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Warren A, Nyavor Y, Beguelin A, Frame LA. Dangers of the chronic stress response in the context of the microbiota-gut-immune-brain axis and mental health: a narrative review. Front Immunol 2024; 15:1365871. [PMID: 38756771 PMCID: PMC11096445 DOI: 10.3389/fimmu.2024.1365871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
More than 20% of American adults live with a mental disorder, many of whom are treatment resistant or continue to experience symptoms. Other approaches are needed to improve mental health care, including prevention. The role of the microbiome has emerged as a central tenet in mental and physical health and their interconnectedness (well-being). Under normal conditions, a healthy microbiome promotes homeostasis within the host by maintaining intestinal and brain barrier integrity, thereby facilitating host well-being. Owing to the multidirectional crosstalk between the microbiome and neuro-endocrine-immune systems, dysbiosis within the microbiome is a main driver of immune-mediated systemic and neural inflammation that can promote disease progression and is detrimental to well-being broadly and mental health in particular. In predisposed individuals, immune dysregulation can shift to autoimmunity, especially in the presence of physical or psychological triggers. The chronic stress response involves the immune system, which is intimately involved with the gut microbiome, particularly in the process of immune education. This interconnection forms the microbiota-gut-immune-brain axis and promotes mental health or disorders. In this brief review, we aim to highlight the relationships between stress, mental health, and the gut microbiome, along with the ways in which dysbiosis and a dysregulated immune system can shift to an autoimmune response with concomitant neuropsychological consequences in the context of the microbiota-gut-immune-brain axis. Finally, we aim to review evidenced-based prevention strategies and potential therapeutic targets.
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Affiliation(s)
- Alison Warren
- The Frame-Corr Laboratory, Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Yvonne Nyavor
- Department of Biotechnology, Harrisburg University of Science and Technology, Harrisburg, PA, United States
| | - Aaron Beguelin
- The Department of Biotechnology, Johns Hopkins University, Baltimore, MD, United States
| | - Leigh A. Frame
- The Frame-Corr Laboratory, Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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Wang X, Tong J, Liang C, Wang X, Ma Y, Tao S, Liu M, Wang Y, Liu J, Yan S, Gao G, Wu X, Huang K, Cao Y, Tao F. Trimester-specific effects of maternal exposure to single and mixed metals on cord serum inflammatory cytokines levels: A prospective birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 895:165086. [PMID: 37379910 DOI: 10.1016/j.scitotenv.2023.165086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Cord blood inflammatory cytokines are vital in early-life programming. An increasing number of studies concern the effect of maternal exposure to different metal elements during pregnancy on inflammatory cytokines, but limited studies have explored the association between maternal exposure to mixed metals and cord blood inflammatory cytokine levels. METHODS We measured serum concentrations of vanadium (V), copper (Cu), arsenic (As), cadmium (Cd), and barium (Ba) in the first, second, and third trimesters and eight cord serum inflammatory cytokines (IFN-γ, IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17A, and TNF-α) in 1436 mother-child dyads from the Ma'anshan Birth Cohort. Generalized linear models and Bayesian kernel machine regression (BKMR) were performed to assess the association of single and mixed metal exposure during each trimester with cord serum inflammatory cytokine levels, respectively. RESULTS Regarding metal exposure in the first trimester, V was positively associated with TNF-α (β = 0.33, 95 % CI: 0.13, 0.53); Cu was positively associated with IL-8 (β = 0.23, 95 % CI: 0.07, 0.39); Ba was positively associated with IFN-γ and IL-6; As was negatively associated with IFN-γ and IL-17A; and Cd was negatively associated with IFN-γ, IL-1β, IL-12p70, IL-17A, and TNF-α. BKMR revealed that exposure to metal mixtures in the first trimester was positively associated with IL-8 and TNF-α but negatively associated with IL-17A. Moreover, V contributed the most to these associations. Interaction effects were observed between Cd and As and between Cd and Cu with IL-8, and between Cd and V with IL-17A. Among males, As decreased inflammatory cytokines; among females, Cu increased inflammatory cytokine levels, whereas Cd decreased inflammatory cytokine concentrations. CONCLUSIONS Maternal exposure to metal mixtures in the first trimester interfered with cord serum inflammatory cytokine levels. The associations of maternal exposure to As, Cu and Cd with inflammatory cytokines showed sex differences. Further studies are warranted to support the findings and explore the mechanism of the susceptibility window and sex-specific disparity.
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Affiliation(s)
- Xing Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Juan Tong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Chunmei Liang
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; Hefei 230032, Anhui, China
| | - Xueqing Wang
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; Hefei 230032, Anhui, China
| | - Yufan Ma
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shuman Tao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; Hefei 230032, Anhui, China
| | - Meng Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yafei Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Jia Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Care Hospital, Ma'anshan 243011, Anhui, China
| | - Guopeng Gao
- Ma'anshan Maternal and Child Health Care Hospital, Ma'anshan 243011, Anhui, China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; Hefei 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; Hefei 230032, Anhui, China
| | - Yunxia Cao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; Hefei 230032, Anhui, China.
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Castro-Quintas Á, Palma-Gudiel H, San Martín-González N, Caso JR, Leza JC, Fañanás L. Salivary secretory immunoglobulin A as a potential biomarker of psychosocial stress response during the first stages of life: A systematic review. Front Neuroendocrinol 2023; 71:101083. [PMID: 37479062 DOI: 10.1016/j.yfrne.2023.101083] [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: 02/10/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/23/2023]
Abstract
Mucosal secretory immunoglobulin A (s-IgA) has been recognized as a key component of human first line defense against infection. However, its reactivity to psychosocial stressors is poorly understood. This systematic review aimed to explore whether s-IgA levels changed after psychosocial stress in subjects under the age of 18. Fifteen articles were included. s-IgA basal levels are increased in children older than 9 years old exposed to stress. Furthermore, s-IgA seems to follow a circadian rhythm, which is altered under stress conditions. Finally, the collective evidence suggests that salivary s-IgA rapidly increases under acute stress after puberty. Overall, our review indicates that s-IgA could be considered a potential psychosocial stress biomarker of interest for pediatric and child-juvenile psychiatric population. Further studies are needed to validate the role of s-IgA circadian rhythm and basal levels as psychosocial stress biomarkers and disentangle the role of age and type of stressor.
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Affiliation(s)
- Águeda Castro-Quintas
- Department of Evolutionary Biology, Ecology and Environmental Sciences, University of Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Helena Palma-Gudiel
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Spain; Department of Epidemiology, University of Florida, United States
| | - Nerea San Martín-González
- Department of Evolutionary Biology, Ecology and Environmental Sciences, University of Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Javier R Caso
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Spain; Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid, Imas12. IUIN, Madrid, Spain
| | - Juan C Leza
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Spain; Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid, Imas12. IUIN, Madrid, Spain
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, University of Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain.
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4
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Hamilton OS, Steptoe A. Socioeconomic determinants of inflammation and neuroendocrine activity: A longitudinal analysis of compositional and contextual effects. Brain Behav Immun 2023; 107:276-285. [PMID: 36270438 DOI: 10.1016/j.bbi.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Socioeconomic determinants are well-established modulators of inflammation and neuroendocrine activity. Less clear is whether neighbourhood-contextual or individual-compositional factors are more closely associated with gradients in these biomarkers. Here, we examine how immune and neuroendocrine activity are cross-sectionally and longitudinally nested in meso-level socioeconomic characteristics. Participants, male and female, aged ≥50, were recruited from the English Longitudinal Study of Ageing (ELSA). Neighbourhood (Index of Multiple Deprivation [IMD]) and individual (Wealth/Education/Occupational Social Class [Occupation]) factors were drawn from wave 4 (baseline; 2008). Immune and neuroendocrine biomarkers (indexed by C-reactive protein [CRP; n = 3,968]; fibrinogen [n = 3,932]; white blood cell counts [WBCC; n = 4,022]; insulin-like growth factor-1 [IGF-1; n = 4,056]) were measured at baseline and 4-years later (wave 6; 2012). Covariates at baseline included demographic, clinical, and lifestyle variables. Lower socioeconomic status was associated with heighted inflammation and lower neuroendocrine activity unadjusted both cross-sectionally and longitudinally. With few exceptions, cross-sectional associations remained significant after full adjustment. Prospectively, low IMD remained associated with higher CRP and WBCC; wealth with WBCC; and education and occupation with fibrinogen and WBCC. IMD-biomarker associations were reduced when wealth was simultaneously taken into account. Lifestyle accounted for the greatest variance in associations between socioeconomic indicators and inflammation (≤42.11%), but demographics were more salient to neuroendocrine activity (≤88.46%). Neighbourhood-contextual factors were stronger indicators of aberrant biomarker activity than individual-compositional factors in cross-sectional analyses but were largely explained by wealth differences prospectively. Therefore, immune and neuroendocrine changes depended on the composition of the population living in an area, rather than the area itself.
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Affiliation(s)
- Odessa S Hamilton
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
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5
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Nguyen TNB, Ely BA, Pick D, Patel M, Xie H, Kim-Schulze S, Gabbay V. Clenbuterol attenuates immune reaction to lipopolysaccharide and its relationship to anhedonia in adolescents. Brain Behav Immun 2022; 106:89-99. [PMID: 35914697 PMCID: PMC9817216 DOI: 10.1016/j.bbi.2022.07.163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
While inflammation has been implicated in psychopathology, relationships between immune-suppressing processes and psychiatric constructs remain elusive. This study sought to assess whether β2-agonist clenbuterol (CBL) would attenuate immune activation in adolescents with mood and anxiety symptoms following ex vivo exposure of whole blood to lipopolysaccharide (LPS). Our focus on adolescents aimed to target a critical developmental period when psychiatric conditions often emerge and prior to chronicity effects. To capture a diverse range of immunologic and symptomatologic phenotypes, we included 97 psychotropic-medication free adolescents with mood and anxiety symptoms and 33 healthy controls. All participants had comprehensive evaluations and dimensional assessments of psychiatric symptoms. Fasting whole-blood samples were collected and stimulated with LPS in the presence and absence of CBL for 6 hours, then analyzed for 41 cytokines, chemokines, and hematopoietic growth factors. Comparison analyses used Bonferroni-corrected nonparametric tests. Levels of nine immune biomarkers-including IL-1RA, IL-1β, IL-6, IP-10, MCP-1, MIP-1α, MIP-1β, TGF-α, and TNF-α-were significantly reduced by CBL treatment compared to LPS alone. Exploratory factor analysis reduced 41 analytes into 5 immune factors in each experimental condition, and their relationships with psychiatric symptoms were examined as a secondary aim. CBL + LPS Factor 4-comprising EGF, PDGF-AA, PDGF-AB/BB, sCD40L, and GRO-significantly correlated with anticipatory and consummatory anhedonia, even after controlling for depression severity. This study supports the possible inhibitory effect of CBL on immune activation. Using a data-driven method, distinctive relationships between CBL-affected immune biomarkers and dimensional anhedonia were reported, further elucidating the role of β2-agonism in adolescent affective symptomatology.
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Affiliation(s)
- Tram N B Nguyen
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - Danielle Pick
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - Manishkumar Patel
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Hui Xie
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Seunghee Kim-Schulze
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Vilma Gabbay
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, United States; Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States.
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6
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MacNeill LA, Krogh‐Jespersen S, Zhang Y, Giase G, Edwards R, Petitclerc A, Mithal LB, Mestan K, Grobman WA, Norton ES, Alshurafa N, Moskowitz JT, Tandon SD, Wakschlag LS. Lability of prenatal stress during the COVID-19 pandemic links to negative affect in infancy. INFANCY 2022; 28:136-157. [PMID: 36070207 PMCID: PMC9538880 DOI: 10.1111/infa.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/01/2022] [Accepted: 07/30/2022] [Indexed: 01/19/2023]
Abstract
The association between prenatal stress and children's socioemotional development is well established. The COVID-19 pandemic has been a particularly stressful period, which may impact the gestational environment. However, most studies to-date have examined prenatal stress at a single time point, potentially masking the natural variation in stress that occurs over time, especially during a time as uncertain as the pandemic. This study leveraged dense ecological momentary assessments from a prenatal randomized control trial to examine patterns of prenatal stress over a 14-week period (up to four assessments/day) in a U.S. sample of 72 mothers and infants. We first examined whether varied features of stress exposure (lability, mean, and baseline stress) differed depending on whether mothers reported on their stress before or during the pandemic. We next examined which features of stress were associated with 3-month-old infants' negative affect. We did not find differences in stress patterns before and during the pandemic. However, greater stress lability, accounting for baseline and mean stress, was associated with higher infant negative affect. These findings suggest that pathways from prenatal stress exposure to infant socioemotional development are complex, and close attention to stress patterns over time will be important for explicating these pathways.
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Affiliation(s)
- Leigha A. MacNeill
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Sheila Krogh‐Jespersen
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Yudong Zhang
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Gina Giase
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Renee Edwards
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | | | - Leena B. Mithal
- Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Ann & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
| | - Karen Mestan
- Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Ann & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
| | - William A. Grobman
- Department of Obstetrics and GynecologyThe Ohio State UniversityColumbusOhioUSA
| | - Elizabeth S. Norton
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA,Department of Communication Sciences and DisordersNorthwestern UniversityEvanstonIllinoisUSA
| | - Nabil Alshurafa
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA,Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Judith T. Moskowitz
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - S. Darius Tandon
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Lauren S. Wakschlag
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
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7
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O'Connor TG, Ciesla AA, Sefair AV, Thornburg LL, Brown AS, Glover V, O'Donnell KJ. Maternal prenatal infection and anxiety predict neurodevelopmental outcomes in middle childhood. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:422-434. [PMID: 35238594 PMCID: PMC9069845 DOI: 10.1037/abn0000746] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/30/2021] [Accepted: 12/16/2021] [Indexed: 12/17/2022]
Abstract
Prenatal maternal infection and anxiety have been linked, in separate lines of study, with child neurodevelopment. We extend and integrate these lines of study in a large prospective longitudinal cohort study of child neurodevelopment. Data are based on the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort; prenatal maternal anxiety was assessed from self-report questionnaire; prenatal infection was derived from reports of several conditions in pregnancy (n = 7,042). Child neurodevelopment at approximately 8 years of age was assessed by in-person testing, reports of social and communication problems associated with autism, and psychiatric evaluation. Covariates included psychosocial, demographic, and perinatal/obstetric risks. Prenatal infection was associated with increased likelihood of co-occurring prenatal risk, including anxiety. Regression analyses indicated that both prenatal infection and prenatal anxiety predicted child social and communication problems; the predictions were largely independent of each other. Comparable effects were also found for the prediction of symptoms of attention problems and anxiety symptoms. These results provide the first evidence for the independent effects of prenatal infection and anxiety on a broad set of neurodevelopmental and behavioral and emotional symptoms in children, suggesting the involvement of multiple mechanisms in the prenatal programming of child neurodevelopment. The results further underscore the importance of promoting prenatal physical and mental health for child health outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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8
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Corallo KL, Lyle SM, Carlock MA, Ross TM, Ehrlich KB. Emotional Distress, Targeted Rejection, and Antibody Production After Influenza Vaccination in Adolescence. Psychosom Med 2022; 84:429-436. [PMID: 35100185 PMCID: PMC9064924 DOI: 10.1097/psy.0000000000001054] [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: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to explore how both ongoing emotional distress and the experience of a targeted rejection over the past 6 months are associated with adolescents' antibody response to influenza virus vaccination. We predicted that experiencing a targeted rejection would amplify the hypothesized negative association between emotional distress and antibody response after vaccination. METHODS Adolescent participants (N = 148) completed two study visits (mean [standard deviation] days between visits = 27.4 [1.8]). At the first visit, they provided blood samples, were administered the seasonal (2018-2019) quadrivalent influenza vaccine (Fluzone, Sanofi Pasteur), completed questionnaires, and participated in a semistructured interview. At the second visit, they provided another blood sample. Hemagglutination-inhibition assays were conducted to determine prevaccination and postvaccination antibody titers. Targeted rejection experiences were coded from adolescents' interviews. RESULTS The emotional distress by targeted rejection interaction predicted antibody response to the two A strains and the composite of all vaccine strains (b values = -0.451 to -0.843, p values < .05), but not the two B strains. Results suggested that, among adolescents who experienced a targeted rejection over the past 6 months, emotional distress was negatively associated with vaccine response (however, this finding did not reach statistical significance). Conversely, among adolescents who did not experience a targeted rejection, emotional distress was positively associated with vaccine response (b = 0.173, p = .032). CONCLUSIONS The current study highlights the importance of evaluating both acute life events and ongoing distress as they relate to adaptive immune functioning in adolescence.
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Affiliation(s)
| | | | | | - Ted M. Ross
- Center for Vaccines and Immunology and Department of Infectious Diseases, University of Georgia
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Pfeiffer JR, van Rooij SJH, Mekawi Y, Fani N, Jovanovic T, Michopoulos V, Smith AK, Stevens JS, Uddin M. Blood-derived deoxyribonucleic acid methylation clusters associate with adverse social exposures and endophenotypes of stress-related psychiatric illness in a trauma-exposed cohort of women. Front Psychiatry 2022; 13:892302. [PMID: 36405926 PMCID: PMC9668877 DOI: 10.3389/fpsyt.2022.892302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Adverse social exposures (ASEs) such as low income, low educational attainment, and childhood/adult trauma exposure are associated with variability in brain region measurements of gray matter volume (GMV), surface area (SA), and cortical thickness (CT). These CNS morphometries are associated with stress-related psychiatric illnesses and represent endophenotypes of stress-related psychiatric illness development. Epigenetic mechanisms, such as 5-methyl-cytosine (5mC), may contribute to the biological embedding of the environment but are understudied and not well understood. How 5mC relates to CNS endophenotypes of psychiatric illness is also unclear. In 97 female, African American, trauma-exposed participants from the Grady Trauma Project, we examined the associations of childhood trauma burden (CTQ), adult trauma burden, low income, and low education with blood-derived 5mC clusters and variability in brain region measurements in the amygdala, hippocampus, and frontal cortex subregions. To elucidate whether peripheral 5mC indexes central nervous system (CNS) endophenotypes of psychiatric illness, we tested whether 73 brain/blood correlated 5mC clusters, defined by networks of correlated 5mC probes measured on Illumina's HumanMethylation Epic Beadchip, mediated the relationship between ASEs and brain measurements. CTQ was negatively associated with rostral middle frontal gyrus (RMFG) SA (β =-0.231, p = 0.041). Low income and low education were also associated with SA or CT in a number of brain regions. Seven 5mC clusters were associated with CTQ (pmin = 0.002), two with low education (pmin = 0.010), and three with low income (pmin = 0.007). Two clusters fully mediated the relation between CTQ and RMFG SA, accounting for 47 and 35% of variability, respectively. These clusters were enriched for probes falling in DNA regulatory regions, as well as signal transduction and immune signaling gene ontology functions. Methylome-network analyses showed enrichment of macrophage migration (p = 9 × 10-8), T cell receptor complex (p = 6 × 10-6), and chemokine-mediated signaling (p = 7 × 10-4) pathway enrichment in association with CTQ. Our results support prior work highlighting brain region variability associated with ASEs, while informing a peripheral inflammation-based epigenetic mechanism of biological embedding of such exposures. These findings could also serve to potentiate increased investigation of understudied populations at elevated risk for stress-related psychiatric illness development.
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Affiliation(s)
- John R Pfeiffer
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Carl R. Woese Institute for Genomic Biology, Urbana, IL, United States
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Alicia K Smith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.,Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, United States
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10
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O'Connor TG, Ciesla AA. Maternal Immune Activation Hypotheses for Human Neurodevelopment: Some Outstanding Questions. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:471-479. [PMID: 34688920 PMCID: PMC9021321 DOI: 10.1016/j.bpsc.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022]
Abstract
The Maternal Immune Activation (MIA) hypothesis is a leading model for understanding prenatal influences on individual differences in, and clinical syndromes of, neurodevelopment. Experimental animal and human research has proliferated in recent years, and there is now a sizable research base. Several meta-analyses demonstrate general support for an association between prenatal immune activation and neurodevelopment in human research. However, questions remain about the nature of the immune activation, the network of underlying mechanisms involved, and the breadth of impact across behavioral phenotypes. Complementing recent reviews of results, the current review places particular emphasis on how advances in understanding mechanisms may be improved with greater attention to addressing the methodological variation and limitations of existing studies, and identifies areas for further clinical research.
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Affiliation(s)
- Thomas G O'Connor
- Department of Psychiatry, University of Rochester; Department of Psycholog, University of Rochestery; Department of Neuroscience, University of Rochester; Department of Obstetrics and Gynecology, University of Rochester; Wynne Center for Family Research, University of Rochester.
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11
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Kahve AC, Kaya H, Okuyucu M, Goka E, Barun S, Hacimusalar Y. Do Anxiety and Depression Levels Affect the Inflammation Response in Patients Hospitalized for COVID-19. Psychiatry Investig 2021; 18:505-512. [PMID: 34130442 PMCID: PMC8256149 DOI: 10.30773/pi.2021.0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/12/2021] [Accepted: 02/28/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The whole world is still struggling with the COVID-19 pandemic. Inflammation response, thought to be associated with severe illness and death, is an important research topic in COVID-19. Inflammation is also an essential condition explored in psychiatric illnesses. Our knowledge about the relationship between the inflammation response and psychiatric comorbidities in patients with COVID-19 is very limited. In this study, the relationship between anxiety and depression levels and inflammation response of patients with COVID-19 hospitalized in the hospital was examined. METHODS 175 patients were included in the study. Sociodemographic Data Form, Beck Depression Inventory and Beck Anxiety Inventory were applied to the patients. To evaluate the inflammation responses, blood sedimentation rate, C-reactive protein (CRP), procalcitonin, ferritin, neutrophil/lymphocyte ratio (NLR), and IL-6 levels were examined. RESULTS In our study, no relationship was found between anxiety and depression levels and inflammatory responses in patients hospitalized with a diagnosis of COVID-19. Anxiety and depression levels of women were higher than men, and NLR, ferritin, IL-6 levels were found to be lower than men. Anxiety levels increase with age. There is a positive correlation between NLR and ferritin levels and duration of hospitalization. CONCLUSION Our study examining the relationship of psychiatric comorbidities with the inflammation response and our increasing literature knowledge, together with studies evaluating the mental effects of COVID-19, suggest that determining the relationship between inflammation responses and psychiatric comorbidities in COVID-19, whose pathophysiology has not been clarified yet, maybe an essential step in interventions on the course of the disease.
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Affiliation(s)
- Aybeniz Civan Kahve
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Hasan Kaya
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Merve Okuyucu
- Department of Child and Adolescent Psychiatry, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Erol Goka
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Sureyya Barun
- Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Yunus Hacimusalar
- Department of Psychiatry, University of Health Sciences, Kayseri City Hospital, Kayseri, Turkey
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12
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Parsons C, Roberts R, Mills NT. Review: Inflammation and anxiety-based disorders in children and adolescents - a systematic review and meta-analysis. Child Adolesc Ment Health 2021; 26:143-156. [PMID: 33200498 DOI: 10.1111/camh.12434] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Anxiety-based disorders are common and are often chronic with an onset during childhood or adolescence. An emerging literature has examined the role of inflammation in these disorders by measuring blood concentrations of inflammatory markers such as cytokines, C-reactive protein (CRP) and immune markers such as white blood cell counts. However, existing results are inconsistent, with available meta-analyses only including adult populations. We believe this is the first systematic review and meta-analysis to investigate these inconsistencies among the population of children and adolescents. METHODS A systematic search of five electronic databases was conducted to identify studies which compared inflammatory markers between individuals with an anxiety-based disorder and healthy controls. Study quality was assessed, and pooled effect sizes (Hedges' g) were calculated using random-effects meta-analyses. RESULTS Nine independent studies were identified. The combined meta-analysis of 16 cytokines and CRP was approaching significance; however, no significant between-group difference was observed for meta-analyses of individual inflammatory or immune markers. Heterogeneity was high, and quality assessments identified important limitations; primarily, small sample sizes and a lack of control over confounding variables. CONCLUSIONS Although no significant effects were observed, the small number of included studies and limitations in study or reporting quality render these findings provisional. Research in this area has the potential for important clinical implications in relation to therapeutic interventions. Important recommendations for further research are put forth.
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Affiliation(s)
- Chelsea Parsons
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Rachel Roberts
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Natalie T Mills
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
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13
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Wakschlag LS, Tandon D, Krogh-Jespersen S, Petitclerc A, Nielsen A, Ghaffari R, Mithal L, Bass M, Ward E, Berken J, Fareedi E, Cummings P, Mestan K, Norton ES, Grobman W, Rogers J, Moskowitz J, Alshurafa N. Moving the dial on prenatal stress mechanisms of neurodevelopmental vulnerability to mental health problems: A personalized prevention proof of concept. Dev Psychobiol 2020; 63:622-640. [PMID: 33225463 DOI: 10.1002/dev.22057] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 12/31/2022]
Abstract
Prenatal stress exposure increases vulnerability to virtually all forms of psychopathology. Based on this robust evidence base, we propose a "Mental Health, Earlier" paradigm shift for prenatal stress research, which moves from the documentation of stress-related outcomes to their prevention, with a focus on infant neurodevelopmental indicators of vulnerability to subsequent mental health problems. Achieving this requires an expansive team science approach. As an exemplar, we introduce the Promoting Healthy Brain Project (PHBP), a randomized trial testing the impact of the Wellness-4-2 personalized prenatal stress-reduction intervention on stress-related alterations in infant neurodevelopmental trajectories in the first year of life. Wellness-4-2 utilizes bio-integrated stress monitoring for just-in-time adaptive intervention. We highlight unique challenges and opportunities this novel team science approach presents in synergizing expertise across predictive analytics, bioengineering, health information technology, prevention science, maternal-fetal medicine, neonatology, pediatrics, and neurodevelopmental science. We discuss how innovations across many areas of study facilitate this personalized preventive approach, using developmentally sensitive brain and behavioral methods to investigate whether altering children's adverse gestational exposures, i.e., maternal stress in the womb, can improve their mental health outlooks. In so doing, we seek to propel developmental SEED research towards preventive applications with the potential to reduce the pernicious effect of prenatal stress on neurodevelopment, mental health, and wellbeing.
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Affiliation(s)
- Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Darius Tandon
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Institute for Public Health & Medicine Center for Community Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Amelie Petitclerc
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Ashley Nielsen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Rhoozbeh Ghaffari
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Materials Science & Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
| | - Leena Mithal
- Department of Materials Science & Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA.,Department of Pediatrics (Infectious Diseases), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Michael Bass
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Erin Ward
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Institute for Public Health & Medicine Center for Community Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jonathan Berken
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Feinberg School of Medicine, Chicago, IL, USA
| | - Elveena Fareedi
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Peter Cummings
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Karen Mestan
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics (Neonatology), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elizabeth S Norton
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Communication Sciences & Disorders, School of Communication, Northwestern University, Chicago, IL, USA
| | - William Grobman
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Obstetrics & Gynecology (Maternal-Fetal Medicine), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - John Rogers
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Materials Science & Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
| | - Judith Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Nabil Alshurafa
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Computer Science, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
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14
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O’Connor TG, Willoughby MT, Moynihan JA, Messing S, Vallejo Sefair A, Carnahan J, Yin X, Caserta MT. Early childhood risk exposures and inflammation in early adolescence. Brain Behav Immun 2020; 86:22-29. [PMID: 31059804 PMCID: PMC6825880 DOI: 10.1016/j.bbi.2019.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/26/2019] [Accepted: 05/02/2019] [Indexed: 02/06/2023] Open
Abstract
There is now reliable evidence that early psychosocial stress exposures are associated with behavioral health in children; the degree to which these same kinds of stress exposures predict physical health outcomes is not yet clear. We investigated the links between economic adversity, family and caregiving stress in early childhood and several markers of immune function in early adolescence. The sample is derived from the Family Life Project, a prospective longitudinal study of at-risk families. Socio-demographic and psychosocial risks have been assessed at regular intervals since the children were first assessed at 2 months of age. When the children were early adolescents, we conducted an in-depth health assessment of a subsample of families; blood samples were collected from venipuncture for interleukin(IL)-6, Tumor Necrosis Factor (TNF)-alpha, and C-reactive protein (CRP), as well as glucocorticoid resistance. Results indicated limited but reliable evidence of an association between early risk exposure and inflammation in adolescence. Specifically, caregiver depressive symptoms in early childhood predicted elevated CRP almost a decade later, and the prediction was significant after accounting for multiple covariates such as socio-economic adversity, health behaviors and body mass index. Our findings provide strong but limited evidence that early stress exposures may be associated with inflammation, suggesting one mechanism linking early stress exposure to compromised behavioral and somatic health.
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Affiliation(s)
| | | | - Jan A Moynihan
- Department of Psychiatry, University of Rochester Medical Center
| | - Susan Messing
- Department of Statistics and Bioinformatics, University of Rochester Medical Center
| | | | | | - Xiajuan Yin
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester Medical Center
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15
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Kutuk MO, Tufan AE, Kilicaslan F, Mutluer T, Gokcen C, Karadag M, Yektas C, Kandemir H, Buber A, Guler Aksu G, Topal Z, Giray A, Celik F, Acikbas U, Kutuk O. Novel inflammatory targets for immunotherapies in pediatric patients with trichotillomania. Immunobiology 2020; 225:151913. [PMID: 32113788 DOI: 10.1016/j.imbio.2020.151913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/02/2020] [Accepted: 02/11/2020] [Indexed: 01/10/2023]
Abstract
Immune dysregulation may be important in the etiology of obsessive-compulsive and related disordersandbody-focusedrepetitivebehaviors, such as Trichotillomania (TTM). The role of inflammation and inflammatory markers in TTM has received relatively little attention. This study was aimed to determine the expression levels of inflammatory markers (i.e. IL-1β, IL-1α, IL-4, IL-6, IL-17, TNF-α and TGF-β) in peripheral blood mononuclear cells of children with TTM and healthy controls and to evaluate their association with clinical variables. Seventy-seven patients with TTM and 107 healthy controls were enrolled in the study. Peripheral blood was collected in standardized conditions. The mean age of patients and controls did not differ significantly (10.8 ± 4.4 and 12.0 ± 3.2 years; respectively). The majority of patients with TTM and controls were females (n = 55, 71.4 % and n = 55, 51.4 %; respectively); with a greater preponderance of females among TTM. Patients with TTM had significantly elevated expression levels of TNF-α, IL-6 and IL-17 compared to controls. However, the expression level of IL-4 was significantly reduced in TTM patients compared to controls. Accordingly, we found a pro-inflammatory state in TTM and those findings may suggest novel treatment options for TTM and further, cross-disciplinary studies focusing on neuro- inflammation in TTM conducted on larger samples are needed.
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Affiliation(s)
- Meryem Ozlem Kutuk
- Department of Child and Adolescent Psychiatry, Baskent University, Dr. Turgut Noyan Medical and Research Center, Adana, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Fethiye Kilicaslan
- Department of Child and Adolescent Psychiatry, Mehmet Akif İnan Education and Research Hospital, Sanliurfa, Turkey
| | - Tuba Mutluer
- Department of Child and Adolescent Psychiatry, Koc University, İstanbul, Turkey
| | - Cem Gokcen
- Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - Mehmet Karadag
- Department of Child and Adolescent Psychiatry, Mardin State Hospital, Mardin, Turkey
| | - Cigdem Yektas
- Department of Child and Adolescent Psychiatry, Düzce University, Düzce, Turkey
| | - Hasan Kandemir
- Department of Child and Adolescent Psychiatry, Celal Bayar University, Manisa, Turkey
| | - Ahmet Buber
- Department of Child and Adolescent Psychiatry, Pamukkale University, Denizli, Turkey
| | - Gulen Guler Aksu
- Department of Child and Adolescent Psychiatry, Mersin University, Mersin, Turkey
| | - Zehra Topal
- Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - Asli Giray
- Department of Genetic and Bioengineering, Alanya Alaaddin Keykubat University, Alanya, Turkey
| | - Fatma Celik
- Department of Child and Adolescent Psychiatry, Malatya Training and Research Hospital, Malatya, Turkey
| | - Ufuk Acikbas
- Department of Medical Genetics, Baskent University, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Turkey
| | - Ozgur Kutuk
- Department of Medical Genetics, Baskent University, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Turkey.
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16
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Heard-Garris N, Davis MM, Estabrook R, Burns J, Briggs-Gowan M, Allen N, Carnethon M, Aguayo L, Wakschlag L, Penedo F. Adverse childhood experiences and biomarkers of inflammation in a diverse cohort of early school-aged children. Brain Behav Immun Health 2020; 1:100006. [PMID: 38377426 PMCID: PMC8474684 DOI: 10.1016/j.bbih.2019.100006] [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: 10/01/2019] [Accepted: 10/10/2019] [Indexed: 11/19/2022] Open
Abstract
Objective The objective of this study was to evaluate the relationship between ACEs and inflammatory profiles (i.e., pro- and anti-) in early childhood and to examine whether patterns differ for racial/ethnic subgroups. Study design Using longitudinal data from the Multidimensional Assessment of Preschoolers Study (MAPS) (N = 122), we examined the relationship between adverse childhood experiences (ACEs) beginning at birth, C -reactive protein (CRP), and both pro-inflammatory (i.e., IL-1 β, IL-6, TNF, and CRP) and anti-inflammatory (i.e. IL-4 and IL-10) biomarkers during early school age (ages 6-8 years). Results No children in the sample were reported to have experienced 0 ACES, 7% had 1 ACE, 51% had 2-3 ACEs, and 42% had 4 or more ACEs accumulated by the early school-age wave (ESA). There were no significant associations between cumulative ACEs and inflammatory markers. However, parental substance abuse, a specific ACE, was positively correlated with a pro-inflammatory profile at early school age (r = 0.18, p<.05). Specifically, substance abuse as an ACE was associated with higher levels of pro-inflammatory markers such as IL-1 β and IL-6. Additionally, Hispanics with ACEs had higher levels of CRP than Black and white individuals. Conclusions Children with histories of ACEs, especially those with parental substance abuse, may have higher levels of inflammation. Better understanding the role of inflammation in the development of chronic diseases for individuals with ACEs may allow earlier identification and prevention of disease during childhood for those at the highest risk.
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Affiliation(s)
- Nia Heard-Garris
- Division of Academic General Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Box 86, Chicago, IL, 60611, USA
- Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, 303 E. Superior St. Chicago, IL, 60611, USA
| | - Matthew M. Davis
- Division of Academic General Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Box 86, Chicago, IL, 60611, USA
- Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, 303 E. Superior St. Chicago, IL, 60611, USA
- Departments of Medicine, Medical Social Sciences, and Preventive Medicine, Northwestern University Feinberg School of Medicine, 676 N St. Clair Street Arkes Pavilion, Suite 2300, Chicago, IL, 60611, USA
| | - Ryne Estabrook
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair St, 19th Floor, Chicago, IL, 60611, USA
| | - James Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair St, 19th Floor, Chicago, IL, 60611, USA
| | - Margaret Briggs-Gowan
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030-1410, USA
| | - Norrina Allen
- Departments of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr. Suite 1400, Chicago, IL, 60611, USA
| | - Mercedes Carnethon
- Departments of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr. Suite 1400, Chicago, IL, 60611, USA
| | - Liliana Aguayo
- Division of Academic General Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA
- Departments of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr. Suite 1400, Chicago, IL, 60611, USA
| | - Lauren Wakschlag
- Institute for Innovations in Developmental Science, Northwestern University, 633 N. St. Clair, Suite 19-041, Chicago, IL, 60611, USA
- Departments of Medical Social Sciences, Pediatrics, Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine and Weinberg College of Arts and Sciences, Northwestern University, 633 N. St. Clair St., 19th Floor, Chicago, IL, 60611, USA
| | - Frank Penedo
- Departments of Psychology and Medicine, University of Miami, Florida, P.O. Box 248185, Coral Gables, FL, 33124, USA
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17
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Irwin JL, McSorley EM, Yeates AJ, Mulhern MS, Strain JJ, Watson GE, Grzesik K, Thurston SW, Love TM, Smith TH, Broberg K, Shamlaye CF, Myers GJ, Davidson PW, van Wijngaarden E. Maternal immune markers during pregnancy and child neurodevelopmental outcomes at age 20 months in the Seychelles Child Development Study. J Neuroimmunol 2019; 335:577023. [PMID: 31445378 DOI: 10.1016/j.jneuroim.2019.577023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 12/17/2022]
Abstract
Immune dysregulation during pregnancy may influence behavior and neurodevelopment in offspring, but few human studies have tested this hypothesis. Using structural equation modeling, we examined associations between maternal inflammatory markers at 28 weeks gestation and child neurodevelopmental outcomes at 20 months of age in a sample of 1453 mother-child pairs. We observed several associations between maternal inflammatory markers measured in the late second or early third trimester and child neurodevelopmental outcomes. The direction of association for some markers was unexpected. Further research is warranted to confirm and elucidate the exact nature of these findings.
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Affiliation(s)
- Jessica L Irwin
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Emeir M McSorley
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA Co. Londonderry, UK
| | - Alison J Yeates
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA Co. Londonderry, UK
| | - Maria S Mulhern
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA Co. Londonderry, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA Co. Londonderry, UK
| | - Gene E Watson
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Katherine Grzesik
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Sally W Thurston
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Tanzy M Love
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Tristram H Smith
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Karin Broberg
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-17177, Solna, Stockholm, Sweden
| | | | - Gary J Myers
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Philip W Davidson
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America
| | - Edwin van Wijngaarden
- University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States of America.
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18
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Schwarz JM. Frank Beach Award Winner - The future of mental health research: Examining the interactions of the immune, endocrine and nervous systems between mother and infant and how they affect mental health. Horm Behav 2019; 114:104521. [PMID: 30981689 PMCID: PMC7367439 DOI: 10.1016/j.yhbeh.2019.04.008] [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: 02/01/2019] [Revised: 03/28/2019] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
Pregnancy and the postpartum period are periods of significant change in the immune and endocrine systems. This period of life is also associated with an increased risk of mental health disorders in the mother, and an increased risk of developmental and neuropsychiatric disorders in her infant. The collective data described here supports the idea that peripartum mood disorders in mother and developmental disorders in her infant likely reflects multiple pathogeneses, stemming from various interactions between the immune, endocrine and nervous systems, thereby resulting in various symptom constellations. In this case, testing the mechanisms underlying specific symptoms of these disorders (e.g. deficits in specific types of learning or anhedonia) may provide a better understanding of the various physiological interactions and multiple etiologies that most likely underlie the risk of mental health disorders during this unique time in life. The goal here is to summarize the current understanding of how immune and endocrine factors contribute to maternal mental health, while simultaneously understanding the impact these unique interactions have on the developing brain of her infant.
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Affiliation(s)
- Jaclyn M Schwarz
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE 19716, USA.
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Abstract
OBJECTIVE The aim of the study was to examine the association of lifetime maternal depression with regulation of immune responses in the infant, measured by cytokine levels and lymphocyte proliferation (LP) in cord blood mononuclear cells collected at delivery. METHODS We studied women recruited in early pregnancy into the Project Viva longitudinal cohort who had cord blood assayed after delivery (N = 463). Women reported about depressive symptoms in midpregnancy (Edinburgh Postnatal Depression Scale) and depression history by questionnaire. Immune responses were assayed by an index of LP, and concentrations of five cytokines (interleukin [IL]-6, IL-10, IL-13, tumor necrosis tumor necrosis factor factor α, and interferon γ) after incubation of cord blood mononuclear cells either in medium alone or stimulated with phytohemagglutinin (PHA), cockroach extract, or house dust mite extract. We examined associations of maternal depression with these sets of cytokine measures using multivariable linear or tobit regression analyses. RESULTS After adjustment for confounders (mother's age, race/ethnicity, education, household income, season of birth, and child sex), levels of IL-10 after stimulation with cockroach or dust mite allergen were lower in cord blood from ever versus never depressed women, and a similar trend was evident in IL-10 stimulated with PHA (percentage difference: cockroach extract = -41.4, p = .027; house dust mite extract = 1-36.0, p = .071; PHA = -24.2, p = .333). No significant differences were seen in levels of other cytokines or LP. CONCLUSIONS Maternal depression is associated with offspring immune responses at birth, which may have implications for later life atopic risk or immune function.
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Chacin-Fernández J, Chacin Fuenmayor M, Piñerua-Shuhaibar L, Suarez-Roca H. Psychological intervention based on psychoneuroimmunology improves clinical evolution, quality of life, and immunity of children with leukemia: A preliminary study. Health Psychol Open 2019; 6:2055102919838902. [PMID: 30967959 PMCID: PMC6444782 DOI: 10.1177/2055102919838902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We conducted a non-randomized, open-label clinical trial to assess whether a
psychoneuroimmunology-based intervention enhanced immunity in children with
acute lymphoblastic leukemia undergoing chemotherapy. In total, 16 children (44%
female) received psychoneuroimmunology-based intervention, whereas 12 (50%
female) received health psychoeducation (controls). The primary outcome was
immunity markers, being clinical conditions the secondary outcome.
Psychoneuroimmunology-based intervention increased immune markers (CD8+ T, B,
and natural killer cells, serum immunoglobulin A, and immunoglobulin M) and
quality of life, whereas it shortens the duration of fever and use of
antipyretics, antibiotics, analgesics, and respiratory therapy. Immunity markers
correlated with clinical conditions. Thus, psychoneuroimmunology-based
intervention could reduce hospital cost and increase patient well-being.
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Affiliation(s)
| | | | - Lorena Piñerua-Shuhaibar
- Instituto de Investigaciones Clinicas, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.,Hospital Psiquiátrico de Maracaibo, Venezuela
| | - Heberto Suarez-Roca
- Instituto de Investigaciones Clinicas, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.,Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
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Yanuck SF. Microglial Phagocytosis of Neurons: Diminishing Neuronal Loss in Traumatic, Infectious, Inflammatory, and Autoimmune CNS Disorders. Front Psychiatry 2019; 10:712. [PMID: 31632307 PMCID: PMC6786049 DOI: 10.3389/fpsyt.2019.00712] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/05/2019] [Indexed: 01/08/2023] Open
Abstract
Errors in neuron-microglial interaction are known to lead to microglial phagocytosis of live neurons and excessive neuronal loss, potentially yielding poorer clinical outcomes. Factors that affect neuron-microglial interaction have the potential to influence the error rate. Clinical comorbidities that unfavorably impact neuron-microglial interaction may promote a higher rate of neuronal loss, to the detriment of patient outcome. This paper proposes that many common, clinically modifiable comorbidities have a common thread, in that they all influence neuron-microglial interactions. Comorbidities like traumatic brain injury, infection, stress, neuroinflammation, loss of neuronal metabolic integrity, poor growth factor status, and other factors, all have the potential to alter communication between neurons and microglia. When this occurs, microglial phagocytosis of live neurons can increase. In addition, microglia can shift into a morphological form in which they express major histocompatibility complex II (MHC-II), allowing them to function as antigen presenting cells that present neuronal debris as antigen to invading T cells. This can increase risk for the development of CNS autoimmunity, or can exacerbate existing CNS autoimmunity. The detrimental influence of these comorbidities has the potential to contribute to the mosaic of factors that determine patient outcome in some CNS pathologies that have neuropsychiatric involvement, including TBI and CNS disorders with autoimmune components, where excessive neuronal loss can yield poorer clinical outcomes. Recognition of the impact of these comorbidities may contribute to an understanding of the common clinical observation that many seemingly disparate factors contribute to the overall picture of case management and clinical outcome in these complex disorders. In a clinical setting, knowing how these comorbidities can influence neuron-microglial interaction can help focus surveillance and care on a broader group of potential therapeutic targets. Accordingly, an interest in the mechanisms underlying the influence of these factors on neuron-microglial interactions is appropriate. Neuron-microglial interaction is reviewed, and the various mechanisms by which these potential comorbidities influence neuro-microglial interaction are described.
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Affiliation(s)
- Samuel F Yanuck
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, NC, United States
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Rosen Valverde JN, Backstrand J, Hills L, Tanuos H. Medical-Legal Partnership Impact on Parents' Perceived Stress: A Pilot Study. Behav Med 2019; 45:70-77. [PMID: 29944063 DOI: 10.1080/08964289.2018.1481011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Stress has adverse effects on health, and prolonged stress exposure is a risk factor for several mental and physical illnesses. 1 Families living in poverty face many stressors created and maintained by economic hardship and unaddressed legal and social needs. Medical-Legal Partnerships (MLPs) aim to improve health and well-being by addressing health-harming legal and social needs of patients. This pilot study examined whether MLP-involved parents perceived themselves as stressed; to what they attributed their stress; and whether they reported a reduction in stress when their MLP cases were closed. The study shows improvements in perceived stress following receipt of MLP interventions.
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Affiliation(s)
- Jennifer N Rosen Valverde
- a Education and Health Law Clinic, Legal Director, H.E.A.L. Collaborative® , Rutgers University School of Law, Newark, NJ, USA
| | - Jeffrey Backstrand
- b School of Public Affairs and Administration, Chair, Department of Urban Health Administration , School of Public Health, Rutgers University, Newark, NJ, USA
| | - Laurie Hills
- c School of Public Affairs and Administration , Rutgers University, Newark, NJ, USA
| | - Hanan Tanuos
- d Department of Pediatrics, Director, Pediatric Primary Care, Medical Director, H.E.A.L. Collaborative® , Rutgers-New Jersey Medical School, Newark, NJ, USA
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Inflammation-related epigenetic risk and child and adolescent mental health: A prospective study from pregnancy to middle adolescence. Dev Psychopathol 2018; 30:1145-1156. [PMID: 30068408 DOI: 10.1017/s0954579418000330] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In 785 mother-child (50% male) pairs from a longitudinal epidemiological birth cohort, we investigated associations between inflammation-related epigenetic polygenic risk scores (i-ePGS), environmental exposures, cognitive function, and child and adolescent internalizing and externalizing problems. We examined prenatal and postnatal effects. For externalizing problems, one prenatal effect was found: i-ePGS at birth associated with higher externalizing problems (ages 7-15) indirectly through lower cognitive function (age 7). For internalizing problems, we identified two effects. For a prenatal effect, i-ePGS at birth associated with higher internalizing symptoms via continuity in i-ePGS at age 7. For a postnatal effect, higher postnatal adversity exposure (birth through age 7) associated with higher internalizing problems (ages 7-15) via higher i-ePGS (age 7). Hence, externalizing problems were related mainly to prenatal effects involving lower cognitive function, whereas internalizing problems appeared related to both prenatal and postnatal effects. The present study supports a link between i-ePGS and child and adolescent mental health.
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Osborne BF, Turano A, Caulfield JI, Schwarz JM. Sex- and region-specific differences in microglia phenotype and characterization of the peripheral immune response following early-life infection in neonatal male and female rats. Neurosci Lett 2018; 692:1-9. [PMID: 30367955 DOI: 10.1016/j.neulet.2018.10.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 01/10/2023]
Abstract
Early-life infection has been shown to have profound effects on the brain and behavior across the lifespan, a phenomenon termed "early-life programming". Indeed, many neuropsychiatric disorders begin or have their origins early in life and have been linked to early-life immune activation (e.g. autism, ADHD, and schizophrenia). Furthermore, many of these disorders show a robust sex bias, with males having a higher risk of developing early-onset neurodevelopmental disorders. The concept of early-life programming is now well established, however, it is still unclear how such effects are initiated and then maintained across time to produce such a phenomenon. To begin to address this question, we examined changes in microglia, the immune cells of the brain, and peripheral immune cells in the hours immediately following early-life infection in male and female rats. We found that males showed a significant decrease in BDNF expression and females showed a significant increase in IL-6 expression in the cerebellum following E.coli infection on postnatal day 4; however, for most cytokines examined in the brain and in the periphery we were unable to identify any sex differences in the immune response, at least at the time points examined. Instead, neonatal infection with E.coli increased the expression of a number of cytokines in the brain of both males and females similarly including TNF-α, IL-1β, and CD11b (a marker of microglia activation) in the hippocampus and, in the spleen, TNF-α and IL-1β. We also found that protein levels of GRO-KC, MIP-1a, MCP1, IP-10, TNF-α, and IL-10 were elevated 8-hours postinfection, but this response was resolved by 24-hours. Lastly, we found that males have more thin microglia than females on P5, however, neonatal infection had no effect on any of the microglia morphologies we examined. These data show that sex differences in the acute immune response to neonatal infection are likely gene, region, and even time dependent. Future research should consider these factors in order to develop a comprehensive understanding of the immune response in males and females as these changes are likely the initiating agents that lead to the long-term, and often sex-specific, effects of early-life infection.
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Affiliation(s)
- Brittany F Osborne
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE, 19716, USA.
| | - Alexandra Turano
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE, 19716, USA.
| | - Jasmine I Caulfield
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE, 19716, USA.
| | - Jaclyn M Schwarz
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE, 19716, USA.
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Abstract
There is now a clear focus on incorporating, and integrating, multiple levels of analysis in developmental science. The current study adds to research in this area by including markers of the immune and neuroendocrine systems in a longitudinal study of temperament in infants. Observational and parent-reported ratings of infant temperament, serum markers of the innate immune system, and cortisol reactivity from repeated salivary collections were examined in a sample of 123 infants who were assessed at 6 months and again when they were, on average, 17 months old. Blood from venipuncture was collected for analyses of nine select innate immune cytokines; salivary cortisol collected prior to and 15 min and 30 min following a physical exam including blood draw was used as an index of neuroendocrine functioning. Analyses indicated fairly minimal significant associations between biological markers and temperament at 6 months. However, by 17 months of age, we found reliable and nonoverlapping associations between observed fearful temperament and biological markers of the immune and neuroendocrine systems. The findings provide some of the earliest evidence of robust biological correlates of fear behavior with the immune system, and identify possible immune and neuroendocrine mechanisms for understanding the origins of behavioral development.
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Allswede DM, Zheutlin AB, Chung Y, Anderson K, Hultman CM, Ingvar M, Cannon TD. Complement Gene Expression Correlates with Superior Frontal Cortical Thickness in Humans. Neuropsychopharmacology 2018; 43:525-533. [PMID: 28758643 PMCID: PMC5770755 DOI: 10.1038/npp.2017.164] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 07/10/2017] [Accepted: 07/13/2017] [Indexed: 12/26/2022]
Abstract
Recent work suggests that genes encoding complement proteins that are active in the innate immune system may confer risk for schizophrenia by disrupting typical synaptic pruning in late adolescence. Alterations in the complement pathway may contribute to aberrant cortical thinning in schizophrenia prodromes and reduced prefrontal cortical thickness in chronic schizophrenia patients; however, this theory needs to be translated to humans. We conducted a series of analyses in a sample of adult Swedish twins enriched for schizophrenia (N=129) to assess the plausibility of a relationship between complement gene expression and cortical thickness that could go awry in the etiology of schizophrenia. First, we identified that peripheral mRNA expression levels of two complement genes (C5, SERPING1) made unique contributions to the variance in superior frontal cortical thickness among all participants. Vertex-wise maps of the association between gene expression levels and thickness across the cortex suggested that this relationship was especially strong with SERPING1 in the superior frontal region, consistent with the pattern of disruption in cortical thickness observed in schizophrenia. Additional analyses identified that these genes are expressed in the human superior frontal cortex, that heritable genetic factors influence SERPING1 gene expression levels, and that these associations are observed regardless of case status. These findings provide initial evidence linking the complement system with cortical thinning in humans, a process potentially involved in the pathogenesis of schizophrenia.
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Affiliation(s)
- Dana M Allswede
- Department of Psychology, Yale University,Department of Psychology, Yale University, 2 Hillhouse Ave., PO Box 208205, New Haven, CT 06520, USA, Tel: +1 517 614 3906, E-mail:
| | | | | | | | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Tyrone D Cannon
- Department of Psychology, Yale University,Department of Psychiatry, Yale University, New Haven, CT, USA
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Finegood ED, Rarick JRD, Blair C. Exploring longitudinal associations between neighborhood disadvantage and cortisol levels in early childhood. Dev Psychopathol 2017; 29:1649-1662. [PMID: 29162174 PMCID: PMC5772682 DOI: 10.1017/s0954579417001304] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children who grow up in poverty are more likely to experience chronic stressors that generate "wear" on stress regulatory systems including the hypothalamus-pituitary-adrenal (HPA) axis. This can have long-term consequences for health and well-being. Prior research has examined the role of proximal family and home contributions to HPA axis functioning. However, there is evidence to suggest that more distal levels of context, including neighborhoods, also matter. Prior evidence has primarily focused on adolescents and adults, with little evidence linking the neighborhood context with HPA activity in infancy and toddlerhood. We tested whether neighborhood disadvantage (indexed by US Census data) was associated with basal salivary cortisol levels at 7, 15, and 24 months of child age in a large sample of families (N = 1,292) residing in predominately low-income and rural communities in the United States. Multilevel models indicated that neighborhood disadvantage was positively associated with salivary cortisol levels and that this effect emerged across time. This effect was moderated by the race/ethnicity of children such that the association was only observed in White children in our sample. Findings provide preliminary evidence that the neighborhood context is associated with stress regulation during toddlerhood, elucidating a need for future work to address possible mechanisms.
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Ma D, Serbin LA, Stack DM. Children's anxiety symptoms and salivary immunoglobulin A: A mutual regulatory system? Dev Psychobiol 2017; 60:202-215. [PMID: 29171012 DOI: 10.1002/dev.21590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 10/12/2017] [Indexed: 01/02/2023]
Abstract
Anxiety can impact the immune system resulting in negative health outcomes. Salivary immunoglobulin A (sIgA) is a first line of defense against foreign antigens, with lowered levels indicative of weakened mucosal immunity. Little is known about how anxiety symptoms affect the diurnal rhythm of sIgA secretion, or the longitudinal transactional sequence between the two in children and adolescents. The goals of the two studies were to: (i) explore the concurrent associations between self-reported anxiety symptoms and diurnal variations of sIgA across the day using repeated daily samples of sIgA; and (ii) examine transactional relations between children's anxiety and aggregated total amount of sIgA levels across successive periods from middle childhood (Wave 1; ages 9-12) to early adolescence (Wave 2; ages 12-15), and from early to mid- adolescence (Wave 3; ages 15-18). Concurrent results showed a steeper (positive) rise in diurnal slope of sIgA from awakening to 5 hr post-awakening in children with higher anxiety. Longitudinally, higher levels of total anxiety, and specifically, worries at Wave 1 significantly predicted lower cumulative daily levels of sIgA 3 years later at Wave 2. Lowered sIgA levels at Wave 2 in turn predicted higher anxiety at Wave 3, illustrating a "vicious cycle" feedback loop. These findings broaden our understanding of the developmental links between anxiety symptoms, the immune system, and health.
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Affiliation(s)
- Denise Ma
- Department of Psychology, Concordia University, Center for Research in Human Development, Montreal, Quebec, Canada
| | - Lisa A Serbin
- Department of Psychology, Concordia University, Center for Research in Human Development, Montreal, Quebec, Canada
| | - Dale M Stack
- Department of Psychology, Concordia University, Center for Research in Human Development, Montreal, Quebec, Canada
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Gleason MM, Sexson S. Preparing Trainees for Integrated Care: Triple Board and the Postpediatric Portal Program. Child Adolesc Psychiatr Clin N Am 2017; 26:689-702. [PMID: 28916008 DOI: 10.1016/j.chc.2017.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Training combining the disciplines of pediatrics, psychiatry, and child and adolescent psychiatry dates back to World War II, but formal combined programs began more than 3 decades ago as the Triple Board Program and 10 years ago as the Postpediatric Portal Program (PPPP). Triple board training was rigorously examined as a pilot program and ongoing surveys suggest that it provides successful training of physicians who can pass the required board examinations and contribute to clinical, academic, and administrative/advocacy endeavors. As evidence grows showing the value of integrated care, physicians with combined training will offer a unique perspective for developing systems.
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Affiliation(s)
- Mary Margaret Gleason
- Psychiatry and Behavioral Sciences, Pediatrics Tulane University School of Medicine, 1430 Canal Street #8055, New Orleans, LA 70112, USA.
| | - Sandra Sexson
- Child, Adolescent, and Family Psychiatry, Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St. Sebastian Way, Augusta, GA 30912, USA; Pediatrics, Medical College of Georgia, Augusta University, 997 St. Sebastian Way, Augusta, GA 30912, USA
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Kuhlman KR, Chiang JJ, Horn S, Bower JE. Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease. Neurosci Biobehav Rev 2017; 80:166-184. [PMID: 28577879 PMCID: PMC5705276 DOI: 10.1016/j.neubiorev.2017.05.020] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/13/2017] [Accepted: 05/22/2017] [Indexed: 12/17/2022]
Abstract
Childhood adversity has been repeatedly and robustly linked to physical and mental illness across the lifespan. Yet, the biological pathways through which this occurs remain unclear. Functioning of the inflammatory arm of the immune system and the hypothalamic-pituitary-adrenal (HPA)-axis are both hypothesized pathways through which childhood adversity leads to disease. This review provides a novel developmental framework for examining the role of adversity type and timing in inflammatory and HPA-axis functioning. In particular, we identify elements of childhood adversity that are salient to the developing organism: physical threat, disrupted caregiving, and unpredictable environmental conditions. We propose that existing, well-characterized animal models may be useful in differentiating the effects of these adversity elements and review both the animal and human literature that supports these ideas. To support these hypotheses, we also provide a detailed description of the development and structure of both the HPA-axis and the inflammatory arm of the immune system, as well as recent methodological advances in their measurement. Recommendations for future basic, developmental, translational, and clinical research are discussed.
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Mardini V, Rohde LA, Ceresér KMM, Gubert CDM, da Silva EG, Xavier F, Parcianello R, Röhsig LM, Pechansky F, Pianca TG, Szobot CM. IL-6 and IL-10 levels in the umbilical cord blood of newborns with a history of crack/cocaine exposure in utero: a comparative study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 38:40-9. [PMID: 27074340 DOI: 10.1590/2237-6089-2015-0081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/18/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Prenatal cocaine exposure (PCE) is associated with neurobehavioral problems during childhood and adolescence. Early activation of the inflammatory response may contribute to such changes. Our aim was to compare inflammatory markers (IL-6 and IL-10) both in umbilical cord blood and in maternal peripheral blood at delivery between newborns with history of crack/cocaine exposure in utero and non-exposed newborns. METHODS In this cross-sectional study, 57 newborns with a history of crack/cocaine exposure in utero (EN) and 99 non-exposed newborns (NEN) were compared for IL-6 and IL-10 levels. Sociodemographic and perinatal data, maternal psychopathology, consumption of nicotine and other substances were systematically collected in cases and controls. RESULTS After adjusting for potential confounders, mean IL-6 was significantly higher in EN than in NEN (10,208.54, 95% confidence interval [95%CI] 1,328.54-19,088.55 vs. 2,323.03, 95%CI 1,484.64-3,161.21; p = 0.007; generalized linear model [GLM]). Mean IL-10 was also significantly higher in EN than in NEN (432.22, 95%CI 51.44-812.88 vs. 75.52, 95%CI 5.64-145.39, p = 0.014; GLM). Adjusted postpartum measures of IL-6 were significantly higher in mothers with a history of crack/cocaine use (25,160.05, 95%CI 10,958.15-39,361.99 vs. 8,902.14, 95%CI 5,774.97-12,029.32; p = 0.007; GLM), with no significant differences for IL-10. There was no correlation between maternal and neonatal cytokine levels (Spearman test, p ≥ 0.28 for all measures). CONCLUSIONS IL-6 and IL-10 might be early biomarkers of PCE in newborns. These findings could help to elucidate neurobiological pathways underlying neurodevelopmental changes and broaden the range of possibilities for early intervention.
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Affiliation(s)
- Victor Mardini
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | | | - Emily Galvão da Silva
- Instituto Nacional de Ciência e Tecnologia - Medicina Translacional, Porto Alegre, RS, Brazil
| | | | | | | | - Flávio Pechansky
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Debbané M, Salaminios G, Luyten P, Badoud D, Armando M, Solida Tozzi A, Fonagy P, Brent BK. Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum. Front Hum Neurosci 2016; 10:406. [PMID: 27597820 PMCID: PMC4992687 DOI: 10.3389/fnhum.2016.00406] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 08/02/2016] [Indexed: 11/22/2022] Open
Abstract
In this review article, we outline the evidence linking attachment adversity to psychosis, from the premorbid stages of the disorder to its clinical forms. To better understand the neurobiological mechanisms through which insecure attachment may contribute to psychosis, we identify at least five neurobiological pathways linking attachment to risk for developing psychosis. Besides its well documented influence on the hypothalamic-pituary-adrenal (HPA) axis, insecure attachment may also contribute to neurodevelopmental risk through the dopaminergic and oxytonergic systems, as well as bear influence on neuroinflammation and oxidative stress responses. We further consider the neuroscientific and behavioral studies that underpin mentalization as a suite of processes potentially moderating the risk to transition to psychotic disorders. In particular, mentalization may help the individual compensate for endophenotypical impairments in the integration of sensory and metacognitive information. We propose a model where embodied mentalization would lie at the core of a protective, resilience response mitigating the adverse and potentially pathological influence of the neurodevelopmental cascade of risk for psychosis.
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Affiliation(s)
- Martin Debbané
- Faculty of Psychology and Educational Sciences, University of GenevaGeneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
- Office Médico-PédagogiqueGeneva, Switzerland
| | - George Salaminios
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
| | - Patrick Luyten
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
- Faculty of Psychology and Educational Sciences, University of LeuvenLeuven, Belgium
| | - Deborah Badoud
- Faculty of Psychology and Educational Sciences, University of GenevaGeneva, Switzerland
| | | | | | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
| | - Benjamin K. Brent
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA
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Hoeijmakers L, Heinen Y, van Dam AM, Lucassen PJ, Korosi A. Microglial Priming and Alzheimer's Disease: A Possible Role for (Early) Immune Challenges and Epigenetics? Front Hum Neurosci 2016; 10:398. [PMID: 27555812 PMCID: PMC4977314 DOI: 10.3389/fnhum.2016.00398] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/26/2016] [Indexed: 12/11/2022] Open
Abstract
Neuroinflammation is thought to contribute to Alzheimer's disease (AD) pathogenesis that is, to a large extent, mediated by microglia. Given the tight interaction between the immune system and the brain, peripheral immune challenges can profoundly affect brain function. Indeed, both preclinical and clinical studies have indicated that an aberrant inflammatory response can elicit behavioral impairments and cognitive deficits, especially when the brain is in a vulnerable state, e.g., during early development, as a result of aging, or under disease conditions like AD. However, how exactly peripheral immune challenges affect brain function and whether this is mediated by aberrant microglial functioning remains largely elusive. In this review, we hypothesize that: (1) systemic immune challenges occurring during vulnerable periods of life can increase the propensity to induce later cognitive dysfunction and accelerate AD pathology; and (2) that "priming" of microglial cells is instrumental in mediating this vulnerability. We highlight how microglia can be primed by both neonatal infections as well as by aging, two periods of life during which microglial activity is known to be specifically upregulated. Lasting changes in (the ratios of) specific microglial phenotypes can result in an exaggerated pro-inflammatory cytokine response to subsequent inflammatory challenges. While the resulting changes in brain function are initially transient, a continued and/or excess release of such pro-inflammatory cytokines can activate various downstream cellular cascades known to be relevant for AD. Finally, we discuss microglial priming and the aberrant microglial response as potential target for treatment strategies for AD.
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Affiliation(s)
- Lianne Hoeijmakers
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam Amsterdam, Netherlands
| | - Yvonne Heinen
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam Amsterdam, Netherlands
| | - Anne-Marie van Dam
- Department of Anatomy and Neurosciences, Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Netherlands
| | - Paul J Lucassen
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam Amsterdam, Netherlands
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam Amsterdam, Netherlands
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Allswede DM, Buka SL, Yolken RH, Torrey EF, Cannon TD. Elevated maternal cytokine levels at birth and risk for psychosis in adult offspring. Schizophr Res 2016; 172:41-5. [PMID: 26897476 DOI: 10.1016/j.schres.2016.02.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pregnancy and birth complications, particularly those associated with maternal inflammation and fetal hypoxia, are associated with increased risk for schizophrenia later in life. However, the molecular mechanisms underlying these associations are not fully delineated. This study sought to examine the effect of exposure to maternal inflammation on risk of developing psychosis in adulthood. Maternal serum levels of pro-inflammatory Th1 cytokines (IL-2, interferon gamma [IFN-γ], IL-12) and Th17 cytokines (IL-1b, IL-6, IL-8, tumor necrosis factor alpha [TNF-α], granulocyte macrophage colony stimulating factor [gm-csf]) and anti-inflammatory Th2 cytokines (IL-4, IL-5, and IL-13) and Treg cytokines (IL-10) were evaluated for association with later psychosis in the offspring. METHODS Subjects were 43 adults with psychoses and 43 matched controls followed from gestation as part of the Philadelphia cohort of the National Collaborative Perinatal Project. Adult symptoms of psychosis were assessed via medical records review and confirmed with a validation study. Archived maternal serum samples collected at the time of birth were analyzed for cytokine levels using a multiplex bead assay. RESULTS Individuals exposed to elevated maternal levels of anti-inflammatory Th2 cytokines (≥75th percentile) were significantly less likely to develop psychosis in adulthood. CONCLUSIONS These results may suggest that increased maternal levels of anti-inflammatory cytokines during the perinatal period could protect against the development of psychosis.
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Affiliation(s)
- Dana M Allswede
- Department of Psychology, Yale University, New Haven, CT, USA.
| | - Stephen L Buka
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
| | - Robert H Yolken
- The Stanley Medical Research Institute, Chevy Chase, MD, USA.
| | - E Fuller Torrey
- The Stanley Medical Research Institute, Chevy Chase, MD, USA.
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA.
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Gariup M, Gonzalez A, Lázaro L, Torres F, Serra-Pagès C, Morer A. IL-8 and the innate immunity as biomarkers in acute child and adolescent psychopathology. Psychoneuroendocrinology 2015; 62:233-42. [PMID: 26325024 DOI: 10.1016/j.psyneuen.2015.08.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The role of inflammation in psychopathology has received great attention over the past decades. Immune system dysfunction and altered cytokine levels have been reported in most psychiatric disorders in adults. Few data are available regarding children and adolescents (C&A), or regarding the relationship between cytokine levels and psychosocial stress. This study investigates the profile of the most described cytokines in a sample of C&A inpatients affected by an acute psychiatric condition requiring hospitalization, in comparison with healthy subjects, as well as possible associations between psychosocial stressors and psychopathology and/or cytokine concentrations. METHODS Patients with a diagnosis of Affective, Anxiety, Adjustment, Psychotic, Obsessive-Compulsive, Tic or Tourette Disorders were consecutively recruited from our clinic between June 2010 and February 2012. Controls were recruited from the same geographic area. All subjects were between 8 and 17 years old. Twelve cytokines are compared: interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL_10, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IFN-γ-induced protein-10 (IP-10), monocyte chemoattractant protein (MCP)-1. Psychosocial stress was measured through the Stressful Life Events Scale, Child and Parents versions (SLES-C and SLES-P) and the evaluation of the family integrity. RESULTS One hundred and eleven subjects (77C&A inpatients and 34 healthy controls), of which 54 were males (49%), with a median (interquartile range) age of 16 (13.7-17.3) years, were included in this study. IL-1β, IL6, IL8, IP-10, MCP-1 and monocytes were found to be significantly higher in the patient group (p<0.05). Differences were confirmed when adjusting by BMI, age, gender and drug intake at admission for all cytokines except MCP-1. IL-8 and IL-1β were also higher throughout the different diagnostic categories, than in control group (p<0.05). Stress measures were higher in patients. A significant correlation was found between stress measured by the SLES and some inflammatory markers: SLES_C with IL-1β, IL-8, MCP-1, and SLES_P with IL-1β and monocytes absolute and relative counts (Spearman's r between 0.219 and 0.297, p<0.05). Logistic regression identified the following variables as independent predictors of the patient condition, (odds ratio per quartile, p-value): IL8 (1, 0.9, 12.1, 32.0, p=0.044), IP10 (1, 14.1, 2.5, 3.7, p=0.044), monocyte absolute count (1, 1.1, 6.0, 19.4, p=0.030). CONCLUSIONS Results show elevated inflammation markers from the innate immune system across C&A acute psychiatric diagnosis, and suggest a link between psychopathology, inflammation and stress. Inflammatory markers resulted predictors of patient status. These exploratory results are coherent with current psychoneuroimmunology and neurodevelopmental investigations.
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Affiliation(s)
- Maria Gariup
- Psychiatry Department, Kolding Hospital, Skovvejen, Kolding 6000, Denmark; Medicine Faculty, Barcelona University, C/ Villarroel 170, Barcelona 08036, Spain.
| | - Azucena Gonzalez
- Immunonlogy Dept., Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain.
| | - Luisa Lázaro
- Medicine Faculty, Barcelona University, C/ Villarroel 170, Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Child and Adolescent Psychiatry, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Group G04, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain.
| | - Ferran Torres
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Carles Serra-Pagès
- Medicine Faculty, Barcelona University, C/ Villarroel 170, Barcelona 08036, Spain; Immunonlogy Dept., Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Astrid Morer
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Child and Adolescent Psychiatry, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Group G04, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain.
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Provençal N, Booij L, Tremblay RE. The developmental origins of chronic physical aggression: biological pathways triggered by early life adversity. ACTA ACUST UNITED AC 2015; 218:123-33. [PMID: 25568459 DOI: 10.1242/jeb.111401] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Longitudinal epidemiological studies with birth cohorts have shown that physical aggression in humans does not appear suddenly in adolescence as commonly thought. In fact, physically aggressive behaviour is observed as early as 12 months after birth, its frequency peaks around 2-4 years of age and decreases in frequency until early adulthood. However, a minority of children (3-7%) maintain a high frequency of physical aggression from childhood to adolescence and develop serious social adjustment problems during adulthood. Genetic factors and early social experiences, as well as their interaction, have been shown to play an important role in the development of chronic aggressive behaviour. However, the biological mechanisms underlying these associations are just beginning to be uncovered. Recent evidence suggests that epigenetic mechanisms are responsive to adverse environments and could be involved in the development of chronic aggression. Using both gene candidate and genomic approaches, recent studies have identified epigenetic marks, such as DNA methylation alterations in genes involved in the stress response and the serotonin and immune systems to be partly responsible for the long-lasting effects of early adversity. Further longitudinal studies with biological, environmental and behavioural assessments from birth onwards are needed to elucidate the sequence of events that leads to these long-lasting epigenetic marks associated with early adversity and aggression.
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Affiliation(s)
- Nadine Provençal
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Linda Booij
- Ste-Justine Hospital Research Center, Montreal, QC H3T 1C5, Canada Department of Psychology and Psychiatry, Queen's University, Kingston, ON K7L 3N6, Canada Department of Psychiatry, University of Montreal, Montreal, QC H3T 1J4, Canada Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada
| | - Richard E Tremblay
- Ste-Justine Hospital Research Center, Montreal, QC H3T 1C5, Canada Department of Psychology and Pediatrics, University of Montreal, Montreal, QC H2V 2S9, Canada School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin 4, Ireland Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk 634050, Russian Federation
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O'Connor TG, Wang H, Moynihan JA, Wyman PA, Carnahan J, Lofthus G, Quataert SA, Bowman M, Burke AS, Caserta MT. Observed parent-child relationship quality predicts antibody response to vaccination in children. Brain Behav Immun 2015; 48:265-73. [PMID: 25862953 PMCID: PMC4508214 DOI: 10.1016/j.bbi.2015.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 04/01/2015] [Accepted: 04/03/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Quality of the parent-child relationship is a robust predictor of behavioral and emotional health for children and adolescents; the application to physical health is less clear. METHODS We investigated the links between observed parent-child relationship quality in an interaction task and antibody response to meningococcal conjugate vaccine in a longitudinal study of 164 ambulatory 10-11 year-old children; additional analyses examine associations with cortisol reactivity, BMI, and somatic illness. RESULTS Observed Negative/Conflict behavior in the interaction task predicted a less robust antibody response to meningococcal serotype C vaccine in the child over a 6 month-period, after controlling for socio-economic and other covariates. Observer rated interaction conflict also predicted increased cortisol reactivity following the interaction task and higher BMI, but these factors did not account for the link between relationship quality and antibody response. CONCLUSIONS The results begin to document the degree to which a major source of child stress exposure, parent-child relationship conflict, is associated with altered immune system development in children, and may constitute an important public health consideration.
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Affiliation(s)
- Thomas G O'Connor
- Wynne Center for Family Research, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States; Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States.
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Jan A Moynihan
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Peter A Wyman
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Jennifer Carnahan
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Gerry Lofthus
- Department of Medicine, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Sally A Quataert
- Department of Microbiology and Immunology, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Melissa Bowman
- Department of Pediatrics, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Anne S Burke
- Department of Psychology, University of Rochester, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States.
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Hoeijmakers L, Lucassen PJ, Korosi A. The interplay of early-life stress, nutrition, and immune activation programs adult hippocampal structure and function. Front Mol Neurosci 2015; 7:103. [PMID: 25620909 PMCID: PMC4288131 DOI: 10.3389/fnmol.2014.00103] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/16/2014] [Indexed: 01/08/2023] Open
Abstract
Early-life adversity increases the vulnerability to develop psychopathologies and cognitive decline later in life. This association is supported by clinical and preclinical studies. Remarkably, experiences of stress during this sensitive period, in the form of abuse or neglect but also early malnutrition or an early immune challenge elicit very similar long-term effects on brain structure and function. During early-life, both exogenous factors like nutrition and maternal care, as well as endogenous modulators, including stress hormones and mediator of immunological activity affect brain development. The interplay of these key elements and their underlying molecular mechanisms are not fully understood. We discuss here the hypothesis that exposure to early-life adversity (specifically stress, under/malnutrition and infection) leads to life-long alterations in hippocampal-related cognitive functions, at least partly via changes in hippocampal neurogenesis. We further discuss how these different key elements of the early-life environment interact and affect one another and suggest that it is a synergistic action of these elements that shapes cognition throughout life. Finally, we consider different intervention studies aiming to prevent these early-life adversity induced consequences. The emerging evidence for the intriguing interplay of stress, nutrition, and immune activity in the early-life programming calls for a more in depth understanding of the interaction of these elements and the underlying mechanisms. This knowledge will help to develop intervention strategies that will converge on a more complete set of changes induced by early-life adversity.
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Affiliation(s)
- Lianne Hoeijmakers
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam Amsterdam, Netherlands
| | - Paul J Lucassen
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam Amsterdam, Netherlands
| | - Aniko Korosi
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam Amsterdam, Netherlands
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Marques AH, Bjørke-Monsen AL, Teixeira AL, Silverman MN. Maternal stress, nutrition and physical activity: Impact on immune function, CNS development and psychopathology. Brain Res 2014; 1617:28-46. [PMID: 25451133 DOI: 10.1016/j.brainres.2014.10.051] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 10/20/2014] [Accepted: 10/25/2014] [Indexed: 12/14/2022]
Abstract
Evidence suggests that maternal and fetal immune dysfunction may impact fetal brain development and could play a role in neurodevelopmental disorders, although the definitive pathophysiological mechanisms are still not completely understood. Stress, malnutrition and physical inactivity are three maternal behavioral lifestyle factors that can influence immune and central nervous system (CNS) functions in both the mother and fetus, and may therefore, increase risk for neurodevelopmental/psychiatric disorders. First, we will briefly review some aspects of maternal-fetal immune system interactions and development of immune tolerance. Second, we will discuss the bidirectional communication between the immune system and CNS and the pathways by which immune dysfunction could contribute to neurodevelopmental disorders. Third, we will discuss the effects of prenatal stress and malnutrition (over and undernutrition) on perinatal programming of the CNS and immune system, and how this might influence neurodevelopment. Finally, we will discuss the beneficial impact of physical fitness during pregnancy on the maternal-fetal unit and infant and how regular physical activity and exercise can be an effective buffer against stress- and inflammatory-related disorders. Although regular physical activity has been shown to promote neuroplasticity and an anti-inflammatory state in the adult, there is a paucity of studies evaluating its impact on CNS and immune function during pregnancy. Implementing stress reduction, proper nutrition and ample physical activity during pregnancy and the childbearing period may be an efficient strategy to counteract the impact of maternal stress and malnutrition/obesity on the developing fetus. Such behavioral interventions could have an impact on early development of the CNS and immune system and contribute to the prevention of neurodevelopmental and psychiatric disorders. Further research is needed to elucidate this relationship and the underlying mechanisms of protection. This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease.
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Affiliation(s)
- Andrea Horvath Marques
- Obsessive--Compulsive Spectrum Disorders Program, Department & Institute of Psychiatry, University of São Paulo, Medical School, São Paulo, Brazil.
| | | | - Antônio L Teixeira
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marni N Silverman
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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O’Connor TG, Moynihan JA, Wyman PA, Carnahan J, Lofthus G, Quataert SA, Bowman M, Caserta MT. Depressive symptoms and immune response to meningococcal conjugate vaccine in early adolescence. Dev Psychopathol 2014; 26:1567-76. [PMID: 25422979 PMCID: PMC5771474 DOI: 10.1017/s0954579414001242] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Research findings in psychoneuroimmunology document reliable, bidirectional linkages among psychological processes, the nervous system, and the immune system. However, available data are based almost entirely on animal and adult human studies; the application to children and adolescents is uncertain. We capitalized on the experimental leverage provided by a routine vaccination to examine the link between mood symptoms and the immune response to a vaccine challenge in early adolescence. One hundred twenty-six 11-year-olds for whom vaccine response data were available were assessed at prevaccination and 4 weeks, 3 months, and 6 months following vaccination; self-report ratings of depression and anxiety as well as measures of psychosocial and somatic risk were assessed prior to vaccine response. Analyses indicated that children's internalizing mood symptoms were associated with elevated and persistently higher antibody responses, with evidence extending to two of the four serogroups. The associations remained after controlling for multiple possible confounders (social class, body mass index, sleep, psychosocial risk, and pubertal status). The observed enhanced vaccine response associated with depressive and anxious symptoms in early adolescence may reflect an important developmental difference in immune system-brain interplay between adults and children, and it underscores the need for further developmental studies of psychoneuroimmunology.
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Leckman JF. Commentary: What does immunology have to do with brain development and psychopathology?--a commentary on O'Connor et al. (2014). J Child Psychol Psychiatry 2014; 55:632-4. [PMID: 24840172 DOI: 10.1111/jcpp.12259] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2013] [Indexed: 11/29/2022]
Affiliation(s)
- James F Leckman
- Child Study Center, Departments of Psychiatry, Pediatrics and Psychology, Yale University, New Haven, CT, USA
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Modulation of adult hippocampal neurogenesis by early-life environmental challenges triggering immune activation. Neural Plast 2014; 2014:194396. [PMID: 24891958 PMCID: PMC4033517 DOI: 10.1155/2014/194396] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 04/11/2014] [Indexed: 02/03/2023] Open
Abstract
The immune system plays an important role in the communication between the human body and the environment, in early development as well as in adulthood. Per se, research has shown that factors such as maternal stress and nutrition as well as maternal infections can activate the immune system in the infant. A rising number of research studies have shown that activation of the immune system in early life can augment the risk of some psychiatric disorders in adulthood, such as schizophrenia and depression. The mechanisms of such a developmental programming effect are unknown; however some preliminary evidence is emerging in the literature, which suggests that adult hippocampal neurogenesis may be involved. A growing number of studies have shown that pre- and postnatal exposure to an inflammatory stimulus can modulate the number of proliferating and differentiating neural progenitors in the adult hippocampus, and this can have an effect on behaviours of relevance to psychiatric disorders. This review provides a summary of these studies and highlights the evidence supporting a neurogenic hypothesis of immune developmental programming.
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