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Mellon SH, Bersani FS, Lindqvist D, Hammamieh R, Donohue D, Dean K, Jett M, Yehuda R, Flory J, Reus VI, Bierer LM, Makotkine I, Abu Amara D, Henn Haase C, Coy M, Doyle FJ, Marmar C, Wolkowitz OM. Metabolomic analysis of male combat veterans with post traumatic stress disorder. PLoS One 2019; 14:e0213839. [PMID: 30883584 PMCID: PMC6422302 DOI: 10.1371/journal.pone.0213839] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/02/2019] [Indexed: 12/26/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is associated with impaired major domains of psychology and behavior. Individuals with PTSD also have increased co-morbidity with several serious medical conditions, including autoimmune diseases, cardiovascular disease, and diabetes, raising the possibility that systemic pathology associated with PTSD might be identified by metabolomic analysis of blood. We sought to identify metabolites that are altered in male combat veterans with PTSD. In this case-control study, we compared metabolomic profiles from age-matched male combat trauma-exposed veterans from the Iraq and Afghanistan conflicts with PTSD (n = 52) and without PTSD (n = 51) (‘Discovery group’). An additional group of 31 PTSD-positive and 31 PTSD-negative male combat-exposed veterans was used for validation of these findings (‘Test group’). Plasma metabolite profiles were measured in all subjects using ultrahigh performance liquid chromatography/tandem mass spectrometry and gas chromatography/mass spectrometry. We identified key differences between PTSD subjects and controls in pathways related to glycolysis and fatty acid uptake and metabolism in the initial ‘Discovery group’, consistent with mitochondrial alterations or dysfunction, which were also confirmed in the ‘Test group’. Other pathways related to urea cycle and amino acid metabolism were different between PTSD subjects and controls in the ‘Discovery’ but not in the smaller ‘Test’ group. These metabolic differences were not explained by comorbid major depression, body mass index, blood glucose, hemoglobin A1c, smoking, or use of analgesics, antidepressants, statins, or anti-inflammatories. These data show replicable, wide-ranging changes in the metabolic profile of combat-exposed males with PTSD, with a suggestion of mitochondrial alterations or dysfunction, that may contribute to the behavioral and somatic phenotypes associated with this disease.
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Affiliation(s)
- Synthia H. Mellon
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, United States of America
- * E-mail:
| | - F. Saverio Bersani
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Daniel Lindqvist
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Rasha Hammamieh
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Duncan Donohue
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Kelsey Dean
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Marti Jett
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Rachel Yehuda
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Janine Flory
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Victor I. Reus
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Linda M. Bierer
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Iouri Makotkine
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Duna Abu Amara
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
| | - Clare Henn Haase
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
| | - Michelle Coy
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Francis J. Doyle
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Charles Marmar
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
- Stephen and Alexandra Cohen Veteran Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, United States of America
| | - Owen M. Wolkowitz
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
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Lindqvist D, Mellon SH, Dhabhar FS, Yehuda R, Grenon SM, Flory JD, Bierer LM, Abu-Amara D, Coy M, Makotkine I, Reus VI, Aschbacher K, Bersani FS, Marmar CR, Wolkowitz OM. Increased circulating blood cell counts in combat-related PTSD: Associations with inflammation and PTSD severity. Psychiatry Res 2017; 258:330-336. [PMID: 28942957 DOI: 10.1016/j.psychres.2017.08.052] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/18/2017] [Accepted: 08/20/2017] [Indexed: 12/18/2022]
Abstract
Inflammation is reported in post-traumatic stress disorder (PTSD). Few studies have investigated circulating blood cells that may contribute to inflammation. We assessed circulating platelets, white blood cells (WBC) and red blood cells (RBC) in PTSD and assessed their relationship to inflammation and symptom severity. One-hundred and sixty-three male combat-exposed veterans (82 PTSD, 81 non-PTSD) had blood assessed for platelets, WBC, and RBC. Data were correlated with symptom severity and inflammation. All cell counts were significantly elevated in PTSD. There were small mediation effects of BMI and smoking on these relationships. After adjusting for these, the differences in WBC and RBC remained significant, while platelet count was at trend level. In all subjects, all of the cell counts correlated significantly with inflammation. Platelet count correlated with inflammation only in the PTSD subjects. Platelet count, but none of the other cell counts, was directly correlated with PTSD severity ratings in the PTSD group. Combat PTSD is associated with elevations in RBC, WBC, and platelets. Dysregulation of all three major lineages of hematopoietic cells in PTSD, as well as their significant correlation with inflammation, suggest clinical significance of these changes.
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Affiliation(s)
- Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco (UCSF), School of Medicine, San Francisco, CA, United States; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Sciences, University of California San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - Firdaus S Dhabhar
- Department of Psychiatry & Behavioral Sciences, Sylvester Comprehensive Cancer Center, University of Miami, FL, United States
| | - Rachel Yehuda
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - S Marlene Grenon
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States; Department of Surgery, Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Janine D Flory
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Linda M Bierer
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Duna Abu-Amara
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, New York, United States
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - Iouri Makotkine
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - Kirstin Aschbacher
- Department of Psychiatry, University of California San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - F Saverio Bersani
- Department of Psychiatry, University of California San Francisco (UCSF), School of Medicine, San Francisco, CA, United States; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Charles R Marmar
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, New York, United States.
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco (UCSF), School of Medicine, San Francisco, CA, United States.
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Lindqvist D, Dhabhar FS, Mellon SH, Yehuda R, Grenon SM, Flory JD, Bierer LM, Abu-Amara D, Coy M, Makotkine I, Reus VI, Bersani FS, Marmar CR, Wolkowitz OM. Increased pro-inflammatory milieu in combat related PTSD - A new cohort replication study. Brain Behav Immun 2017; 59:260-264. [PMID: 27638184 DOI: 10.1016/j.bbi.2016.09.012] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/30/2016] [Accepted: 09/12/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Several lines of evidence indicate that increased inflammation is associated with Post-Traumatic Stress Disorder (PTSD). We have previously reported that peripheral inflammatory markers are significantly higher in combat-exposed veterans with than without PTSD. This study was designed to replicate these findings in a new study cohort using the same population and recruitment strategies. METHODS Sixty-one male war veterans (31 PTSD and 30 control subjects) were included in this replication study. Levels of Interleukin-6, Tumor Necrosis Factor-alpha, Gamma interferon, and high-sensitivity C-reactive protein were quantified in blood samples. A standardized "total pro-inflammatory score" was calculated to limit the number of statistical comparisons. The Clinician Administered PTSD Scale (CAPS) rating scale was used to assess PTSD symptom severity. RESULTS PTSD subjects had significantly higher total pro-inflammatory scores compared to non-PTSD subjects in unadjusted analysis (Cohen's d=0.75, p=0.005) as well as after adjusting for potentially confounding effects of age, BMI, smoking, and potentially interfering medications and somatic co-morbidities (p=0.023). There were no significant correlations between inflammatory markers and severity of symptoms within the PTSD group. CONCLUSIONS We replicated, in a new sample, our previous finding of increased inflammatory markers in combat-exposed PTSD subjects compared to combat-exposed non-PTSD controls. These findings strongly add to the growing literature suggesting that immune activation may be an important aspect of PTSD pathophysiology, although not directly correlated with current PTSD symptom levels in the PTSD group.
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Affiliation(s)
- Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, United States; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
| | - Firdaus S Dhabhar
- Department of Psychiatry & Behavioral Sciences, Sylvester Comprehensive Cancer Center, University of Miami, FL, United States
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, United States
| | - Rachel Yehuda
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - S Marlene Grenon
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States; Department of Surgery, Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Janine D Flory
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Linda M Bierer
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Duna Abu-Amara
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, New York, United States
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, United States
| | - Iouri Makotkine
- James J. Peters Veterans Administration Medical Center Bronx, New York, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, United States
| | - F Saverio Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Charles R Marmar
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, New York, United States.
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, United States.
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Bersani FS, Wolkowitz OM, Milush JM, Sinclair E, Eppling L, Aschbacher K, Lindqvist D, Yehuda R, Flory J, Bierer LM, Matokine I, Abu-Amara D, Reus VI, Coy M, Hough CM, Marmar CR, Mellon SH. A population of atypical CD56(-)CD16(+) natural killer cells is expanded in PTSD and is associated with symptom severity. Brain Behav Immun 2016; 56:264-70. [PMID: 27025668 DOI: 10.1016/j.bbi.2016.03.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/22/2016] [Accepted: 03/25/2016] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) has been associated with immune disturbances, including a higher incidence of infections and autoimmune diseases as well as a net pro-inflammatory state. Natural killer (NK) cells, a key component of the innate immune system, have been less well-studied in PTSD despite their importance in immunity. METHODS We studied two independent samples of combat-exposed male war veterans with or without PTSD, the first ("Discovery Sample") to generate hypotheses, and the second ("Validation Sample") to replicate the findings. The Discovery Sample was comprised of 42 PTSD subjects and 42 controls. The Validation Sample was comprised of 25 PTSD subjects and 30 controls. Participants had fasting, morning blood samples collected for examination of the frequency of NK cell subsets, determined by flow cytometry. The current and lifetime Clinician Administered PTSD Scale (CAPS) was used to assess symptom severity. Statistical analyses were adjusted for age and BMI. RESULTS PTSD subjects compared to controls had (i) a significantly higher relative frequency of atypical CD56(-)CD16(+) NK cells in the Discovery Sample (p=0.027), which was replicated in the Validation Sample (p=0.004) and the combined sample (p<0.001), and (ii) a non-significantly lower relative frequency of CD56(bright)CD16(-) NK cells in the two samples (p=0.082; p=0.118), which became statistically significant in the combined sample (p=0.020). Further, within subjects with PTSD of both samples, the relative frequency of atypical CD56(-)CD16(+) NK cells was near significantly positively correlated with lifetime PTSD severity (p=0.074). DISCUSSION This study is the first to characterize NK cell subsets in individuals with PTSD. The results suggest that combat-exposed men with PTSD exhibit an aberrant profile of NK cells with significantly higher frequencies of an atypical population of CD56(-)CD16(+) cells and possibly lower frequencies of the functional CD56(bright)CD16(-) NK cell subsets. Higher proportions of dysfunctional CD56(-)CD16(+) cells have been reported in certain chronic viral infections and in senescent individuals. It is possible that this could contribute to immune dysfunctions and prematurely senescent phenotypes seen in PTSD.
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Affiliation(s)
- Francesco S Bersani
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
| | - Jeffrey M Milush
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Elizabeth Sinclair
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Lorrie Eppling
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Kirstin Aschbacher
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Linda M Bierer
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Iouri Matokine
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Duna Abu-Amara
- Department of Psychiatry, New York University, New York, NY, USA; Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, USA
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Christina M Hough
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Charles R Marmar
- Department of Psychiatry, New York University, New York, NY, USA; Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, USA
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Science, University of California San Francisco, San Francisco, CA, USA
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Bersani FS, Wolkowitz OM, Lindqvist D, Yehuda R, Flory J, Bierer LM, Makotine I, Abu-Amara D, Coy M, Reus VI, Epel ES, Marmar C, Mellon SH. Global arginine bioavailability, a marker of nitric oxide synthetic capacity, is decreased in PTSD and correlated with symptom severity and markers of inflammation. Brain Behav Immun 2016; 52:153-160. [PMID: 26515034 DOI: 10.1016/j.bbi.2015.10.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Psychiatric, physical and biological aspects of posttraumatic stress disorder (PTSD) may be associated with dysfunctions in several cellular processes including nitric oxide (NO) production. NO is synthesized from arginine in a reaction carried out by NO synthase (NOS) enzymes. The recently introduced "global arginine bioavailability ratio" (GABR; ratio of arginine to [ornithine+citrulline]) has been proposed as a reliable approximation of NO synthetic capacity in vivo. The objectives of the present study were to test the hypotheses that (i) subjects with combat-related PTSD have lower GABR scores than combat controls, (ii) GABR score is inversely associated with the severity of psychopathological measures, (iii) GABR score is inversely associated with markers of inflammation. METHODS Metabolic profiling for plasma samples (i.e. arginine, citrulline and ornithine) and inflammation markers (interleukin [IL]-6, IL-1β, tumor necrosis factor [TNF]-α, interferon [IFN]-γ and C-reactive protein [CRP]) were assessed in 56 combat-exposed males with PTSD and 65 combat-exposed males without PTSD. We assessed severity of PTSD (Clinician Administered PTSD Scale [CAPS]) and depression (Beck Depression Inventory-II [BDI-II]) as well as history of early life trauma (Early Trauma Inventory [ETI]) and affectivity (Positive and Negative Affect Schedule [PANAS]). RESULTS The GABR value was (i) significantly lower in PTSD subjects compared to controls (p=0.001), (ii) significantly inversely correlated with markers of inflammation including IL6 (p=0.04) and TNFα (p=0.02), and (iii) significantly inversely correlated with CAPS current (p=0.001) and lifetime (p<0.001) subscales, ETI (p=0.045) and PANAS negative (p=0.006). Adding antidepressant use or MDD diagnosis as covariates led to similar results. Adding age and BMI as covariates also led to similar results, with the exception of IL6 and ETI losing their significant association with GABR. DISCUSSION This study provides the first evidence that global arginine bioavailability, a marker of NO synthetic capacity in vivo, is lower in veterans with PTSD and is negatively associated with some markers of inflammation as well as with measures of PTSD symptom severity, negative affectivity and childhood adverse experiences. These findings add to the accumulating evidence that specific cellular dysfunction may be associated with the symptomatology of PTSD and may help to explain the higher burden of cardio-metabolic disturbances seen in this disorder.
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Affiliation(s)
- Francesco Saverio Bersani
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States.
| | - Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Janine Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Linda M Bierer
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Iouri Makotine
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Duna Abu-Amara
- Department of Psychiatry, New York University, United States; Department of Psychiatry, Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, United States
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Elissa S Epel
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States; Center for Health and Community, University of California San Francisco, San Francisco, CA, United States
| | - Charles Marmar
- Department of Psychiatry, New York University, United States; Department of Psychiatry, Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, United States
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Science, University of California San Francisco, San Francisco, CA, United States
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Bersani FS, Lindqvist D, Mellon SH, Epel ES, Yehuda R, Flory J, Henn-Hasse C, Bierer LM, Makotkine I, Abu-Amara D, Coy M, Reus VI, Lin J, Blackburn EH, Marmar C, Wolkowitz OM. Association of dimensional psychological health measures with telomere length in male war veterans. J Affect Disord 2016; 190:537-542. [PMID: 26571103 DOI: 10.1016/j.jad.2015.10.037] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 10/12/2015] [Accepted: 10/16/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several psychiatric disorders may be characterized by peripheral telomere shortening. However, it is unclear whether telomere shortening is associated with these psychiatric disorders per se or, rather, with underlying dimensional parameters that are often, but not necessarily, associated with them. We explored the association between dimensional psychopathological measures and telomere length (TL) in granulocytes among veterans independent of psychiatric diagnosis. METHODS Seventy-six combat-exposed male veterans (41 psychiatrically healthy, 18 with Posttraumatic Stress Disorder [PTSD] and 17 with concomitant PTSD and Major Depressive Disorder [MDD]) had TL assayed. Assessments included Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory-II (BDI-II), Early Trauma Inventory (ETI), Symptom Checklist-90-R Global Severity Index (SCL-90-GSI), Perceived Stress Scale (PSS) and Positive and Negative Affect Schedule (PANAS). Correlations were corrected for age, BMI, antidepressants and ethnicity. RESULTS Across subjects, TL was negatively correlated with early trauma (p<0.001), global psychopathological severity (p=0.044) and perceived stress (p=0.019), positively correlated with positive affect (p=0.026), not significantly correlated with symptom severity of PTSD, depression or negative affect. Across these dimensions, early trauma and positive affect were associated with TL after excluding subjects with somatic illnesses. LIMITATIONS The study was cross-sectional with a moderate sample size and only male combat-exposed subjects. CONCLUSIONS These preliminary findings suggest that early trauma, severity of perceived stress and general psychopathological symptoms are more closely associated with shorter TL than is the severity of core diagnostic symptoms of PTSD or MDD, whereas positive affect is associated with longer TL. Larger-scale studies should assess TL associated with specific psychiatric dimensions, apart from only categorical psychiatric diagnoses, to develop more specific biologically-relevant endophenotypes.
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Affiliation(s)
- Francesco S Bersani
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Science, University of California San Francisco, San Francisco, CA, USA
| | - Elissa S Epel
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Center for Health and Community, University of California San Francisco, San Francisco, CA, USA
| | - Rachel Yehuda
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Clare Henn-Hasse
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Linda M Bierer
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Iouri Makotkine
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Duna Abu-Amara
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth H Blackburn
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Charles Marmar
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
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Bersani FS, Morley C, Lindqvist D, Epel ES, Picard M, Yehuda R, Flory J, Bierer LM, Makotkine I, Abu-Amara D, Coy M, Reus VI, Lin J, Blackburn EH, Marmar C, Wolkowitz OM, Mellon SH. Mitochondrial DNA copy number is reduced in male combat veterans with PTSD. Prog Neuropsychopharmacol Biol Psychiatry 2016; 64:10-7. [PMID: 26120081 DOI: 10.1016/j.pnpbp.2015.06.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/21/2015] [Accepted: 06/23/2015] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Mitochondrial abnormalities may be involved in PTSD, although few studies have examined this. Mitochondrial DNA copy number (mtDNAcn) in blood cells is an emerging systemic index of mitochondrial biogenesis and function. The present study assessed mtDNAcn in male combat-exposed veterans with PTSD compared to those without PTSD as well as its correlation with clinical scales. METHODS mtDNAcn was assessed with a TaqMan multiplex assay in granulocytes of 43 male combat veterans with (n=43) or without (n=44) PTSD. Twenty of the PTSD subjects had co-morbid major depressive disorder (MDD). The Clinician Administered PTSD Scale (CAPS), the Positive and Negative Affect Schedule (PANAS), the Early Trauma Inventory (ETI) and the Beck Depression Inventory II (BDI-II) were used for the clinical assessments. All analyses were corrected for age and BMI. RESULTS mtDNAcn was significantly lower in subjects with PTSD (p<0.05). Within the PTSD group, those with moderate PTSD symptom severity had relatively higher mtDNAcn than those with mild or severe symptoms (p<0.01). Within the PTSD group, mtDNAcn was positively correlated with PANAS positive subscale ratings (p<0.01) but was not significantly correlated with PANAS negative subscale, ETI or BDI-II ratings. DISCUSSION This study provides the first evidence of: (i) a significant decrease of mtDNAcn in combat PTSD, (ii) a possible "inverted-U" shaped relationship between PTSD symptom severity and mtDNAcn within PTSD subjects, and (iii) a direct correlation of mtDNAcn with positive affectivity within PTSD subjects. Altered mtDNAcn in PTSD may reflect impaired energy metabolism, which might represent a novel aspect of its pathophysiology.
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Affiliation(s)
- Francesco Saverio Bersani
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Claire Morley
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Elissa S Epel
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Center for Health and Community, University of California San Francisco, San Francisco, CA, USA
| | - Martin Picard
- Center for Mitochondrial and Epigenomic Medicine, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel Yehuda
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Linda M Bierer
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Iouri Makotkine
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Duna Abu-Amara
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth H Blackburn
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Charles Marmar
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Science, University of California San Francisco, San Francisco, CA, USA
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Lindqvist D, Wolkowitz OM, Mellon S, Yehuda R, Flory JD, Henn-Haase C, Bierer LM, Abu-Amara D, Coy M, Neylan TC, Makotkine I, Reus VI, Yan X, Taylor NM, Marmar CR, Dhabhar FS. Proinflammatory milieu in combat-related PTSD is independent of depression and early life stress. Brain Behav Immun 2014; 42:81-8. [PMID: 24929195 DOI: 10.1016/j.bbi.2014.06.003] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 05/20/2014] [Accepted: 06/02/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chronic inflammation may be involved in combat-related post-traumatic stress disorder (PTSD) and may help explain comorbid physical diseases. However, the extent to which combat exposure per se, depression, or early life trauma, all of which are associated with combat PTSD, may confound the relationship between PTSD and inflammation is unclear. METHODS We quantified interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and C-reactive protein (CRP) in 51 combat-exposed males with PTSD and 51 combat-exposed males without PTSD, and assessed PTSD and depression severity as well as history of early life trauma. To decrease the possibility of Type I errors, we summed standardized scores of IL-1β, IL-6, TNFα, IFNγ and CRP into a total "pro-inflammatory score". PTSD symptom severity was assessed with the Clinician Administered PTSD Scale (CAPS) rating scale. RESULTS Subjects with PTSD had significantly higher pro-inflammatory scores compared to combat-exposed subjects without PTSD (p=0.006), and even after controlling for early life trauma, depression diagnosis and severity, body mass index, ethnicity, education, asthma/allergies, time since combat and the use of possibly confounding medications (p=0.002). Within the PTSD group, the pro-inflammatory score was not significantly correlated with depressive symptom severity, CAPS total score, or with the number of early life traumas. CONCLUSIONS Combat-related PTSD in males is associated with higher levels of pro-inflammatory cytokines, even after accounting for depression and early life trauma. These results, from one of the largest studies of inflammatory cytokines in PTSD to date, suggest that immune activation may be a core element of PTSD pathophysiology more so than a signature of combat exposure alone.
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Affiliation(s)
- Daniel Lindqvist
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, United States; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, United States.
| | - Synthia Mellon
- Department of OB/GYN and Reproductive Sciences, University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - Rachel Yehuda
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, NY, United States
| | - Janine D Flory
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, NY, United States
| | - Clare Henn-Haase
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, NY, United States
| | - Linda M Bierer
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, NY, United States
| | - Duna Abu-Amara
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, NY, United States
| | - Michelle Coy
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - Thomas C Neylan
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - Iouri Makotkine
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, NY, United States
| | - Victor I Reus
- Department of Psychiatry, University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, United States
| | - Xiaodan Yan
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, NY, United States
| | - Nicole M Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Charles R Marmar
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, NYU, NY, United States.
| | - Firdaus S Dhabhar
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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Coy M, Neilands JB. A new generation of antibodies. J APPL ANIM WELF SCI 2005; 1:103-17. [PMID: 16363975 DOI: 10.1207/s15327604jaws0102_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Antibodies, proteins produced in animals that bind with high specificity and affinity to a seemingly limitless variety of biomolecules, have an essential role in clinical medicine and basic biological research. Methods to produce antibody fragments on the surface of bacterial viruses were surveyed for their ability to replace animal-dependent antibodies. The use of filamentous phage to display antibody fragments derived from semisynthetic antibody genes was found to produce proteins that bind to antigens with a variety, specificity, and affinity similar to those produced in animal systems.
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Affiliation(s)
- M Coy
- Division of Biochemistry and Molecular Biology, University of California, Berkeley 94720, USA
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Abstract
The interaction of the Ferric Uptake Regulation (Fur) protein with the backbone of operator DNA was analyzed by hydroxyl radical footprinting and the ethylation interference assay. Comparison of the contacts made by Fur and those made by proteins containing the helix-turn-helix or related motifs shows that the mode of DNA binding by this repressor is unique. Ethylation interference experiments demonstrate that there are relatively few phosphate contacts of unique disposition while hydroxyl radical footprinting demonstrates that Fur-operator contacts are segregated on one face of the helix and span nearly three successive major grooves.
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Affiliation(s)
- M Coy
- Chemical Biodynamics, University of California, Berkeley 94720, USA
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Abstract
The 12 histidine and four cysteine residues of the Fur repressor of Escherichia coli were changed, respectively, to leucine and serine by site-directed mutagenesis of the fur gene. The affects of these mutations were measured in vivo by ligation of the mutated genes to a wild-type fur promoter followed by measurement of the ability of these plasmids to regulate expression of a lacZ fusion in the aerobactin operon. In vitro affects were assayed by insertion of the mutated genes in the expression vector pMON2064 attended by isolation of the altered Fur proteins and appraisal of their capacity to bind to operator DNA. The results suggest that cysteine residues at positions 92 and 95 are important for the activity of the Fur protein.
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Affiliation(s)
- M Coy
- Division of Biochemistry and Molecular Biology, University of California, Berkeley 94720
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Abstract
Proteolytic enzymes were used to detect metal-induced conformational changes in the ferric uptake regulation (Fur) protein of Escherichia coli K12. Metal binding results in enhanced cleavage of the N-terminal region of Fur by trypsin and chymotrypsin. Activation of both trypsinolysis sensitivity and DNA binding have similar metal ion specificity and concentration dependencies, suggesting that the conformational change detected is required for operator DNA binding. Isolation and characterization of biochemically generated fragments of Fur as well as other data indicate that the N-terminal region is necessary for the interaction of the repressor with DNA and that a C-terminal domain is sufficient for binding to metal ions.
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Affiliation(s)
- M Coy
- Department of Molecular and Cellular Biology, University of California, Berkeley 94720
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Coy M, Paw BH, Bindereif A, Neilands JB. Isolation and properties of N epsilon-hydroxylysine:acetyl coenzyme A N epsilon-transacetylase from Escherichia coli pABN11. Biochemistry 1986; 25:2485-9. [PMID: 3521734 DOI: 10.1021/bi00357a030] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The enzyme N epsilon-hydroxylysine acetylase has been isolated from Escherichia coli 294 carrying recombinant plasmid ABN11. Activity of the enzyme was followed by measurement of the rate of appearance of 2-nitro-5-thiobenzoate, the product of cleavage of 5,5'-dithiobis(2-nitrobenzoate) by free coenzyme A released from its acetyl derivative. The enzyme bound firmly to Reactive Blue 2-Sepharose CL-6B and was eluated with 1.5 M KCl. The protein gave a single band, corresponding to a Mr of 33,000, on polyacrylamide gel electrophoresis in sodium dodecyl sulfate. In contrast, gel filtration of the native enzyme gave a Mr of 150,000-200,000. A sequence analysis of the DNA at the junction of the first and second genes in the aerobactin operon, considered in conjunction with the N-terminal amino acid sequence of the isolated protein, enabled the conclusion that the acetylase is specified by the second gene in the complex. The enzyme transfers the acetyl moiety from acetyl coenzyme A to a variety of hydroxylamines, with N epsilon-hydroxylysine as the preferred substrate. In agreement with the results found by affinity chromatography, Coomassie Blue was observed to act as a potent inhibitor.
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