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van de Vyver M, Benecke RM, van den Heuvel L, Kruger MJ, Powrie Y, Seedat S, Smith C. Posttraumatic stress disorder is characterized by functional dysregulation of dermal fibroblasts. Biochimie 2024; 225:10-18. [PMID: 38719136 DOI: 10.1016/j.biochi.2024.05.006] [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: 04/09/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/24/2024]
Abstract
Incidence of mental health disorders are rising in modernity, with psychological stress linked to a propensity for developing various chronic diseases due to a relative inability of the body to counter the allostatic load on cellular level. Despite these high rates of comorbidities associated with posttraumatic stress disorder (PTSD), there is still a lack of understanding in terms of the peripheral effects of PTSD on tissue level. Therefore, the purpose of this study was to profile basal dermal fibroblast functional status in PTSD using a wide range of markers involved in the cell-to-cell communication facilitated by fibroblasts. Primary dermal fibroblasts derived from patients diagnosed with PTSD (n = 11) and matched trauma exposed controls (i.e. who did not develop PTSD, n = 10) were cultured using standard techniques. The patients and controls were matched based on age, sex, body-mass index (BMI) and lifestyle. The growth rate, population doubling time, cell surface marker expression (CD31, FNDC5) (flow cytometry), secretome (TIMP-2, MMP-9) (ELISAs), intracellular signalling capacity (Fluo-4 Ca2+ flux) and gene expression (IL-6, IL-10, PTX-3, iNOS, Arg1) were compared between groups. The data illustrated significant PTSD-associated fibroblast conditioning resulting in a blunted signalling capacity. This observation highlights the importance of including tissue-specific investigations in future studies focused on elucidating the association between PTSD and subsequent risk for somatic disease.
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Affiliation(s)
- M van de Vyver
- Experimental Medicine Research Group, Division Internal Medicine, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, South Africa
| | - R M Benecke
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, South Africa
| | - L van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa; South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - M J Kruger
- Experimental Medicine Research Group, Division Internal Medicine, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, South Africa
| | - Y Powrie
- Experimental Medicine Research Group, Division Internal Medicine, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, South Africa
| | - S Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa; South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - C Smith
- Experimental Medicine Research Group, Division Internal Medicine, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, South Africa.
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Friedman MR, Badri S, Bowleg L, Haberlen SA, Jones DL, Kempf MC, Konkle-Parker D, Kwait J, Martinson J, Mimiaga MJ, Plankey MW, Stosor V, Tsai AC, Turan JM, Ware D, Wu K. Intersectional stigma and the non-communicable disease syndemic in the context of HIV: protocol for a multisite, observational study in the USA. BMJ Open 2024; 14:e075368. [PMID: 38670612 PMCID: PMC11057270 DOI: 10.1136/bmjopen-2023-075368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/22/2023] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic. METHODS AND ANALYSIS Collecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design. ETHICS AND DISSEMINATION This protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.
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Grants
- U01 HL146245 NHLBI NIH HHS
- U01 HL146208 NHLBI NIH HHS
- UL1 TR001409 NCATS NIH HHS
- KL2 TR001432 NCATS NIH HHS
- U01 HL146192 NHLBI NIH HHS
- U01 HL146242 NHLBI NIH HHS
- TL1 TR001431 NCATS NIH HHS
- U01 HL146193 NHLBI NIH HHS
- R01 HL160326 NHLBI NIH HHS
- U01 HL146194 NHLBI NIH HHS
- U01 HL146241 NHLBI NIH HHS
- P30 AI027767 NIAID NIH HHS
- P30 AI050409 NIAID NIH HHS
- U01 HL146333 NHLBI NIH HHS
- U01 HL146205 NHLBI NIH HHS
- P30 MH116867 NIMH NIH HHS
- P30 AI073961 NIAID NIH HHS
- U01 HL146201 NHLBI NIH HHS
- U01 HL146204 NHLBI NIH HHS
- U01 HL146202 NHLBI NIH HHS
- UL1 TR001881 NCATS NIH HHS
- UL1 TR000004 NCATS NIH HHS
- U01 HL146240 NHLBI NIH HHS
- U01 HL146203 NHLBI NIH HHS
- UL1 TR003098 NCATS NIH HHS
- P30 AI050410 NIAID NIH HHS
- Data Analysis and Coordination Center
- National Heart, Lung, and Blood Institute (NHLBI)
- National Institutes of Health, National Heart, Lung, and Blood Institute
- National Institutes of Health (NIH)
- UCLA
- CTSA
- ICTR
- National Institutes of Health, Office of AIDS Research (OAR)
- UCSF
- the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Institute On Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD)
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Affiliation(s)
- M Reuel Friedman
- Department of Urban-Global Public Health, Rutgers University, Newark, New Jersey, USA
| | - Sheila Badri
- Hektoen Institute of Medicine, Chicago, Illinois, USA
| | - Lisa Bowleg
- Department of Psychology, The George Washington University, Washington, District of Columbia, USA
| | - Sabina A Haberlen
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Deborah L Jones
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
| | - Mirjam-Colette Kempf
- Schools of Nursing, Public Health, and Medicine, University of Albama, Birmingham, Alabama, USA
| | - Deborah Konkle-Parker
- Schools of Nursing, Medicine, and Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jenn Kwait
- Whitman-Walker Institute, Washington, District of Columbia, USA
| | - Jeremy Martinson
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Matthew J Mimiaga
- Center for LGBTQ+ Advocacy, Research & Health and Department of Epidemiology, University of California-Los Angeles, Los Angeles, California, USA
| | - Michael W Plankey
- Department of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Valentina Stosor
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alexander C Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
- School of Medicine and Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Janet M Turan
- Schools of Nursing, Public Health, and Medicine, University of Albama, Birmingham, Alabama, USA
| | - Deanna Ware
- Department of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Katherine Wu
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Rowe K, Bröcker E, Suliman S, Blaauw R, Seedat S, van den Heuvel LL. The relationship between nutrient intake and executive function in adults with post-traumatic stress disorder. J Affect Disord 2024; 349:125-131. [PMID: 38199386 DOI: 10.1016/j.jad.2024.01.065] [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: 10/07/2023] [Revised: 12/18/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Executive function (EF) deficits are common in adults with post-traumatic stress disorder (PTSD). Macro- and micronutrient intake are potential modifiable factors that may influence EF in PTSD. OBJECTIVES To explore the relationship between the daily dietary intake of ω-3 and ω-6 polyunsaturated fatty acids (PUFAs), vitamin C, vitamin E, vitamin D, vitamin B12 and folate, and EF in adults with PTSD. METHODS This was a cross-sectional observational study of adults with PTSD who completed neurocognitive assessments (n = 201). Digit span backwards, spatial span backwards, Stroop test and the Ruff Figural Fluency Task were used to assess EF. FoodFinder nutrient intake based on 24-h dietary recalls was used to calculate average daily nutrient intake. Multivariable linear regression models were used to regress EF on the nutrient variables. RESULTS Intake of vitamin E, ω-3 PUFAs, and ω-6 PUFAs were all positively associated with planning and set-shifting, with vitamin E (adjusted β = 0.20, p = 0.004) and ω-6 (adjusted β = 0.17, p = 0.01) remaining significant after adjustment for age; sex; education and body mass index. Vitamin D intake was negatively associated with interference (adjusted β = -0.21, p = 0.01). Vitamin C, vitamin B12 and folate intake were not associated with EF. LIMITATIONS 24-h dietary recall data is limited by recall bias. Circulating nutrient levels were not measured. CONCLUSIONS Dietary intake of vitamins E, ω-3 and ω-6 may be important modifiable factors affecting EF in adults with PTSD. Randomised controlled trials are needed to investigate whether micro- and macronutrient interventions can improve EF and other outcomes in PTSD.
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Affiliation(s)
- Kirsten Rowe
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa.
| | - Erine Bröcker
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sharain Suliman
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Renée Blaauw
- Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leigh Luella van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
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Leenders AEM, Kremer-Hooft van Huijsduijnen E, Robalo B, van Male R, De Luca A, Kemps R, Hoving E, Lequin MH, Grootenhuis MA, Partanen M. Unraveling the relations between post-traumatic stress symptoms, neurocognitive functioning, and limbic white matter in pediatric brain tumor patients. Neurooncol Adv 2024; 6:vdae026. [PMID: 38476931 PMCID: PMC10929421 DOI: 10.1093/noajnl/vdae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Background Pediatric brain tumor patients are at risk of developing neurocognitive impairments and associated white matter alterations. In other populations, post-traumatic stress symptoms (PTSS) impact cognition and white matter. This study aims to investigate the effect of PTSS on neurocognitive functioning and limbic white matter in pediatric brain tumor patients. Methods Sixty-six patients (6-16 years) completed neuropsychological assessment and brain MRI (1-year post-diagnosis) and parents completed PTSS proxy questionnaires (CRIES-13; 1-3 months and 1-year post-diagnosis). Mean Z-scores and percentage impaired (>1SD) for attention, processing speed, executive functioning, and memory were compared to normscores (t-tests, chi-square tests). Multi-shell diffusion MRI data were analyzed for white matter tractography (fractional anisotropy/axial diffusivity). Effects of PTSS on neurocognition and white matter were explored with linear regression models (FDR correction for multiple testing), including age at diagnosis, treatment intensity, and tumor location as covariates. Neurocognition and limbic white matter associations were explored with correlations. Results Attention (M = -0.49, 33% impaired; P < .05) and processing speed (M = -0.57, 34% impaired; P < .05) were significantly lower than healthy peers. PTSS was associated with poorer processing speed (β = -0.64, P < .01). Treatment intensity, age at diagnosis, and tumor location, but not PTSS, were associated with limbic white matter metrics. Neurocognition and white matter metrics were not associated. Conclusions Higher PTSS was associated with poorer processing speed, highlighting the need for monitoring, and timely referrals to optimize psychological well-being and neurocognitive functioning. Future research should focus on longitudinal follow-up and explore the impact of PTSS interventions on neurocognitive performance.
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Affiliation(s)
- Anne E M Leenders
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Bruno Robalo
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Rosa van Male
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Rachèl Kemps
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Eelco Hoving
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Maarten H Lequin
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marita Partanen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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5
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Kuckuck S, Lengton R, Boon MR, Boersma E, Penninx BWJH, Kavousi M, van Rossum EFC. Long-term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta-analysis. J Intern Med 2024; 295:2-19. [PMID: 37926862 DOI: 10.1111/joim.13739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The striking link of Cushing's syndrome with the metabolic syndrome (MetS) and cardiovascular disease (CVD) suggests that long-term exposure to extremely high cortisol levels catalyzes cardiometabolic deterioration. However, it remained unclear whether the findings from the extreme glucocorticoid overabundance observed in Cushing's syndrome could be translated into more subtle variations in long-term glucocorticoid levels among the general population, for example, due to chronic stress. Here, we performed a systematic review (PROSPERO: CRD42023425541) of evidence regarding the role of subtle variations in long-term biological stress, measured as levels of scalp hair cortisol (HairF) and cortisone (HairE), in the context of MetS and CVD in adults. We also performed a meta-analysis on the cross-sectional difference in HairF levels between individuals with versus without CVD. Seven studies were included regarding MetS, sixteen regarding CVD, and one regarding both. Most articles indicated a strong, consistent cross-sectional association of higher HairF and HairE levels with CVD, which was confirmed by our meta-analysis for HairF (eight studies, SMD = 0.48, 95% confidence intervals [CIs]: 0.16-0.79, p = 0.0095). Moreover, these relationships appear largely independent of standard risk factors. Age seems relevant as the effect seems stronger in younger individuals. Results regarding the associations of HairF and HairE with MetS were inconsistent. Altogether, long-term biological stress, measured as HairF and HairE, is associated with the presence of CVD, and less consistently with MetS. Prospective studies need to evaluate the directionality of this relationship and determine whether HairF and HairE can be used in addition to standard risk factors in predicting future cardiometabolic deterioration.
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Affiliation(s)
- Susanne Kuckuck
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robin Lengton
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mariëtte R Boon
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Schindler-Gmelch L, Capito K, Steudte-Schmiedgen S, Kirschbaum C, Berking M. Hair Cortisol Research in Posttraumatic Stress Disorder - 10 Years of Insights and Open Questions. A Systematic Review. Curr Neuropharmacol 2024; 22:1697-1719. [PMID: 37550910 DOI: 10.2174/1570159x21666230807112425] [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: 10/27/2022] [Revised: 01/05/2023] [Accepted: 01/13/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Cortisol is one of the most extensively studied biomarkers in the context of trauma/posttraumatic stress disorder (PTSD). For more than a decade, hair cortisol concentrations (HCC) have been measured in this context, leading to a two-staged dysregulation model. Specifically, an elevated secretion during/immediately after trauma exposure eventually reverts to hyposecretion with increasing time since trauma exposure has been postulated. OBJECTIVE The aim of our systematic review was to re-evaluate the two-staged secretion model with regard to the accumulated diagnostic, prognostic, and intervention-related evidence of HCC in lifetime trauma exposure and PTSD. Further, we provide an overview of open questions, particularly with respect to reporting standards and quality criteria. METHOD A systematic literature search yielded 5,046 records, of which 31 studies were included. RESULTS For recent/ongoing (traumatic) stress, the predictions of cortisol hypersecretion could be largely confirmed. However, for the assumed hyposecretion temporally more distal to trauma exposure, the results are more ambiguous. As most studies did not report holistic overviews of trauma history and confounding influences, this may largely be attributable to methodological limitations. Data on the prognostic and intervention-related benefits of HCC remain sparse. CONCLUSION Over the last decade, important insights could be gained about long-term cortisol secretion patterns following lifetime trauma exposure and PTSD. This systematic review integrates these insights into an updated secretion model for trauma/PTSD. We conclude with recommendations for improving HCC research in the context of trauma/PTSD in order to answer the remaining open questions.
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Affiliation(s)
- Lena Schindler-Gmelch
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Klara Capito
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Moodley A, Womersley JS, Swart PC, van den Heuvel LL, Malan-Müller S, Seedat S, Hemmings SMJ. A network analysis investigating the associations between posttraumatic stress symptoms, markers of inflammation and metabolic syndrome. J Psychiatr Res 2023; 165:105-114. [PMID: 37487292 DOI: 10.1016/j.jpsychires.2023.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/22/2023] [Accepted: 07/15/2023] [Indexed: 07/26/2023]
Abstract
Chronic systemic inflammation has been implicated in trauma exposure, independent of a psychiatric diagnosis, and in posttraumatic stress disorder (PTSD) and its highly comorbid conditions, such as metabolic syndrome (MetS). The present study used network analysis to examine the interacting associations between pro-inflammatory cytokines, posttraumatic stress (PTS) symptoms and symptom clusters, and individual components of MetS, in a cohort of 312 participants (n = 139 PTSD cases, n = 173 trauma-exposed controls). Pro-inflammatory cytokines were measured in serum samples using immunoturbidimetric and multiplex assays. Three network models were assessed, and the decision on which model to use was guided by network stability estimates and denseness. Weak negative associations were observed between interleukin one beta (IL-1β) and detachment (D6) and irritability (E1); tumour necrosis factor alpha (TNFα) and hypervigilance (E3); and C-reactive protein (CRP) and emotional cue reactivity (B4), which could be due to high cortisol levels present in a female-majority cohort. Network models also identified positive associations between CRP and waist circumference, blood pressure, and high-density lipoprotein cholesterol (HDL-C). The strongest association was observed between CRP and waist circumference, providing evidence that central obesity is an important inflammatory component of MetS. Some networks displayed high instability, which could be due to the small pool of participants with viable cytokine data. Overall, this study provides evidence for associations between inflammation, PTS symptoms and components of MetS. Future longitudinal studies measuring pro-inflammatory cytokines in the immediate aftermath of trauma are required to gain better insight into the role of inflammation in trauma-exposure and PTSD.
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Affiliation(s)
- Allegra Moodley
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; Department of Biomedical Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Jacqueline S Womersley
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Patricia C Swart
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Leigh L van den Heuvel
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Stefanie Malan-Müller
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; Department of Pharmacology and Toxicology, Faculty of Medicine, University Complutense Madrid (UCM), Madrid, Spain; Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain; Neurochemistry Research Institute UCM, Hospital 12 de Octubre Research Institute (Imas12), Madrid, Spain
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa.
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8
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Johnsen AM, Theodorsson E, Broström A, Wagman P, Fransson EI. Work-related factors and hair cortisol concentrations among men and women in emergency medical services in Sweden. Sci Rep 2023; 13:12877. [PMID: 37553457 PMCID: PMC10409737 DOI: 10.1038/s41598-023-40076-x] [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: 03/30/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023] Open
Abstract
Ambulance personnel in emergency medical services are exposed to physical demands and stress during work, and an increased prevalence of ill health has been observed in this group. The aim was to compare hair cortisol concentration (HCC) among Swedish ambulance personnel with HCC in a population-based reference sample, to analyse differences between women and men, and differences due to work-related factors. Samples of hair 1 cm closest to the skin (5-10 mg) were collected and analysed for cortisol by radioimmunoassay. Moreover, the participants responded to a questionnaire regarding their work environment. The HCC among the ambulance personnel did not differ from the HCC in the population-based reference sample (median 19.2 vs. 22.2 pg/mg, p = 0.319), nor were there statistically significant differences between women and men. Furthermore, no associations were found between HCC and physical and psychosocial work demands, work stress, or rest and recovery from work. However, occupational balance was positively correlated with HCC (rp = 0.240; p = 0.044). The association remained statistically significant after adjustment for sex, age, hair bleaching, and corticosteroid treatment in a linear regression model. This study adds knowledge regarding HCC among ambulance personnel, and thus contributes to the overall picture of work environment and health for this group.
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Affiliation(s)
- Anna M Johnsen
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Elvar Theodorsson
- Department of Biomedical and Clinical Science, Clinical Chemistry, Linköping University, Linköping, Sweden
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Petra Wagman
- Department of Rehabilitation, Jönköping University, Jönköping, Sweden
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9
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Swart PC, Du Plessis M, Rust C, Womersley JS, van den Heuvel LL, Seedat S, Hemmings SMJ. Identifying genetic loci that are associated with changes in gene expression in PTSD in a South African cohort. J Neurochem 2023; 166:705-719. [PMID: 37522158 PMCID: PMC10953375 DOI: 10.1111/jnc.15919] [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: 01/18/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023]
Abstract
The molecular mechanisms underlying posttraumatic stress disorder (PTSD) are yet to be fully elucidated, especially in underrepresented population groups. Expression quantitative trait loci (eQTLs) are DNA sequence variants that influence gene expression, in a local (cis-) or distal (trans-) manner, and subsequently impact cellular, tissue, and system physiology. This study aims to identify genetic loci associated with gene expression changes in a South African PTSD cohort. Genome-wide genotype and RNA-sequencing data were obtained from 32 trauma-exposed controls and 35 PTSD cases of mixed-ancestry, as part of the SHARED ROOTS project. The first approach utilised 108 937 single-nucleotide polymorphisms (SNPs) (MAF > 10%) and 11 312 genes with Matrix eQTL to map potential eQTLs, while controlling for covariates as appropriate. The second analysis was focused on 5638 SNPs related to a previously calculated PTSD polygenic risk score for this cohort. SNP-gene pairs were considered eQTLs if they surpassed Bonferroni correction and had a false discovery rate <0.05. We did not identify eQTLs that significantly influenced gene expression in a PTSD-dependent manner. However, several known cis-eQTLs, independent of PTSD diagnosis, were observed. rs8521 (C > T) was associated with TAGLN and SIDT2 expression, and rs11085906 (C > T) was associated with ZNF333 expression. This exploratory study provides insight into the molecular mechanisms associated with PTSD in a non-European, admixed sample population. This study was limited by the cross-sectional design and insufficient statistical power. Overall, this study should encourage further multi-omics approaches towards investigating PTSD in diverse populations.
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Affiliation(s)
- Patricia C. Swart
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders UnitCape TownSouth Africa
| | - Morne Du Plessis
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders UnitCape TownSouth Africa
| | - Carlien Rust
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders UnitCape TownSouth Africa
| | - Jacqueline S. Womersley
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders UnitCape TownSouth Africa
| | - Leigh L. van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders UnitCape TownSouth Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders UnitCape TownSouth Africa
| | - Sian M. J. Hemmings
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders UnitCape TownSouth Africa
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10
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Kische H, Voss C, Haring R, Ollmann TM, Pieper L, Kirschbaum C, Beesdo-Baum K. Hair androgen concentrations and depressive disorders in adolescents from the general population. Eur Child Adolesc Psychiatry 2023; 32:1375-1389. [PMID: 35112167 PMCID: PMC10326161 DOI: 10.1007/s00787-021-01929-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/12/2021] [Indexed: 11/26/2022]
Abstract
Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up. We investigated multivariable regression models for cross-sectional and longitudinal associations of hair testosterone, dehydroepiandrosterone (DHEA), and their cortisol ratios with 12-month diagnoses of major depressive disorder (MDD) and MDD without any anxiety disorder assessed with standardized diagnostic interview (DIA-X-5), and with dimensional depression scores (PHQ-9, PROMIS), separately for males and females. The potential moderating effect of social support was determined. Cross-sectional analyses yielded inverse associations of testosterone and DHEA with MDD and MDD without any anxiety disorders in males. In cross-sectional and longitudinal analyses, baseline ratio cortisol/DHEA was significantly, inversely associated to PROMIS-depression in males. Only cross-sectional associations for ratio cortisol/DHEA and PROMIS-depression remained significant after Bonferroni-Holm correction. No robust associations were observed in female participants. Social support exerted no consistent moderating effect on the investigated association. The present observational cohort study showed no consistent association of hair androgen concentrations with depressive disorders in adolescents. However, findings provide some support for the association between the cortisol/DHEA ratio and depression in males. Longitudinal research designs in large samples are needed to understand the interplay between androgens, depression, and developmental and social factors in youth.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Robin Haring
- Faculty of Applied Public Health, European University of Applied Sciences, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Theresa Magdalena Ollmann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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11
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Wang Z, Luo C, Zhou EW, Sandhu AF, Yuan X, Williams GE, Cheng J, Sinha B, Akbar M, Bhattacharya P, Zhou S, Song BJ, Wang X. Molecular Toxicology and Pathophysiology of Comorbid Alcohol Use Disorder and Post-Traumatic Stress Disorder Associated with Traumatic Brain Injury. Int J Mol Sci 2023; 24:ijms24108805. [PMID: 37240148 DOI: 10.3390/ijms24108805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The increasing comorbidity of alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD) associated with traumatic brain injury (TBI) is a serious medical, economic, and social issue. However, the molecular toxicology and pathophysiological mechanisms of comorbid AUD and PTSD are not well understood and the identification of the comorbidity state markers is significantly challenging. This review summarizes the main characteristics of comorbidity between AUD and PTSD (AUD/PTSD) and highlights the significance of a comprehensive understanding of the molecular toxicology and pathophysiological mechanisms of AUD/PTSD, particularly following TBI, with a focus on the role of metabolomics, inflammation, neuroendocrine, signal transduction pathways, and genetic regulation. Instead of a separate disease state, a comprehensive examination of comorbid AUD and PTSD is emphasized by considering additive and synergistic interactions between the two diseases. Finally, we propose several hypotheses of molecular mechanisms for AUD/PTSD and discuss potential future research directions that may provide new insights and translational application opportunities.
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Affiliation(s)
- Zufeng Wang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Forensic Medicine, Soochow University, Suzhou 215006, China
| | - Chengliang Luo
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Forensic Medicine, Soochow University, Suzhou 215006, China
| | - Edward W Zhou
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Aaron F Sandhu
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Xiaojing Yuan
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - George E Williams
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jialu Cheng
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Bharati Sinha
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Mohammed Akbar
- Division of Neuroscience & Behavior, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA
| | - Pallab Bhattacharya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar 382355, Gujarat, India
| | - Shuanhu Zhou
- Harvard Medical School, Harvard Stem Cell Institute, Boston, MA 02115, USA
| | - Byoung-Joon Song
- Section of Molecular Pharmacology and Toxicology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA
| | - Xin Wang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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12
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On making (and turning adaptive to) maladaptive aversive memories in laboratory rodents. Neurosci Biobehav Rev 2023; 147:105101. [PMID: 36804263 DOI: 10.1016/j.neubiorev.2023.105101] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
Fear conditioning and avoidance tasks usually elicit adaptive aversive memories. Traumatic memories are more intense, generalized, inflexible, and resistant to attenuation via extinction- and reconsolidation-based strategies. Inducing and assessing these dysfunctional, maladaptive features in the laboratory are crucial to interrogating posttraumatic stress disorder's neurobiology and exploring innovative treatments. Here we analyze over 350 studies addressing this question in adult rats and mice. There is a growing interest in modeling several qualitative and quantitative memory changes by exposing already stressed animals to freezing- and avoidance-related tests or using a relatively high aversive training magnitude. Other options combine aversive/fearful tasks with post-acquisition or post-retrieval administration of one or more drugs provoking neurochemical or epigenetic alterations reported in the trauma aftermath. It is potentially instructive to integrate these procedures and incorporate the measurement of autonomic and endocrine parameters. Factors to consider when defining the organismic and procedural variables, partially neglected aspects (sex-dependent differences and recent vs. remote data comparison) and suggestions for future research (identifying reliable individual risk and treatment-response predictors) are discussed.
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13
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Neurobiochemical biomarkers and other risk factors for post-traumatic acute stress disorder. J Psychiatr Res 2023; 157:276-284. [PMID: 36527741 DOI: 10.1016/j.jpsychires.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/07/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
Trauma is a leading cause of mortality and morbidity around the world and many trauma patients could suffer from a series of cognitive and mental disorders including acute stress disorder (ASD). Yet, little research has been done to investigate the influencing factors and pathogenesis of post-traumatic ASD. Therefore, this study investigated main influencing factors and neurobiochemical biomarkers of ASD in trauma patients with a purpose of early clinical identification and intervention. The patients were followed up by general questionnaire and Acute Stress Disorder scale (ASDS). Using the diagnostic criteria of ASD, the study participants were divided into ASD group and non-ASD group. The generalized estimating equation (GEE) multivariate analysis suggested that life stress, sleep less than 8 h, trauma from road traffic crash, overall pain intensity, injury severity, overall fear after trauma were risk factors for ASD. Neutrophil to lymphocyte ratio (NLR) showed a downward trend in both groups (P < 0.05), and the ASD group was higher than the non-ASD group (P = 0.015). Glu to GABA ratio (GGR) in the ASD group were higher than the non-ASD group (P < 0.001). Both patient demographics and patient's condition could impact the risk of developing ASD after a major injury.
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14
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Bürgin D, Clemens V, Varghese N, Eckert A, Huber M, Bruttin E, Boonmann C, Unternährer E, O'Donovan A, Schmid M. Adverse and traumatic exposures, posttraumatic stress disorder, telomere length, and hair cortisol – Exploring associations in a high-risk sample of young adult residential care leavers. Brain Behav Immun Health 2022; 26:100524. [PMID: 36213488 PMCID: PMC9535425 DOI: 10.1016/j.bbih.2022.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/17/2022] [Accepted: 09/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Childhood adversities (CAs), potentially traumatic exposures (PTEs), and posttraumatic stress disorder (PTSD) are known to increase the risk for poor health outcomes, including diseases of aging and early mortality. Telomere length (TL) and hair cortisol concentrations (HCC) are biomarkers known to be associated with CA and PTEs, and PTSD, but there is considerable heterogeneity in findings. Objectives This study aims to investigate the association of CAs, PTEs, and PTSD with TL and HCC in a high-risk sample of young adults who were previously placed in youth residential care institutions throughout Switzerland. Method Our sample includes 130 participants (30.8% women, M Age = 26.5 ± 3.7 years) with previous youth residential care placements (MPlacements= 3.9). CAs and PTEs, as well as PTSD, were assessed with self-reported questionnaires and semi-structured clinical interviews. Immune cell TL was measured with quantitative polymerase chain reaction (qPCR) in whole blood. Hair samples were collected for HCC measurement and assayed with high-sensitivity ELISA. Multivariate regression models were fitted to describe the associations between CAs, PTEs, and PTSD with TL and HCC, adjusting for covariates. Results In our high-risk sample, a higher burden of CAs, PTEs, Criterion A trauma, and PTSD was associated with longer TL. PTEs, Criterion A trauma, and PTSD were associated with lower HCC, however no significant associations between CAs and HCC were found. The magnitude of these effects varied depending on the dimensional or categorical nature of the stress-phenotype and the specific measure used. Conclusions Our findings are in contrast with many, but not all, previous studies of associations between adversity and both TL and HCC. For instance, our findings are in line with other studies that find a state of hypocortisolism in PTSD. Better measurement of adversities and trauma, multisystem biomarker approaches, and more research in larger high-risk samples at the upper end of the adversity-continuum is warranted. In this high-risk sample,childhood adversities, potential traumatic exposures, criterion A trauma, or posttraumatic stress disorder (PTSD) was associated with longer telomere length (TL). Potentially traumatic exposures, criterion A trauma, and PTSD were associated with lower hair cortisol concentrations. The magnitude of these effects varied depending on the dimensional or categorical nature of the stress-phenotype and the specific measure used. Hypocortisolism might explain findings of longer TL in participants with cumulated adverse and traumatic exposures. Research in high-risk populations is strongly needed as results across the entire spectrum of adversity exposures may not generalize to the top end of the spectrum.
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Affiliation(s)
- David Bürgin
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Corresponding author. University Psychiatric Hospitals Basel Research Department for Child and Adolescent Psychiatry Wilhelm-Klein Strasse 27, 4056, Basel, Switzerland.
| | - Vera Clemens
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Nimmy Varghese
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Anne Eckert
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Mara Huber
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Evelyne Bruttin
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Cyril Boonmann
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Eva Unternährer
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Aoife O'Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Marc Schmid
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
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15
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van den Heuvel LL, Smit AM, Stalder T, Kirschbaum C, Seedat S, Emsley R. Hair cortisol levels in schizophrenia and metabolic syndrome. Early Interv Psychiatry 2022; 16:902-911. [PMID: 34978366 DOI: 10.1111/eip.13238] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 08/16/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
AIM Individuals with schizophrenia demonstrate higher rates of metabolic syndrome (MetS) than the general population. Hair cortisol concentrations (HCC) reflect longer-term cortisol secretion and can provide additional insights into the role of the hypothalamic pituitary adrenal (HPA) axis in schizophrenia and co-occurring MetS. METHODS In a case-control study of 16 patients with schizophrenia (11 first episode psychosis [FEP] and 5 chronic) and 21 controls hair samples, representing a 3-month retrospective window of cortisol, were collected and analysed utilizing liquid chromatography tandem mass spectrometry. We investigated whether schizophrenia and MetS co-occurrence were associated with HCC utilizing multivariate regression models. We also explored the longitudinal trajectory of HCC in FEP patients by conducting a mixed models analysis. RESULTS At baseline HCC were significantly lower (Cohen's d = 0.88) in patients with schizophrenia than in controls (p = .014). HCC increased from baseline to month-12 in FEP patients compared to controls, demonstrating a trend towards significance (p = .097). MetS was not associated with HCC at baseline, but HCC increased significantly from baseline to month-12 in relation to MetS (p = .037). CONCLUSIONS In a subgroup of schizophrenia patients, psychosis may be associated with a blunted HPA axis with lower long-term cortisol output. MetS was associated with an increase in HCC and elevated cortisol levels observed in schizophrenia may be related to increased rates of MetS in schizophrenia patients.
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Affiliation(s)
- Leigh Luella van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anna Margaretha Smit
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Tobias Stalder
- Clinical Psychology, University of Siegen, Siegen, Germany
| | - Clemens Kirschbaum
- Biological Psychology, Dresden University of Technology, Dresden, Germany
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robin Emsley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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16
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van der Valk E, Abawi O, Mohseni M, Abdelmoumen A, Wester V, van der Voorn B, Iyer A, van den Akker E, Hoeks S, van den Berg S, de Rijke Y, Stalder T, van Rossum E. Cross-sectional relation of long-term glucocorticoids in hair with anthropometric measurements and their possible determinants: A systematic review and meta-analysis. Obes Rev 2022; 23:e13376. [PMID: 34811866 PMCID: PMC9285618 DOI: 10.1111/obr.13376] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Long-term glucocorticoids (HairGC) measured in scalp hair have been associated with body mass index (BMI), waist circumference (WC), and waist-hip-ratio (WHR) in several cross-sectional studies. We aimed to investigate the magnitude, strength, and clinical relevance of these relations across all ages. METHODS We performed a systematic review and meta-analysis (PROSPERO registration CRD42020205187) searching for articles relating HairGC to measures of obesity. Main outcomes were bivariate correlation coefficients and unadjusted simple linear regression coefficients relating hair cortisol (HairF) and hair cortisone (HairE) to BMI, WC, and WHR. RESULTS We included k = 146 cohorts (n = 34,342 individuals). HairGC were positively related to all anthropometric measurements. The strongest correlation and largest effect size were seen for HairE-WC: pooled correlation 0.18 (95%CI 0.11-0.24; k = 7; n = 3,158; I2 = 45.7%) and pooled regression coefficient 11.0 cm increase in WC per point increase in 10-log-transformed HairE (pg/mg) on liquid-chromatography-(tandem) mass spectrometry (LC-MS) (95%CI 10.1-11.9 cm; k = 6; n = 3,102). Pooled correlation for HairF-BMI was 0.10 (95%CI 0.08-0.13; k = 122; n = 26,527; I2 = 51.2%) and pooled regression coefficient 0.049 kg/m2 per point increase in 10-log-transformed HairF (pg/mg) on LC-MS (95%CI 0.045-0.054 kg/m2 ; k = 26; n = 11,635). DISCUSSION There is a consistent positive association between HairGC and BMI, WC, and WHR, most prominently and clinically relevant for HairE-WC. These findings overall suggest an altered setpoint of the hypothalamic-pituitary-adrenal axis with increasing central adiposity.
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Affiliation(s)
- Eline van der Valk
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ozair Abawi
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mostafa Mohseni
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Amir Abdelmoumen
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent Wester
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bibian van der Voorn
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anand Iyer
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erica van den Akker
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sanne Hoeks
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Sjoerd van den Berg
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Yolanda de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tobias Stalder
- Department of Clinical Psychology, University of Siegen, Siegen, Germany
| | - Elisabeth van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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17
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Kim J, Li L, Korous KM, Valiente C, Tsethlikai M. Chronic stress predicts post-traumatic stress disorder symptoms via executive function deficits among urban American Indian children. Stress 2022; 25:97-104. [PMID: 35037551 DOI: 10.1080/10253890.2021.2024164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Little is known about how chronic exposure to stress affects mental health among American Indian (AI) children. The current study aimed to fill this gap by exploring if hair cortisol concentration (HCC), an indicator of chronic stress, predicted post-traumatic stress disorder (PTSD) symptoms through deficits in executive function (EF) skills commonly referred to as inhibitory control, working memory, and cognitive flexibility. A total of 163 urban AI children between 8- and 15-years old participated in the study (92 girls, 56.4%; Mage = 11.19, SD = 1.98). Chronic stress was measured as the concentration of cortisol in children's hair. EF deficits and PTSD symptoms were reported by primary caregivers using the Behavior Rating Inventory of Executive Function and the Trauma Symptom Checklist for Young Children. The results demonstrated that higher HCC was indirectly associated with more PTSD symptoms through deficits in EF skills. Specifically, higher levels of HCC were related to more symptoms of PTSD arousal through impaired working memory, and more symptoms of PTSD avoidance and Intrusion through deficits in cognitive flexibility. The findings suggest interventions that reduce or buffer chronic stress, or that focus on improving EF skills, may promote not only cognitive development but also the mental health of AI children.
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Affiliation(s)
- Juyoung Kim
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Longfeng Li
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Kevin M Korous
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Carlos Valiente
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Monica Tsethlikai
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
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18
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Bröcker E, Olff M, Suliman S, Kidd M, Mqaisi B, Greyvenstein L, Kilian S, Seedat S. A clinician-monitored 'PTSD Coach' intervention: findings from two pilot feasibility and acceptability studies in a resource-constrained setting. Eur J Psychotraumatol 2022; 13:2107359. [PMID: 36212116 PMCID: PMC9542529 DOI: 10.1080/20008066.2022.2107359] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The high prevalence of trauma exposure and consequent post-traumatic stress disorder (PTSD) is well documented in low- and middle-income countries, and most individuals with PTSD have limited access to treatment in these settings. Freely available internet-based interventions, such as PTSD Coach (web-based and mobile application), can help to address this gap and improve access to and efficiency of care. Objective: We conducted two pilot studies to evaluate the feasibility, acceptability, and preliminary effectiveness of PTSD Coach in a South African resource-constrained context. Method: Pilot 1: Participants with PTSD (n = 10) were randomized to counsellor-supported PTSD Coach Online (PCO) or enhanced treatment as usual. Pilot 2: Participants (n = 10) were randomized to counsellor-supported PTSD Coach Mobile App or self-managed PTSD Coach Mobile App. Feasibility and acceptability were assessed by comparing attrition rates (loss to follow-up), reviewing participant and counsellor feedback contained in fieldnotes, and analysing data on the 'Perceived helpfulness of the PTSD Coach App' (Pilot 2). PTSD symptom severity was assessed with the Clinician Administered PTSD Scale for DSM-5 (CAPS-5), changes between treatment and control groups were compared, the reliable change index (RCI) was calculated, and clinically significant changes were determined. Results: Three participants in Pilot 1 and two participants in Pilot 2 were lost to follow-up. Fieldnotes indicated that PTSD Coach Mobile App addressed identified computer literacy challenges in Pilot 1 (PCO); and a shorter duration of intervention (from 8 to 4 weeks) was associated with less attrition. The RCI indicated that four participants in Pilot 1 and eight participants in Pilot 2 experienced significant improvement in PTSD symptom severity. Conclusions: The preliminary results suggest that both platforms can alleviate PTSD symptoms, and that the involvement of volunteer counsellors is beneficial. The use of PTSD Coach Mobile App may be more feasible than the online version (PCO) in our setting. HIGHLIGHTS Research on supported PTSD Coach interventions is limited in resource-constrained settings.Both volunteer counsellor-supported PTSD Coach Online and the PTSD Coach Mobile App showed preliminary reliable and clinically significant changes.The use of PTSD Coach Mobile App seems more feasible than the volunteer counsellor-supported PTSD Coach Online.
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Affiliation(s)
- Erine Bröcker
- Department of Psychiatry and MRC Genomics of Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Sharain Suliman
- Department of Psychiatry and MRC Genomics of Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Martin Kidd
- Department of Psychiatry and MRC Genomics of Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Busisiwe Mqaisi
- Department of Psychiatry and MRC Genomics of Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - L Greyvenstein
- Department of Psychiatry and MRC Genomics of Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sanja Kilian
- Department of Psychiatry and MRC Genomics of Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry and MRC Genomics of Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Medication-enhanced psychotherapy for posttraumatic stress disorder: Recent findings on oxytocin’s involvement in the neurobiology and treatment of posttraumatic stress disorder. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e3645. [DOI: 10.32872/cpe.3645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background
Traumatic experiences may result in Posttraumatic Stress Disorder (PTSD), which is characterized as an exaggerated fear response that cannot be extinguished over time or in safe environments. What are beneficial psychotherapeutic treatment options for PTSD patients? Can oxytocin (OXT), which is involved in the stress response, and safety learning, ameliorate PTSD symptomatology and enhance psychotherapeutic effects? Here, we will review recent studies regarding OXT’s potential to enhance psychotherapeutic therapies for PTSD treatment.
Method
We conducted a literature review on the neurobiological underpinnings of PTSD especially focusing on OXT’s involvement in the biology and memory formation of PTSD. Furthermore, we researched successful psychotherapeutic treatments for PTSD patients and discuss how OXT may facilitate observed psychotherapeutic effects.
Results
For a relevant proportion of PTSD patients, existing psychotherapies are not beneficial. OXT may be a promising candidate to enhance psychotherapeutic effects, because it dampens responses to stressful events and allows for a faster recovery after stress. On a neural basis, OXT modulates processes that are involved in stress, arousal and memory. OXT effectively counteracts memory impairments caused by stress and facilitates social support seeking which is a key resilience factor for PTSD and which is beneficial in psychotherapeutic settings.
Conclusion
OXT has many characteristics that are promising to positively influence psychotherapy for PTSD patients. It potentially reduces intrusions, but preserves memory of the event itself. Introducing OXT into psychotherapeutic settings may result in better treatment outcomes for PTSD patients. Future research should directly investigate OXT’s effects on PTSD, especially in psychotherapeutic settings.
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20
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Sopp MR, Michael T, Lass-Hennemann J, Haim-Nachum S, Lommen MJJ. Longitudinal associations between hair cortisol, PTSD symptoms, and sleep disturbances in a sample of firefighters with duty-related trauma exposure. Psychoneuroendocrinology 2021; 134:105449. [PMID: 34687966 DOI: 10.1016/j.psyneuen.2021.105449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/15/2021] [Accepted: 10/11/2021] [Indexed: 01/04/2023]
Abstract
Several studies have found evidence of altered cortisol levels in patients with posttraumatic stress disorder (PTSD). Based on these findings, it is assumed that these patients may show signs of cortisol dysregulation after trauma. Posttrauma cortisol levels are thus considered a potential biomarker of PTSD. However, longitudinal studies using indicators of long-term cortisol secretion such as hair cortisol concentrations (HCC) are scarce. The current study investigated prospective associations between HCC and PTSD symptoms in a sample of Dutch firefighters taking into account varying levels of work-related trauma severity. In addition, we assessed posttraumatic sleep disturbances as a secondary outcome measure to investigate whether effects generalize to this frequent comorbidity of PTSD. Three hundred seventy-one Dutch firefighters with a mean of 14.01 years of work experience were included in the analyses. Baseline assessment included the collection of hair samples and the measurement of work-related trauma severity, PTSD symptoms, and sleep disturbances. PTSD symptoms and sleep disturbance were re-assessed after six and twelve months. Multilevel analyses indicate a significant positive correlation between HCC and baseline PTSD symptoms in those with average or above-average work-related trauma severity. A similar pattern was evident for posttraumatic sleep disturbances at baseline. Moreover, higher HCC predicted more posttraumatic sleep disturbances after 6 months in participants with above-average work-related trauma severity. No other associations emerged for PTSD symptoms or posttraumatic sleep disturbances at six or twelve months. As such, our study supports the existence of a cross-sectional association between HCC and trauma symptoms, which may vary for different levels of subjective trauma severity. The longitudinal stability of this association should be reinvestigated by future research.
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Affiliation(s)
- M R Sopp
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123 Saarbrücken, Germany
| | - T Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123 Saarbrücken, Germany.
| | - J Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123 Saarbrücken, Germany
| | - S Haim-Nachum
- School of Education, Bar-Ilan University, Ramat-Gan, Israel
| | - M J J Lommen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
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21
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Mazgelytė E, Mažeikienė A, Burokienė N, Matuzevičienė R, Linkevičiūtė A, Kučinskienė ZA, Karčiauskaitė D. Association between hair cortisol concentration and metabolic syndrome. Open Med (Wars) 2021; 16:873-881. [PMID: 34179504 PMCID: PMC8209412 DOI: 10.1515/med-2021-0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/08/2021] [Accepted: 04/23/2021] [Indexed: 11/30/2022] Open
Abstract
Metabolic syndrome (MetS) is a highly prevalent disorder defined as a cluster of cardiometabolic risk factors including obesity, hyperglycemia, hypertension, and dyslipidemia. It is believed that excessive cortisol secretion due to psychosocial stress-induced hypothalamic-pituitary-adrenal axis activation might be involved in the pathogenesis of MetS. We sought to explore the association between MetS and psychosocial risk factors, as well as cortisol concentration measured in different biological specimens including saliva, blood serum, and hair samples. The study was conducted on a sample of 163 young and middle-aged men who were divided into groups according to the presence of MetS. Hair cortisol concentration (HCC) was determined using high performance liquid chromatography with UV detection, while blood serum and salivary cortisol levels were measured by enzyme-linked immunoassay. Lipid metabolism biomarkers were determined using routine laboratory methods. Anthropometric and lifestyle characteristics, as well as self-reported psychosocial indicators, were also examined. Significantly higher HCC and lower social support level among participants with MetS compared with individuals without MetS were found. However, no significant differences in blood serum and salivary cortisol levels were observed between men with and without MetS. In conclusion, chronically elevated cortisol concentration might be a potential contributing factor to the development of MetS.
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Affiliation(s)
- Eglė Mazgelytė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Asta Mažeikienė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Neringa Burokienė
- Clinics of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rėda Matuzevičienė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Aušra Linkevičiūtė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Zita Aušrelė Kučinskienė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Dovilė Karčiauskaitė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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22
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Swart PC, van den Heuvel LL, Lewis CM, Seedat S, Hemmings SMJ. A Genome-Wide Association Study and Polygenic Risk Score Analysis of Posttraumatic Stress Disorder and Metabolic Syndrome in a South African Population. Front Neurosci 2021; 15:677800. [PMID: 34177453 PMCID: PMC8222611 DOI: 10.3389/fnins.2021.677800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a trauma-related disorder that frequently co-occurs with metabolic syndrome (MetS). MetS is characterized by obesity, dyslipidemia, and insulin resistance. To provide insight into these co-morbidities, we performed a genome-wide association study (GWAS) meta-analysis to identify genetic variants associated with PTSD, and determined if PTSD polygenic risk scores (PRS) could predict PTSD and MetS in a South African mixed-ancestry sample. The GWAS meta-analysis of PTSD participants (n = 260) and controls (n = 343) revealed no SNPs of genome-wide significance. However, several independent loci, as well as five SNPs in the PARK2 gene, were suggestively associated with PTSD (p < 5 × 10-6). PTSD-PRS was associated with PTSD diagnosis (Nagelkerke's pseudo R 2 = 0.0131, p = 0.00786), PTSD symptom severity [as measured by CAPS-5 total score (R 2 = 0.00856, p = 0.0367) and PCL-5 score (R 2 = 0.00737, p = 0.0353)], and MetS (Nagelkerke's pseudo R 2 = 0.00969, p = 0.0217). These findings suggest an association between PTSD and PARK2, corresponding with results from the largest PTSD-GWAS conducted to date. PRS analysis suggests that genetic variants associated with PTSD are also involved in the development of MetS. Overall, the results contribute to a broader goal of increasing diversity in psychiatric genetics.
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Affiliation(s)
- Patricia C. Swart
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leigh L. van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Cathryn M. Lewis
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sian M. J. Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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23
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Broeks CW, Choenni V, Kok R, van der Voorn B, de Kruijff I, van den Akker ELT, van Rossum EFC, Hoogendijk WJG, Hillegers MHJ, Kamperman AM, Lambregtse-Van den Berg MP. An exploratory study of perinatal hair cortisol concentrations in mother-infant dyads with severe psychiatric disorders versus healthy controls. BJPsych Open 2021; 7:e28. [PMID: 33407971 PMCID: PMC8058941 DOI: 10.1192/bjo.2020.159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Maternal psychopathology during pregnancy is associated with negative outcomes in offspring. Increased placental transfer of maternal cortisol may contribute to mediate this association. Hair cortisol concentrations (HCCs) appear to be a good biomarker of long-term prenatal stress exposure. Little is known about the associations between severe maternal psychopathology and perinatal infant HCCs. AIMS We assessed HCCs in the perinatal period in mother-infant dyads with and without severe psychiatric disorders. METHOD We examined group differences in HCCs of mother-infant dyads (n = 18) subjected to severe maternal psychiatric disorders versus healthy control dyads (n = 27). We assessed the correlation of HCCs between mother and infant within both groups, and the association between current maternal symptoms and HCCs in patient dyads. RESULTS Median (interquartile range) and distribution of HCC differed in patients compared with control mothers (U = 468.5, P = 0.03). HCCs in infants of patients did not differ from control infants (U = 250.0, P = 0.67). Subsequently, we found that HCCs within healthy control dyads were correlated (n = 27, r 0.55 (0.14), P = 0.003), but were not within patient dyads (n = 18, r 0.082 (0.13), P = 0.746). HCCs in infants of patients showed a positive correlation with maternal symptoms (n = 16, r = 0.63 (0.06), P = 0.008). CONCLUSIONS These preliminary findings suggest that infant HCC reflect perinatal stress exposure. In infants, these early differences could influence lifetime hypothalamic-pituitary-adrenal axis functioning, which might be associated with increased susceptibility to later disease.
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Affiliation(s)
- Carlinde W Broeks
- Department of Psychiatry, Erasmus University Medical Center, the Netherlands; and Department of Psychiatry, Arkin Institute for Mental Health, the Netherlands
| | - Vandhana Choenni
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands
| | - Rianne Kok
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Bibian van der Voorn
- Department of Pediatric Endocrinology, Obesity Center CGG, Erasmus MC-Sophia Children's Hospital, the Netherlands; and Division of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center, the Netherlands
| | - Ineke de Kruijff
- Department of Pediatrics, St Antonius Hospital Nieuwegein, the Netherlands
| | | | - Elisabeth F C van Rossum
- Division of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center, the Netherlands
| | | | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands
| | - Astrid M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, the Netherlands; and Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Center, the Netherlands
| | - Mijke P Lambregtse-Van den Berg
- Department of Psychiatry, Erasmus University Medical Center, the Netherlands; and Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands
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24
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Fazekas CL, Sipos E, Klaric T, Török B, Bellardie M, Erjave GN, Perkovic MN, Lauc G, Pivac N, Zelena D. Searching for glycomic biomarkers for predicting resilience and vulnerability in a rat model of posttraumatic stress disorder. Stress 2020; 23:715-731. [PMID: 32666865 DOI: 10.1080/10253890.2020.1795121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is triggered by traumatic events in 10-20% of exposed subjects. N-linked glycosylation, by modifying protein functions, may provide an important environmental link predicting vulnerability. Our goals were (1) to find alterations in plasma N-glycome predicting stress-vulnerability; (2) to investigate how trauma affects N-glycome in the plasma (PGP) and in three PTSD-related brain regions (prefrontal cortex, hippocampus and amygdala; BGP), hence, uncover specific targets for PTSD treatment. We examined male (1) controls, (2) traumatized vulnerable and (3) traumatized resilient rats both before and several weeks after electric footshock. Vulnerable and resilient groups were separated by z-score analysis of behavior. Higher freezing behavior and decreased social interest were detected in vulnerable groups compared to control and resilient rats. Innate anxiety did not predict vulnerability, but pretrauma levels of PGP10(FA1G1Ga1), PGP11(FA2G2), and PGP15(FA3G2) correlated positively with it, the last one being the most sensitive. Traumatic stress induced a shift from large, elaborate N-glycans toward simpler neutral structures in the plasma of all traumatized animals and specifically in the prefrontal cortex of vulnerable rats. In plasma trauma increased PGP17(A2G2S) level in vulnerable animals. In all three brain regions, BGP11(F(6)A2B) was more abundant in vulnerable rats, while most behavioral correlations occurred in the prefrontal cortex. In conclusion, we found N-glycans (especially PGP15(FA3G2)) in plasma as possible biomarkers of vulnerability to trauma that warrants further investigation. Posttrauma PGP17(A2G2S1) increase showed overlap with human results highlighting the utility and relevance of this animal model. Prefrontal cortex is a key site of trauma-induced glycosylation changes that could modulate the behavioral outcome.
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Affiliation(s)
- Csilla Lea Fazekas
- Behavioral Neurobiology, Institute of Experimental Medicine, Budapest, Hungary
- Janos Szentagothai School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Eszter Sipos
- Behavioral Neurobiology, Institute of Experimental Medicine, Budapest, Hungary
| | - Thomas Klaric
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
- Glycobiology Laboratory, Genos Ltd, Zagreb, Croatia
| | - Bibiána Török
- Behavioral Neurobiology, Institute of Experimental Medicine, Budapest, Hungary
- Janos Szentagothai School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Manon Bellardie
- Behavioral Neurobiology, Institute of Experimental Medicine, Budapest, Hungary
| | - Gordana Nedic Erjave
- Laboratory for Molecular Neuropsychiatry, Ruđer Bošković Institute, Zagreb, Croatia
| | | | - Gordan Lauc
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
- Glycobiology Laboratory, Genos Ltd, Zagreb, Croatia
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Ruđer Bošković Institute, Zagreb, Croatia
| | - Dóra Zelena
- Behavioral Neurobiology, Institute of Experimental Medicine, Budapest, Hungary
- Centre for Neuroscience, Szentágothai Research Centre, Institute of Physiology, Medical School, University of Pécs, Pécs, Hungary
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25
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Al-Abbasi FA, Kumar V, Anwar F. Biochemical and toxicological effect of diazepam in stress-induced cardiac dysfunctions. Toxicol Rep 2020; 7:788-794. [PMID: 32642445 PMCID: PMC7334438 DOI: 10.1016/j.toxrep.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022] Open
Abstract
Evaluation of diazepam in stress-induced cardiac dysfunction in rats. Alteration of cardiac biomarkers and ionic concentrations by stress. Restoration of altered cardiac biomarkers and ionic concentrations by diazepam. Restoration of architectures of cardiomyocytes by diazepam.
Diazepam is a medicine of the family benzodiazepine, used to treat various CNS disorders. To date, no study is available for biochemical analysis of diazepam in cardiac dysfunction. This study aimed to determine the effect of diazepam in stress-induced cardiac dysfunctions in rats. Male Wistar Albino rats were divided into four groups with six animals in each group for 90 days of the experimental protocol. Group1 served as a Normal Control (NC), Groups 2, as a Disease Control (DC), Group 3 as a Diazepam Control (DIC), and Group 4 as a Disease + Diazepam Treatment (DDT). Disease Control and Disease + Diazepam Treatment animals exposed to regular stress by forced swimming exercise method for 3 months. Diazepam Control and Disease + Diazepam Treatment received 5 mg/kg/p.o the daily dose of diazepam. At the end of the protocol, animals were sacrificed, heart preserved, blood collected, and utilized for biochemical estimations. Heart weight was increased in DC as compared to NC. Serum levels of cardiac biomarkers, creatine phosphokinase (CPK), creatine kinase-MB (CPK-MB), lactate dehydrogenase (LDH), High sensitivity C-reactive protein (hs-CRP) and troponin I (TnI) were significantly increased in DC as compared to NC. Heart tissue examined for histological changes. The altered serum levels of CPK, CPK-MB, LDH, hs-CRP, and TnI were significantly restored by the treatment of diazepam. Serum levels of Sodium, Potassium, Calcium, and Magnesium was increased in DC animals as compared to NC. The altered ionic level was also restored by the treatment of diazepam. Level of various cardiac markers and ions in the plasma were also slightly elevated in DIC. Histopathological studies are also in agreement with serological examinations and bonafide cardioprotective influences of diazepam in cardiac dysfunction. Conclusively research findings endorse the cardioprotective effect of diazepam in stress-induced cardiac dysfunction in rats.
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Affiliation(s)
- Fahad A Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Saudi Arabia
| | - Vikas Kumar
- Department of Pharmaceutical Sciences, Shalom Institute of Health and Allied Sciences (SIHAS), Sam Higginbottom University of Agriculture, Technology & Sciences (SHUATS), Allahabad, India
| | - Firoz Anwar
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Saudi Arabia
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