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Liu Y, Li C, Ren H, Han K, Wang X, Zang S, Zhao G. The relationship of peripheral blood cell inflammatory biomarkers and psychological stress in unmedicated major depressive disorder. J Psychiatr Res 2024; 176:155-162. [PMID: 38865865 DOI: 10.1016/j.jpsychires.2024.06.013] [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: 12/22/2023] [Revised: 05/07/2024] [Accepted: 06/08/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Recent research has explored the linkage between major depressive disorder (MDD) and inflammation, especially via altered peripheral blood immune markers. However, the relationship between several novel leukocyte-derived ratios (LDR) and psychological stress in MDD remains uncertain. This study aimed to explore the relationship between LDR, clinical characteristics, recent life events, and childhood maltreatment in MDD patients. METHODS A cross-sectional case-control study was conducted involving 59 healthy controls (HC) and 50 unmedicated MDD patients. Subjects underwent psychological assessments and peripheral blood measurements. LDR assessed in this study included neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), white blood cell-to-mean platelet volume ratio (WMR), systemic immune inflammation index (SII), multiplication of neutrophil and monocyte counts (MNM), and systemic inflammation response index (SIRI). RESULTS MDD patients displayed significant alterations in WMR, PLR, and MNM compared to HC, as well as correlations between several LDR and various clinical features (duration of untreated psychosis and dNLR, the nine-item Patient Health Questionnaire and PLR, the 7-item Generalized Anxiety Disorder Questionnaire and SIRI (NLR and dNLR). There was a significant difference in the comparison of WMR in first-episode patients than in recurrent patients. Analyses further revealed an association between Life Event Scale total scores and NLR (dNLR). No correlation was found between Childhood Trauma Questionnaire total (or subscale) scores and LDR. Additionally, WMR and dNLR presented potential predictive value for distinguishing between MDD and HC. CONCLUSION The study concludes that MDD and some clinical features are associated with alterations in some peripheral blood LDR. These findings emphasize the potential role of peripheral blood LDR in the pathogenesis and clinical heterogeneity of MDD.
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Affiliation(s)
- Yigang Liu
- Department of Clinical Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Cuicui Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Honghong Ren
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ke Han
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shuqi Zang
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Guoqing Zhao
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Andersen SL. Increasing CB2 Receptor Activity after Early Life Stress Prevents Depressive Behavior in Female Rats. Biomolecules 2024; 14:464. [PMID: 38672480 PMCID: PMC11047932 DOI: 10.3390/biom14040464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/28/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Early adversity, the loss of the inhibitory GABAergic interneuron parvalbumin, and elevated neuroinflammation are associated with depression. Individuals with a maltreatment history initiate medicinal cannabis use earlier in life than non-maltreated individuals, suggesting self-medication. Female rats underwent maternal separation (MS) between 2 and 20 days of age to model early adversity or served as colony controls. The prelimbic cortex and behavior were examined to determine whether MS alters the cannabinoid receptor 2 (CB2), which has anti-inflammatory properties. A reduction in the CB2-associated regulatory enzyme MARCH7 leading to increased NLRP3 was observed with Western immunoblots in MS females. Immunohistochemistry with stereology quantified numbers of parvalbumin-immunoreactive cells and CB2 at 25, 40, and 100 days of age, revealing that the CB2 receptor associated with PV neurons initially increases at P25 and subsequently decreases by P40 in MS animals, with no change in controls. Confocal and triple-label microscopy suggest colocalization of these CB2 receptors to microglia wrapped around the parvalbumin neuron. Depressive-like behavior in MS animals was elevated at P40 and reduced with the CB2 agonist HU-308 or a CB2-overexpressing lentivirus microinjected into the prelimbic cortex. These results suggest that increasing CB2 expression by P40 in the prelimbic cortex prevents depressive behavior in MS female rats.
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Affiliation(s)
- Susan L Andersen
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
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3
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Kautz MM, McArthur BA, Moriarity DP, Ellman LM, Klugman J, Coe CL, Abramson LY, Alloy LB. The Impact of Early and Recent Life Stress on Trajectories of Inflammatory Biomarkers in a Diverse Sample of Adolescents. Res Child Adolesc Psychopathol 2023; 51:1883-1894. [PMID: 36786893 PMCID: PMC10642298 DOI: 10.1007/s10802-023-01026-3] [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] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/15/2023]
Abstract
Elevated inflammatory activity is one possible pathway through which exposure to childhood adversity engenders risk for physical and psychiatric illnesses. Limited research has investigated the compounding effects of childhood and adolescent stress exposure on changes in circulating levels of inflammatory biomarkers. This study assessed whether childhood adversity interacted with chronic or acute stress during adolescence to affect the temporal trajectories of five inflammatory biomarkers across at least three blood draws in a diverse sample of adolescents (N = 134; observations = 462). Using multilevel modeling, the interaction of childhood adversity, time, and within-person variance of acute stressors significantly predicted trajectories of higher interleukin-10 levels, controlling for demographics, medication use, and body mass index. Adolescents with high levels of childhood adversity who were exposed to a higher frequency of acute stressors compared to their own average rate of stress exposure consistently had higher levels of IL-10 as they got older, but those with average and below frequency of acute stressors had decreasing trajectories of log IL-10 as they matured. The results demonstrate how events early in life shape biological responses to the adolescent environment. This study also highlights the importance of developmental timing on the body's enhanced reactivity to acute and sustained stressors following childhood adversity.
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Affiliation(s)
- Marin M Kautz
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | | | - Daniel P Moriarity
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Lauren M Ellman
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Joshua Klugman
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Wisconsin, USA
| | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, Wisconsin, USA
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA.
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4
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Cruz D. Childhood Trauma Questionnaire-Short Form: Evaluation of Factor Structure and Measurement Invariance. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1099-1108. [PMID: 38045834 PMCID: PMC10689687 DOI: 10.1007/s40653-023-00556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 12/05/2023]
Abstract
Childhood trauma is known to put individuals at risk for mental and physical challenges later in life. Retrospective assessment of early abuse and neglect is critical for prevention and intervention efforts targeted at reducing the negative impacts of childhood trauma. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely used measure to assess trauma among adolescents and adults, though there are some inconsistencies with regard to its factor structure and psychometric properties. The purpose of the current study was twofold: (1) to evaluate the hypothesized five-factor structure of CTQ-SF and (2) to test measurement invariance (equivalence) of the instrument across gender and race in a large, nationally representative sample of US adults (N = 863). Confirmatory factor analysis results indicate that the five-factor model fit the data well. The results also show that the five-factor model is generally invariant by gender and racial/ethnic groups and that the form's subscales positively correlate with depression, anxiety, and abnormal inflammatory biomarker activity. Assessment is critical for the advocacy and treatment of individuals who have experienced abuse and neglect as children and adolescents. Our findings suggest that the CTQ-SF is a valuable tool for assessing childhood trauma and can be used in advocacy and treatment efforts.
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Affiliation(s)
- Daniel Cruz
- The Institute for Trauma-Informed Research, Evaluation, and Training, LLC, Morris Plains, NJ 07950 United States
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5
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Kitamura S, Matsuoka K, Takahashi M, Yoshikawa H, Minami A, Ohnishi H, Ishida R, Miyasaka T, Tai Y, Ochi T, Tanaka T, Makinodan M. Association of adverse childhood experiences and cortical neurite density alterations with posttraumatic stress disorder symptoms in autism spectrum disorder. Front Psychiatry 2023; 14:1215429. [PMID: 37743992 PMCID: PMC10515392 DOI: 10.3389/fpsyt.2023.1215429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Background Posttraumatic stress disorder (PTSD) can be a source of significant social and daily distress in autism spectrum disorder (ASD). Compared to typically developed (TD) individuals, people with ASD are at an increased risk of adverse childhood experiences (ACEs), which can result in abnormal neuronal development. However, whether or how ACEs influence abnormal neural development and PTSD symptoms in ASD has not been fully elucidated. Methods Thirty-nine TD individuals and 41 individuals with ASD underwent T1-weighted magnetic resonance imaging and neurite orientation dispersion and density imaging (NODDI), with axonal and dendritic densities assessed in terms of the orientation dispersion index and neurite density index (NDI), respectively. Voxel-based analyses were performed to explore the brain regions associated with PTSD symptoms, and the relationships between the severity of ACEs and PTSD symptoms and NODDI parameters in the extracted brain regions were examined. Results There was a significant positive association between PTSD symptom severity and NDI in the bilateral supplementary motor area; right superior frontal, left supramarginal, and right superior temporal gyrus; and right precuneus in the ASD group, but not in the TD group. ACE severity was significantly associated with NDI in the right superior frontal and left supramarginal gyrus and right precuneus in the ASD group. Moreover, NDI in the right precuneus mainly predicted the severity of PTSD symptoms in the ASD group, but not the TD group. Conclusion These results suggest that ACE-associated higher neurite density is of clinical importance in the pathophysiology of PTSD symptoms in ASD.
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Affiliation(s)
- Soichiro Kitamura
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Functional Brain Imaging Research, National Institute Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Kiwamu Matsuoka
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Functional Brain Imaging Research, National Institute Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Masato Takahashi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Hiroaki Yoshikawa
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Akihiro Minami
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Hiroki Ohnishi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Rio Ishida
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshiteru Miyasaka
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Yumi Tai
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Tomoko Ochi
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Toshihiro Tanaka
- Department of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
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Oliveira LC, Wirowski N, Souza PBD, Lobato AS, Jansen K, de Azevedo Cardoso T, Mondin TC, Oses JP, Kapczinski F, Souza LDDM, Azevedo da Silva R, Pedrotti Moreira F. Childhood trauma, inflammatory biomarkers and the presence of a current depressive episode: Is there a relationship in subjects from a population study? J Psychiatr Res 2023; 158:255-260. [PMID: 36621181 DOI: 10.1016/j.jpsychires.2022.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
This study aims to compare the serum cytokine levels between controls, individuals with a current depressive episode (CDE) with childhood trauma and individuals with CDE without childhood trauma. This is a cross-sectional with paired sample nested in a population-based study. For the purposes of the current study, subjects who had psychotic symptoms, generalized anxiety disorder, and who refused to perform blood collection were excluded. Subsequently, only individuals who had a current depressive episode were selected (n = 76). Another 76 subjects were randomly paired by sex and age, constituting a population control group. The measurements of serum cytokine levels were performed using the multiplex analysis method. In the group with a CDE, when compared to the population control group, the following cytokines were high: IL-1β, IL-2, IL-4, IL-6, IL-17A, IFN-γ and TNF-α (p < 0.05). On the other hand, there was a decrease in the levels of cytokines IL-10 (p = 0.027) and IL12p70 (p = 0.001). Bonferroni test demonstrates that there is no statistically significant difference in serum cytokine levels between subjects with a CDE, with and without trauma (p > 0.05). In a multivariable logistic regression, adjusting for socioeconomic status, tobacco, alcohol and illicit drugs abuse/dependence, and use of psychiatric medication, we found that cytokines serum levels remained associated with CDE even when adjusted for these potential confounders. Our findings demonstrate that monitoring cytokine levels and immune function may be beneficial in preventing the development of a CDE. However, future research is necessary to investigate the impact of trauma on the relationship between inflammation and CDE.
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Affiliation(s)
| | - Natália Wirowski
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Pedro Borges de Souza
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | - Karen Jansen
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Thaíse Campos Mondin
- Pro-rectory of Student Affairs, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Jean Pierre Oses
- Post Graduation Program of Physiological Science, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Mood disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | | | - Ricardo Azevedo da Silva
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Pedrotti Moreira
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.
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7
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Wong RS, Tung KTS, Chan KL, Wong WHS, Tsang HW, Chow CHY, Chua GT, Tso WWY, Yam JC, Wong ICK, lp P. Evidence of individual differences in the long-term social, psychological, and cognitive consequences of child maltreatment. Child Adolesc Psychiatry Ment Health 2022; 16:88. [PMID: 36424655 PMCID: PMC9686092 DOI: 10.1186/s13034-022-00524-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prevalence and consequences of child maltreatment are alarming, but evidence from studies with long follow-up intervals are limited. This study examined the long-term consequences of child maltreatment in relation to age of onset and follow-up interval. METHODS The exposed group comprised 63 individuals (aged 13-34 years) with a first-time diagnosis of child maltreatment between 2001 and 2010, whereas the unexposed group comprised 63 individuals who were matched upon gender, age of onset, follow-up period, and poverty status at the index hospital admission but had no medical records of maltreatment in Hong Kong. The participants completed a set of questionnaires on executive functions and mental health and provided blood samples for measurement of IL-6 and IL-10 levels during a health assessment session. RESULTS Compared with the unexposed group, the exposed group reported poorer maternal care during childhood (β = -4.64, p < 0.001) and had lower family support (β = -2.97, p = 0.010) and higher inflammatory responses (IL-6: β = 0.15, p = 0.001; IL-10: β = 0.11, p = 0.011) at follow-up. Additionally, the associations of childhood maltreatment exposure with family support and maternal care differed by age of onset and the length of time since exposure. CONCLUSIONS This matched cohort study highlights childhood maltreatment as a risk factor for systemic inflammation and an indicator of suboptimal social environment, both of which could persist over a long period of time.
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Affiliation(s)
- Rosa S. Wong
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China ,grid.194645.b0000000121742757Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, SAR China
| | - Keith T. S. Tung
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Ko Ling Chan
- grid.16890.360000 0004 1764 6123Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Wilfred H. S. Wong
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Hing Wai Tsang
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Clare H. Y. Chow
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Gilbert T. Chua
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Winnie W. Y. Tso
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China ,grid.194645.b0000000121742757State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR China
| | - Jason C. Yam
- grid.10784.3a0000 0004 1937 0482Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ian C. K. Wong
- grid.194645.b0000000121742757Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, SAR China ,grid.83440.3b0000000121901201Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Patrick lp
- grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR China
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Tabatabaei F, Nabipour Hosseini ST. Urinary Incontinence during Early Adolescence due to a Large Vesicovaginal Fistula Associated with Childhood Sexual Abuse. IRANIAN JOURNAL OF MEDICAL SCIENCES 2022; 47:500-502. [PMID: 36117586 PMCID: PMC9445866 DOI: 10.30476/ijms.2022.94190.2545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/27/2022] [Accepted: 03/20/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Fatemeh Tabatabaei
- Department of Obstetrics and Gynecology, Division of Gynecologic Laparoscopic Surgeries, Talegani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran,
Iranian Society of Minimally Invasive Gynecology, Iran University of Medical Sciences, Tehran, Iran
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9
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Cruz D, Lichten M, Berg K, George P. Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Front Psychiatry 2022; 13:800687. [PMID: 35935425 PMCID: PMC9352895 DOI: 10.3389/fpsyt.2022.800687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.
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Affiliation(s)
- Daniel Cruz
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | | | - Kevin Berg
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | - Preethi George
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
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10
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Kung PL, Chou TW, Lindman M, Chang NP, Estevez I, Buckley BD, Atkins C, Daniels BP. Zika virus-induced TNF-α signaling dysregulates expression of neurologic genes associated with psychiatric disorders. J Neuroinflammation 2022; 19:100. [PMID: 35462541 PMCID: PMC9036774 DOI: 10.1186/s12974-022-02460-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/07/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) is an emerging flavivirus of global concern. ZIKV infection of the central nervous system has been linked to a variety of clinical syndromes, including microcephaly in fetuses and rare but serious neurologic disease in adults. However, the potential for ZIKV to influence brain physiology and host behavior following apparently mild or subclinical infection is less well understood. Furthermore, though deficits in cognitive function are well-documented after recovery from neuroinvasive viral infection, the potential impact of ZIKV on other host behavioral domains has not been thoroughly explored. METHODS We used transcriptomic profiling, including unbiased gene ontology enrichment analysis, to assess the impact of ZIKV infection on gene expression in primary cortical neuron cultures. These studies were extended with molecular biological analysis of gene expression and inflammatory cytokine signaling. In vitro observations were further confirmed using established in vivo models of ZIKV infection in immunocompetent hosts. RESULTS Transcriptomic profiling of primary neuron cultures following ZIKV infection revealed altered expression of key genes associated with major psychiatric disorders, such as bipolar disorder and schizophrenia. Gene ontology enrichment analysis also revealed significant changes in gene expression associated with fundamental neurobiological processes, including neuronal development, neurotransmission, and others. These alterations to neurologic gene expression were also observed in the brain in vivo using several immunocompetent mouse models of ZIKV infection. Mechanistic studies identified TNF-α signaling via TNFR1 as a major regulatory mechanism controlling ZIKV-induced changes to neurologic gene expression. CONCLUSIONS Our studies reveal that cell-intrinsic innate immune responses to ZIKV infection profoundly shape neuronal transcriptional profiles, highlighting the need to further explore associations between ZIKV infection and disordered host behavioral states.
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Affiliation(s)
- Po-Lun Kung
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
| | - Tsui-Wen Chou
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
| | - Marissa Lindman
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
| | - Nydia P. Chang
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
| | - Irving Estevez
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
| | - Benjamin D. Buckley
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
| | - Colm Atkins
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
| | - Brian P. Daniels
- grid.430387.b0000 0004 1936 8796Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Room B314, Piscataway, NJ 08854 USA
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Abstract
The overarching objective is to review how early exposure to adversity interacts with inflammation to alter brain maturation. Both adversity and inflammation are significant risk factors for psychopathology. Literature relevant to the effects of adversity in children and adolescents on brain development is reviewed. These studies are supported by research in animals exposed to species-relevant stressors during development. While it is known that exposure to adversity at any age increases inflammation, the effects of inflammation are exacerbated at developmental stages when the immature brain is uniquely sensitive to experiences. Microglia play a vital role in this process, as they scavenge cellular debris and prune synapses to optimize performance. In essence, microglia modify the synapse to match environmental demands, which is necessary for someone with a history of adversity. Overall, by piecing together clinical and preclinical research areas, what emerges is a picture of how adversity uniquely sculpts the brain. Microglia interactions with the inhibitory neurotransmitter GABA (specifically, the subtype expressing parvalbumin) are discussed within contexts of development and adversity. A review of inflammation markers in individuals with a history of abuse is combined with preclinical studies to describe their effects on maturation. Inconsistencies within the literature are discussed, with a call for standardizing methodologies relating to the age of assessing adversity effects, measures to quantify stress and inflammation, and more brain-based measures of biochemistry. Preclinical studies pave the way for interventions using anti-inflammation-based agents (COX-2 inhibitors, CB2 agonists, meditation/yoga) by identifying where, when, and how the developmental trajectory goes awry.
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12
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Toenders YJ, Laskaris L, Davey CG, Berk M, Milaneschi Y, Lamers F, Penninx BWJH, Schmaal L. Inflammation and depression in young people: a systematic review and proposed inflammatory pathways. Mol Psychiatry 2022; 27:315-327. [PMID: 34635789 DOI: 10.1038/s41380-021-01306-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/12/2021] [Accepted: 09/13/2021] [Indexed: 02/07/2023]
Abstract
Depression onset peaks during adolescence and young adulthood. Current treatments are only moderately effective, driving the search for novel pathophysiological mechanisms underlying youth depression. Inflammatory dysregulation has been shown in adults with depression, however, less is known about inflammation in youth depression. This systematic review identified 109 studies examining the association between inflammation and youth depression and showed subtle evidence for inflammatory dysregulation in youth depression. Longitudinal studies support the bidirectional association between inflammation and depression in youth. We hypothesise multiple inflammatory pathways contributing to depression. More research is needed on anti-inflammatory treatments, potentially tailored to individual symptom profiles.
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Affiliation(s)
- Yara J Toenders
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Liliana Laskaris
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Michael Berk
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
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13
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Simon MS, Schiweck C, Arteaga-Henríquez G, Poletti S, Haarman BCM, Dik WA, Schwarz M, Vrieze E, Mikova O, Joergens S, Musil R, Claes S, Baune BT, Leboyer M, Benedetti F, Furlan R, Berghmans R, de Wit H, Wijkhuijs A, Arolt V, Müller N, Drexhage HA. Monocyte mitochondrial dysfunction, inflammaging, and inflammatory pyroptosis in major depression. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110391. [PMID: 34171401 DOI: 10.1016/j.pnpbp.2021.110391] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The macrophage theory of depression states that macrophages play an important role in Major Depressive Disorder (MDD). METHODS MDD patients (N = 140) and healthy controls (N = 120) participated in a cross-sectional study investigating the expression of apoptosis/growth and lipid/cholesterol pathway genes (BAX, BCL10, EGR1, EGR2, HB-EGF, NR1H3, ABCA1, ABCG1, MVK, CD163, HMOX1) in monocytes (macrophage/microglia precursors). Gene expressions were correlated to a set of previously determined and reported inflammation-regulating genes and analyzed with respect to various clinical parameters. RESULTS MDD monocytes showed an overexpression of the apoptosis/growth/cholesterol and the TNF genes forming an inter-correlating gene cluster (cluster 3) separate from the previously described inflammation-related gene clusters (containing IL1 and IL6). While upregulation of monocyte gene cluster 3 was a hallmark of monocytes of all MDD patients, upregulation of the inflammation-related clusters was confirmed to be found only in the monocytes of patients with childhood adversity. The latter group also showed a downregulation of the cholesterol metabolism gene MVK, which is known to play an important role in trained immunity and proneness to inflammation. CONCLUSIONS The upregulation of cluster 3 genes in monocytes of all MDD patients suggests a premature aging of the cells, i.e. mitochondrial apoptotic dysfunction and TNF "inflammaging", as a general feature of MDD. The overexpression of the IL-1/IL-6 containing inflammation clusters and the downregulation of MVK in monocytes of patients with childhood adversity indicates a shift in this condition to a more severe inflammation form (pyroptosis) of the cells, additional to the signs of premature aging and inflammaging.
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Affiliation(s)
- Maria S Simon
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, 80336 Munich, Germany.
| | - Carmen Schiweck
- Department of Neurosciences, Psychiatry Research Group, KUL University of Leuven, Leuven 3000, Belgium
| | - Gara Arteaga-Henríquez
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, 80336 Munich, Germany
| | - Sara Poletti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milan 20125, Italy
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, Netherlands
| | - Wim A Dik
- Department of Immunology, Erasmus Medical Center, Rotterdam 3015 GD, Netherlands
| | - Markus Schwarz
- Institute of Laboratory Medicine, University Hospital, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Elske Vrieze
- Department of Neurosciences, Psychiatry Research Group, KUL University of Leuven, Leuven 3000, Belgium
| | - Olya Mikova
- Foundation Biological Psychiatry, Sofia, Bulgaria
| | - Silke Joergens
- Department of Mental Health, University of Münster, 48149 Münster, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, 80336 Munich, Germany
| | - Stephan Claes
- Department of Neurosciences, Psychiatry Research Group, KUL University of Leuven, Leuven 3000, Belgium
| | - Bernhard T Baune
- Department of Mental Health, University of Münster, 48149 Münster, Germany
| | - Marion Leboyer
- Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, F-94010, Créteil, France; AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, F-94010, Créteil, France
| | - Francesco Benedetti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milan 20125, Italy
| | - Roberto Furlan
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano 20132, Italy
| | - Raf Berghmans
- Advanced Practical Diagnostics BVBA, Turnhout 2300, Belgium
| | - Harm de Wit
- Department of Immunology, Erasmus Medical Center, Rotterdam 3015 GD, Netherlands
| | - Annemarie Wijkhuijs
- Department of Immunology, Erasmus Medical Center, Rotterdam 3015 GD, Netherlands; RMS, Rotterdam, Netherlands
| | - Volker Arolt
- Department of Mental Health, University of Münster, 48149 Münster, Germany
| | - Norbert Müller
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, 80336 Munich, Germany
| | - Hemmo A Drexhage
- Department of Immunology, Erasmus Medical Center, Rotterdam 3015 GD, Netherlands
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14
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Rengasamy M, Marsland A, McClain L, Kovats T, Walko T, Pan L, Price RB. Linking childhood trauma and cytokine levels in depressed adolescents. Psychoneuroendocrinology 2021; 133:105398. [PMID: 34479104 PMCID: PMC8530984 DOI: 10.1016/j.psyneuen.2021.105398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/28/2021] [Accepted: 08/21/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Evidence supports raised circulating levels of inflammatory mediators, such as interleukin-6 (IL-6) and tumor necrosis factor (TNFα), among clinically depressed adults, although preliminary findings in adolescents are mixed. Independently, meta-analyses identify correlations between childhood trauma and elevated cytokine levels in adulthood. Here, we examine the possible role of individual differences in exposure to childhood trauma in contributing to variability in cytokine levels in depressed adolescents. METHODS 52 depressed adolescents and 20 healthy adolescents completed measures of childhood trauma and provided blood for the assessment of plasma IL-6 and TNFα. Cross-sectional associations of childhood trauma and cytokine measures were assessed in both depressed and healthy adolescents, along with exploratory analysis of childhood trauma subtypes. Longitudinal relationships between childhood trauma and cytokine measures were also studied in an exploratory fashion within a subset of depressed participants (n = 36). RESULTS Higher childhood trauma (particularly emotional abuse) was positively associated with TNFα in depressed adolescents. Childhood trauma was not linked to longitudinal changes in cytokine levels. DISCUSSION In depressed adolescents, childhood trauma may relate to higher levels of the proinflammatory cytokine TNFα and contribute to heterogeneity in cytokine elevation among depressed adolescents. Such findings may ultimately help guide more effective individualized treatments for adolescents with depression.
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Affiliation(s)
- Manivel Rengasamy
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Anna Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Lora McClain
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Tessa Kovats
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Thomas Walko
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Lisa Pan
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rebecca B Price
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, USA
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15
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Brown M, Worrell C, Pariante CM. Inflammation and early life stress: An updated review of childhood trauma and inflammatory markers in adulthood. Pharmacol Biochem Behav 2021; 211:173291. [PMID: 34695507 DOI: 10.1016/j.pbb.2021.173291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
Inflammation, as a neurobiological consequence of childhood trauma, has frequently been reported across research, however, recent investigations suggest this relationship may be dependent on specificities such as type of trauma, type of inflammatory marker, and additional mediatory variables - such as body mass index (BMI), age, and sex. As an updated version of a previous review by Baumeister et al., the current review comprised a search of PubMed, which identified 37 articles that collectively assessed 4 inflammatory markers (CRP, IL-6, TNFα and IL-1β). A review of the studies revealed predominantly non-significant associations between childhood trauma and elevated levels of all inflammatory markers in adulthood. However, in line with previous research, discrepancies in significance arose when considering type of trauma, type of inflammatory marker, and additional variables. Compared to neglect, abuse showed greater significant associations with elevated inflammatory markers in adulthood, though this was dependent on the individual subtypes (emotional, physical or sexual). Mediation analyses reported BMI as a significant mediator, though, when controlled for, no significant differences were found. Sex differences were reported but investigations were sparse. Future research should investigate the mediatory role of sex differences in the inflammatory effects of childhood trauma. Many studies in the review were restricted by use of the same trauma measure - the Childhood Trauma Questionnaire. To assess greater variety of trauma types, future studies should utilize other standardized measures to explore these avenues.
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Affiliation(s)
- Mollie Brown
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Courtney Worrell
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Carmine M Pariante
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
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16
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van der Feltz-Cornelis CM, Bakker M, Kaul A, Kuijpers TW, von Känel R, van Eck van der Sluijs JF. IL-6 and hsCRP in Somatic Symptom Disorders and related disorders. Brain Behav Immun Health 2021; 9:100176. [PMID: 34589907 PMCID: PMC8474154 DOI: 10.1016/j.bbih.2020.100176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/16/2020] [Accepted: 10/28/2020] [Indexed: 12/26/2022] Open
Abstract
Interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) are biomarkers of systemic low-grade inflammation (SLI) in depression and anxiety. The question if SLI in those conditions is related to comorbid chronic medical conditions has not been resolved. DSM-5 Somatic symptom disorders and related disorders (SSRD) are conditions with serious distress related to physical symptoms as main criterion. They can occur in patients with medically unexplained symptoms (MUS) and in patients with known comorbid chronic medical conditions. Often, comorbid depression and anxiety are present. SSRDs offer the opportunity to explore the role of SLI in relation to mental distress, including trauma, MUS, chronic medical conditions and comorbid mental disorder. AIM We hypothesized that increased IL-6 and hsCRP may be directly linked to SLI in SSRD, and that comorbid chronic medical conditions, childhood trauma, current stress and comorbid depression and anxiety may be risk factors that account for some of the variance of SLI in SSRD. METHODS We explored these relationships in a large sample of 241 consecutive outpatients with SSRD. RESULTS Mean hsCRP level was 3.66 mg/l, and mean IL-6 level was 3.58 pg/ml. IL-6 and hsCRP levels were associated with each other: τ = 0.249, p < .001; a medium size correlation. Comorbid chronic medical conditions, adverse childhood events other than sexual trauma, and current stress levels were not associated with IL-6 or hsCRP levels. CONCLUSION IL-6 and hsCRP are elevated in SSRD, indicating SLI in SSRD independently of comorbid chronic medical conditions. In clinical research, elevated IL-6 and hsCRP can be used as biomarkers of SLI and can indicate risk for childhood sexual abuse in SSRD. Elevated hsCRP may be a biomarker indicating risk for comorbid depression or high pain levels in SSRD as well.
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Affiliation(s)
- Christina M. van der Feltz-Cornelis
- Department of Health Sciences, Hull York Medical School, University of York, York, UK
- Corresponding author. Department of Health Sciences, MHARG, HYMS, YBRI, University of York, ARRC Building, T204, Heslington, York, YO10 5DN, UK.
| | - Marjan Bakker
- Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Arvind Kaul
- St. George’s University Hospitals NHS Foundation Trust, London, UK
| | - Taco W. Kuijpers
- Emma Children’s Hospital, Dept. of Pediatric Immunology, Rheumatology and Infectious Diseases, Amsterdam University Medical Center (Amsterdam UMC), Amsterdam, the Netherlands
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jonna F. van Eck van der Sluijs
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands
- Altrecht Psychosomatic Medicine, Zeist, the Netherlands
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17
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Lee J, Chi S, Lee MS. Molecular Biomarkers for Pediatric Depressive Disorders: A Narrative Review. Int J Mol Sci 2021; 22:ijms221810051. [PMID: 34576215 PMCID: PMC8464852 DOI: 10.3390/ijms221810051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/05/2021] [Accepted: 09/14/2021] [Indexed: 01/31/2023] Open
Abstract
Depressive disorder in childhood and adolescence is a highly prevalent mood disorder that tends to recur throughout life. Untreated mood disorders can adversely impact a patient’s quality of life and cause socioeconomic loss. Thus, an accurate diagnosis and appropriate treatment is crucial. However, until now, diagnoses and treatments were conducted according to clinical symptoms. Objective and biological validation is lacking. This may result in a poor outcome for patients with depressive disorder. Research has been conducted to identify the biomarkers that are related to depressive disorder. Cumulative evidence has revealed that certain immunologic biomarkers including brain-derived neurotrophic factor (BDNF) and cytokines, gastrointestinal biomarkers, hormones, oxidative stress, and certain hypothalamus-pituitary axis biomarkers are associated with depressive disorder. This article reviews the biomarkers related to the diagnosis and treatment of pediatric depressive disorders. To date, clinical biomarker tests are not yet available for diagnosis or for the prediction of treatment prognosis. However, cytokines such as Interleukin-2, interferon-gamma, tumor necrosis factor-alpha, and BDNF have shown significant results in previous studies of pediatric depressive disorder. These biomarkers have the potential to be used for diagnosis, prognostic assessment, and group screening for those at high risk.
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Affiliation(s)
- Jongha Lee
- Department of Psychiatry, Korea University Ansan Hospital, Ansan 15355, Korea;
| | - Suhyuk Chi
- Department of Psychiatry, Korea University Guro Hospital, Seoul 08308, Korea;
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University Guro Hospital, Seoul 08308, Korea;
- Correspondence: ; Tel.: +82-2-2626-3163; Fax: +82-2-852-1937
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18
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The association of child maltreatment and systemic inflammation in adulthood: A systematic review. PLoS One 2021; 16:e0243685. [PMID: 33831008 PMCID: PMC8031439 DOI: 10.1371/journal.pone.0243685] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/22/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction Child maltreatment (CM) is associated with mental and physical health disorders in adulthood. Some studies have identified elevated markers of systemic inflammation in adult survivors of CM, and inflammation may mediate the association between CM and later health problems. However, there are methodological inconsistencies in studies of the association between CM and systemic inflammation and findings are conflicting. We performed a systematic review to examine the association of CM with systemic inflammation in adults. Methods A pre-registered systematic review was performed following PRISMA guidelines. Medline, Embase, Scopus and PsychInfo were searched for studies of the association of CM with blood markers of inflammation in adults. Quality was assessed using the Crowe Critical Appraisal Tool. We had intended to perform a meta-analysis, but this was not possible due to variation in study design and reporting. Results Forty-four articles met criteria for inclusion in the review. The most widely reported biomarkers were C-Reactive Protein (CRP) (n = 27), interleukin-6 (IL-6) (n = 24) and Tumour Necrosis Factor-alpha (TNF-a) (n = 17). Three studies were prospective (all relating to CRP) and the remainder were retrospective. 86% of studies were based in high income countries. In the prospective studies, CM was associated with elevated CRP in adulthood. Results of retrospective studies were conflicting. Methodological issues relating to the construct of CM, methods of analysis, and accounting for confounding or mediating variables (particularly Body Mass Index) may contribute to the uncertainty in the field. Conclusions There is some robust evidence from prospective studies that CM is associated with elevated CRP in adulthood. We have identified significant methodological inconsistencies in the literature and have proposed measures that future researchers could employ to improve consistency across studies. Further prospective, longitudinal, research using robust and comparable measures of CM with careful consideration of confounding and mediating variables is required to bring clarity to this field.
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Silva RC, Maffioletti E, Gennarelli M, Baune BT, Minelli A. Biological correlates of early life stressful events in major depressive disorder. Psychoneuroendocrinology 2021; 125:105103. [PMID: 33360031 DOI: 10.1016/j.psyneuen.2020.105103] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 12/14/2022]
Abstract
Major depressive disorder (MDD) is the most common psychiatric disorder and responds for important psychosocial consequences. Stressful life events, especially early life stress (ELS), contribute to an increased probability to develop MDD, leading in particular to severe and chronic manifestation and unfavorable treatment outcome. The association between ELS and MDD seems to have biological bases, consisting in dysregulations occurring at different levels. The aim of this narrative review is to propose an overview of the literature ranging from genetic, epigenetic, expression and protein to neuroimaging correlates underlying this relationship. A search on Pubmed of studies assessing biological correlates of ELS in MDD development, focusing on human studies conducted in both peripheral and brain tissues, was performed. Evidence indicated that the hypothalamic-pituitary-adrenal (HPA) axis and the serotonergic, dopaminergic, neurotrophin and oxytocin systems might play a role in the mediation between ELS and MDD. The most consistent results were found for genetic and epigenetic studies and indicated a joint involvement of the systems mentioned. Expression studies are less numerous and point to an involvement of stress-related systems. Concerning protein studies, the main mediators are markers related to the inflammatory and immune systems. Neuroimaging studies aiming at evaluating brain alterations connecting ELS and MDD in relation to biomarkers indicated the hippocampus, the amygdala and the frontal cortex as important anatomical mediators. These findings can build the bases for future research and clinical interventions; indeed, the clarification of biological mechanisms mediating the relationship between ELS and MDD can lead to new and individualized preventive and therapeutic possibilities.
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Affiliation(s)
- Rosana Carvalho Silva
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Elisabetta Maffioletti
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy; Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy; Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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20
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Maalouf O, Daigneault I, Dargan S, McDuff P, Frappier JY. Relationship between Child Sexual Abuse, Psychiatric Disorders and Infectious Diseases: A Matched-Cohort Study. JOURNAL OF CHILD SEXUAL ABUSE 2020; 29:749-768. [PMID: 32045342 DOI: 10.1080/10538712.2019.1709242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/01/2019] [Accepted: 12/08/2019] [Indexed: 06/10/2023]
Abstract
Child sexual abuse (CSA) has been strongly associated with a range of psychological and physical problems in childhood and adulthood, such as anxiety, post-traumatic stress disorder (PTSD), and infectious diseases. Despite the strength of these associations, no studies to date have investigated psychobiological processes that might underlie the relationship between CSA and physical health problems occurring during childhood, such as infectious diseases. The goal of the current study is to evaluate PTSD as a potential mediator between CSA and the occurrence of infectious diseases among children and adolescents. Furthermore, we postulate that PTSD plays a specific role as an indicator of chronic stress during childhood, in comparison to other mental disorders, such as anxious and non-anxious disorders (e.g., depression). Via a prospective matched-cohort design, administrative data were used to document PTSD, anxious and non-anxious disorders, and infectious diseases. The sample size was 882 persons with a substantiated report of sexual abuse and 882 matched controls. Negative binomial regressions revealed that CSA is associated with a greater number of anxious diseases diagnoses that, in turn, predict more infectious diseases diagnoses. These findings highlight the importance of preventing and intervening among sexually abused youth with anxious disorder symptoms to limit negative outcomes on physical health.
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21
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Lamers F, Milaneschi Y, Vinkers CH, Schoevers RA, Giltay EJ, Penninx BWJH. Depression profilers and immuno-metabolic dysregulation: Longitudinal results from the NESDA study. Brain Behav Immun 2020; 88:174-183. [PMID: 32272220 DOI: 10.1016/j.bbi.2020.04.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/27/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is linked to higher cardio-metabolic comorbidity that may in part be due to the low-grade inflammation and poorer metabolic health observed in MDD. Heterogeneity of MDD is however large, and immune-inflammatory and metabolic dysregulation is present in only part of the MDD cases. We examined the associations of four depression dimensional profilers (atypical energy-related symptom dimension, melancholic symptom dimension, childhood trauma severity, and anxious distress symptom dimension) with immuno-metabolic outcomes, both cross-sectionally and longitudinally. METHODS Three waves covering a 6-year follow-up (>7000 observations) of the Netherlands Study of Depression and Anxiety (NESDA) were used. Depression profilers were based on the Inventory of Depressive Symptomatology, the Beck Anxiety Inventory, and the Childhood Trauma index. An inflammatory index (based on IL-6 and CRP), a metabolic syndrome index (based on the five metabolic syndrome components), and a combination of these two indices were constructed. Mixed models were used for cross-sectional and longitudinal models, controlling for covariates. RESULTS Of the four depression profilers, only the atypical, energy-related symptom dimension showed robust associations with higher scores on the inflammatory, metabolic syndrome and combined inflammatory-metabolic indexes cross-sectionally, as well as at follow-up. The melancholic symptom dimension was associated with lower scores on the metabolic syndrome index both cross-sectionally and longitudinally. CONCLUSION The atypical energy-related symptom dimension was linked to poorer immune-inflammatory and metabolic health, while the melancholic symptom dimension was linked to relatively better metabolic health. Persons with high atypical energy-related symptom burden, representing an immuno-metabolic depression, may be the most important group to target in prevention programs for cardiometabolic disease, and may benefit most from treatments targeting immuno-metabolic pathways.
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Affiliation(s)
- Femke Lamers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Yuri Milaneschi
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Christiaan H Vinkers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands; Amsterdam UMC, Department of Anatomy and Neurosiences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
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22
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Gill H, El-Halabi S, Majeed A, Gill B, Lui LMW, Mansur RB, Lipsitz O, Rodrigues NB, Phan L, Chen-Li D, McIntyre RS, Rosenblat JD. The Association Between Adverse Childhood Experiences and Inflammation in Patients with Major Depressive Disorder: A Systematic Review. J Affect Disord 2020; 272:1-7. [PMID: 32379599 DOI: 10.1016/j.jad.2020.03.145] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/13/2020] [Accepted: 03/29/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Replicated evidence has documented elevated levels of pro-inflammatory cytokines in populations with major depressive disorder (MDD). However, childhood trauma, a risk factor for MDD, has been separately shown to also impact inflammatory systems; its potential moderating effect on inflammation in MDD has been less frequently investigated. METHODS We systematically searched the PubMed, Google Scholar, Scopus, Web of Science, and PsycINFO databases between database inception to June 19th, 2019 using the search string: (Childhood trauma or Adverse childhood experiences or childhood abuse or childhood rape or physical abuse or emotional abuse) AND (Inflammation or inflammatory cytokines or interleukin-6 or tumor necrosis factor-alpha or c-reactive protein) AND (Major Depressive Disorder or Depression). RESULTS We identified nine articles that evaluated inflammatory biomarkers in MDD populations with adverse childhood experiences (ACE). Eight articles evaluated IL-6, three articles evaluated CRP, and five articles evaluated TNF-α. The strongest effects were observed for IL-6; six studies reported significantly elevated levels of IL-6 in MDD and ACE patients compared to healthy controls and/or MDD-only populations. Meanwhile, only three studies found TNF-α to be significantly elevated in the MDD and ACE cohort. In contrast, MDD-ACE populations did not exhibit significantly elevated CRP. LIMITATIONS The methodological heterogeneity amongst studies was very high. CONCLUSION The current review suggests that MDD and ACE subpopulations present elevated levels of IL-6 compared to MDD-only and healthy control populations. Therefore, research should consider whether elevated inflammation in MDD is just an epiphenomenon of previous ACE and whether MDD-ACE subgroups are more likely to respond to immune-inflammatory targeted intervention.
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Affiliation(s)
- Hartej Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
| | - Sabine El-Halabi
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Amna Majeed
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Barjot Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Leanna M W Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Orly Lipsitz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Nelson B Rodrigues
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Lee Phan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - David Chen-Li
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Joshua Daniel Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
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23
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Tang A, Fox NA, Nelson CA, Zeanah CH, Slopen N. Externalizing trajectories predict elevated inflammation among adolescents exposed to early institutional rearing: A randomized clinical trial. Psychoneuroendocrinology 2019; 109:104408. [PMID: 31442936 PMCID: PMC6842705 DOI: 10.1016/j.psyneuen.2019.104408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There has been mounting interest in the pathophysiological relation between inflammation and psychopathology. In this paper, we examined associations between internalizing and externalizing psychopathology and inflammation in adolescents with a history of severe psychosocial deprivation and children reared in typical family contexts. METHOD The Bucharest Early Intervention Project is a longitudinal randomized trial of high-quality foster care as an alternative to institutional care. This report is based on 56 institutionalized children randomized to care as usual, 59 institutionalized children randomized to foster care, and 101 never institutionalized children who were recruited as an in-country comparison sample. Externalizing and internalizing behaviors were reported by parents and teachers at ages 8, 12, and 16. At age 16, C-reactive protein (CRP) was derived from blood spots in a subset of participants (n = 127). Multiple-group latent growth curve models were used to examine externalizing and internalizing trajectories and their associations with CRP. RESULTS Among children assigned to care as usual, higher levels of externalizing behaviors at age 8, as well as smaller decreases in these behaviors from 8 to 16 years predicted higher levels of CRP at age 16. In the same group of children, higher internalizing behaviors at age 8, but not the rate of change in these behaviors, also predicted higher levels of CRP. In contrast, these relations were not observed in the children assigned to foster care and never institutionalized controls. CONCLUSIONS Early institutional rearing is associated with a coupling of psychopathology and inflammation, whereas early placement into foster care buffers against these risks. These findings have implications for promoting healthy mental and physical development amongst institutionalized children.
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States.
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States
| | - Charles A Nelson
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States
| | - Charles H Zeanah
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Natalie Slopen
- Shool of Public Health, University of Maryland, College Park, MD, United States
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24
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McIntyre RS, Subramaniapillai M, Lee Y, Pan Z, Carmona NE, Shekotikhina M, Rosenblat JD, Brietzke E, Soczynska JK, Cosgrove VE, Miller S, Fischer EG, Kramer NE, Dunlap K, Suppes T, Mansur RB. Efficacy of Adjunctive Infliximab vs Placebo in the Treatment of Adults With Bipolar I/II Depression: A Randomized Clinical Trial. JAMA Psychiatry 2019; 76:783-790. [PMID: 31066887 PMCID: PMC6506894 DOI: 10.1001/jamapsychiatry.2019.0779] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE To our knowledge, no study has previously evaluated whether individuals with bipolar depression enriched a priori on the basis of biochemical and/or phenotypic immuno-inflammatory activation would differentially respond to an anti-inflammatory agent for the treatment of depressive symptoms. OBJECTIVE To assess the antidepressant efficacy of adjunctive infliximab, a monoclonal antibody targeting tumor necrosis factor, in adults with bipolar I and bipolar II depression and inflammatory conditions. DESIGN, SETTING, AND PARTICIPANTS This 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of 60 participants was conducted at 2 outpatient tertiary care sites in Canada and the United States. Eligible adults (aged 18-65 years) met DSM-5-defined criteria for bipolar I or bipolar II depression and exhibited pretreatment biochemical and/or phenotypic evidence of inflammatory activation. Participants were enrolled between October 1, 2015, and April 30, 2018. Data analysis was performed from May 1 through July 31, 2018, using modified intent-to-treat analysis. INTERVENTIONS Patients were randomized to receive 3 intravenous infusions of infliximab therapy or placebo at baseline and at weeks 2 and 6 of the 12-week study. MAIN OUTCOMES AND MEASURES The primary efficacy outcome was baseline-to-end point (ie, week-12) change in Montgomery-Asberg Depression Rating Scale (MADRS) total score. History of childhood maltreatment, as assessed by the Childhood Trauma Questionnaire, was used for exploratory analyses as 1 of several secondary outcomes. RESULTS A total of 60 participants were randomized to infliximab (n = 29 [48%]; mean [SD] age, 45.0 [11.7] years; 20 of 28 female [71%]) or to placebo (n = 31 [52%]; mean [SD] age, 46.8 [10.2] years; 26 of 30 female [87%]) across study sites. Overall baseline-to-end point change in MADRS total score was observed across treatment × time interaction (χ2 = 10.33; P = .04); reduction in symptom severity was not significant at week 12 (relative risk, 1.09; 95% CI, 0.80-1.50; df = 1; P = .60). As part of a secondary analysis, a significant treatment × time × childhood maltreatment interaction was observed in which infliximab-treated individuals with childhood history of physical abuse exhibited greater reductions in MADRS total score (χ2 = 12.20; P = .02) and higher response rates (≥50% reduction in MADRS total score) (χ2 = 4.05; P = .04). CONCLUSIONS AND RELEVANCE Infliximab did not significantly reduce depressive symptoms compared with placebo in adults with bipolar depression. Results from secondary analyses identified a subpopulation (ie, those reporting physical and/or sexual abuse) that exhibited a significant reduction in depressive symptoms with infliximab treatment compared with placebo. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02363738.
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Affiliation(s)
- Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | | | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Zihang Pan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Nicole E. Carmona
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Margarita Shekotikhina
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada,Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Joshua D. Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Elisa Brietzke
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada,Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Joanna K. Soczynska
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Victoria E. Cosgrove
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Palo Alto, California
| | - Shefali Miller
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Palo Alto, California
| | - Eileen Grace Fischer
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Palo Alto, California
| | - Nicole E. Kramer
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Palo Alto, California
| | - Kiley Dunlap
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Palo Alto, California
| | - Trisha Suppes
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Palo Alto, California
| | - Rodrigo B. Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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25
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Chase KA, Melbourne JK, Rosen C, McCarthy-Jones S, Jones N, Feiner BM, Sharma RP. Traumagenics: At the intersect of childhood trauma, immunity and psychosis. Psychiatry Res 2019; 273:369-377. [PMID: 30682559 DOI: 10.1016/j.psychres.2018.12.097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/06/2018] [Accepted: 12/18/2018] [Indexed: 01/26/2023]
Abstract
Early childhood trauma, including physical, sexual or emotional abuse, neglect, harm or threat of harm, is associated with adulthood dysregulation of the immune system. Trauma can induce chronic immune system activation. Associations between a chronic pro-inflammatory state and schizophrenia are an enduring finding of psychiatry, with elevated cytokine concentrations correlated with psychotic symptom severity. Most importantly, persons with schizophrenia and a history of childhood trauma demonstrate increased cytokine levels. Specific types of childhood trauma can also differentially impact the expression of unique immune markers. This study tested the hypotheses that levels of adverse childhood experiences (ACEs) would be associated with levels of peripheral immune activity assessed by IL6, IFNG, CXCL10, IRF1, STAT1 and TLR4 mRNA expression, and that there would be an association between ACEs and psychosis along a continuum from non-clinical controls (NCC) to psychotic disorders such as schizophrenia. These hypotheses were tested in 20 schizophrenia, 20 NCC. We found correlations between ACEs scores and immune markers, specifically IL6. We also found a positive association between ACEs and positive symptoms. Childhood trauma, through its effects on IL6, may be a risk factor for schizophrenia.
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Affiliation(s)
- Kayla A Chase
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA.
| | - Jennifer K Melbourne
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
| | | | - Nev Jones
- Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, USA
| | - Benjamin M Feiner
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
| | - Rajiv P Sharma
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
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26
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PI3K/Akt/NF-κB signaling pathway regulates behaviors in adolescent female rats following with neonatal maternal deprivation and chronic mild stress. Behav Brain Res 2019; 362:199-207. [PMID: 30630016 DOI: 10.1016/j.bbr.2019.01.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/07/2019] [Accepted: 01/07/2019] [Indexed: 12/11/2022]
Abstract
The early-life aversive experiences are associated with the increased risk for adolescent neuropsychiatric disorders and neuroinflammation. So, we used neonatal maternal deprivation (NMD) and chronic mild stress (CMS) to build adolescent depression model and investigate the role of microglia activation, PI3K/Akt/NF-κB pathway in female rats. Pups in NMD group were separated from mothers for 3 h each day from postnatal day (PND) 2 to PND 21 and rats in CMS group were subjected to one mild stressor each day from PND 22 to PND 42. Sucrose preference test (SPT), open field test (OFT), novel objective recognition test (NORT), Elevated-plus maze (EPM), marble burying test (MBT) and forced swimming test (FST) were performed from PND 42 to PND 50. Iba-1, pPI3K/PI3K, pAkt/Akt, and NF-κB expressions in the prefrontal cortex (PFC) and hippocampus (HIP) were detected by Western-Blot. Contents of IL-6, IL-1β and TNF-α were detected by ELISA method. It was found NMD + CMS increased the immobility time, buried marble number, inflammatory cytokines release and reduced the sucrose consumption ratio, time ratio and distance ratio in open arm, crossing times, rearing times. Furthermore, it decreased the discrimination ratio (DR) and discrimination index (DI) in T2 phase. NMD + CMS upregulated the expression of Iba-1, pPI3K/PI3K, pacts/Akt, and NF-κB in PFC and HIP. NMD or CMS solely didn't affect all these behaviors in rats. Sertraline treatment reversed these changes after NMD + CMS. In view of our findings we propose the NMD + CMS procedure as a potentially useful animal model to analyze developmental emotional behaviors and cognitive dysfunction in adolescent female rats, which may be related with microglial activation and PI3k/Akt/NF-κB pathway upregulation.
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27
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Olvera Alvarez HA, Kubzansky LD, Campen MJ, Slavich GM. Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health. Neurosci Biobehav Rev 2018; 92:226-242. [PMID: 29874545 PMCID: PMC6082389 DOI: 10.1016/j.neubiorev.2018.06.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 01/21/2023]
Abstract
Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.
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Affiliation(s)
- Hector A Olvera Alvarez
- School of Nursing, University of Texas at El Paso, Health Science and Nursing Building, Room 359, 500 West University Avenue, El Paso, TX, USA.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico, Albuquerque, NM, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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28
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D'Elia ATD, Matsuzaka CT, Neto JBB, Mello MF, Juruena MF, Mello AF. Childhood Sexual Abuse and Indicators of Immune Activity: A Systematic Review. Front Psychiatry 2018; 9:354. [PMID: 30127754 PMCID: PMC6088139 DOI: 10.3389/fpsyt.2018.00354] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 07/16/2018] [Indexed: 02/05/2023] Open
Abstract
Background: Childhood sexual abuse (CSA) is a prevalent subtype of early life stress associated with changes in immunological and neuroendocrine systems leading to inflammatory responses of the organism and increasing several inflammatory and immune markers. We aimed to conduct a systematic review concerning the association between CSA and indicators of immune activity. Methods: We conducted a search for articles in PubMed, Scopus, PsycINFO, and Web of Science, using the key words: ("Child sexual abuse" OR "childhood maltreatment" OR "sexual violence" OR "posttraumatic stress disorder" OR "rape") AND ("cytokines" OR "inflammatory markers" OR "interleukin" OR "tumor necrosis factor" OR "C-reactive protein"). PRISMA guidelines were used in order to improve the quality of this research, and MeSH terms were used in PubMed. Results: A total of 3,583 studies were found and, after application of the exclusion criteria, 17 studies were included in this review. Most studies reported an increase of inflammatory activity associated with the presence of early abuse. IL-6, TNF- α, and C-reactive protein were the most frequently analyzed markers and some studies showed higher levels in individuals that suffered CSA compared with controls, although the results were heterogeneous, as was the assessment of CSA, repeated trauma, and time of occurrence. It was not possible to perform a meta-analysis because the results were diversified. Conclusion: CSA is associated with changes in inflammatory markers levels. Improving the assessment of subtypes of trauma is important to further understand the complex correlations of CSA and its biological consequences such as psychiatric and physical illness in later life.
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Affiliation(s)
- Ana T. D. D'Elia
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Department of Medicine, Federal University of São Carlos, São Carlos, Brazil
- *Correspondence: Ana T. D. D'Elia
| | - Camila T. Matsuzaka
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Jair B. B. Neto
- Department of Medicine, Federal University of São Carlos, São Carlos, Brazil
| | - Marcelo F. Mello
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Mario F. Juruena
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, Kings College London, London, United Kingdom
- Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Andrea F. Mello
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
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29
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Fonseca MB, Andrades RSD, Bach SDL, Wiener CD, Oses JP. Bipolar and Schizophrenia Disorders Diagnosis Using Artificial Neural Network. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/nm.2018.94021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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