Cytokine alterations in pediatric internalizing disorders: Systematic review and exploratory multi-variate meta-analysis

Mental Ill-Health in young people with systemic autoinflammatory disease - a scoping review

Systemic autoinflammatory disorders (SAID), immune dysregulation disorders with onset frequently occurring in youth, are defined by unprovoked inflammation. Research suggest inflammation is associated with the pathogenesis of mental ill-health. Separately, research has identified that mental ill-health is prevalent in people with immune dysregulation disorders compared to healthy controls or those with other chronic diseases, and the psychosocial impacts of these diseases on quality of life can be debilitating. This review aimed to broadly identify the extent and nature of research involving young people with SAIDs and mental ill-health. A scoping review was conducted across 6 databases of peer-reviewed articles referring to SAIDs and mental ill-health in young people. Of 727 studies, 41 met the inclusion criteria. Thirty-seven were observational studies, including 18 case studies or series. Four studies were treatment trials. Fourteen observational studies investigated the prevalence of mental ill-health in a SAID population with large sample sizes. Most studies were conducted in Türkiye, involving Behçet's syndrome or familial Mediterranean fever and anxiety, depression, and psychosis were strongly represented. Findings suggest an association between mental ill-health and SAID activity in young people. Anxiety and depression were associated with some specific SAIDs duration, symptom severity, SAID flare recency and frequency, and SAID treatment effects. Co-occurrence and resolution of SAID flares and mental ill-health with treatment were frequent themes in case studies of some SAIDs. Further research is required on the prevalence and risk of developing mental ill-health among young people with SAIDs, along with associations between mental ill-health, other SAIDs and disease activity, other participant variables, and appropriate management of mental ill-health in this population.

Preliminary Evidence That Shared Genetic Influences Underlie Comorbidity Between Self-Reported Eating and Internalizing Disorders and Gastrointestinal Disease in Adult Women and Men

INTRODUCTION

Accumulating research suggests both eating disorders (EDs) and internalizing disorders (e.g., anxiety, depression) are associated with gastrointestinal disease (e.g., irritable bowel syndrome, inflammatory bowel disease). However, the mechanisms underlying comorbidity with gastrointestinal disease-and whether they may differ for eating and internalizing disorders-remain poorly understood. Addressing these gaps is a critical first step to refining etiologic models of comorbidity and identifying potential targets for intervention.

METHOD

Participants included female and male twins ages 18-65 from the population-based MSU Twin Registry (N = 5883). Lifetime history of EDs, internalizing disorders, and gastrointestinal disease was assessed via questionnaire. We first examined whether EDs and internalizing disorders were independently associated with gastrointestinal disease phenotypically. We then used trivariate Cholesky decomposition twin models to investigate whether EDs and internalizing disorders were related to gastrointestinal disease through overlapping or distinct genetic/environmental pathways.

RESULTS

Eating (OR = 2.54, p = 0.009) and internalizing (OR = 2.14, p < 0.001) disorders were independently associated with gastrointestinal disease. Conclusions were unchanged after adjusting for important covariates (e.g., body mass index, age) and did not significantly differ across sex. Twin models suggested genetic influences shared by all three conditions explained their co-occurrence, with 31% of the variance in EDs and 12% of the variance in gastrointestinal disease attributable to genetic influences shared with internalizing disorders.

CONCLUSION

Shared genetic mechanisms may contribute to comorbidity between EDs, internalizing disorders, and gastrointestinal disease. Identifying overlapping molecular pathways could potentially lead to novel interventions that simultaneously address all three conditions.

The mind, brain, and body study: A protocol for examining the effects of the gut-brain-immune axis on internalizing symptoms in youth exposed to caregiving-related early adversity

Experiences of caregiving-related adversity are common and one of the strongest predictors of internalizing psychopathology (i.e., anxiety and depression). Specifically, individuals who have been exposed to such early adversities have altered affective neurodevelopment, impaired memory systems, increased risk of developing internalizing disorders, greater inflammation, and differences in gastrointestinal (gut) microbiome composition. Crucially, the gut microbiome undergoes a sensitive period of development that precedes neural and immune sensitive periods, thus making it a potentially fruitful target for intervention. Though previous work has assessed neural, immune, and gut microbiome systems in individuals exposed to early adversity, studies have primarily looked at these biological systems independently. The Mind, Brain, and Body study (MBB) implements multimodal and longitudinal design to assess how changes in the gut microbiome following caregiving-related adversity may underlie altered affective neurodevelopment, memory, and immune functioning in youth and contribute to internalizing symptoms. Across three waves, spread approximately 12-18 months apart, youth with and without previous experiences of caregiving-related adversity completed self-report measures of mental and physical health, provided stool, saliva, hair, and blood samples, and completed an MRI scan. Results of this study will expand our knowledge on how the gut microbiome shapes several biological and cognitive systems and motivate future work investigating the gut microbiome as potential target for intervention.

Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Patients with Asthma: A Systematic Review and Meta-Analysis

OBJECTIVE

Sublingual immunotherapy (SLIT) has been widely applied to treat patients with allergic rhinitis (AR). However, meta-analyses on the efficacy of SLIT in AR patients with asthma are still limited.

METHODS

Literature without language limitation published before October 28, 2022, were retrieved from PubMed, EMBASE, and Cochrane Library. STATA 16.0 software was used for the meta-analysis of the extracted data. The results reported were symptom scores, drug scores, adverse effects rates, and cost of treatment.

RESULTS

Ten studies involving 1722 patients met the inclusion criteria. The total rhinitis score (TRSS) (weighted mean difference [WMD] = -1.23, 95% CI: -1.39--1.06, P < .001) and total asthma symptom score (TASS) (WMD = -1.00, 95% CI: -1.12-0.89, P < .001) were significantly lower in the SLIT group than the placebo group. The SLIT group had higher rates of treatment-related adverse events (relative risk [RR] = 2.82, 95% CI: 1.77-4.48, P < .001) and total costs of treatment (standardized mean difference [SMD] = 0.71, 95% CI: 0.45-0.97, P < .001). There was no significant difference in inhaled corticosteroids (ICS) dose (P = .195), fractional exhaled nitric oxide (FeNO) (P = .158), forced expiratory volume in 1 s (FEV1) (P = .237), and direct costs of treatment (P = .630) between the SLIT and placebo groups.

CONCLUSION

SLIT may be a therapeutic method for improving rhinitis symptoms and asthma symptoms in AR patients with asthma. However, as there was significant heterogeneity in results, more high-quality and well-designed studies are needed in the future to elucidate the efficacy of SLIT.

Puncture approaches and guidance techniques of radiofrequency thermocoagulation through foramen Ovale for primary trigeminal neuralgia: Systematic review and meta-analysis

Objective

Trigeminal neuralgia (TN) is one of the leading causes of facial pain and seriously affects patients' quality of life. Foramen ovale (FO) radiofrequency thermocoagulation is a classic approach for the treatment of TN that has failed pharmacological therapy. This study summarized the safety and efficacy of transforaminal radiofrequency thermocoagulation for TN by comparing puncture approaches or guidance techniques, thereby providing higher-quality clinical evidence.

Methods

Databases including PubMed, Embase, Cochrane Library, CNKI, and Wanfang were searched for relevant studies published before May 2022. Relevant data were extracted for analysis to compare methodological variables and clinical outcomes.

Results

This meta-analysis included 27 studies with a total of 1,897 patients. In terms of puncture approaches, FO had a significant advantage in reducing VAS at 12 months postoperatively (P = 0.019) and efficacy (P = 0.043). However, FO performed poorly on complications (P < 0.001), operation time (P < 0.001), and the number of needle adjustments (P < 0.001). Regarding the guidance techniques, the adjunctive use of guidance techniques could reduce patients' 6-month VAS (P < 0.001) and 12-month VAS (P < 0.001), improve the efficacy (P = 0.032), reduce recurrence rates (P = 0.001), shorten operation times (P < 0.001), decrease times of intraoperative fluoroscopy (P < 0.001), and improve the success of the first puncture (P < 0.001).

Conclusion

FO radiofrequency thermocoagulation has advantages in efficacy it can still better relieve the pain of patients 12 months postoperatively. However, FO has disadvantages in complications, recurrences, and operation time. The adjunctive use of guidance techniques has a positive effect on treatment efficacy and safety during FO radiofrequency thermocoagulation. However, the results still require large samples and high-quality randomized clinical trials to confirm.

Evaluation of Inflammatory Response System (IRS) and Compensatory Immune Response System (CIRS) in Adolescent Major Depression

Purpose

Nowadays, the role of two tightly interconnected systems, the inflammatory response system (IRS) and the compensatory immune response system (CIRS) in depression, is increasingly discussed. Various studies indicate pro-inflammatory activity in adolescent depression; however, there is an almost complete lack of findings about IRS and CIRS balance. Thus, we aimed to assess different IRS and CIRS indices, profiles, and IRS/CIRS ratios in drug-naïve MDD patients at adolescent age, with respect to sex.

Patients and Methods

One hundred MDD adolescents (40 boys, average age: 15.4±1.2 yrs.) and 60 controls (28 boys, average age: 15.3±1.5 yrs.) were examined. Evaluated parameters were 1. plasma levels of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, interferon gamma, tumor necrosis factor alpha (TNF-α), soluble receptor of IL-6 (sIL-6R), soluble receptors of TNF-α (sTNF-R1, sTNF-R2); 2. profiles: IL-6 trans-signaling, M1 macrophage signaling, helper T lymphocytes (Th) 1 profile, regulatory T lymphocytes (Treg)+Th2, allIRS, and allCIRS; 3. IRS vs CIRS activity ratios: TNF-α/TNF-R1, TNF-α/TNF-R2, TNF-α/sTNF-Rs (ie sTNF-R1+sTNF-R2), Th1/Th2, Th1/Treg, Th1/Th2+Treg, M1/Th2, M1/Treg, M1/Treg+Th2, allIRS/allCIRS.

Results

MDD patients showed increased IL-4, IL-10, TNF-α, sIL-6R, Treg+Th2, allIRS, allCIRS, and TNF-α/sTNF-Rs, and decreased Th1/Th2+Treg. MDD females showed increased IL-10 and TNF-α compared to control females. MDD males showed increased IL-4, IL-10, sIL-6R, Treg+Th2, and TNF-α/TNF-R1 compared to control males. Increased sTNF-R1 was found in MDD males compared to MDD females. Positive correlations were found between CDI score and sIL-6R and IL-10 in the total group and between CDI score and IL-10 in adolescent males.

Conclusion

Our study for the first time extensively evaluated IRS and CIRS interactions revealing enhanced pro-inflammatory TNF-α signaling and IL-6 trans-signaling in association with increased IL-10- and IL-4-mediated anti-inflammatory activity in first-episode depression at the adolescent age. Moreover, results reflect the sex-specific simultaneous activation of IRS and CIRS pathways in adolescent depression.