart disease. Front Cardiovasc Med 2023; 10:1072042. [PMID: 37153459 PMCID: PMC10160413 DOI: 10.3389/fcvm.2023.1072042] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Stress is an important risk factor for modern chronic diseases, with distinct influences in males and females. The sex specificity of the mammalian stress response contributes to the sex-dependent development and impacts of coronary artery disease (CAD). Compared to men, women appear to have greater susceptibility to chronic forms of psychosocial stress, extending beyond an increased incidence of mood disorders to include a 2- to 4-fold higher risk of stress-dependent myocardial infarction in women, and up to 10-fold higher risk of Takotsubo syndrome-a stress-dependent coronary-myocardial disorder most prevalent in post-menopausal women. Sex differences arise at all levels of the stress response: from initial perception of stress to behavioural, cognitive, and affective responses and longer-term disease outcomes. These fundamental differences involve interactions between chromosomal and gonadal determinants, (mal)adaptive epigenetic modulation across the lifespan (particularly in early life), and the extrinsic influences of socio-cultural, economic, and environmental factors. Pre-clinical investigations of biological mechanisms support distinct early life programming and a heightened corticolimbic-noradrenaline-neuroinflammatory reactivity in females vs. males, among implicated determinants of the chronic stress response. Unravelling the intrinsic molecular, cellular and systems biological basis of these differences, and their interactions with external lifestyle/socio-cultural determinants, can guide preventative and therapeutic strategies to better target coronary heart disease in a tailored sex-specific manner.
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Affiliation(s)
- Tessa J. Helman
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
- Correspondence: Tessa J. Helman
| | - John P. Headrick
- Schoolof Pharmacy and Medical Sciences, Griffith University, Southport, QLD, Australia
| | | | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
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Karshikoff B, Lekander M, Lasselin J. Editorial: Vulnerability and protective factors for inflammation-associated somatoform and mental disorders. Brain Behav Immun 2022; 106:227-230. [PMID: 36055543 DOI: 10.1016/j.bbi.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bianka Karshikoff
- Department of Social Sciences, University of Stavanger, Stavanger, Norway; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Julie Lasselin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
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Hu N, Zhang X, Yu Z, Du Y, He X, Wang H, Pu L, Pan D, He S, Liu X, Li J. Effects of oral exposure to leachate from boiled-water treated plastic products on gut microbiome and metabolomics. JOURNAL OF HAZARDOUS MATERIALS 2022; 439:129605. [PMID: 35863224 DOI: 10.1016/j.jhazmat.2022.129605] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
By simulating plastic exposure patterns in modern society, the impact of daily exposure to plastic products on mammals was explored. In this study, Institute for Cancer Research (ICR) mice were used to establish drinking water exposure models of three popular kinds of plastic products, including non-woven tea bags, food-grade plastic bags and disposable paper cups. Feces and urine of mice were collected for gut microbiome and metabolomics analysis. Our results showed that the diversity and composition of gut microbiota changed at genus level compared to control group. Lactobacillus, Parabacteroides, Escherichia-shigella and Staphylococcus decreased while Lachnospiraceae increased treated with non-woven tea bags. Escherichia-shigella and Alistipes increased while Parabacteroides decreased treated with food grade plastic bags. Muribaculaceae decreased in the gut microbiota of mice treated with disposable paper cups. Metabolomics has seen changes in the number of metabolites and enrichment of metabolic pathways related to inflammatory responses and immune function. Inflammatory responses were found in histological and biochemical examination. In summary, this study demonstrated that long-term oral exposure to leachate form boiled-water treated plastic products might have effects on gut microbiome and metabolome, which further provided new insights about potential adverse effects for human beings.
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Affiliation(s)
- Naifan Hu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xue Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Zhenfan Yu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Yurun Du
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xiaoxue He
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Huihui Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Lining Pu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Degong Pan
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Shulan He
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xiaojuan Liu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
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Chronic social instability stress down-regulates IL-10 and up-regulates CX3CR1 in tumor-bearing and non-tumor-bearing female mice. Behav Brain Res 2022; 435:114063. [PMID: 35988637 DOI: 10.1016/j.bbr.2022.114063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/01/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022]
Abstract
Extensive literature has reported a link between stress and tumor progression, and between both of these factors and mental health. Despite the higher incidence of affective disorders in females and the neurochemical differences according to sex, female populations have been understudied. The aim of this study was therefore to analyze the effect of stress on tumor development in female OF1 mice. For this purpose, subjects were inoculated with B16F10 melanoma cells and exposed to the Chronic Social Instability Stress (CSIS) model. Behavioral, neurochemical and neuroendocrine parameters were analyzed. Female mice exposed to CSIS exhibited reduced body weight and increased arousal, but there was no evidence of depressive behavior or anxiety. Exposure to CSIS did not affect either corticosterone levels or tumor development, although it did provoke an imbalance in cerebral inflammatory cytokines, decreasing IL-10 expression (IL-6/IL-10 and TNF-α/IL-10); chemokines, increasing CX3CR1 expression (CX3CL1/CX3CR1); and glucocorticoid receptors, decreasing GR expression (MR/GR). In contrast, tumor development did not alter body weight and, although it did alter behavior, it did so to a much lesser extent. Tumor inoculation did not affect corticosterone levels, but increased the MR/GR ratio in the hippocampus and provoked an imbalance in cerebral inflammatory cytokines and chemokines, although differently from stress. These results underscore the need for experimental approaches that allow us to take sex differences into account when exploring this issue, since these results appear to indicate that the female response to stress is mediated by mechanisms different from those often proposed in relation to male mice.
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Early life adversity drives sex-specific anhedonia and meningeal immune gene expression through mast cell activation. Brain Behav Immun 2022; 103:73-84. [PMID: 35339629 PMCID: PMC9149134 DOI: 10.1016/j.bbi.2022.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 02/25/2022] [Accepted: 03/16/2022] [Indexed: 01/06/2023] Open
Abstract
Exposure to early life adversity (ELA) in the form of physical and/or psychological abuse or neglect increases the risk of developing psychiatric and inflammatory disorders later in life. It has been hypothesized that exposure to ELA results in persistent, low grade inflammation that leads to increased disease susceptibility by amplifying the crosstalk between stress-processing brain networks and the immune system, but the mechanisms remain largely unexplored. The meninges, a layer of three overlapping membranes that surround the central nervous system (CNS)- dura mater, arachnoid, and piamater - possess unique features that allow them to play a key role in coordinating immune trafficking between the brain and the peripheral immune system. These include a network of lymphatic vessels that carry cerebrospinal fluid from the brain to the deep cervical lymph nodes, fenestrated blood vessels that allow the passage of molecules from blood to the CNS, and a rich population of resident mast cells, master regulators of the immune system. Using a mouse model of ELA consisting of neonatal maternal separation plus early weaning (NMSEW), we sought to explore the effects of ELA on sucrose preference behavior, dura mater expression of inflammatory markers and mast cell histology in adult male and female C57Bl/6 mice. We found that NMSEW alone does not affect sucrose preference behavior in males or females, but it increases the dura mater expression of the genes coding for mast cell protease CMA1 (cma1) and the inflammatory cytokine TNF alpha (tnf alpha) in females. When NMSEW is combined with an adult mild stress (that does not affect behavior or gene expression in NH animals) females show reduced sucrose preference and even greater increases in meningeal cma1 levels. Interestingly, systemic administration of the mast cell stabilizer Ketotifen before exposure to adult stress prevents both, reduction in sucrose preference an increases in cma1 expression in NMSEW females, but facilitates stress-induced sucrose anhedonia in NMSEW males and NH females. Finally, histological analyses showed that, compared to males, females have increased baseline activation levels of mast cells located in the transverse sinus of the dura mater, where the meningeal lymphatics run along, and that, in males and females exposed to adult stress, NMSEW increases the number of mast cells in the interparietal region of the dura mater and the levels of mast cell activation in the sagittal sinus regions of the dura mater. Together, our results indicate that ELA induces long-term meningeal immune gene changes and heightened sensitivity to adult stress-induced behavioral and meningeal immune responses and that these effects could mediated via mast cells.
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Women with lower systemic inflammation demonstrate steeper cognitive decline with age: Results from a large prospective, longitudinal sample. Brain Behav Immun Health 2022; 22:100465. [PMID: 35586361 PMCID: PMC9108464 DOI: 10.1016/j.bbih.2022.100465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/15/2022] [Accepted: 04/21/2022] [Indexed: 12/15/2022] Open
Abstract
Background Men and women experience large disparities in prevalence, detection, and clinical course of neurodegenerative diseases. Inflammation has been implicated in the pathogenesis of neurodegenerative diseases, yet there is a paucity of literature documenting sex differences in this phenomenon in prospective, longitudinal studies. Methods Participants were 4217 non-smoking individuals (62.2% female; aged 46–91 at enrollment) enrolled in the Health and Retirement Study who provided dried blood spots and completed a standardized assessment of cognitive function 3 times across 8 years. Inflammation was indexed using C-reactive protein (CRP). Results Higher CRP was associated with lower concurrent cognitive function, b = −0.13 (SE = 0.06), p < .05, but less decline in cognitive function over time, b = 0.02 (SE = 0.01), p < .05. Sex moderated the association between CRP and decline in total cognitive function, b = 0.02 (SE = 0.01), p < .05, such that the steepest declines in cognitive function were observed among women with the lowest CRP concentrations. Conclusions Women with lower systemic inflammation as measured by CRP may be at risk of going undetected for neurodegenerative disease, especially given their overall higher cognitive scores. This may perpetuate sex-related disparities in prevention and clinical course. Attention to the underlying biological mechanisms explaining the link between lower CRP and risk for cognitive decline for women and its potential clinical implications are needed. Sex differences in links between inflammation and cognitive function are under-explored. Higher CRP was associated with lower concurrent cognitive function, only in men. Women with lower CRP showed the steepest declines in cognitive functioning.
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Kopecky R, Příplatová L, Boschetti S, Talmont-Kaminski K, Flegr J. Le Petit Machiavellian Prince: Effects of Latent Toxoplasmosis on Political Beliefs and Values. EVOLUTIONARY PSYCHOLOGY 2022; 20:14747049221112657. [PMID: 35903902 PMCID: PMC10303488 DOI: 10.1177/14747049221112657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022] Open
Abstract
Humans infected by Toxoplasma gondii express no specific symptoms but manifest higher incidence of many diseases, disorders and differences in personality and behavior. The aim of this study was to compare the political beliefs and values of Toxoplasma-infected and Toxoplasma-free participants. We measured beliefs and values of 2315 responders via an online survey (477 Toxoplasma-infected) using the Political Beliefs and Values Inventory (PI34). This study showed Toxoplasma-infected and Toxoplasma-free participants of our cross-sectional study differed in three of four factors of PI34, scoring higher in Tribalism and lower in Cultural liberalism and Anti-Authoritarianism. We found sex differences in political beliefs associated with Toxoplasma infection. Infected women scored higher in tribalism and lower in cultural liberalism, compared with the Toxoplasma-free control group, while infected men scored higher in economic equity. These results fit with sexual differences in behavior and attitude observed after toxoplasmosis infection. Controlling for the effect of worse physical health and mental health had little impact, suggesting that impaired health did not cause these changes. Rather than adaptation to prevalence of parasites, as suggested by parasite-stress theory, the differences might be side-effects of long-term mild inflammatory reaction. However, to get clear picture of the mild inflammation effects, more research focused on different infectious diseases is needed.
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Affiliation(s)
- Robin Kopecky
- Institute of Philosophy of the Czech
Academy of Sciences, Prague, Czechia
| | - Lenka Příplatová
- Institute of Philosophy of the Czech
Academy of Sciences, Prague, Czechia
| | - Silvia Boschetti
- Institute of Philosophy of the Czech
Academy of Sciences, Prague, Czechia
| | | | - Jaroslav Flegr
- Laboratory of Evolutionary Biology,
Department of Philosophy and History of Sciences, Faculty of Science, Charles
University, Prague, Czechia
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26
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Querido NR, Kenkhuis MF, van Roekel EH, Breukink SO, van Duijnhoven FJB, Janssen-Heijnen ML, Keulen ET, Ueland PM, Vogelaar FJ, Wesselink E, Bours MJ, Weijenberg MP. Longitudinal associations between inflammatory markers and fatigue up to two years after colorectal cancer treatment. Cancer Epidemiol Biomarkers Prev 2022; 31:1638-1649. [PMID: 35654354 DOI: 10.1158/1055-9965.epi-22-0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/14/2022] [Accepted: 05/20/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Fatigue is often reported by colorectal cancer survivors (CRC) and largely impacts their quality of life. Inflammation has been linked to fatigue mainly in breast cancer patients. Therefore, we investigated how inflammation is longitudinally associated with fatigue in CRC survivors, up to 2 years post-treatment. METHODS A total of 257 patients from the ongoing Energy for life after ColoRectal cancer (EnCoRe) cohort study were included in the analysis. Plasma levels of IL6, IL8, IL10, TNFα, hsCRP, and fatigue were measured at 6 weeks, 6, 12, and 24 months post-treatment. Fatigue was measured through the validated Checklist Individual Strength (CIS total, 20-140), consisting of four subscales - subjective fatigue (8-56), motivation (4-28), physical activity (3-21), and concentration (5-35), and the EORTC QLQ-C30 fatigue subscale (0-100). Linear mixed-models were used to assess the confounder-adjusted longitudinal associations between inflammatory markers and overall fatigue along with the subscales. RESULTS Mean levels of CIS fatigue decreased from 62.9 at 6 weeks to 53.0 at 24 months. In general, levels of inflammatory markers also decreased over time. No statistically significant longitudinal associations were found between IL6, IL8, IL10, TNFα, and fatigue. Higher levels of hsCRP were associated with more CIS fatigue (β per SD 3.21, 95% CI 1.42; 5.01) and EORTC fatigue (β 2.41, 95% CI 0.72; 4.10). CONCLUSION Increased levels of hsCRP are longitudinally associated with more post-treatment fatigue in CRC survivors. IMPACT These findings suggest that low-grade inflammation may play a role in fatigue reported by CRC survivors up to 2 years post-treatment.
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Hazeltine DB, Polokowski AR, Reigada LC. Inflammatory Cytokines, but Not Dietary Patterns, Are Related to Somatic Symptoms of Depression in a Sample of Women. Front Psychiatry 2022; 13:822466. [PMID: 35651828 PMCID: PMC9149097 DOI: 10.3389/fpsyt.2022.822466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background Depression is a heterogenous disorder with both cognitive and somatic symptom dimensions that may differentially relate to systemic inflammation. Diet, which has the potential to modulate both inflammation levels and mood, is yet to be studied within the context of individual depression dimensions. This study examined the associations between inflammatory cytokines and dietary patterns with depressive symptom dimension profiles among a sample of women recruited in a non-clinical setting. Methods Inflammatory cytokines (IL-6 and TNF-α), inflammatory diet (Diet Inflammatory Index; DII), and depressive symptoms (Beck Depression Inventory-II; BDI-II) were measured in 136 females (M age = 22.01 ± 4.02, range 18-59 years). Multiple linear regressions were used to investigate the relationships between inflammatory cytokines and diet with self-reported cognitive, somatic, and total depressive symptoms, adjusting for demographic factors. Results Findings showed that increased somatic dimension scores were positively associated with IL-6 (ß = 0.273, p = 0.002) and TNF-α (ß = 0.215, p = 0.017), but not inflammatory diet (p = 0.300). Total BDI-II scores were only positively associated with IL-6 (ß = 0.221, p = 0.012), and cognitive dimension scores were not associated with any inflammation measures. Conclusions These findings contribute to existing evidence that inflammatory cytokines are associated with the somatic symptoms of depression. Inflammatory diet index was not associated with depression measures.
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Affiliation(s)
- Danielle Belden Hazeltine
- Department of Psychology, Brooklyn College, City University of New York, New York, NY, United States
- Program in Psychology, The Graduate Center, City University of New York, New York, NY, United States
| | - Ashley Rose Polokowski
- Department of Psychology, Brooklyn College, City University of New York, New York, NY, United States
- Program in Psychology, The Graduate Center, City University of New York, New York, NY, United States
- Psycho-Oncology, Monter Cancer Center, Northwell Health Cancer Institute, New York, NY, United States
| | - Laura Christine Reigada
- Department of Psychology, Brooklyn College, City University of New York, New York, NY, United States
- Program in Psychology, The Graduate Center, City University of New York, New York, NY, United States
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Clephane K, O'Loughlin JI, Bodnar TS, Wilson MC, Stariha JT, Craig AN, Weinberg J, Brotto LA, Lorenz TK. Lack of Evidence for a Relationship Between Salivary CRP and Women's Sexual Desire: An Investigation Across Clinical and Healthy Samples. J Sex Med 2022; 19:745-760. [PMID: 35296386 PMCID: PMC9064911 DOI: 10.1016/j.jsxm.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/29/2022] [Accepted: 02/04/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Inflammation has been linked to a variety of mental and physical health outcomes that disproportionately impact women, and which can impair sexual function; thus, there is reason to expect a link between inflammation and women's sexual functioning. AIM To test the hypothesis that higher concentrations of C-reactive protein (CRP), a general biomarker of inflammation, would predict women's lower sexual desire. METHOD As 2 independent research teams, we conducted 3 separate studies (total n = 405) that assessed salivary CRP and various measurements of sexual desire in different women populations. OUTCOMES Female Sexual Function Index, Sexual Desire Inventory-2, Decreased Sexual Desire Screener, and Sexual Interest and Desire Inventory. RESULTS Regardless of the way sexual desire was measured (e.g., state vs trait; general desire vs. desire functioning) and the population sampled (i.e., healthy vs. clinically diagnosed with sexual dysfunction), all the studies revealed null results. CLINICAL IMPLICATIONS While exploratory, the convergence of these null results across studies and researchers suggests that if there is an association between inflammation and women's sexual desire, it is likely very subtle. STRENGTHS & LIMITATIONS Across 2 independent research teams, 3 unrelated studies, and various measurements of sexual desire, results were consistent. These points lend to the generalizability of the results. However, study designs were cross-sectional. CONCLUSIONS Future research may reveal (i) a non-linear threshold effect, such that inflammation does not begin to impact women's sexual desire until it is at a high level, (ii) inflammatory biomarkers other than CRP might be more sensitive in detecting associations between inflammation and desire, should they exist, or (iii) the mechanisms underlying sexual dysfunction may differ between sexes. Clephane K, et al. Lack of Evidence for a Relationship Between Salivary CRP and Women's Sexual Desire: An Investigation Across Clinical and Healthy Samples. J Sex Med 2022;19:745-760.
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Affiliation(s)
- Kirstin Clephane
- University of Nebraska - Lincoln, Center for Brain, Biology and Behavior, Lincoln, NE, USA; University of Nebraska - Lincoln, Psychology Department, Lincoln, NE, USA
| | - Julia I O'Loughlin
- University of British Columbia, Department of Educational and Counselling Psychology, and Special Education, Vancouver, British Columbia, CA, USA
| | - Tamara S Bodnar
- University of British Columbia, Department of Cellular and Physiological Sciences, Vancouver, British Columbia, CA, USA
| | - M Claire Wilson
- Indiana University, Department of Psychological and Brain Sciences, Bloomington, IN, USA
| | - Jordan Tb Stariha
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, British Columbia, CA, USA
| | - Amber N Craig
- Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, Milwaukee, WI, USA
| | - Joanne Weinberg
- University of British Columbia, Department of Cellular and Physiological Sciences, Vancouver, British Columbia, CA, USA
| | - Lori A Brotto
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, British Columbia, CA, USA; University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, CA, USA
| | - Tierney K Lorenz
- University of Nebraska - Lincoln, Center for Brain, Biology and Behavior, Lincoln, NE, USA; University of Nebraska - Lincoln, Psychology Department, Lincoln, NE, USA.
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Baseline Pro-Inflammatory Cytokine Levels Moderate Psychological Inflexibility in Behavioral Treatment for Chronic Pain. J Clin Med 2022; 11:jcm11092285. [PMID: 35566411 PMCID: PMC9102370 DOI: 10.3390/jcm11092285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 02/06/2023] Open
Abstract
Background: The medical and scientific communities struggle to understand chronic pain and find effective treatments. Multimodal approaches are encouraging but show significant individual differences. Methods: Seventy-eight persons (56 women) with chronic pain received Acceptance and Commitment Therapy and provided blood samples before and after treatment. The participants completed surveys with the blood sampling. Blood plasma was analyzed for IL-6 and TNF-α levels with the Olink Inflammation Panel (Olink Bioscience Uppsala, Sweden). The treatment effects and moderating effects of low-grade inflammation on changes in outcomes were analyzed using linear mixed models. Results: Pain interference (p < 0.001) and psychological inflexibility (p < 0.001) improved significantly during treatment, but pain intensity did not (p = 0.078). Cytokine levels did not change over the course of the treatment (IL-6/TNF-α p = 0.086/0.672). Mean baseline levels of IL-6 and TNF-α moderated improvement in psychological inflexibility during the course of treatment (p = 0.044), but cytokine levels did not moderate changes in pain interference (p = 0.205) or pain intensity (p = 0.536). Conclusions: Higher baseline inflammation levels were related to less improvement in psychological inflexibility. Low-grade inflammation may be one factor underlying the variability in behavioral treatment in chronic pain.
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Spencer HF, Berman RY, Boese M, Zhang M, Kim SY, Radford KD, Choi KH. Effects of an intravenous ketamine infusion on inflammatory cytokine levels in male and female Sprague-Dawley rats. J Neuroinflammation 2022; 19:75. [PMID: 35379262 PMCID: PMC8981848 DOI: 10.1186/s12974-022-02434-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/20/2022] [Indexed: 12/29/2022] Open
Abstract
Background Ketamine, a multimodal dissociative anesthetic drug, is widely used as an analgesic following traumatic injury. Although ketamine may produce anti-inflammatory effects when administered after injury, the immunomodulatory properties of intravenous (IV) ketamine in a non-inflammatory condition are unclear. In addition, most preclinical studies use an intraperitoneal (IP) injection of ketamine, which limits its clinical translation as patients usually receive an IV ketamine infusion after injury. Methods Here, we administered sub-anesthetic doses of a single IV ketamine infusion (0, 10, or 40 mg/kg) to male and female Sprague–Dawley rats over a 2-h period. We collected blood samples at 2- and 4-h post-ketamine infusion to determine plasma inflammatory cytokine levels using multiplex immunoassays. Results The 10 mg/kg ketamine infusion reduced spontaneous locomotor activity in male and female rats, while the 40 mg/kg infusion stimulated activity in female, but not male, rats. The IV ketamine infusion produced dose-dependent and sex-specific effects on plasma inflammatory cytokine levels. A ketamine infusion reduced KC/GRO and tumor necrosis factor alpha (TNF-α) levels in both male and female rats, interleukin-6 (IL-6) levels in female rats, and interleukin-10 (IL-10) levels in male rats. However, most cytokine levels returned to control levels at 4-h post-infusion, except for IL-6 levels in male rats and TNF-α levels in female rats, indicating a different trajectory of certain cytokine changes over time following ketamine administration. Conclusions The current findings suggest that sub-anesthetic doses of an IV ketamine infusion may produce sex-related differences in the effects on peripheral inflammatory markers in rodents, and further research is warranted to determine potential therapeutic effects of an IV ketamine infusion in an inflammatory condition.
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Affiliation(s)
- Haley F Spencer
- Program in Neuroscience, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Rina Y Berman
- Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Martin Boese
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Michael Zhang
- Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Sharon Y Kim
- Program in Neuroscience, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Kennett D Radford
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Kwang H Choi
- Program in Neuroscience, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. .,Center for the Study of Traumatic Stress, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. .,Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. .,Department of Psychiatry, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Ghosh S, Mohammed Z, Singh I. Bruton's tyrosine kinase drives neuroinflammation and anxiogenic behavior in mouse models of stress. J Neuroinflammation 2021; 18:289. [PMID: 34895246 PMCID: PMC8665324 DOI: 10.1186/s12974-021-02322-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/12/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Current therapies targeting several neurotransmitter systems are only able to partially mitigate the symptoms of stress- and trauma-related disorder. Stress and trauma-related disorders lead to a prominent inflammatory response in humans, and in pre-clinical models. However, mechanisms underlying the induction of neuroinflammatory response in PTSD and anxiety disorders are not clearly understood. The present study investigated the mechanism underlying the activation of proinflammatory NLRP3 inflammasome and IL1β in mouse models of stress. METHODS We used two mouse models of stress, i.e., mice subjected to physical restraint stress with brief underwater submersion, and predator odor stress. Mice were injected with MCC950, a small molecule specific inhibitor of NLRP3 activation. To pharmacologically inhibit BTK, a specific inhibitor ibrutinib was used. To validate the observation from ibrutinib studies, a separate group of mice was injected with another BTK-specific inhibitor LFM-A13. Seven days after the induction of stress, mice were examined for anxious behavior using open field test (OFT), light-dark test (LDT), and elevated plus maze test (EPM). Following the behavior tests, hippocampus and amygdale were extracted and analyzed for various components of NLRP3-caspase 1-IL1β pathway. Plasma and peripheral blood mononuclear cells were also used to assess the induction of NLRP3-Caspase 1-IL-1β pathway in stressed mice. RESULTS Using two different pre-clinical models of stress, we demonstrate heightened anxious behavior in female mice as compared to their male counterparts. Stressed animals exhibited upregulation of proinflammatory IL1β, IL-6, Caspase 1 activity and NLRP3 inflammasome activation in brain, which were significantly higher in female mice. Pharmacological inhibition of NLRP3 inflammasome activation led to anxiolysis as well as attenuated neuroinflammatory response. Further, we observed induction of activated Bruton's tyrosine kinase (BTK), an upstream positive-regulator of NLRP3 inflammasome activation, in hippocampus and amygdala of stressed mice. Next, we conducted proof-of-concept pharmacological BTK inhibitor studies with ibrutinib and LFM-A13. In both sets of experiments, we found BTK inhibition led to anxiolysis and attenuated neuroinflammation, as indicated by significant reduction of NLRP3 inflammasome and proinflammatory IL-1β in hippocampus and amygdala. Analysis of plasma and peripheral blood mononuclear cells indicated peripheral induction of NLRP3-caspase 1-IL1β pathway in stressed mice. CONCLUSION Our study identified BTK as a key upstream regulator of neuroinflammation, which drives anxiogenic behavior in mouse model of stress. Further, we demonstrated the sexually divergent activation of BTK, providing a clue to heightened neuroinflammation and anxiogenic response to stress in females as compared to their male counterparts. Our data from the pharmacological inhibition studies suggest BTK as a novel target for the development of potential clinical treatment of PTSD and anxiety disorders. Induction of pBTK and NLRP3 in peripheral blood mononuclear cells of stressed mice suggest the potential effect of stress on systemic inflammation.
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Affiliation(s)
- Simantini Ghosh
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
- Department of Psychology, Ashoka University, Rai, India.
| | | | - Itender Singh
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Ambedkar Center for Biomedical Research, Delhi University, New Delhi, India
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Lasselin J. Back to the future of psychoneuroimmunology: Studying inflammation-induced sickness behavior. Brain Behav Immun Health 2021; 18:100379. [PMID: 34761246 PMCID: PMC8566772 DOI: 10.1016/j.bbih.2021.100379] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022] Open
Abstract
What do we know about sickness behavior? In this article, I guide you through some of the complexity of sickness behavior occurring after an immune challenge. I highlight the many features of behavioral and affective changes induced during experimental endotoxemia in humans, and describe how little we know about many of these features. I argue that we need to dismantle the components of inflammation-induced sickness behavior, and study each component in detail. I also point out the large inter-individual differences in inflammation-induced behavioral and affective changes, and the fact that psychosocial factors likely interact with inflammation to shape inflammation-induced sickness behavior. PNI clearly lacks investigations of the vulnerability and resilient factors underlying the inter-individual variability in sickness behavior. Throughout the article, I base my argument on my published articles, and provide concrete examples from my experience and the data that I have collected over the past 10 years. Given the relevance of inflammation-induced sickness behavior for inflammation-associated depression and for how people react to infections, I encourage current and future psychoneuroimmunologists to return towards basic science of sickness behavior. Inflammation-related sickness behavior is relevant for inflammation-associated depression The many features of sickness behavior should be investigated in detail There are large inter-individual variability in sickness behavior Vulnerability and resilient factors predicting sickness responses are little known I call for a return towards basic science of sickness behavior.
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Affiliation(s)
- Julie Lasselin
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91, Stockholm, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Osher Center for Integrative Medicine, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden
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Fransson E. Psychoneuroimmunology in the context of perinatal depression - Tools for improved clinical practice. Brain Behav Immun Health 2021; 17:100332. [PMID: 34589817 PMCID: PMC8474604 DOI: 10.1016/j.bbih.2021.100332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022] Open
Abstract
Maternal mental health spans in a temporary manner from pre-conception through the phases of pregnancy, childbirth, and the postpartum period (i.e., perinatal). The psychoneuroimmunology (PNI) field has made important contributions to the knowledge of the pathophysiology of poor perinatal mental health, but the PNI lens could be used more broadly to inform clinical practice. This review argues that PNI holds the key to several important aspects of variations in mental health for pregnant and postpartum women. This review describes existing knowledge from studies on immune activation in maternal depression during pregnancy and postpartum, and other important features such as stress reactivity, the microbiome, and its metabolites. The importance of objective measures for screening and prediction is discussed as well as the need for novel therapeutics to treat poor mental health in the perinatal period. The PNI framework could thus be further applied to inform research about the mechanisms of perinatal psychiatric morbidity, which could pave the way for future precision medicine for perinatal mental health issues.
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Affiliation(s)
- Emma Fransson
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Belonwu SA, Li Y, Bunis D, Rao AA, Solsberg CW, Tang A, Fragiadakis GK, Dubal DB, Oskotsky T, Sirota M. Sex-Stratified Single-Cell RNA-Seq Analysis Identifies Sex-Specific and Cell Type-Specific Transcriptional Responses in Alzheimer's Disease Across Two Brain Regions. Mol Neurobiol 2021; 59:276-293. [PMID: 34669146 PMCID: PMC8786804 DOI: 10.1007/s12035-021-02591-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Alzheimer’s disease (AD) is a pervasive neurodegenerative disorder that disproportionately affects women. Since neural anatomy and disease pathophysiology differ by sex, investigating sex-specific mechanisms in AD pathophysiology can inform new therapeutic approaches for both sexes. Previous bulk human brain RNA sequencing studies have revealed sex differences in dysregulated molecular pathways related to energy production, neuronal function, and immune response; however, the sex differences in disease mechanisms are yet to be examined comprehensively on a single-cell level. We leveraged nearly 74,000 cells from human prefrontal and entorhinal cortex samples from the first two publicly available single-cell RNA sequencing AD datasets to perform a case versus control sex-stratified differential gene expression analysis and pathway network enrichment in a cell type-specific manner for each brain region. Our examination at the single-cell level revealed sex differences in AD prominently in glial cells of the prefrontal cortex. In the entorhinal cortex, we observed the same genes and networks to be perturbed in opposing directions between sexes in AD relative to healthy state. Our findings contribute to growing evidence of sex differences in AD-related transcriptomic changes, which can fuel the development of therapies that may prove more effective at reversing AD pathophysiology.
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Affiliation(s)
- Stella A Belonwu
- Bakar Computational Health Sciences Institute, University of California San Francisco, 490 Illinois St, San Francisco, CA, 94143, USA.,Pharmaceutical Sciences and Pharmacogenomics Graduate Program, University of California San Francisco, San Francisco, CA, USA
| | - Yaqiao Li
- Bakar Computational Health Sciences Institute, University of California San Francisco, 490 Illinois St, San Francisco, CA, 94143, USA.,Pharmaceutical Sciences and Pharmacogenomics Graduate Program, University of California San Francisco, San Francisco, CA, USA
| | - Daniel Bunis
- Bakar Computational Health Sciences Institute, University of California San Francisco, 490 Illinois St, San Francisco, CA, 94143, USA.,CoLabs, University of California, San Francisco, San Francisco, CA, USA.,Bakar ImmunoX Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Arjun Arkal Rao
- CoLabs, University of California, San Francisco, San Francisco, CA, USA.,Bakar ImmunoX Initiative, University of California, San Francisco, San Francisco, CA, USA.,Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Caroline Warly Solsberg
- Bakar Computational Health Sciences Institute, University of California San Francisco, 490 Illinois St, San Francisco, CA, 94143, USA.,Pharmaceutical Sciences and Pharmacogenomics Graduate Program, University of California San Francisco, San Francisco, CA, USA
| | - Alice Tang
- Bakar Computational Health Sciences Institute, University of California San Francisco, 490 Illinois St, San Francisco, CA, 94143, USA.,Bioengineering Graduate Program, University of California San Francisco, San Francisco, CA, USA
| | - Gabriela K Fragiadakis
- CoLabs, University of California, San Francisco, San Francisco, CA, USA.,Bakar ImmunoX Initiative, University of California, San Francisco, San Francisco, CA, USA.,Department of Medicine, Division of Rheumatology, University of California, San Francisco, San Francisco, CA, USA
| | - Dena B Dubal
- Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA, USA.,Neurosciences Graduate Program, University of California, San Francisco, San Francisco, CA, USA.,Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Tomiko Oskotsky
- Bakar Computational Health Sciences Institute, University of California San Francisco, 490 Illinois St, San Francisco, CA, 94143, USA.,Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, University of California San Francisco, 490 Illinois St, San Francisco, CA, 94143, USA. .,Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
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Montagud-Romero S, Miñarro J, Rodríguez-Arias M. Unravelling the Neuroinflammatory Mechanisms Underlying the Effects of Social Defeat Stress on Use of Drugs of Abuse. Curr Top Behav Neurosci 2021; 54:153-180. [PMID: 34628585 DOI: 10.1007/7854_2021_260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The immune system provides the first line of the organism's defenses, working to maintain homeostasis against external threats and respond also to internal danger signals. There is much evidence to suggest that modifications of inflammatory parameters are related to vulnerability to develop mental illnesses, such as depression, autism, schizophrenia, and substance use disorders. In addition, not only are inflammatory parameters related to these disorders, but stress also induces the activation of the immune system, as recent preclinical research demonstrates. Social stress activates the immune response in the central nervous system through a number of mechanisms; for example, by promoting microglial stimulation, modifying peripheral and brain cytokine levels, and altering the blood brain barrier, which allows monocytes to traffic into the brain. In this chapter, we will first deal with the most important short- and long-term consequences of social defeat (SD) stress on the neuroinflammatory response. SD experiences (brief episodes of social confrontations during adolescence and adulthood) induce functional modifications in the brain, which are accompanied by an increase in proinflammatory markers. Most importantly, inflammatory mechanisms play a significant role in mediating the process of adaptation in the face of adversity (resilience vs susceptibility), allowing us to understand individual differences in stress responses. Secondly, we will address the role of the immune system in the vulnerability and enhanced sensitivity to drugs of abuse after social stress. We will explore in depth the effects seen in the inflammatory system in response to social stress and how they enhance the rewarding effects of drugs such as alcohol or cocaine. To conclude, we will consider pharmacological and environmental interventions that seek to influence the inflammatory response to social stress and diminish increased drug intake, as well as the translational potential and future directions of this exciting new field of research.
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Affiliation(s)
- S Montagud-Romero
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
| | - J Miñarro
- Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Valencia, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS-Trastornos Adictivos), Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - M Rodríguez-Arias
- Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Valencia, Spain. .,Red Temática de Investigación Cooperativa en Salud (RETICS-Trastornos Adictivos), Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain.
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Rats bred for low intrinsic aerobic exercise capacity link obesity with brain inflammation and reduced structural plasticity of the hippocampus. Brain Behav Immun 2021; 97:250-259. [PMID: 34224822 DOI: 10.1016/j.bbi.2021.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Increasing evidence shows obesity and poor metabolic health are associated with cognitive deficits, but the mechanistic connections have yet to be resolved. We studied rats selectively bred for low and high intrinsic aerobic capacity in order to test the association between low physical fitness, a genetic predisposition for obesity, and brain health. We hypothesized that low-capacity runner (LCR) rats with concurrently greater levels of adiposity would have increased hippocampal inflammation and reduced plasticity compared to the more physically fit high-capacity runner (HCR) rats. METHODS We examined markers for inflammation and brain plasticity in the hippocampi of LCR rats and compared them to HCR rats. The effect of age was determined by studying the rats at a young age (8 weeks) and later in life (40 weeks). We used western blots and immunohistochemistry to quantify the expression of target proteins. RESULTS Our study showed that the number of adult-born new neurons in the hippocampus was significantly lower in LCR rats than it was in HCR rats already at a young age and that the difference became more pronounced with age. The expression of synaptic proteins was higher in young animals relative to older ones. Brain inflammation tended to be higher in LCR rats than it was in the HCR rats, and more prominent in older rats than in young ones. CONCLUSION Our study is the first to demonstrate that low intrinsic aerobic fitness that is associated with obesity and poor metabolic health is also linked with reduced hippocampal structural plasticity at a young age. Our results also suggest that inflammation of the brain could be one factor mediating the link between obesity and poor cognitive performance.
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De Meij J, Alfanek Z, Morel L, Decoeur F, Leyrolle Q, Picard K, Carrier M, Aubert A, Séré A, Lucas C, Laforest G, Helbling JC, Tremblay ME, Cota D, Moisan MP, Marsicano G, Layé S, Nadjar A. Microglial Cannabinoid Type 1 Receptor Regulates Brain Inflammation in a Sex-Specific Manner. Cannabis Cannabinoid Res 2021; 6:488-507. [PMID: 34591647 DOI: 10.1089/can.2020.0170] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Neuroinflammation is a key feature shared by most, if not all, neuropathologies. It involves complex biological processes that act as a protective mechanism to fight against the injurious stimuli, but it can lead to tissue damage if self-perpetuating. In this context, microglia, the main cellular actor of neuroinflammation in the brain, are seen as a double-edged sword. By phagocyting neuronal debris, these cells can not only provide tissue repair but can also contribute to neuronal damage by releasing harmful substances, including inflammatory cytokines. The mechanisms guiding these apparent opposing actions are poorly known. The endocannabinoid system modulates the release of inflammatory factors such as cytokines and could represent a functional link between microglia and neuroinflammatory processes. According to transcriptomic databases and in vitro studies, microglia, the main source of cytokines in pathological conditions, express the cannabinoid type 1 receptor (CB1R). Methods: We thus developed a conditional mouse model of CB1R deletion specifically in microglia, which was subjected to an immune challenge (peripheral lipopolysaccharide injection). Results: Our results reveal that microglial CB1R differentially controls sickness behavior in males and females. Conclusion: These findings add to the comprehension of neuroinflammatory processes and might be of great interest for future studies aimed at developing therapeutic strategies for brain disorders with higher prevalence in men.
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Affiliation(s)
- Julia De Meij
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Zain Alfanek
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Lydie Morel
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Fanny Decoeur
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Quentin Leyrolle
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Katherine Picard
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, Canada.,Division of Medical Sciences, University of Victoria, Victoria, Canada.,Department of Molecular Medicine, Université Laval, Québec City, Canada
| | - Micael Carrier
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, Canada.,Division of Medical Sciences, University of Victoria, Victoria, Canada
| | - Agnes Aubert
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Alexandra Séré
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Céline Lucas
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Gerald Laforest
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | | | - Marie-Eve Tremblay
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, Canada.,Division of Medical Sciences, University of Victoria, Victoria, Canada.,Department of Molecular Medicine, Université Laval, Québec City, Canada.,Neurology and Neurosurgery Department, McGill University, Montreal, Canada.,Department of Biochemistry and Molecular Biology, The University of British Columbia, Vancouver, Canada
| | - Daniela Cota
- INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Bordeaux, France
| | | | - Giovanni Marsicano
- INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Bordeaux, France
| | - Sophie Layé
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France
| | - Agnès Nadjar
- NutriNeuro, INRAE, Bordeaux INP, University of Bordeaux, Bordeaux, France.,INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Bordeaux, France
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Hong Y, Wu W, Wang S, Hao Q, Zheng H, Li S, Zhang X, Sun R. Angiotensin II type 1 receptor blockade attenuates posttraumatic stress disorder-related chronic pain by inhibiting glial activation in the spinal cord. Neuropharmacology 2021; 196:108704. [PMID: 34252405 DOI: 10.1016/j.neuropharm.2021.108704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/01/2021] [Accepted: 07/05/2021] [Indexed: 12/28/2022]
Abstract
Clinically, posttraumatic stress disorder (PTSD) and chronic pain are highly comorbid conditions, but the underlying mechanisms of and therapeutic strategies against PTSD-related pain remain unclear. Our previous studies suggested that dysregulation of neuroinflammation contributes to the development of stress-induced hyperalgesia. Recent studies reported that angiotensin II was a 'stress-related hormone', and could induce glial activation by stimulating the type 1 receptor (AT1R). In the present study, we aimed to investigate whether AT1R blockade could attenuate mechanical allodynia induced by PTSD-like stress. Adult male rats were exposed to single prolonged stress (SPS) to establish a model of PTSD-pain comorbidity. Our results showed that SPS exposure increased the levels of angiotensin II in the hippocampus, prefrontal cortex (PFC) and spinal cord; intraperitoneal injection of losartan attenuated SPS-induced mechanical allodynia, and suppressed SPS-induced glial activation (both microglia and astrocytes) and proinflammatory cytokine expression in the PFC and spinal cord, but not in the hippocampus. We further showed that intrathecal injection of losartan also exerted anti-hyperalgesic effect and suppressed SPS-induced glial activation and proinflammatory cytokine expression in the spinal cord. These results indicated that AT1R blockade by losartan attenuated mechanical allodynia induced by PTSD-like stress, and this may be attributed to the suppression of glial activation and proinflammatory cytokine expression in the spinal cord. Although further research is warranted to verify our findings in female rodents and to assess pharmacological effects of AT1R blockade in PFC and hippocampus, our study suggested the therapeutic potential of targeting AT1R in the treatment of PTSD-related chronic pain.
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Affiliation(s)
- Yishun Hong
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenyao Wu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuo Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Quanshui Hao
- Department of Anesthesiology, Huanggang Central Hospital, Huanggang, China
| | - Hua Zheng
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiyong Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xianwei Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Rao Sun
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Sharifi S, Caracciolo G, Pozzi D, Digiacomo L, Swann J, Daldrup-Link HE, Mahmoudi M. The role of sex as a biological variable in the efficacy and toxicity of therapeutic nanomedicine. Adv Drug Deliv Rev 2021; 174:337-347. [PMID: 33957181 DOI: 10.1016/j.addr.2021.04.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/19/2021] [Accepted: 04/29/2021] [Indexed: 02/08/2023]
Abstract
Males and females have physiological, hormonal, and genetic differences that can cause different responses to medicinal treatments. The role of sex in the pharmacokinetics and pharmacodynamics of drugs is well established in the literature. However, researchers have yet to robustly and consistently consider the impact of sex differences on the pharmacokinetics and pharmacodynamics of nanomedicine formulations when designing nanomedicine therapeutics and/or constructing clinical trials. In this review, we highlight the physiological and anatomical differences between sexes and discuss how these differences can influence the therapeutic efficacy, side effects, and drug delivery safety of nanomedicine products. A deep understanding of the effects of sex on nano-based drug delivery agents will robustly improve the risk assessment process, resulting in safer formulations, successful clinical translation, and improved therapeutic efficacies for both sexes.
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Lombardo G, Mondelli V, Dazzan P, Pariante CM. Sex hormones and immune system: A possible interplay in affective disorders? A systematic review. J Affect Disord 2021; 290:1-14. [PMID: 33989924 DOI: 10.1016/j.jad.2021.04.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 03/15/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sex hormones and the immune system may play a key role in sex differences in affective disorders. The understanding of their interplay may lead to the detection of new sex-specific tailored therapeutic approaches. The aim of this systematic review is to summarise the evidence supporting a possible association between sex hormones and inflammatory biomarkers in people with affective disorders. METHODS A systematic search of the literature published until January 2021 was conducted on PubMed database. The initial search identified a total of 1259 studies; 20 studies investigating inflammatory biomarkers and sex hormones in patients exhibiting depressive symptoms were included: 10 studies focused on patients with affective disorders, and 10 studies focused on women in menopause or in the post-partum period exhibiting depressive symptoms. RESULTS Testosterone and exogenous female sex hormones may play protective roles through their modulation of the immune system, respectively, in male patients with bipolar disorder and in peri-/post-menopausal women with depression. LIMITATIONS The main limitations are the paucity of studies investigating both sex hormones and immune biomarkers, the lack of statistical analyses exploring specifically the association between these two classes of biomarkers, and the great heterogeneity between the participants' samples in the studies. CONCLUSION This review highlights the need to investigate the interplay between sex hormones and immune system in affective disorders. The inconsistent or incomplete evidence may be improved by studies in patients with moderate-high inflammatory levels that specifically evaluate the relationship between sex hormones and the immune system.
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Affiliation(s)
- Giulia Lombardo
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK
| | - Carmine Maria Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Lopes PC, French SS, Woodhams DC, Binning SA. Sickness behaviors across vertebrate taxa: proximate and ultimate mechanisms. J Exp Biol 2021; 224:260576. [PMID: 33942101 DOI: 10.1242/jeb.225847] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There is nothing like a pandemic to get the world thinking about how infectious diseases affect individual behavior. In this respect, sick animals can behave in ways that are dramatically different from healthy animals: altered social interactions and changes to patterns of eating and drinking are all hallmarks of sickness. As a result, behavioral changes associated with inflammatory responses (i.e. sickness behaviors) have important implications for disease spread by affecting contacts with others and with common resources, including water and/or sleeping sites. In this Review, we summarize the behavioral modifications, including changes to thermoregulatory behaviors, known to occur in vertebrates during infection, with an emphasis on non-mammalian taxa, which have historically received less attention. We then outline and discuss our current understanding of the changes in physiology associated with the production of these behaviors and highlight areas where more research is needed, including an exploration of individual and sex differences in the acute phase response and a greater understanding of the ecophysiological implications of sickness behaviors for disease at the population level.
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Affiliation(s)
- Patricia C Lopes
- Schmid College of Science and Technology, Chapman University, Orange, CA 92866, USA
| | - Susannah S French
- Department of Biology and The Ecology Center, Utah State University, Logan, UT 84322, USA
| | - Douglas C Woodhams
- Department of Biology, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Sandra A Binning
- Département de Sciences Biologiques, Université de Montréal, Montréal, QC, Canada, H3C 3J7
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Lopatkiewicz AM, Pera J, Slowik A, Dziedzic T. Association of early and later depressive symptoms with functional outcome after ischemic stroke. J Neural Transm (Vienna) 2021; 128:679-686. [PMID: 33728483 PMCID: PMC8105243 DOI: 10.1007/s00702-021-02328-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/10/2021] [Indexed: 12/01/2022]
Abstract
Background Post-stroke depressive symptoms (DS) can be chronic or transient, occurring shortly or long after stroke and lasting only few months. It remains unclear if the prognosis differs between patients with DS in the acute phase of stroke and those who develop DS several months later. We aimed to determine whether outcomes vary among patients with different trajectories of post-stroke depressive symptoms. Methods Of 698 enrolled patients with ischemic stroke, we included 335 participants (median age: 68, 48% female) who were assessed for DS both 8 days and 3 months post-stroke. We divided patients into 4 groups: without greater DS (Group 1), only earlier DS (Group 2), only later DS (Group 3), and persistent DS (Group 4). Logistic regression was used to determine the association between DS and 3- and 12-month functional outcome. Results Group 2 was predominantly female and had the highest rate of previous stroke or transient ischemic attack. Group 3 was more likely to suffer from delirium and more severe stroke. Group 4 had the highest frequency of vascular risk factors, pre-morbid psychiatric symptoms, and cognitive decline. In multivariate analysis, Group 3, but not Groups 2 and 4, had an increased risk of poor 3- and 12-month functional outcome (adjusted OR 2.59, 95% CI 1.64–4.07, P < 0.01 and OR 3.97, 95% CI 2.32–6.76, P < 0.01, respectively) compared with Group 1. Conclusions Different trajectories of post-stroke DS are related to different outcomes. Patients who only have later DS also have the worst prognosis.
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Affiliation(s)
- Anna Maria Lopatkiewicz
- Department of Neurology, Jagiellonian University Medical College, ul. Botaniczna 3, 31-503, Krakόw, Poland
| | - Joanna Pera
- Department of Neurology, Jagiellonian University Medical College, ul. Botaniczna 3, 31-503, Krakόw, Poland
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, ul. Botaniczna 3, 31-503, Krakόw, Poland
| | - Tomasz Dziedzic
- Department of Neurology, Jagiellonian University Medical College, ul. Botaniczna 3, 31-503, Krakόw, Poland.
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Milleville KA, Awan N, Disanto D, Kumar RG, Wagner AK. Early chronic systemic inflammation and associations with cognitive performance after moderate to severe TBI. Brain Behav Immun Health 2021; 11:100185. [PMID: 34589725 PMCID: PMC8474517 DOI: 10.1016/j.bbih.2020.100185] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/03/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cognitive dysfunction adversely effects multiple functional outcomes and social roles after TBI. We hypothesize that chronic systemic inflammation exacerbates cognitive deficits post-injury and diminishes functional cognition and quality of life (QOL). Yet few studies have examined relationships between inflammation and cognition after TBI. Associations between early chronic serum inflammatory biomarker levels, cognitive outcomes, and QOL 6-months and 12-months after moderate-to-severe TBI were identified using unweighted (uILS) and weighted (wILS) inflammatory load score (ILS) formation. METHODS Adults with moderate-to-severe TBI (n = 157) completed neuropsychological testing, the Functional Impairment Measure Cognitive Subscale (FIM-Cog) and self-reported Percent Back to Normal scale 6 months (n = 139) and 12 months (n = 136) post-injury. Serial serum samples were collected 1-3 months post-TBI. Cognitive composite scores were created as equally weighted means of T-scores derived from a multidimensional neuropsychological test battery. Median inflammatory marker levels associated with 6-month and 12-month cognitive composite T-scores (p < 0.10) were selected for ILS formation. Markers were quartiled, and quartile ranks were summed to generate an uILS. Marker-specific β-weights were derived using penalized ridge regression, multiplied by standardized marker levels, and summed to generate a wILS. ILS associations with cognitive composite scores were assessed using multivariable linear regression. Structural equation models assessed ILS influences on functional cognition and QOL using 12-month FIM-Cog and Percent Back to Normal scales. RESULTS ILS component markers included: IL-1β, TNF-α, sIL-4R, sIL-6R, RANTES, and MIP-1β. Increased sIL-4R levels were positively associated with overall cognitive composite T-scores in bivariate analyses, while remaining ILS markers were negatively associated with cognition. Multivariable receiver operator curves (ROC) showed uILS added 14.98% and 31.93% relative improvement in variance captured compared to the covariates only base model (age, sex, education, Glasgow Coma Scale score) when predicting cognitive composite scores at 6 and 12 months, respectively; wILS added 33.99% and 36.87% relative improvement in variance captured. Cognitive composite mediated wILS associations with FIM-Cog scores at 12 months, and both cognitive composite and FIM-Cog scores mediated wILS associations with QOL. CONCLUSIONS Early chronic inflammatory burden is associated with cognitive performance post-TBI. wILS explains greater variance in cognitive composite T-scores than uILS. Linking inflammatory burden associated with cognitive deficits to functional outcome post-TBI demonstrates the potential impact of immunotherapy interventions aimed at improving cognitive recovery post-TBI.
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Affiliation(s)
- Kristen A. Milleville
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, USA
| | - Nabil Awan
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, USA
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, USA
| | - Dominic Disanto
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, USA
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, USA
| | - Raj G. Kumar
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, USA
| | - Amy K. Wagner
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, USA
- Department of Neuroscience, University of Pittsburgh, USA
- Clinical and Translational Science Institute, University of Pittsburgh, USA
- Safar Center for Resuscitation Research, University of Pittsburgh, USA
- Center for Neuroscience, University of Pittsburgh, USA
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Smith CJ, Bilbo SD. Sickness and the Social Brain: Love in the Time of COVID. Front Psychiatry 2021; 12:633664. [PMID: 33692712 PMCID: PMC7937950 DOI: 10.3389/fpsyt.2021.633664] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/26/2021] [Indexed: 12/11/2022] Open
Abstract
As a highly social species, inclusion in social networks and the presence of strong social bonds are critical to our health and well-being. Indeed, impaired social functioning is a component of numerous neuropsychiatric disorders including depression, anxiety, and substance use disorder. During the current COVID-19 pandemic, our social networks are at risk of fracture and many are vulnerable to the negative consequences of social isolation. Importantly, infection itself leads to changes in social behavior as a component of "sickness behavior." Furthermore, as in the case of COVID-19, males and females often differ in their immunological response to infection, and, therefore, in their susceptibility to negative outcomes. In this review, we discuss the many ways in which infection changes social behavior-sometimes to the benefit of the host, and in some instances for the sake of the pathogen-in species ranging from eusocial insects to humans. We also explore the neuroimmune mechanisms by which these changes in social behavior occur. Finally, we touch upon the ways in which the social environment (group living, social isolation, etc.) shapes the immune system and its ability to respond to challenge. Throughout we emphasize how males and females differ in their response to immune activation, both behaviorally and physiologically.
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Affiliation(s)
- Caroline J Smith
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Staci D Bilbo
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
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Karshikoff B, Martucci KT, Mackey S. Relationship Between Blood Cytokine Levels, Psychological Comorbidity, and Widespreadness of Pain in Chronic Pelvic Pain. Front Psychiatry 2021; 12:651083. [PMID: 34248700 PMCID: PMC8267576 DOI: 10.3389/fpsyt.2021.651083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/14/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Low-grade inflammation has been implicated in the etiology of depression, long-term fatigue and chronic pain. TNFα and IL-6 are perhaps the most studied pro-inflammatory cytokines in the field of psychoneuroimmunology. The purpose of our study was to further investigate these relationships in patients with chronic pelvic pain specifically. Using plasma samples from a large, well-described cohort of patients with pelvic pain and healthy controls via the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network, we examined the relationship between TNFα and IL-6 and comorbid psychological symptoms. We also investigated the relationship between IL-8 and GM-CSF, and widespreadness of pain. Methods: We included baseline blood samples in the analyses, 261 patients (148 women) and 110 healthy controls (74 women). Fourteen pro- and anti-inflammatory or regulatory cytokines were analyzed in a Luminex® xMAP® high-sensitivity assay. We used regression models that accounted for known factors associated with the outcome variables to determine the relationship between cytokine levels and clinical measures. Results: There were no statistical differences in cytokine levels between patients and healthy controls when controlling for age. In patients, TNFα was significantly associated with levels of fatigue (p = 0.026), but not with pain intensity or depression. IL-6 was not significantly related to any of the outcome variables. Women with pelvic pain showed a negative relationship between IL-8 and widespreadness of pain, while men did not (p = 0.003). For both sexes, GM-CSF was positively related to widespreadness of pain (p = 0.039). Conclusion: Our results do not suggest low-grade systemic inflammation in chronic pelvic pain. Higher TNFα blood levels were related to higher fatigue ratings, while higher systemic GM-CSF levels predicted more widespread pain. Our study further suggests a potentially protective role of IL-8 with regard to with regard to the widepreadness of pain in the body, at least for women.
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Affiliation(s)
- Bianka Karshikoff
- Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Katherine T Martucci
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC, United States
| | - Sean Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
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Lasselin J, Lekander M, Benson S, Schedlowski M, Engler H. Sick for science: experimental endotoxemia as a translational tool to develop and test new therapies for inflammation-associated depression. Mol Psychiatry 2021; 26:3672-3683. [PMID: 32873895 PMCID: PMC8550942 DOI: 10.1038/s41380-020-00869-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/25/2020] [Accepted: 08/06/2020] [Indexed: 12/16/2022]
Abstract
Depression is one of the global leading causes of disability, but treatments remain limited and classical antidepressants were found to be ineffective in a substantial proportion of patients. Thus, novel effective therapies for the treatment of depression are urgently needed. Given the emerging role of inflammation in the etiology and pathophysiology of affective disorders, we herein illustrate how experimental endotoxemia, a translational model of systemic inflammation, could be used as a tool to develop and test new therapeutic options against depression. Our concept is based on the striking overlap of inflammatory, neural, and affective characteristics in patients with inflammation-associated depression and in endotoxin-challenged healthy subjects. Experimental administration of endotoxin in healthy volunteers is safe, well-tolerated, and without known long-term health risks. It offers a highly standardized translational approach to characterize potential targets of therapies against inflammation-associated depression, as well as to identify characteristics of patients that would benefit from these interventions, and, therefore, could contribute to improve personalization of treatment and to increase the overall rate of responders.
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Affiliation(s)
- Julie Lasselin
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. .,Stress Research Institute, Stockholm University, 10691, Stockholm, Sweden. .,Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177, Stockholm, Sweden. .,Osher Center for Integrative Medicine, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden.
| | - Mats Lekander
- grid.10548.380000 0004 1936 9377Stress Research Institute, Stockholm University, 10691 Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Osher Center for Integrative Medicine, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - Sven Benson
- grid.5718.b0000 0001 2187 5445Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Manfred Schedlowski
- grid.5718.b0000 0001 2187 5445Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden
| | - Harald Engler
- grid.5718.b0000 0001 2187 5445Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
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Manji Z, Rojas A, Wang W, Dingledine R, Varvel NH, Ganesh T. 5xFAD Mice Display Sex-Dependent Inflammatory Gene Induction During the Prodromal Stage of Alzheimer's Disease. J Alzheimers Dis 2020; 70:1259-1274. [PMID: 31322556 DOI: 10.3233/jad-180678] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Alzheimer's disease (AD) pathology consists of extracellular deposits of amyloid-β peptides (Aβ) and intracellular neurofibrillary tangles. These pathological alterations are accompanied by a neuroinflammatory response consisting of increased expression of inflammatory mediators. An anti-inflammatory strategy designed to prevent or delay the development of AD would benefit from knowing when neuroinflammation appears in the transgenic models during prodromal disease stages relative to Aβ pathology. We investigated the expression patterns of inflammatory mediators in the brain of 5xFAD mice in comparison to development of Aβ deposition. Expression changes in inflammatory mediators and glial markers are more robust in female mice starting at three months of age, in contrast to males in which there is no clear trend through five months. Female and male 5xFAD mice also displayed an age-dependent increase in cortical Aβ deposition congruent with neuroinflammation. Thus, in the 5xFAD mouse model of AD, administration of an anti-inflammatory agent would be most efficacious when administered before three months of age.
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Affiliation(s)
- Zahra Manji
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA, USA
| | - Asheebo Rojas
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA, USA
| | - Wenyi Wang
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA, USA
| | - Raymond Dingledine
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nicholas H Varvel
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA, USA
| | - Thota Ganesh
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA, USA
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Elucidating vulnerability to inflammation-induced hyperalgesia: Predictors of increased musculoskeletal pain sensitivity during experimental endotoxemia. Brain Behav Immun 2020; 88:302-307. [PMID: 32592864 DOI: 10.1016/j.bbi.2020.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/15/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022] Open
Abstract
Despite broad clinical implications, the mechanisms linking inflammation and pain remain incompletely understood. Using human experimental endotoxemia as a translational model of systemic inflammation, we aimed to elucidate putative vulnerability factors of inflammation-induced musculoskeletal hyperalgesia. We pooled data from three published randomized controlled trials, resulting in a sample of N = 98 healthy volunteers who received either low-dose endotoxin (lipopolysaccharide) or vehicle (saline) intravenously. As measure of musculoskeletal pain sensitivity, pressure pain thresholds (PPTs) were assessed at baseline and 3 h post injection with a handheld algometer for the low back (erector spinae muscle), calf (gastrocnemius muscle), and shoulder region (deltoid muscle). Implementing multiple regression models, we tested the contribution of putative vulnerability factors on musculoskeletal hyperalgesia during systemic inflammation, including acute changes in pro-inflammatory cytokines, state anxiety and mood, as well as pre-existing symptoms of anxiety and depression. Endotoxin application led to significant increases in plasma cytokines, state anxiety, and negative mood, and significantly decreased PPTs for all muscle groups. Regression models revealed that greater M. erector spinae PPT changes were predicted by higher HADS-anxiety scores. Higher TNF-α concentration emerged as predictor for M. gastrocnemius PPT changes, and more pronounced TNF-α increase and higher HADS-anxiety were predictive for M. deltoideus PPTs. HADS scores emerged as predictor for a mean PPT score (computed across all body sites). Together, our results indicate that musculoskeletal hyperalgesia during systemic inflammation is related to pro-inflammatory cytokines, specifically TNF-α. Importantly, subclinical anxiety symptoms (even though in a low and normal range in this cohort of healthy volunteers) may contribute to inflammation-induced hyperalgesia, making individuals more vulnerable to the detrimental effects of systemic inflammation.
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Lasselin J, Benson S, Hebebrand J, Boy K, Weskamp V, Handke A, Hasenberg T, Remy M, Föcker M, Unteroberdörster M, Brinkhoff A, Engler H, Schedlowski M. Immunological and behavioral responses to in vivo lipopolysaccharide administration in young and healthy obese and normal-weight humans. Brain Behav Immun 2020; 88:283-293. [PMID: 32485294 DOI: 10.1016/j.bbi.2020.05.071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Obesity is associated with an increase prevalence of neuropsychiatric symptoms and diseases, such as depression. Based on the facts that pro-inflammatory cytokines are able to modulate behavior, and that obesity is characterized by a chronic low-grade inflammatory state, inflammation has been hypothesized to contribute to the neuropsychiatric comorbidity in obese individuals. However, a causal link between inflammation and the development of neuropsychiatric symptoms is hard to establish in humans. Here, we used an inflammatory stimulus, i.e. the intravenous injection of lipopolysaccharide (LPS), in a double-blind placebo-controlled design, to determine the vulnerability of obese individuals to inflammation-induced behavioral changes. The hypothesis was that obese individuals would show heightened behavioral response compared to normal-weight subjects for the same inflammatory stimulus, reflecting an increased sensitivity to the behavioral effects of pro-inflammatory cytokines. LPS (dose 0.8 ng/kg body weight, adjusted for estimated blood volume in obese subjects) and placebo (saline) were intravenously injected in 14 obese healthy subjects and 23 normal-weight healthy subjects in a within-subject, randomized, crossover design. LPS administration induced, in both groups, an acute increase in blood concentrations of cytokines (interleukin-6, tumor necrosis factor-α, and IL-10), as well as in body temperature, cortisol, norepinephrine, sickness symptoms, fatigue, negative mood, and state anxiety. There were little differences in the immune and behavioral responses to LPS between obese and normal-weight subjects, but the cortisol response to LPS was strongly attenuated in obese individuals. Higher percentage of body fat was related to a lower cortisol response to LPS. Taken together, the population of young and healthy obese individuals in this study did not exhibit an increased behavioral sensitivity to cytokines, but an attenuated cortisol response to the immune challenge. Future studies will need to determine whether additional physiological and psychological factors interact with the state of obesity to increase the risk for inflammation-induced neuropsychiatric symptoms.
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Affiliation(s)
- Julie Lasselin
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany; Stress Research Institute, Stockholm University, 10691 Stockholm, Sweden; Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden.
| | - Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, Germany
| | - Karoline Boy
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Vera Weskamp
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Analena Handke
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Till Hasenberg
- Helios Adipositas Zentrum West, Helios St. Elisabeth Klinik Oberhausen, Witten/Herdecke University, Josefstr. 3, 46045 Oberhausen, Germany
| | - Miriam Remy
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, Germany
| | - Meike Unteroberdörster
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany; Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Alexandra Brinkhoff
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany; Department of Nephrology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
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Wang X, Zhang Y, Kong H, Cheng J, Zhang M, Sun Z, Wang S, Liu J, Qu H, Zhao Y. Novel mulberry silkworm cocoon-derived carbon dots and their anti-inflammatory properties. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2020; 48:68-76. [PMID: 31852285 DOI: 10.1080/21691401.2019.1699810] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Mulberry silkworm cocoon (MSC) carbonisata has been used for the treatment of inflammatory diseases for hundreds of years; however, after years of research efforts, little information is available on its anti-inflammatory components and underlying mechanism. We developed novel carbon dots (CDs) derived from MSC carbonisata (MSC-CDs), for the first time, with an average diameter of 2.26-9.35 nm and a quantum yield (QY) of 6.32%. The MSC-CDs were prepared using a modified pyrolysis method, and no further modification and external surface passivation agent was required. With abundant surface groups, MSC-CDs showed distinct solubility and bioactivity. In this study, we innovatively used three classical experimental models of inflammation to evaluate the anti-inflammatory bioactivity of MSC-CDs. The results indicated that MSC-CDs exhibited marked anti-inflammatory bioactivity which was likely mediated by inhibition of the expression of interleukin-6 and tumour necrosis factor-α. These results suggest that MSC-CDs possess a remarkable anti-inflammatory property, which provides evidence to support further investigation of the considerable potential and effective material basis of this traditional Chinese medicine.
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Affiliation(s)
- Xiaoke Wang
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Zhang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Hui Kong
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
| | - Jinjun Cheng
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
| | - Meiling Zhang
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
| | - Ziwei Sun
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
| | - Suna Wang
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
| | - Jiaxing Liu
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
| | - Huihua Qu
- Beijing Institute of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Zhao
- School of Preclinical Medicine, Beijing Key Laboratory, Beijing University of Chinese Medicine, Beijing, China
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