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Gürbüzer N, Güler MC, Tör İH. Methamphetamine Use Disorder and Inflammation: A Case-Control Study. Psychiatry Investig 2024; 21:513-520. [PMID: 38811000 PMCID: PMC11136578 DOI: 10.30773/pi.2023.0199] [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: 06/15/2023] [Revised: 12/14/2023] [Accepted: 02/27/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE Methamphetamine use disorder (MUD) is a global health condition that impairs a person's health which may result in morbidity and mortality. Inflammation is a crucial process playing a vital role in MUD. For this reason, it is necessary to examine biochemical parameters for follow-up and treatment alternatives. METHODS We aimed to reveal the relationship between inflammatory response and MUD by evaluating peripheral hemogram parameters, leukocyte count, subtypes, and their ratios to each other, systemic immune inflammation index (SII), monocyte/high-density lipoprotein (HDL) ratio, and human C-reactive protein (CRP) in adult men with MUD. We included 76 adult male participants in the patient group and 70 adult male participants in the control group. We calculated the neutrophil/lymphocyte rate (NLR), monocyte/lymphocyte rate (MLR), platelet/lymphocyte rate (PLR), and basophil/lymphocyte rate (BLR). In addition, we obtained the SII and the monocyte/HDL rate. RESULTS The patients' leukocyte (p<0.001), platelet (p<0.001), plateletcrit (PCT) (p=0.002), neutrophil (p<0.001), monocyte (p=0.002), CRP (p<0.001), NLR (p=0.001), PLR (p=0.004), MLR (p=0.009), SII (p<0.001) and monocyte/HDL ratio (p<0.001) were higher than the control group. We observed a significant and positive relationship between the daily methamphetamine intake, and methamphetamine use duration (p=0.002), PCT (p=0.044), neutrophil (p=0.021), NLR (p=0.001), PLR (p=0.004), MLR (p=0.029), and SII (p<0.001). Daily methamphetamine intake had a significant and positive effect on SII. A one-unit increase in daily methamphetamine intake elevated SII by 165.53 units. CONCLUSION The results confirm the presence of peripheral subclinical inflammation and systemic immune inflammation in adult men with MUD.
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Affiliation(s)
- Nilifer Gürbüzer
- Department of Psychiatry, Regional Training and Research Hospital, University of Health Sciences, Erzurum, Turkey
| | - Mustafa Can Güler
- Department of Physiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - İbrahim Hakkı Tör
- Department of Anesthesiology and Reanimation, Regional Training and Research Hospital, University of Health Sciences, Erzurum, Turkey
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Funchal GA, Schuch JB, Zaparte A, Sanvicente-Vieira B, Viola TW, Grassi-Oliveira R, Bauer ME. Cocaine-use disorder and childhood maltreatment are associated with the activation of neutrophils and increased inflammation. Acta Neuropsychiatr 2024; 36:97-108. [PMID: 36847141 DOI: 10.1017/neu.2023.11] [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] [Indexed: 03/01/2023]
Abstract
BACKGROUND Cocaine-use disorder (CUD) has been associated with early life adversity and activated cellular immune responses. Women are most vulnerable to complications from chronic substance disorders, generally presenting an intense feeling of abstinence and consuming significant drug amounts. Here, we investigated neutrophil functional activities in CUD, including the formation of neutrophil extracellular traps (NETs) and related intracellular signalling. We also investigated the role of early life stress in inflammatory profiles. METHODS Blood samples, clinical data, and history of childhood abuse or neglect were collected at the onset of detoxification treatment of 41 female individuals with CUD and 31 healthy controls (HCs). Plasma cytokines, neutrophil phagocytosis, NETs, intracellular reactive oxygen species (ROS) generation, and phosphorylated protein kinase B (Akt) and mitogen-activated protein kinases (MAPK)s were assessed by flow cytometry. RESULTS CUD subjects had higher scores of childhood trauma than controls. Increased plasma cytokines (TNF-α, IL-1β, IL-6, IL-8, IL-12, and IL-10), neutrophil phagocytosis, and production of NETs were reported in CUD subjects as compared to HC. Neutrophils of CUD subjects also produced high levels of intracellular ROS and had more activated Akt and MAPKs (p38/ERK), which are essential signalling pathways involved in cell survival and NETs production. Childhood trauma scores were significantly associated with neutrophil activation and peripheral inflammation. CONCLUSION Our study reinforces that smoked cocaine and early life stress activate neutrophils in an inflammatory environment.
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Affiliation(s)
- Giselle A Funchal
- Laboratory of Immunobiology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Jaqueline B Schuch
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Aline Zaparte
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- LSU Health New Orleans School of Medicine, Pulmonary/Critical Care & Allergy/Immunology, New Orleans, LA, USA
| | - Breno Sanvicente-Vieira
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Thiago W Viola
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Moisés E Bauer
- Laboratory of Immunobiology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- National Institute of Science and Technology - Neuroimmunomodulation (INCT-NIM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasília, DF, Brazil
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Kok Kendirlioglu B, Arat Celik HE, Buyuksandalyaci Tunc AE, Ozmen M, Corekli Kaymakcı E, Demir S, Kuçukgoncu S. Lymphocyte-related ratios, systemic immune-inflammatory and systemic inflammatory response index in alcohol use disorder. J Immunoassay Immunochem 2024; 45:38-49. [PMID: 37953614 DOI: 10.1080/15321819.2023.2277806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Addictive disorders are associated with systemic and central nervous system inflammation, which may be important for the onset and development of these diseases. Although lymphocyte-related parameters have recently been studied in alcohol use disorder (AUD), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) haven't. Lymphocyte-related ratios, SII and SIRI levels were evaluated between AUD and healthy controls (HC) in this study. It was a retrospective and cross-sectional study. This study included 72 patients with AUD and 184 individuals in the HC group. Lymphocyte related ratios such as neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR), SII and SIRI values were compared. Compared to HC group, NLR (p < 0.001), MLR (p < 0.001), and SIRI (p < 0.001) levels were significantly higher in AUD group. There was also a significant relationship between NLR and AST/ALT ratio in the AUD group (p = 0.022). The results of this study support that AUD is a chronic inflammatory psychiatric disorder. In addition, it may be useful to evaluate these markers in relation to liver enzymes in patients with AUD, as alcohol consumption causes liver damage. These markers may also be used in future studies to assess treatment response and disease severity.
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Affiliation(s)
| | | | | | - Melike Ozmen
- Medicine Faculty Department of Psychiarty, Maltepe University, Istanbul, Turkey
| | | | - Sevin Demir
- Medicine Faculty Department of Family Medicine, Maltepe University, Istanbul, Turkey
| | - Suat Kuçukgoncu
- Medicine Faculty Department of Psychiarty, Maltepe University, Istanbul, Turkey
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Turan Ç, Şenormancı G, Neşelioğlu S, Budak Y, Erel Ö, Şenormancı Ö. Oxidative Stress and Inflammatory Biomarkers in People with Methamphetamine Use Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:572-582. [PMID: 37424424 PMCID: PMC10335902 DOI: 10.9758/cpn.22.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/03/2023] [Accepted: 03/06/2023] [Indexed: 07/11/2023]
Abstract
Objective This study aimed to investigate the blood serum levels of biomarkers specifying oxidative stress status and systemic inflammation between people using methamphetamine (METH) and the control group (CG). Serum thiol/disulfide balance and ischemia-modified albumin levels were studied to determine oxidative stress, and serum interleukin-6 (IL-6) levels and complete blood count (CBC) were to assess inflammation. Methods Fifty patients with METH use disorder (MUD) and 36 CG participants were included in the study. Two tubes of venous blood samples were taken to measure oxidative stress, serum thiol/disulfide balance, ischemia-modified albumin, and IL-6 levels between groups. The correlation of parameters measuring oxidative stress and inflammation between groups with sociodemographic data was investigated. Results In this study, serum total thiol, free thiol levels, disulfide/native thiol percentage ratios, and serum ischemia- modified albumin levels of the patients were statistically significantly higher than the healthy controls. No difference was observed between the groups in serum disulfide levels and serum IL-6 levels. Considering the regression analysis, only the duration of substance use was a statistically significant factor in explaining serum IL-6 levels. The parameters showing inflammation in the CBC were significantly higher in the patients than in the CG. Conclusion CBC can be used to evaluate systemic inflammation in patients with MUD. Parameters measuring thiol/disulfide homeostasis and ischemia-modified albumin can be, also, used to assess oxidative stress.
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Affiliation(s)
- Çetin Turan
- Department of Psychiatry, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Güliz Şenormancı
- Department of Psychiatry, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Salim Neşelioğlu
- Clinic of Clinical Biochemistry, Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Yasemin Budak
- Department of Biochemistry, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Özcan Erel
- Clinic of Clinical Biochemistry, Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Ömer Şenormancı
- Department of Clinical Psychology, University of Beykent, Istanbul, Turkey
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Brown KT, Levis SC, O'Neill CE, Levy C, Rice KC, Watkins LR, Bachtell RK. Toll-like receptor 4 antagonists reduce cocaine-primed reinstatement of drug seeking. Psychopharmacology (Berl) 2023; 240:1587-1600. [PMID: 37286899 PMCID: PMC10732226 DOI: 10.1007/s00213-023-06392-w] [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: 02/21/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
RATIONALE Cocaine can increase inflammatory neuroimmune markers, including chemokines and cytokines characteristic of innate inflammatory responding. Prior work indicates that the Toll-like receptor 4 (TLR4) initiates this response, and administration of TLR4 antagonists provides mixed evidence that TLR4 contributes to cocaine reward and reinforcement. OBJECTIVE These studies utilize (+)-naltrexone, the TLR4 antagonist, and mu-opioid inactive enantiomer to examine the role of TLR4 on cocaine self-administration and cocaine seeking in rats. METHODS (+)-Naltrexone was continuously administered via an osmotic mini-pump during the acquisition or maintenance of cocaine self-administration. The motivation to acquire cocaine was assessed using a progressive ratio schedule following either continuous and acute (+)-naltrexone administration. The effects of (+)-naltrexone on cocaine seeking were assessed using both a cue craving model and a drug-primed reinstatement model. The highly selective TLR4 antagonist, lipopolysaccharide from Rhodobacter sphaeroides (LPS-Rs), was administered into the nucleus accumbens to determine the effectiveness of TLR4 blockade on cocaine-primed reinstatement. RESULTS (+)-Naltrexone administration did not alter the acquisition or maintenance of cocaine self-administration. Similarly, (+)-naltrexone was ineffective at altering the progressive ratio responding. Continuous administration of (+)-naltrexone during forced abstinence did not impact cued cocaine seeking. Acute systemic administration of (+)-naltrexone dose-dependently decreased cocaine-primed reinstatement of previously extinguished cocaine seeking, and administration of LPS-Rs into the nucleus accumbens shell also reduced cocaine-primed reinstatement of cocaine seeking. DISCUSSION These results complement previous studies suggesting that the TLR4 plays a role in cocaine-primed reinstatement of cocaine seeking, but may have a more limited role in cocaine reinforcement.
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Affiliation(s)
- Kyle T Brown
- Department of Psychology and Neuroscience and Center for Neuroscience, Boulder, CO, USA
| | - Sophia C Levis
- Department of Psychology and Neuroscience and Center for Neuroscience, Boulder, CO, USA
| | - Casey E O'Neill
- Department of Psychology and Neuroscience and Center for Neuroscience, Boulder, CO, USA
| | - Catherine Levy
- Department of Psychology and Neuroscience and Center for Neuroscience, Boulder, CO, USA
| | - Kenner C Rice
- Drug Design and Synthesis Section, National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Linda R Watkins
- Department of Psychology and Neuroscience and Center for Neuroscience, Boulder, CO, USA
| | - Ryan K Bachtell
- Department of Psychology and Neuroscience and Center for Neuroscience, Boulder, CO, USA.
- Institute for Behavioral Genetics University of Colorado Boulder, Boulder, CO, USA.
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Lin J, Arnovitz M, Kotbi N, Francois D. Substance Use Disorders in the Geriatric Population: a Review and Synthesis of the Literature of a Growing Problem in a Growing Population. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2023:1-20. [PMID: 37360959 PMCID: PMC10241125 DOI: 10.1007/s40501-023-00291-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/28/2023]
Abstract
Purpose of review Substance use disorders are becoming increasingly prevalent in the geriatric population, necessitating an updated understanding of the existing literature. This review aims to describe the epidemiology, special considerations, and management of substance use disorders in older adults. Recent findings PubMed, Ovid MEDLINE, and PsychINFO databases were searched from their inception through June 2022 using the following keywords: "substance use disorder," "substance abuse," "abuse," "illicit substances," "illicit drugs," "addiction," "geriatric," "elderly," "older adults," "alcohol," "marijuana," "cannabis," "cocaine," "heroin," "opioid," and "benzodiazepine." Our findings suggest an increasing trend in substance use in older adults despite medical and psychiatric consequences when using such substances. The majority of older patients admitted to substance abuse treatment programs were not referred by healthcare providers, suggesting room for improvement in the screening and discussion of substance use disorders. Our review also suggests that there should be careful consideration of COVID-19 and racial disparities when screening, diagnosing, and treating substance use disorders in the older population. Summary This review provides updated information on epidemiology, special considerations, and management of substance use disorders in older adults. As substance use disorders become more prevalent in older adults, primary care physicians must be prepared to recognize and diagnose substance use disorders as well as collaborate with and refer patients to geriatric medicine, geriatric psychiatry, and addiction medicine.
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Affiliation(s)
- Jenny Lin
- Weill Cornell Medicine, New York, NY USA
| | - Mitchell Arnovitz
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Nabil Kotbi
- Weill Cornell Medicine, New York Presbyterian/Westchester, 21 Bloomingdale Road, White Plains, NY 10605 USA
| | - Dimitry Francois
- Weill Cornell Medicine, New York Presbyterian/Westchester, 21 Bloomingdale Road, White Plains, NY 10605 USA
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Choi NG, Choi BY, Marti CN, DiNitto DM, Baker SD. Substance use and medical outcomes in those age 50 and older involving cocaine and metamfetamine reported to United States poison centers. Clin Toxicol (Phila) 2023; 61:400-407. [PMID: 37083082 PMCID: PMC10339160 DOI: 10.1080/15563650.2023.2185494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 04/22/2023]
Abstract
CONTEXT Cocaine and metamfetamine use and overdose deaths among United States adults have been increasing in recent years. We examined associations of medical outcomes with co-used opioids and other substances among cocaine, and metamfetamine exposures in people age ≥50 years (N = 9300) reported to the National Poison Data System, 2015-2021. METHODS We first described increases in these exposures over time. We fitted generalized linear models for a Poisson distribution with a log link, one for cocaine exposures and the other for metamfetamine exposures, to examine associations of medical outcomes (major effects/death versus all others) with co-used other substances, controlling for exposure year and demographics. RESULTS The number of exposures increased steadily during the seven years, but metamfetamine exposures increased more rapidly starting in 2018. One-fifth of cocaine and one-sixth of metamfetamine exposures suffered major effects/death. Co-use of prescription opioids (incident risk ratio = 2.00, 95% CI = 1.76-2.28 for cocaine; incident risk ratio = 1.62, 95% CI = 1.27-2.07 for metamfetamine), illicit fentanyl (incident risk ratio =1.88, 95% CI = 1.08-3.27 for cocaine; incident risk ratio = 2.05, 95% CI = 1.04-4.06 for metamfetamine), heroin (incident risk ratio =1.62, 95% CI = 1.37-1.90 for cocaine), or amfetamine (incident risk ratio =1.73, 95% CI = 1.28-2.33 for cocaine) was associated with a higher likelihood of major effects/death. DISCUSSION Increases in the number of cocaine and metamfetamine exposures among older adults reported to poison centers are of concern, and so is the increased risk of major effects/death from polysubstance use, especially prescription and illicit opioids, among these illicit psychostimulant users. CONCLUSIONS Healthcare provider screening of individuals at risk of cocaine and/or metamfetamine use and psychoeducation about the dangers of these substance use are needed.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Bryan Y Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine & Bayhealth Medical Center, Dover, DE, USA
| | - C Nathan Marti
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Diana M DiNitto
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Ray S, Sil S, Kannan M, Periyasamy P, Buch S. Role of the gut-brain axis in HIV and drug abuse-mediated neuroinflammation. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11092. [PMID: 38389809 PMCID: PMC10880759 DOI: 10.3389/adar.2023.11092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/23/2023] [Indexed: 02/24/2024]
Abstract
Drug abuse and related disorders are a global public health crisis affecting millions, but to date, limited treatment options are available. Abused drugs include but are not limited to opioids, cocaine, nicotine, methamphetamine, and alcohol. Drug abuse and human immunodeficiency virus-1/acquired immune deficiency syndrome (HIV-1/AIDS) are inextricably linked. Extensive research has been done to understand the effect of prolonged drug use on neuronal signaling networks and gut microbiota. Recently, there has been rising interest in exploring the interactions between the central nervous system and the gut microbiome. This review summarizes the existing research that points toward the potential role of the gut microbiome in the pathogenesis of HIV-1-linked drug abuse and subsequent neuroinflammation and neurodegenerative disorders. Preclinical data about gut dysbiosis as a consequence of drug abuse in the context of HIV-1 has been discussed in detail, along with its implications in various neurodegenerative disorders. Understanding this interplay will help elucidate the etiology and progression of drug abuse-induced neurodegenerative disorders. This will consequently be beneficial in developing possible interventions and therapeutic options for these drug abuse-related disorders.
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Affiliation(s)
- Sudipta Ray
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Susmita Sil
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Muthukumar Kannan
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Palsamy Periyasamy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Shilpa Buch
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
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Cabrera-Mendoza B, Stertz L, Najera K, Selvaraj S, Teixeira AL, Meyer TD, Fries GR, Walss-Bass C. Within subject cross-tissue analyzes of epigenetic clocks in substance use disorder postmortem brain and blood. Am J Med Genet B Neuropsychiatr Genet 2023; 192:13-27. [PMID: 36056652 PMCID: PMC9742183 DOI: 10.1002/ajmg.b.32920] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/22/2022] [Accepted: 08/16/2022] [Indexed: 12/14/2022]
Abstract
There is a possible accelerated biological aging in patients with substance use disorders (SUD). The evaluation of epigenetic clocks, which are accurate estimators of biological aging based on DNA methylation changes, has been limited to blood tissue in patients with SUD. Consequently, the impact of biological aging in the brain of individuals with SUD remains unknown. In this study, we evaluated multiple epigenetic clocks (DNAmAge, DNAmAgeHannum, DNAmAgeSkinBlood, DNAmPhenoAge, DNAmGrimAge, and DNAmTL) in individuals with SUD (n = 42), including alcohol (n = 10), opioid (n = 19), and stimulant use disorder (n = 13), and controls (n = 10) in postmortem brain (prefrontal cortex) and blood tissue obtained from the same individuals. We found a higher DNAmPhenoAge (β = 0.191, p-value = 0.0104) and a nominally lower DNAmTL (β = -0.149, p-value = 0.0603) in blood from individuals with SUD compared to controls. SUD subgroup analysis showed a nominally lower brain DNAmTL in subjects with alcohol use disorder, compared to stimulant use disorder and controls (β = 0.0150, p-value = 0.087). Cross-tissue analyzes indicated a lower blood DNAmTL and a higher blood DNAmAge compared to their respective brain values in the SUD group. This study highlights the relevance of tissue specificity in biological aging studies and suggests that peripheral measures of epigenetic clocks in SUD may depend on the specific type of drug used.
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Affiliation(s)
- Brenda Cabrera-Mendoza
- PECEM, Faculty of Medicine, Universidad Nacional
Autónoma de México, Mexico City, 04510, Mexico
| | - Laura Stertz
- Louis A. Faillace, MD, Department of Psychiatry and
Behavioral Sciences, McGovern Medical School, University of Texas Health Science
Center at Houston, Houston, TX, 77054, USA
| | - Katherine Najera
- Louis A. Faillace, MD, Department of Psychiatry and
Behavioral Sciences, McGovern Medical School, University of Texas Health Science
Center at Houston, Houston, TX, 77054, USA
| | - Sudhakar Selvaraj
- Louis A. Faillace, MD, Department of Psychiatry and
Behavioral Sciences, McGovern Medical School, University of Texas Health Science
Center at Houston, Houston, TX, 77054, USA
| | - Antonio L. Teixeira
- Louis A. Faillace, MD, Department of Psychiatry and
Behavioral Sciences, McGovern Medical School, University of Texas Health Science
Center at Houston, Houston, TX, 77054, USA
| | - Thomas D. Meyer
- Louis A. Faillace, MD, Department of Psychiatry and
Behavioral Sciences, McGovern Medical School, University of Texas Health Science
Center at Houston, Houston, TX, 77054, USA
| | - Gabriel R. Fries
- Louis A. Faillace, MD, Department of Psychiatry and
Behavioral Sciences, McGovern Medical School, University of Texas Health Science
Center at Houston, Houston, TX, 77054, USA
- Center for Precision Health, School of Biomedical
Informatics, University of Texas Health Science Center at Houston, Houston, TX,
77054, USA
| | - Consuelo Walss-Bass
- Louis A. Faillace, MD, Department of Psychiatry and
Behavioral Sciences, McGovern Medical School, University of Texas Health Science
Center at Houston, Houston, TX, 77054, USA
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10
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Zhu X, Zhou H. Neutrophil-to-Lymphocyte Ratio Can Distinguish Patients with Liver Cirrhosis from Healthy People but Cannot Distinguish Patients with Cirrhotic Hepatocellular Carcinoma from Patients with Liver Cirrhosis. J Hepatocell Carcinoma 2022; 9:1127-1136. [PMID: 36338430 PMCID: PMC9628700 DOI: 10.2147/jhc.s387189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/15/2022] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Identifying cirrhotic hepatocellular carcinoma (HCC) during liver cirrhosis (LC) stage is pivotal for improving the clinical outcomes of cirrhotic HCC patients. Inflammation-driven markers play a crucial role in tumorigenesis and tumor progression. Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory response marker. This study aimed to evaluate the ability of NLR to distinguish cirrhotic HCC from LC. METHODS Data of healthy control (HC) people, LC patients, cirrhotic HCC patients, and non-cirrhotic HCC patients were retrospectively analyzed. Mann-Whitney U test and Chi-squared test were used to compare demographic and clinical parameters in different groups. Spearman correlation analysis was used to assess correlations. Receiver operating characteristic (ROC) curves were performed to determine diagnostic accuracy. RESULTS A total of 419 participants were enrolled in this study, including 152 HC people, 131 LC patients, 96 cirrhotic HCC patients, and 40 non-cirrhotic HCC patients. Level of NLR was elevated significantly in LC compared with HC (P < 0.001). No significant differences were found for NLR between LC and cirrhotic HCC (P = 0.083), as well as between cirrhotic HCC and non-cirrhotic HCC (P = 0.729). NLR was positively correlated with platelet-to-lymphocyte ratio (r = 0.33, P < 0.001). The area under the ROC curve (AUC) value for NLR to distinguish LC from HC was 0.759 (P < 0.001), and AUC value to distinguish cirrhotic HCC from LC was 0.567 (P = 0.083), and AUC value to distinguish non-cirrhotic HCC from cirrhotic HCC was 0.519 (0.415-0.623) (P = 0.729). CONCLUSION NLR can distinguish LC from HC but cannot not distinguish cirrhotic HCC from LC.
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Affiliation(s)
- Xuming Zhu
- Department of Laboratory Medicine, the Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China,Correspondence: Xuming Zhu, Department of Laboratory Medicine, the Affiliated Wuxi People’s Hospital of Nanjing Medical University, No. 299 at Qingyang Road, Wuxi, 214023, People’s Republic of China, Email
| | - Hongxing Zhou
- Department of Laboratory Medicine, the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, People’s Republic of China
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Zolopa C, Høj SB, Minoyan N, Bruneau J, Makarenko I, Larney S. Ageing and older people who use illicit opioids, cocaine or methamphetamine: a scoping review and literature map. Addiction 2022; 117:2168-2188. [PMID: 35072313 PMCID: PMC9544522 DOI: 10.1111/add.15813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 01/06/2022] [Indexed: 11/26/2022]
Abstract
AIMS To provide an overview of research literature on ageing and older people who use illicit opioids and stimulants by documenting the conceptual frameworks used and content areas that have been investigated. METHODS We conducted a scoping review of literature relating to ageing and older people who use illicit stimulants and opioids, defining 'older' as 40 years and above. Primary studies, secondary studies and editorials were included. Searches were conducted in PubMed and Embase in July 2020 and March 2021; the Cochrane library was searched in November 2021. Charted data included methodological details, any conceptual frameworks explicitly applied by authors and the content areas that were the focus of the publication. We developed a hierarchy of content areas and mapped this to provide a visual guide to the research area. RESULTS Of the 164 publications included in this review, only 16 explicitly applied a conceptual framework. Seven core content areas were identified, with most publications contributing to multiple content areas: acknowledgement of drug use among older people (n = 64), health status (n = 129), health services (n = 109), drug use practices and patterns (n = 84), social environments (n = 74), the criminal legal system (n = 28) and quality of life (n = 15). CONCLUSIONS The literature regarding older people who use illicit drugs remains under-theorized. Conceptual frameworks are rarely applied and few have been purposely adapted to this population. Health status and health services access and use are among the most frequently researched topics in this area.
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Affiliation(s)
- Camille Zolopa
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada
| | - Stine B Høj
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada
| | - Nanor Minoyan
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Social and Preventative Medicine, School of Public Health, Université de Montréal, Montreal, Québec, Canada
| | - Julie Bruneau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Iuliia Makarenko
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Sarah Larney
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
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12
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Jiang Q, Yu T, Huang K, Huang X, Zhang Q, Hu S. The impact of medical insurance reimbursement on postoperative inflammation reaction in distinct cardiac surgery from a single center. BMC Health Serv Res 2022; 22:494. [PMID: 35418067 PMCID: PMC9008956 DOI: 10.1186/s12913-022-07920-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
Abstract
Background Evidences shows that socioeconomic status is reversely associated with the risk of morbidity and mortality for people with cardiovascular disease via pro-inflammation mechanism, but the population profile is not deeply defined on. We aimed to investigate the impact of medical insurance coverage on postoperative systemic inflammatory reaction in two kinds of disease populations undergoing distinct cardiac procedures. Methods A total of 515 patients receiving open mitral valve procedure with high-total expense from May 2013 through May 2021 in Sichuan Provincial People’s Hospital were retrospectively collected and stratified according to medical insurance reimbursement: low coverage with high out-pocket (< 30%), medium coverage (≤ 60%, but ≥ 30%), and high coverage (> 60%). Another 118 cases undergoing atrium septum defect (ASD) or patent foramen ovale (PFO) occlusion and taking on consistent low-total expense and low-coverage (< 30%) were also classified according to their insured conditions. The postoperative systemic inflammatory response indexes were high sensitivity C-reactive protein (hs-CRP) and the neutrophil–lymphocyte ratio (NLR). Results Low insurance reimbursement population undergoing open mitral valve procedure had a higher level of hs-CRP and NLR but not troponin I protein or lactate within 48 h postoperatively, and higher thoracic drainage, longer ventilation use and stay in intensive care unit. No significant difference in inflammatory indexes existed among diverse medical insurance coverage in population undergoing ASD/PFO occlusion. Conclusions Higher inflammatory reaction and weaker clinical recovery was associated with lower insurance coverage population undergoing open mitral valve procedure but not ASD/PFO interventional occlusion procedure. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07920-8.
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Affiliation(s)
- Qin Jiang
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, No.32, West Second Section First Ring Road, Chengdu, 610072, China.
| | - Tao Yu
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, No.32, West Second Section First Ring Road, Chengdu, 610072, China
| | - Keli Huang
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, No.32, West Second Section First Ring Road, Chengdu, 610072, China
| | - Xiaobo Huang
- Department of Surgical Intensive Care Unit, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, China
| | - Qingfeng Zhang
- Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, China
| | - Shengshou Hu
- Department of Cardiac Surgery, Fuwai Hospital, National, Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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13
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Choi NG, DiNitto DM, Marti CN, Choi BY. U.S. older adults' heroin and psychostimulant use treatment admissions, 2012-2019: Sociodemographic and clinical characteristics. Drug Alcohol Depend 2022; 231:109256. [PMID: 34998248 PMCID: PMC8810593 DOI: 10.1016/j.drugalcdep.2021.109256] [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: 09/09/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Increases in U.S. older adults' nonprescription opioid and psychostimulant use call for examining their treatment admissions for these substances. METHODS Using admissions age 55 + involving heroin (N = 299,073) from the 2012-2019 Treatment Episode Data Set-Admissions, we examined trends and sociodemographic and clinical characteristics of three groups: (1) heroin-only admissions (i.e., not involving cocaine or methamphetamine), (2) heroin-cocaine admissions, and (3) heroin-methamphetamine admissions. Bivariable and multivariable logistic regression analyses were conducted to examine the research questions. RESULTS Between 2012 and 2019, the numbers of both heroin-only and heroin-cocaine admissions increased 2.3-fold and heroin-methamphetamine admissions increased seven-fold. First time heroin-methamphetamine admissions increased 18-fold. Heroin-methamphetamine admissions were concentrated in the Western region and heroin-cocaine admissions in the Northeastern region. Multivariable analyses showed a nearly 6 times higher relative risk ratio (RRR; 95% CI=5.24-6.74) for heroin-methamphetamine vs. heroin-only admissions in 2019 compared to 2012. Being non-Hispanic Black, compared to non-Hispanic White, was associated with a RRR of 2.4 (95% CI=2.34-2.46) for heroin-cocaine admissions and a RRR of 0.14 (95% CI=0.12-0.15) for heroin-methamphetamine admissions. Late-onset heroin use, experience of homelessness and other psychiatric problems, and past 30-day arrest episodes were associated with a higher likelihood of heroin-cocaine and heroin-methamphetamine admissions, while injection drug use (IDU) was associated with a higher likelihood of heroin-methamphetamine admissions only. CONCLUSIONS Healthcare providers should assess and monitor psychostimulant, methamphetamine in particular, use among older adults. Those who use heroin and psychostimulants should receive substance use treatment and help to secure stable housing and meet other living needs.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin,Corresponding author: Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712.
| | - Diana M. DiNitto
- Steve Hicks School of Social Work, University of Texas at Austin
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine & Bay Health
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14
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KULU M, ÖZSOY F, DEMİR B. Alkol ve madde kullanım bozukluğu tanılı hastalarda inflamasyon düzeyleri. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.975848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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15
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Karatoprak S, Uzun N, Akıncı MA, Dönmez YE. Neutrophil-lymphocyte and Platelet-lymphocyte Ratios among Adolescents with Substance Use Disorder: A Preliminary Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:669-676. [PMID: 34690121 PMCID: PMC8553541 DOI: 10.9758/cpn.2021.19.4.669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/25/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022]
Abstract
Objective Substance use disorder (SUD) is a serious public health problem affecting both the individual and the society, and substance use-related deaths and disability have been shown to increase gradually. Recent etiologic studies have reported that there is a relation between inflammatory parameters and psychiatric disorders. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) used as an indicator of inflammation have been shown to be increased in various psychiatric disorders. In this study, we aimed to investigate the NLR and PLR in adolescents with SUD. Methods This study was conducted by retrospectively examining the records of 55 male adolescents who were followed up with SUD in a child and adolescent psychiatry outpatient clinic between November 2019−June 2020. Patients who had comorbid psychiatric disorder were included, and those who received any psychotropic medication were excluded. A total of 61 healthy male adolescents in the same age range without any psychiatric disorders were recruited as a control group. Neutrophil-lymphocyte-platelet counts were noted retrospectively from complete blood tests, and NLR-PLR were calculated. Results The NLR and PLR of adolescents with SUD were significantly higher than the healthy adolescents (p < 0.01, p < 0.01, respectively). In addition, conduct disorder, depression, and attention deficit/hyperactivity disorder, which were determined as the most common comorbid psychiatric disorders had no effects on NLR (p = 0.513, p = 0.584, p = 0.394, respectively) and PLR (p = 0.210, p = 0.346, p = 0.359, respectively). Conclusion The results of current study indicate that inflammatory processes may have a key role in the pathophysiology of SUD.
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Affiliation(s)
- Serdar Karatoprak
- Department of Child and Adolescent Psychiatry, Elazıg Fethi Sekin City Hospital, Elazıg, Turkey
| | - Necati Uzun
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Dr. Ali Kemal Belviranlı Maternity and Children’s Hospital, Konya, Turkey
| | - Yunus Emre Dönmez
- Department of Child and Adolescent Psychiatry, School of Medicine, Inonu University, Malatya, Turkey
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16
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Zhu X, Zhou L, Li Q, Pan R, Zhang J, Cui Y. Combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio: A novel marker in distinguishing children with exacerbated asthma. Int J Immunopathol Pharmacol 2021; 35:20587384211040641. [PMID: 34514899 PMCID: PMC8442497 DOI: 10.1177/20587384211040641] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Both C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR)
are commonly elevated in patients with asthma. It is necessary to develop a
novel marker, the combined score of CRP level and NLR (C-NLR score) based on
cutoff points of CRP and NLR, and apply it in asthma diagnosis. The aim of
this study was to explore whether C-NLR could distinguish children with
exacerbated asthma. Methods Children suffering from exacerbated asthma were regarded as the asthmatic
group (n = 86), which was divided into three groups: mild
(n = 54), moderate (n = 17), and
severe (n = 15). The control group consisted of children
without any allergic disease and infection (n = 38). To
compare CRP level and NLR between the asthmatic group and control group, a
receiver-operating characteristic curve was constructed to determine area
under the curve (AUC) and optimal cutoff point. Thereafter, the C-NLR score
was classified as follows: C-NLR score of 2 with an elevated CRP level and
high NLR, a C-NLR score of 1 with one of these abnormalities, and a C-NLR
score of 0 with a normal CRP level and low NLR. The C-NLR score was then
compared among different asthma groups. Results In the control group, the CRP level and NLR were 1.9 (0.5–2.6) mg/L and 1.01
(0.69–1.31), respectively. In the asthmatic group, the CRP level and NLR
were 7.3 (3.2–14.2) mg/L and 3.08 (1.73–5.34), respectively, which were
higher than those in the control group (p < 0.001 for
CRP and p < 0.001 for NLR). The AUC of CRP was 0.86, and
the optimal cutoff point was 3.6 mg/L. The AUC of NLR was 0.86, and the
optimal cutoff point was 1.72. The AUC of the C-NLR score was 0.94, and the
optimal cutoff point was 1. Conclusions C-NLR, a novel inflammatory marker, was applied here for the exacerbated
asthma for the first time. Our study has shown C-NLR is a promising marker
to distinguish children with exacerbated asthma from healthy children.
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Affiliation(s)
- Xuming Zhu
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Lina Zhou
- Department of Respiratory Medicine, Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Qingqing Li
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Ruilin Pan
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Jian Zhang
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Yubao Cui
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
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17
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Jeong SH, Kim YS. Challenges in Prescribing Clozapine in the Era of COVID-19: A Review Focused on Immunological Implications. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:411-422. [PMID: 34294611 PMCID: PMC8316651 DOI: 10.9758/cpn.2021.19.3.411] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 01/01/2023]
Abstract
The global COVID-19 pandemic has disrupted every aspect of the healthcare system. Apart from the issues surrounding COVID-19 itself, care for existing patients has met many challenges. One such challenge is caring for patients who are on clozapine treatment and have been confirmed positive for COVID-19. Schizophrenia has been considered to have a deep connection with the immune system, and clozapine can induce further changes in this system. COVID-19 can ravage the compromised immune system and aggravate tissue damage. The intricate relations between schizophrenia, clozapine, and COVID-19 make it difficult to predict the clinical course of COVID-19 in clozapine-treated patients. However, the rigid prohibition on using clozapine if COVID-19 is confirmed may harm patients. Patients who have to use clozapine are often refractory cases with no alternatives. Therefore, the decision to maintain or stop clozapine must be made after a comprehensive review of the patient’s unique situation. To do this, theoretical and practical issues surrounding the use of clozapine in COVID-19 should be reviewed and discussed. In this review, we gather useful information surrounding this issue and present an overview. Focusing on the immune system, various theoretical possibilities that could arise from schizophrenia, clozapine, and COVID-19 were carefully examined, and practical checklists for the care of these patients were explored. It is hoped that this review will convince many clinicians to pay attention to this momentous issue and facilitate more active sharing of clinical experiences.
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Affiliation(s)
- Seong Hoon Jeong
- Department of Neuropsychiatry, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Yong Sik Kim
- Department of Neuropsychiatry, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.,Institute of Clinical Psychopharmacology, Dongguk University College of Medicine, Goyang, Korea
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18
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Assis MA, Carranza PG, Ambrosio E. A "Drug-Dependent" Immune System Can Compromise Protection against Infection: The Relationships between Psychostimulants and HIV. Viruses 2021; 13:v13050722. [PMID: 33919273 PMCID: PMC8143316 DOI: 10.3390/v13050722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 01/31/2023] Open
Abstract
Psychostimulant use is a major comorbidity in people living with HIV, which was initially explained by them adopting risky behaviors that facilitate HIV transmission. However, the effects of drug use on the immune system might also influence this phenomenon. Psychostimulants act on peripheral immune cells even before they reach the central nervous system (CNS) and their effects on immunity are likely to influence HIV infection. Beyond their canonical activities, classic neurotransmitters and neuromodulators are expressed by peripheral immune cells (e.g., dopamine and enkephalins), which display immunomodulatory properties and could be influenced by psychostimulants. Immune receptors, like Toll-like receptors (TLRs) on microglia, are modulated by cocaine and amphetamine exposure. Since peripheral immunocytes also express TLRs, they may be similarly affected by psychostimulants. In this review, we will summarize how psychostimulants are currently thought to influence peripheral immunity, mainly focusing on catecholamines, enkephalins and TLR4, and shed light on how these drugs might affect HIV infection. We will try to shift from the classic CNS perspective and adopt a more holistic view, addressing the potential impact of psychostimulants on the peripheral immune system and how their systemic effects could influence HIV infection.
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Affiliation(s)
- María Amparo Assis
- Facultad de Ciencias Médicas, Universidad Nacional de Santiago del Estero (UNSE), Santiago del Estero G4200, Argentina;
- Laboratorio de Biología Molecular, Inmunología y Microbiología, Instituto Multidisciplinario de Salud, Tecnología y Desarrollo (IMSaTeD), CONICET-UNSE, Santiago del Estero G4206, Argentina
- Departamento de Psicobiología, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain;
- Correspondence:
| | - Pedro Gabriel Carranza
- Facultad de Ciencias Médicas, Universidad Nacional de Santiago del Estero (UNSE), Santiago del Estero G4200, Argentina;
- Laboratorio de Biología Molecular, Inmunología y Microbiología, Instituto Multidisciplinario de Salud, Tecnología y Desarrollo (IMSaTeD), CONICET-UNSE, Santiago del Estero G4206, Argentina
- Facultad de Agronomía y Agroindustrias, Universidad Nacional de Santiago del Estero, Santiago del Estero G4206, Argentina
| | - Emilio Ambrosio
- Departamento de Psicobiología, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain;
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19
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Bachmann MC, Bellalta S, Basoalto R, Gómez-Valenzuela F, Jalil Y, Lépez M, Matamoros A, von Bernhardi R. The Challenge by Multiple Environmental and Biological Factors Induce Inflammation in Aging: Their Role in the Promotion of Chronic Disease. Front Immunol 2020; 11:570083. [PMID: 33162985 PMCID: PMC7591463 DOI: 10.3389/fimmu.2020.570083] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/24/2020] [Indexed: 12/13/2022] Open
Abstract
The aging process is driven by multiple mechanisms that lead to changes in energy production, oxidative stress, homeostatic dysregulation and eventually to loss of functionality and increased disease susceptibility. Most aged individuals develop chronic low-grade inflammation, which is an important risk factor for morbidity, physical and cognitive impairment, frailty, and death. At any age, chronic inflammatory diseases are major causes of morbimortality, affecting up to 5-8% of the population of industrialized countries. Several environmental factors can play an important role for modifying the inflammatory state. Genetics accounts for only a small fraction of chronic-inflammatory diseases, whereas environmental factors appear to participate, either with a causative or a promotional role in 50% to 75% of patients. Several of those changes depend on epigenetic changes that will further modify the individual response to additional stimuli. The interaction between inflammation and the environment offers important insights on aging and health. These conditions, often depending on the individual's sex, appear to lead to decreased longevity and physical and cognitive decline. In addition to biological factors, the environment is also involved in the generation of psychological and social context leading to stress. Poor psychological environments and other sources of stress also result in increased inflammation. However, the mechanisms underlying the role of environmental and psychosocial factors and nutrition on the regulation of inflammation, and how the response elicited for those factors interact among them, are poorly understood. Whereas certain deleterious environmental factors result in the generation of oxidative stress driven by an increased production of reactive oxygen and nitrogen species, endoplasmic reticulum stress, and inflammation, other factors, including nutrition (polyunsaturated fatty acids) and behavioral factors (exercise) confer protection against inflammation, oxidative and endoplasmic reticulum stress, and thus ameliorate their deleterious effect. Here, we discuss processes and mechanisms of inflammation associated with environmental factors and behavior, their links to sex and gender, and their overall impact on aging.
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Affiliation(s)
| | - Sofía Bellalta
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roque Basoalto
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Yorschua Jalil
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Macarena Lépez
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Anibal Matamoros
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Institute of Biological Sciences (ICB), Federal University of Pará, Belem, Brazil
| | - Rommy von Bernhardi
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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