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Michaelis S, Zelzer S, Schneider C, Schnedl WJ, Baranyi A, Meinitzer A, Herrmann M, Enko D. The possible role of quinolinic acid as a predictive marker in patients with SARS-CoV-2. Clin Chim Acta 2023; 550:117583. [PMID: 37802207 DOI: 10.1016/j.cca.2023.117583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND AND AIMS Quinolinic acid (QA) is a metabolite of the kynurenine pathway, which is activated by inflammatory stimuli during viral infection. We investigated the role of QA in patients infected with SARS-CoV-2, particularly its prognostic value for survival. METHODS Overall, 104 unvaccinated inpatients were included, divided into a survival (N = 80) and a deceased group (N = 24). Plasma levels of tryptophan, kynurenine, QA, C-reactive protein (CRP) and procalcitonin (PCT) were measured on admission and after seven days. The QA/TRP ratio and the relative differences between the measurements for QA (QA-Diff) and QA/TRP (Diff-QA/TRP) were calculated. RESULTS Among the kynurenine pathway markers, QA-Diff showed the highest discriminatory power for the survival prognosis (Youden index 0.467, cut-off -1.3 %, AUC 0.733, p < 0.001, sensitivity 0.79, specificity 0.675). Among the inflammatory markers, CRP showed the highest discriminatory power (Youden index 0.533, cut-off 25.0 mg/L, AUC 0.794, p < 0.001, sensitivity 0.958, specificity 0.575). A significant correlation between QA and PCT was found on admission and after one week (Spearman's rho 0.455 and 0.539, all p-values < 0.001). CONCLUSIONS QA may serve as prognostic marker for survival in patients with SARS-CoV-2. The repeated measurements during the first week of the disease may enhance the prognostic power.
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Affiliation(s)
- Simon Michaelis
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria.
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Christopher Schneider
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria
| | - Wolfgang J Schnedl
- Practice for General Internal Medicine, Dr.-Theodor-Körner-Straße 19b, 8600 Bruck/Mur, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical, University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Schönthaler EMD, Dalkner N, von Lewinski D, Reininghaus EZ, Baranyi A. Machiavellianism and psychopathy affect sleep quality in people with affective disorders and mentally healthy individuals. Front Psychol 2023; 14:1248931. [PMID: 37780148 PMCID: PMC10539687 DOI: 10.3389/fpsyg.2023.1248931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Deteriorated sleep quality is a predisposing factor and symptom of affective disorders (AD). It is important to investigate factors driving the relationship between sleep and AD, such as personality traits. Previous research has shown that personality traits such as the Dark Triad personality traits (DT) narcissism, Machiavellianism, and psychopathy are associated with sleep problems and AD. The current study examined the moderating influence of the DT in the relationship between AD [versus healthy controls (HC)] and sleep quality. Methods Data of 657 individuals (267 HC, 390 AD; 483 female, 166 male, eight diverse; Mage = 34.87, SDage = 13.86) were collected in an online survey, which administered the Pittsburgh Sleep Quality Index and the Short Dark Triad questionnaire. Results Moderation analyses controlling for age and gender revealed that Machiavellianism (b = -0.76, p < 0.05, R2 = 0.35) and psychopathy (b = -1.15, p < 0.05, R2 = 0.35), but not narcissism (b = -0.20, p = 0.620, R2 = 0.35), had a negative effect on sleep quality. Specifically, this effect is more pronounced in the HC group, but sleep quality is generally worse in AD. Conclusion Our findings indicate that Machiavellianism and psychopathy should be considered in the prevention and treatment of AD-associated sleep problems. Particularly, monitoring these traits could help to implement timely measures for the prevention of sleep problems, such as psychoeducation and sleep hygiene. The results highlight the role of personality in the aetiopathogenesis of AD and require further differentiation to examine the underlying pathways between the DT, sleep, and AD.
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Affiliation(s)
- Elena M. D. Schönthaler
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Nina Dalkner
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Dirk von Lewinski
- Clinical Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Eva Z. Reininghaus
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Baranyi
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
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Brugger F, Schönthaler EMD, Baranyi A, Reininghaus EZ, von Lewinski D, Dalkner N. Metabolic Syndrome in Affective Disorders: Associations with Dark Triad Personality Traits. Metabolites 2023; 13:956. [PMID: 37623899 PMCID: PMC10456228 DOI: 10.3390/metabo13080956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Previous research has focused on the relationship between affective disorders (AD) and metabolic syndrome (MetS). Aside from biological and lifestyle factors, personality traits were identified as influencing aspects. In particular, the Dark Triad personality traits (DT; Machiavellianism, narcissism, psychopathy) were connected to both AD and worse somatic health, thus possibly resulting in MetS. This observational study aimed to investigate the associations between DT and anthropometric parameters and differences in the DT traits concerning the presence of MetS in individuals with AD. A total of 112 individuals (females = 59, males = 51, diverse = 2, Mage = 47.5, SDage = 11.5) with AD filled out the Short Dark Triad questionnaire. Body Mass Index (BMI) and MetS criteria, including blood pressure, waist circumference, lipid, and glucose levels, were assessed. For Machiavellianism, a positive association with BMI (r = 0.29, p < 0.05) and a negative association with systolic blood pressure (r = -0.23, p < 0.05) were found. No relationship between the overall MetS and DT score (r = 0.08, p = 0.409) was observed. The results were limited by the lack of a control group and the cross-sectional study design, which does not allow for the determination of causality. Machiavellianism was associated with a higher BMI and lower systolic blood pressure, indicating a deteriorating health effect of this trait. Possibly, the higher prevalence of MetS in AD stems from aspects such as lifestyle or medication intake, which might also be influenced by DT. Further research is needed to disentangle underlying mechanisms.
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Affiliation(s)
- Fiona Brugger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Elena M. D. Schönthaler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Eva Z. Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Dirk von Lewinski
- Department of Cardiology, Medical University of Graz, 8036 Graz, Austria;
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
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Enko D, Michaelis S, Schneider C, Schaflinger E, Baranyi A, Schnedl WJ, Muller DJ. The Use of Next-Generation Sequencing in Pharmacogenomics. Clin Lab 2023; 69. [PMID: 37560847 DOI: 10.7754/clin.lab.2023.230103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
BACKGROUND Next-generation sequencing (NGS) methods have become more commonly performed in clinical and research laboratories. METHODS This review summarizes the current laboratory NGS-based diagnostic approaches in pharmacogenomics including targeted multi-gene panel sequencing, whole-exome sequencing (WES), and whole-genome sequencing (WGS). RESULTS Clinical laboratories perform multiple non-uniform types of pharmacogenetic panels, which can reduce the overall number of single-gene tests to be more cost-efficient. Compared to the targeted multi-gene panels, which are not typically designed to detect novel variants, WES and WGS have a greater potential to identify secondary pharmacogenomic findings, which might be predictive for the pharmacotherapy outcome of different patient settings. WGS overcomes the limitations of WES enabling a more accurate exome-sequencing at appropriate coverage and the sequencing of non-coding regions. Different NGS-based study designs with different test strategies and study populations, varying sample sizes, and distinct analytical and interpretation procedures lead to different identification results of pharmacogenomic variants. CONCLUSIONS The rapid progress in gene sequencing technologies will overcome the clinical and laboratory challenges of WES and WGS. Further high throughput NGS-based pharmacogenomics studies in different populations and patient settings are necessary to expand knowledge about rare functional variants and to enhance translation in clinical practice.
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Michaelis S, Schneider C, Schnedl WJ, Baranyi A, Enko D. Comparison of cycle-threshold-values between two commercial SARS-CoV-2 PCR assays. EXCLI J 2023; 22:397-399. [PMID: 37346804 PMCID: PMC10279969 DOI: 10.17179/excli2023-5981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/03/2023] [Indexed: 06/23/2023]
Affiliation(s)
- Simon Michaelis
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria
| | - Christopher Schneider
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria
| | - Wolfgang J. Schnedl
- Practice for General Internal Medicine, Dr.-Theodor-Körner-Straße 19b, 8600 Bruck/Mur, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Michaelis S, Zelzer S, Schneider C, Schnedl WJ, Baranyi A, Meinitzer A, Herrmann M, Enko D. Alteration of the kynurenine pathway is inversely associated with the humoral immune response in patients with SARS-CoV-2. Clin Chim Acta 2022; 537:77-79. [PMID: 36279939 PMCID: PMC9585843 DOI: 10.1016/j.cca.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 11/30/2022]
Abstract
Background The scale and the course of antibody production in patients with SARS-CoV-2 is highly variable. Factors involved in the immune regulation during the infection may play a major role in the antibody response. We investigated the relationship between the inflammatory markers of the kynurenine pathway and the concentration of antibodies against SARS-CoV-2 in infected patients 8 – 11 days after admission. Methods The study included 72 SARS-CoV-2 - positive inpatients hospitalized between August 2020 and April 2021. The plasma concentrations of tryptophan, kynurenine, anti-SARS-CoV-2 antibodies and the leucocyte count were measured 8 – 11 days after admission. The kynurenine/tryptophan ratio (KYN/TRP ratio) was calculated. Tertiles based on the values for tryptophan, kynurenine, KYN/TRP ratio and the leucocytes were generated. Results Statistically significant correlations were observed between anti-SARS-CoV-2 antibodies and tryptophan, kynurenine, KYN/TRP ratio and the leucocytes (p-values < 0.001–0.007). The high kynurenine and KYN/TRP ratio tertiles showed significantly lower antibody titers compared to the low tertiles (p-values 0.017 and < 0.001). The low tryptophan and leucocytes tertiles showed significantly lower antibody titers compared to the high tertiles (p-values 0.001 and 0.008). Conclusion Patients with higher activation levels of the kynurenine pathway tended to develop lower anti-SARS-CoV-2 antibody titers.
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Affiliation(s)
- Simon Michaelis
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria,Corresponding author at: Institute of Clinical Chemistry and Laboratory Medicine General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Christopher Schneider
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria
| | - Wolfgang J. Schnedl
- Practice for General Internal Medicine, Dr.-Theodor-Körner-Straße 19b, 8600 Bruck/Mur, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical, University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Nürnberger P, von Lewinski D, Rothenhäusler HB, Braun C, Reinbacher P, Kolesnik E, Baranyi A. A biopsychosocial model of severe fear of COVID-19. PLoS One 2022; 17:e0264357. [PMID: 35226661 PMCID: PMC8884481 DOI: 10.1371/journal.pone.0264357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/08/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction COVID-19 is a respiratory infection that causes not only somatic health issues, but also frequently psychosocial burdens. The aims of this study were to investigate biopsychosocial factors that might further aggravate fear of COVID-19, and to establish a biopsychosocial model of severe fear of COVID-19. Methods 368 participants were included in this study. Biopsychosocial factors observed comprised biological factors (somatic risk), psychological factors (state/trait anxiety, physical symptoms of anxiety, severe health anxiety, specific phobias, depression), and psychosocial factors (social support, financial losses, social media consumption, social contacts with COVID-19 infected people). Psychometric questionnaires included State-Trait Anxiety Inventory, Beck’s Anxiety Inventory, Whiteley-Index / Illness Attitude Scales, Specific Phobia Questionnaire, WHO-5 and Social Support Survey. Results 162/368 (44.0%) participants had almost no fear, 170/368 (46.2%) participants had moderate fear, and 45/368 (12.2%) participants had severe fear of COVID-19. Female participants showed higher levels of fear of COVID-19 than male participants (gender: χ2 = 18.47, p<0.001). However, the level of fear of COVID-19 increased in male participants when they had contact with people who were infected with COVID-19, while in contrast the level of fear of COVID-19 decreased in female participants when they had such contacts [ANCOVA: fear of COVID-19 (contact x gender): F(1,363) = 5.596, p = .019]. Moreover, participants without relationships showed higher levels of fear of COVID-19 (marital status: χ2 = 14.582, p = 0.024). Furthermore, financial losses due to the COVID-19 were associated with higher levels of fear of COVID-19 [ANCOVA: fear of COVID-19(financial loss x gender): F(1, 363) = 22.853, p< .001]. Multiple regression analysis revealed female gender, severe health anxiety (WI-IAS) and state /trait anxiety (STAI) as significant predictors of severe fear of COVID-19. Conclusion In this study significant predictors of severe fear of COVID-19 were female gender, pre-existing state and trait anxiety, as well as severe health anxiety. The finding of significant predictors of fear of COVID-19 might contribute to detect people who might suffer most from severe, overwhelming fear of COVID-19 at an early stage.
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Affiliation(s)
- Patrick Nürnberger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Dirk von Lewinski
- Department of Internal Medicine Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Celine Braun
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Patrick Reinbacher
- Department of Orthopaedics and Traumatology, Medical University of Graz, Graz, Austria
| | - Ewald Kolesnik
- Department of Internal Medicine Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
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Baranyi A, Meinitzer A, von Lewinski D, Rothenhäusler HB, Amouzadeh-Ghadikolai O, Harpf H, Harpf L, Traninger H, Hödl R, Harb BM, Obermayer-Pietsch B, Schweinzer M, Braun CK, Enko D. Sex-specific differences in trimethylamine N-oxide (TMAO) concentrations before and after cardiac rehabilitation in acute myocardial infarction patients. EXCLI J 2022; 21:1-10. [PMID: 35145364 PMCID: PMC8822301 DOI: 10.17179/excli2021-4366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/03/2021] [Indexed: 12/05/2022]
Abstract
Trimethylamine N-oxide (TMAO) is a biomarker of cardiovascular risk and may enhance the progression of atherosclerosis. The aim of the study was to determine whether there are sex-specific differences in TMAO concentrations before and after cardiac rehabilitation in acute myocardial infarction (AMI) patients. A total of 56 participants [45/56 (80.4 %) males, 11/56 (19.6 %) females] were drawn from AMI inpatients hospitalized at the Division of Cardiology, Medical University of Graz, Austria. For the assessment of TMAO, serum samples were collected within the first day after hospital admission due to AMI and at the start and end of cardiac rehabilitation. Shortly after hospital admission due to AMI, females had significantly higher TMAO blood concentrations than males. These initially high TMAO levels remained almost unchanged in the female AMI patients until the start of cardiac rehabilitation and only reached the lower TMAO concentrations observed in the male patients after rehabilitation [female patients: TMAO (acute myocardial infarction) = 5.93 μmol/L (SE = 1.835); TMAO (start of rehabilitation) = 5.68 μmol/L (SE = 1.217); TMAO (end of rehabilitation) = 3.89 μmol/L (SE = 0.554); male patients: TMAO (acute myocardial infarction) = 3.02 μmol/L (SE = 0.255), TMAO (start of rehabilitation) = 3.91 μmol/L (SE = 0.346), TMAO (end of rehabilitation) = 4.04 μmol/L (SE = 0.363)]. After AMI, women might be at higher cardiovascular risk due to persistently higher levels of TMAO. High TMAO levels in women might decrease after cardiac rehabilitation due to cardiac rehabilitation-associated lifestyle modifications. These lifestyle modifications after AMI might also prevent increases in TMAO concentrations in men.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Dirk von Lewinski
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria,*To whom correspondence should be addressed: Dirk von Lewinski, Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Tel: +43-316-385-80684, E-mail:
| | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Hanns Harpf
- ZARG Zentrum für ambulante Rehabilitation GmbH, Graz, Austria
| | - Leonhard Harpf
- ZARG Zentrum für ambulante Rehabilitation GmbH, Graz, Austria
| | - Heimo Traninger
- ZARG Zentrum für ambulante Rehabilitation GmbH, Graz, Austria
| | - Ronald Hödl
- Ordination Hödl, Ordinationszentrum Privatklinik Graz Ragnitz, Berthold-Linder-Weg 15, 8047 Graz, Austria
| | - Birgit M. Harb
- Pensionsversicherungsanstalt, SKA-RZ St. Radegund für Herz-Kreislauferkrankungen, St. Radegund, Austria
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Endocrinology Lab Platform, Medical University of Graz, Graz, Austria
| | - Melanie Schweinzer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Celine K. Braun
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Dietmar Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Michaelis S, Zelzer S, Schnedl WJ, Baranyi A, Meinitzer A, Enko D. Assessment of tryptophan and kynurenine as prognostic markers in patients with SARS-CoV-2. Clin Chim Acta 2021; 525:29-33. [PMID: 34902346 PMCID: PMC8662911 DOI: 10.1016/j.cca.2021.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/07/2021] [Indexed: 01/06/2023]
Abstract
Background Immune dysregulation and inflammation in patients with SARS-CoV-2 is associated with a poor clinical outcome. We investigated the value of the inflammatory markers tryptophan and kynurenine in predicting the survival outcome of patients with SARS-CoV-2. Methods The study included 252 inpatients with a SARS-CoV-2 infection hospitalized between August 2020 and April 2021. Two groups were generated based on disease survival (survival group: n = 199; deceased group: n = 53). Plasma concentrations of tryptophan, kynurenine and interleukin-6 (IL-6) were measured on admission. In a subset of patients (n = 105; 81 survivors and 24 deceased) concentrations of tryptophan and kynurenine were checked 7 days after admission. The kynurenine/tryptophan ratio (TRP/KYN ratio) was calculated. Results On admission, the deceased group showed significantly higher concentrations of kynurenine and a significantly higher KYN/TRP ratio compared to the survival group (p-values < 0.001). Kynurenine and the KYN/TRP ratio significantly correlated with IL-6 (ρ = 0.441 and 0.448, p-values < 0.001). In the survival group, kynurenine and the KYN/TRPratio were significantly lower after seven days (p-values < 0.001). In the deceased group, no significant differences were found between the measurements. Conclusion Kynurenine and the KYN/TRP ratio are potentially useful parameters in predicting the survival outcome in SARS-CoV-2 positive patients.
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Affiliation(s)
- Simon Michaelis
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria.
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Wolfgang J Schnedl
- Practice for General Internal Medicine, Dr.-Theodor-Körner-Straße 19b, 8600 Bruck/Mur, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Lafer I, Michaelis S, Schneider C, Baranyi A, Schnedl WJ, Holasek S, Zelzer S, Niedrist T, Meinitzer A, Enko D. Beta-trace protein concentrations at the blood-cerebrospinal fluid barrier - acute phase affects protein status. EXCLI J 2021; 20:1446-1452. [PMID: 34737686 PMCID: PMC8564902 DOI: 10.17179/excli2021-4148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/31/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Ingrid Lafer
- Department of Internal Medicine, General Hospital Hochsteiermark, Mürzzuschlag, Austria
| | - Simon Michaelis
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria
| | - Christopher Schneider
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Sandra Holasek
- Department of Immunology and Pathophysiology, Medical University of Graz, Otto Loewi Research Center, Graz, Austria
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Von Lewinski D, Enko D, Rotenhaeusler HP, Amouzadeh-Ghadikolai O, Harpf H, Harpf L, Traninger H, Obermayer-Pietsch B, Von Lewinski F, Schweinzer M, Braun C, Meinitzer A, Baranyi A. TMAO (trimethylamine n-oxide) as a potential biomarker of individual severe stress perception in posttraumatic stress disorder (PTSD)-vulnerable patients after acute myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Acute myocardial infarction is not only a somatic disease but potentially triggers psychological effects, too. Post-traumatic stress disorder (PTSD) is a common stress-related disorder. It is characterized by numerous symptoms, such as flashbacks, intrusions, nightmares and severe anxiety, as well as uncontrollable, intense and disturbing thoughts and feelings related to the traumatic experience. However, with regard to the development of PTSD, individual stress perception might be crucial since not every serious traumatic experience leads to PTSD. To date, almost no biological correlates of an individual's perception of stress have been identified as being associated with the long-term development of PTSD.
Objective
The aim of the study was to determine whether blood levels of TMAO vary immediately after AMI (1) in patients with or without depression, and (2) in patients with AMI induced PTSD symptomatology (subsyndromal PTSD and full PTSD). Furthermore, we investigated whether TMAO is a potential biomarker that might be useful in the prediction of PTSD symptomatology in the long term.
Method
A total of 114 AMI patients were assessed with standardized clinical psychiatric interviews based on the Hamilton Depression Scale (HAMD-17) after admission to the hospital and 6 months later. In addition, the CAPS-5 was used to explore PTSD symptoms (subsyndromal PTSD and full PTSD) 6 months after AMI. To assess patients' TMAO status, serum samples were collected at hospitalization and 6 months after AMI.
Results
Study participants with post-myocardial infarction PTSD symptomatology (subsyndromal PTSD and full PTSD) had significantly higher TMAO levels immediately after AMI than patients without PTSD symptoms (ANCOVA: TMAO (PTSD x time), F = 4.544, df = 1, p=0.035). In contrast, depressive symptomatology 6 months after AMI had no influence on TMAO levels (TMAO (depression x time), F = 0.083, df = 1, p=0.774). With the inclusion of additional clinical predictors in a hierarchical logistic regression model, TMAO becomes a significant predictor of PTSD symptomatology.
Conclusions
An elevated TMAO level immediately after AMI might reflect severe stress in PTSD-vulnerable patients, which might also lead to a short-term increased gut permeability to trimethylamine (TMA), the precursor of TMAO. Thus, elevated TMAO might be a biological correlate for stress that is associated with vulnerability to PTSD and might help to identify patients at increased risk.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Von Lewinski
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - D Enko
- Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria
| | - H P Rotenhaeusler
- Medical University of Graz, Department of Psychiatry and Psychotherapeutic Medicine, Graz, Austria
| | | | - H Harpf
- Center for outpatient rehabilitation Graz, Graz, Austria
| | - L Harpf
- Center for outpatient rehabilitation Graz, Graz, Austria
| | - H Traninger
- Center for outpatient rehabilitation Graz, Graz, Austria
| | | | - F Von Lewinski
- Medical University of Graz, Department of Endocrinology, Graz, Austria
| | - M Schweinzer
- Medical University of Graz, Department of Psychiatry and Psychotherapeutic Medicine, Graz, Austria
| | - C Braun
- Medical University of Graz, Department of Psychiatry and Psychotherapeutic Medicine, Graz, Austria
| | - A Meinitzer
- Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria
| | - A Baranyi
- Medical University of Graz, Department of Psychiatry and Psychotherapeutic Medicine, Graz, Austria
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Enko D, Zelzer S, Baranyi A, Herrmann M, Meinitzer A. Determination of Trimethylamine-N-oxide by a Simple Isocratic High-Throughput Liquid-Chromatography Tandem Mass-Spectrometry Method. Clin Lab 2021; 66. [PMID: 32902221 DOI: 10.7754/clin.lab.2020.200122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND As trimethylamine-N-oxide (TMAO) is considered to be associated with various diseases, rapid determination of serum TMAO concentration is of clinical interest. This study is aimed at evaluating the analytical performance of a simple isocratic liquid chromatography-tandem mass-spectrometry (LC-MS/MS) method for TMAO quantification. METHODS TMAO measurements were performed on a tandem mass spectrometer, SCIEX QTRAP 4500 (Applied Biosystems, Framingham, MA, USA), coupled with an Agilent 1260 Infinity HPLC system (Agilent Technologies, Santa Clara, CA, USA). The separation was performed on a Hypercarb Porus Grahitic Carbon (PGC) column (ThermoFisher Scientific, Waltham, MA, USA) by isocratic elution mode. Linearity, precision, recovery, and pre-analytical requirements of the TMAO LC-MS/MS method were evaluated. The imprecision acceptance criteria were defined 15%. We investigated sample stability at room temperature (RT) and assessed the serum TMAO concentrations of 188 healthy adults. RESULTS The TMAO LC-MS/MS method was linear over the concentration range of 0.5 - 80 μmol/L. Intra- and inter-day precision ranged between 2.24 - 3.37% and 6.95 - 9.97%, recovery between 106 - 114%, respectively. At RT, serum samples were stable for 8 days. The median serum TMAO concentration of 188 healthy adults was 2.27 μmol/L (2.5th and 97.5th percentile: 0.75 - 10.46 μmol/L), respectively. CONCLUSIONS The isocratic TMAO LC-MS/MS shows a broad analytical range and meets the imprecision acceptance criteria of 15%. This method is a robust and reliable diagnostic tool for the assessment of the human TMAO status. Serum samples are stable at RT for at least 8 days.
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Baranyi A, Enko D, von Lewinski D, Rothenhäusler HB, Amouzadeh-Ghadikolai O, Harpf H, Harpf L, Traninger H, Obermayer-Pietsch B, Schweinzer M, Braun CK, Meinitzer A. Assessment of trimethylamine N-oxide (TMAO) as a potential biomarker of severe stress in patients vulnerable to posttraumatic stress disorder (PTSD) after acute myocardial infarction. Eur J Psychotraumatol 2021; 12:1920201. [PMID: 34104352 PMCID: PMC8168738 DOI: 10.1080/20008198.2021.1920201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is a frequently observed stress-related disorder after acute myocardial infarction (AMI) and it is characterized by numerous symptoms, such as flashbacks, intrusions and anxiety, as well as uncontrollable thoughts and feelings related to the trauma. Biological correlates of severe stress might contribute to identifying PTSD-vulnerable patients at an early stage. Objective: Aims of the study were (1) to determine whether blood levels of trimethylamine N-oxide (TMAO) vary immediately after AMI in patients with/without AMI-induced PTSD symptomatology, (2) to investigate whether TMAO is a potential biomarker that might be useful in the prediction of PTSD and the PTSD symptom subclusters re-experiencing, avoidance and hyperarousal, and (3) to investigate whether TMAO varies immediately after AMI in patients with/without depression 6 months after AMI. Method: A total of 114 AMI patients were assessed with the Hamilton-Depression Scale after admission to the hospital and 6 months later. The Clinician Administered PTSD Scale for DSM-5 was used to explore PTSD-symptoms at the time of AMI and 6 months after AMI. To assess patients' TMAO status, serum samples were collected at hospitalization and 6 months after AMI. Results: Participants with PTSD-symptomatology had significantly higher TMAO levels immediately after AMI than patients without PTSD-symptoms (ANCOVA: TMAO(PTSD x time), F = 4.544, df = 1, p = 0.035). With the inclusion of additional clinical predictors in a hierarchical logistic regression model, TMAO became a significant predictor of PTSD-symptomatology. No significant differences in TMAO levels immediately after AMI were detected between individuals with/without depression 6 months after AMI. Conclusions: An elevated TMAO level immediately after AMI might reflect severe stress in PTSD-vulnerable patients, which might also lead to a short-term increase in gut permeability to trimethylamine, the precursor of TMAO. Thus, an elevated TMAO level might be a biological correlate for severe stress that is associated with vulnerability to PTSD.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Dietmar Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Dirk von Lewinski
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Hanns Harpf
- ZARG Zentrum Für Ambulante Rehabilitation GmbH, Graz, Austria
| | - Leonhard Harpf
- ZARG Zentrum Für Ambulante Rehabilitation GmbH, Graz, Austria
| | - Heimo Traninger
- ZARG Zentrum Für Ambulante Rehabilitation GmbH, Graz, Austria
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Melanie Schweinzer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Celine K Braun
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Enko D, Moro T, Holasek S, Baranyi A, Schnedl WJ, Zelzer S, Mangge H, Herrmann M, Meinitzer A. Branched-chain amino acids are linked with iron metabolism. Ann Transl Med 2021; 8:1569. [PMID: 33437768 PMCID: PMC7791222 DOI: 10.21037/atm-20-624a] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background The branched-chain amino acids (BCAAs) valine, leucine and isoleucine are reported to influence erythropoiesis and the human iron status. Large study cohorts encompassing biomarkers of iron metabolism and BCAAs are still lacking. Methods We investigated potential interactions between blood concentrations of all three BCAAs valine, leucine and isoleucine and biomarkers of iron metabolism [i.e., hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), iron, transferrin, ferritin, transferrin saturation, soluble transferrin receptor (sTfR)] in 430 outpatients referred for a medical health check-up. Linear regression models were performed to assess possible associations between variables. Results All three BCAAs were positively correlated with Hb, ferritin and the sTfR (r-values: 0.145–0.382; P values: <0.001–0.003). The strongest correlation was observed between valine and Hb (r=0.382; P value <0.001). Linear regression models showed a statistically significant influence of all three BCAAs on Hb and ferritin (β-coefficients: 0.173–0.351; all P values: <0.001). Seventeen patients with anemia (4%) were found with significantly lower serum BCAA concentrations compared to 413 non-anemic individuals (P<0.05). Conclusions These data indicate a pathophysiological link between the three BCAAs valine, leucine and isoleucine and the human iron indicators Hb and ferritin. Further studies are needed to clarify the exact causal mechanisms of these findings.
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Affiliation(s)
- Dietmar Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria
| | - Thomas Moro
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Sandra Holasek
- Department of Immunology and Pathophysiology, Medical University of Graz, Otto Loewi Research Center, Graz, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Enko D, Zelzer S, Wenninger J, Holasek S, Schnedl WJ, Baranyi A, Herrmann M, Meinitzer A. Interleukin-6 is associated with tryptophan metabolism and signs of depression in individuals with carbohydrate malabsorption. EXCLI J 2020; 19:1414-1422. [PMID: 33312105 PMCID: PMC7726491 DOI: 10.17179/excli2020-2940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022]
Abstract
The aim of the present study was to investigate possible associations between interleukin-6 (IL-6), interferon-gamma (INF-γ), tumor necrosis factor-alpha (TNF-α), lactoferrin and lipopolysaccharide binding protein (LBP) with TRP metabolism and signs of depression in a large cohort of outpatients referred for carbohydrate malabsorption testing. Serum concentrations of IL-6, INF-γ, TNF-α, lactoferrin, LBP, tryptophan (TRP), kynurenine (KYN) and kynuric acid were determined in 250 adults referred for lactose and fructose malabsorption testing. All participants filled out the Beck Depression Inventory (BDI). Serum IL-6 levels were positively correlated with the BDI score (p = 0.001, ρ = 0.205) and indicators of TRP metabolism (KYN/TRP ratio, KYN) (P-values < 0.05, ρ = 0.176 and 0.136). Ninety-five individuals with a BDI score > 13 showed significantly higher IL-6 serum levels (1.7 [1.0 - 2.8] vs. 1.1 [0.8 - 1.7] pg/mL, p < 0.001) compared to 115 individuals with a BDI score ≤ 13. LBP showed a positive correlation with the KYN/TRP ratio (p = 0.005, ρ = 0.177). IL-6 and LBP were associated with indicators of TRP metabolism. IL-6 was found to be linked to signs of depression. Individuals with the presence of depressive symptoms showed higher serum IL-6 levels compared to individuals without depressive symptoms.
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Affiliation(s)
- Dietmar Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Julian Wenninger
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Sandra Holasek
- Department of Immunology and Pathophysiology, Medical University of Graz, Graz, Austria
| | | | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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16
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Enko D, Zelzer S, Niedrist T, Holasek S, Baranyi A, Schnedl WJ, Herrmann M, Meinitzer A. Assessment of trimethylamine-N-oxide at the blood-cerebrospinal fluid barrier: Results from 290 lumbar punctures. EXCLI J 2020; 19:1275-1281. [PMID: 33122976 PMCID: PMC7590830 DOI: 10.17179/excli2020-2763] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/08/2020] [Indexed: 01/05/2023]
Abstract
Recently, the microbiome-derived trimethylamine-N-oxide (TMAO) was shown to be present in human cerebrospinal fluid (CSF). However, data on the potential of TMAO crossing the blood-CSF barrier are still lacking. This retrospective study aimed at investigating possible associations between the CSF/serum albumin (QALB) and TMAO (QTMAO) quotient and evaluating QTMAO values in individuals with and without blood-CSF barrier dysfunction. A total of 290 patients, who underwent diagnostic lumbar puncture with QALB and QTMAO determination, were evaluated. Serum and CSF TMAO measurements were performed on a tandem mass spectrometry SCIEX QTRAP 4500 (Applied Biosystems, Framingham, MA, USA) coupled with an Agilent 1260 Infinity HPLC system (Agilent Technologies Santa Clara, CA, USA). Serum and CSF albumin were measured on the Atellica® NEPH 630 system (Siemens Healthineers, Erlangen, Germany). CSF TMAO levels were positively correlated with serum TMAO levels (ρ = 0.709, p < 0.001). The QALB was significantly associated with the QTMAO (ß-coefficient = 0.312; p < 0.001). A total of 117 patients with blood-CSF barrier dysfunction had significantly higher median (Q1 - Q3) QTMAO values (4.7 (2.8 - 7.5) vs. 3.8 (2.5 - 5.7) x 10-1, p = 0.002) compared to 173 individuals with normal blood-CSF barrier function. CSF and serum TMAO concentrations were significantly associated in 290 CSF/serum pairs from lumbar punctures of clinical routine. QALB showed a relevant influence on QTMAO. Present results indicate that TMAO may cross the blood-CSF barrier.
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Affiliation(s)
- Dietmar Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Sandra Holasek
- Department of Immunology and Pathophysiology, Medical University of Graz, Otto Loewi Research Center, Graz, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Enko D, Herrmann M, Baranyi A, Schnedl WJ, Halwachs-Baumann G. Long time blood-transfusion trend in a European general hospital. EXCLI J 2020; 19:855-860. [PMID: 33013261 PMCID: PMC7527503 DOI: 10.17179/excli2020-2526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/16/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Dietmar Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria,Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Austria,Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Austria,*To whom correspondence should be addressed: Dietmar Enko, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; Telephone: +43-316-385-13145, Fax: +43-316-385-13430, E-mail:
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
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Meinitzer S, Baranyi A, Holasek S, Schnedl WJ, Zelzer S, Mangge H, Herrmann M, Meinitzer A, Enko D. Sex-Specific Associations of Trimethylamine-N-Oxide and Zonulin with Signs of Depression in Carbohydrate Malabsorbers and Nonmalabsorbers. Dis Markers 2020; 2020:7897240. [PMID: 31998418 PMCID: PMC6969987 DOI: 10.1155/2020/7897240] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/08/2019] [Accepted: 12/23/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND The microbiome-derived trimethylamine-N-oxide (TMAO) and the intestinal permeability marker zonulin are considered to be linked with depression. Moreover, carbohydrate malabsorption (CMA) was shown to be associated with signs of depression. This study is aimed at investigating possible sex-specific associations between TMAO and zonulin and the presence of depressive signs in individuals with and without CMA. METHODS Serum concentrations of TMAO and zonulin were determined in 115 and 136 individuals with the presence or absence of CMA. All 251 study participants underwent lactase gene C/T-13910 polymorphism genotyping and fructose H2/CH4 breath testing. Additionally, they filled in the Beck Depression Inventory (BDI-II) questionnaire. RESULTS The median TMAO and zonulin serum concentrations were 2.66 (1.93-4.14) μmol/L and 40.83 (34.73-47.48) ng/mL. Serum TMAO levels were positively correlated with depressive symptoms (P = 0.011, ρ = 0.160). The strongest correlations were observed in 87 females (P = 0.010, ρ = 0.274) and 49 males (P = 0.027, ρ = 0.315) without CMA, whereas 115 patients with CMA showed no significant correlations. Zonulin tended to be negatively correlated with the BDI-II score in 49 males without CMA (P = 0.062, ρ = -0.269). CONCLUSION This study demonstrates a positive correlationship between the serum TMAO concentrations and the severity of depressive symptoms in females and males without CMA. Serum zonulin levels were negatively correlated with signs of depression in males without CMA. These findings suggest a gender-specific relationship between the serum TMAO and zonulin concentrations, depression, and CMA.
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Affiliation(s)
- Sophie Meinitzer
- 1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Andreas Baranyi
- 2Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Sandra Holasek
- 3Department of Immunology and Pathophysiology, Medical University of Graz, 8010 Graz, Austria
| | | | - Sieglinde Zelzer
- 1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Harald Mangge
- 1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Markus Herrmann
- 1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Andreas Meinitzer
- 1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Dietmar Enko
- 1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
- 5Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, 8700 Leoben, Austria
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Amouzadeh-Ghadikolai O, Pascale-Scharmüller L, Baranyi A, Lehofer M, Saletu M. [Strangulation as scenic behavior. A case report of a pseudosuicide in the course of a NREM-parasomnia]. Neuropsychiatr 2019; 33:165-169. [PMID: 29992439 DOI: 10.1007/s40211-018-0280-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/18/2018] [Indexed: 06/08/2023]
Abstract
It is generally accepted, that sleepwalkers show complex behaviors leading to non-intended consequences. It is not unusual that these persons are thereby injured. However, sporadically a bizarre endangering of themselves or others is reported also, which ranges from homicide of the life partner to accidental (pseudo-)suicide.In this article, we report on a 28year-old man who unexpectedly attempted to hang himself by a whip at night. We discuss the reasons, why this bizarre act should actually be taken as a scenic behavior in the course of a NREM-parasomnia, and the difficulty to proof this claim.
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Affiliation(s)
- Omid Amouzadeh-Ghadikolai
- Abteilung für Psychiatrie und Psychotherapie III, Standort Süd, Landeskrankenhaus Graz Süd/West, Wagner Jauregg Platz 1, 8053, Graz, Österreich.
- Bereich für Schlafmedizin, Standort Süd, Landeskrankenhaus Graz Süd/West, Wagner Jauregg Platz 1, 8053, Graz, Österreich.
- Universitätsklinik für Medizinische Psychologie und Psychotherapie, Medizinische Universität Graz, Auenbruggerplatz 3, 8036, Graz, Österreich.
| | - Laura Pascale-Scharmüller
- Bereich für Schlafmedizin, Standort Süd, Landeskrankenhaus Graz Süd/West, Wagner Jauregg Platz 1, 8053, Graz, Österreich
| | - Andreas Baranyi
- Universitätsklinik für Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Auenbruggerplatz 3, 8036, Graz, Österreich
| | - Michael Lehofer
- Abteilung für Psychiatrie und Psychotherapie III, Standort Süd, Landeskrankenhaus Graz Süd/West, Wagner Jauregg Platz 1, 8053, Graz, Österreich
| | - Michael Saletu
- Bereich für Schlafmedizin, Standort Süd, Landeskrankenhaus Graz Süd/West, Wagner Jauregg Platz 1, 8053, Graz, Österreich
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20
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Baranyi A, Meinitzer A, Rothenhäusler HB, Amouzadeh-Ghadikolai O, Lewinski DV, Breitenecker RJ, Herrmann M. Metabolomics approach in the investigation of depression biomarkers in pharmacologically induced immune-related depression. PLoS One 2018; 13:e0208238. [PMID: 30496323 PMCID: PMC6264814 DOI: 10.1371/journal.pone.0208238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 11/14/2018] [Indexed: 12/15/2022] Open
Abstract
Background The aim of this study was to identify previously unrecognised biological pathways and biomarkers that might expand the inflammatory hypothesis of depression. Methods Broad metabolomics analyses in plasma samples from 31 chronic hepatitis C-infected patients with and without immune-related depression were carried out using the Absolute IDQ p180 kit—a targeted metabolomics approach of combined direct flow injection and liquid chromatography that measures acylcarnitines, amino acids, biogenic amines, glycerophospholipids, sphingolipids, and sugars. Results The measurements showed that the average concentration of the branched-chain amino acid isoleucine was significantly lower in depressive HCV patients in comparison to non-depressive HCV patients [depression group: Median 51.35 (43.4–60.2 μmol/L) vs. Median 62.10 (38.4–81.7 μmol/L); U = -2.958; p = 0.002]. All other amino acids, acylcarnitines, biogenic amines, glycerophospholipids, sphingolipids, sugars, liver enzymes and thyroid levels showed no statistically significant differences. Conclusions The results of the present study suggest that the branched-chain amino acid isoleucine might play a role in the pathophysiology of immune-related major depression, which expands existing knowledge about inflammatory hypothesis of depression.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- * E-mail: (AB); (AM)
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- * E-mail: (AB); (AM)
| | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Dirk V. Lewinski
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Baranyi A, Amouzadeh-Ghadikolai O, von Lewinski D, Breitenecker RJ, Rothenhäusler HB, Robier C, Baranyi M, Theokas S, Meinitzer A. Revisiting the tryptophan-serotonin deficiency and the inflammatory hypotheses of major depression in a biopsychosocial approach. PeerJ 2017; 5:e3968. [PMID: 29109914 PMCID: PMC5671663 DOI: 10.7717/peerj.3968] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 10/08/2017] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this cross-sectional study was to identify important biopsychosocial correlates of major depression. Biological mechanisms, including the inflammatory and the tryptophan-serotonin deficiency hypotheses of major depression, were investigated alongside health-related quality of life, life satisfaction, and social support. Methods The concentrations of plasma tryptophan, plasma kynurenine, plasma kynurenic acid, serum quinolinic acid, and the tryptophan breakdown to kynurenine were determined alongside health-related quality of life (Medical Outcome Study Form, SF-36), life satisfaction (Life Satisfaction Questionnaire, FLZ), and social support (Social Support Survey, SSS) in 71 depressive patients at the time of their in-patient admittance and 48 healthy controls. Results Corresponding with the inflammatory hypothesis of major depression, our study results suggest a tryptophan breakdown to kynurenine in patients with major depression, and depressive patients had a lower concentration of neuroprotective kynurenic acid in comparison to the healthy controls (Mann-Whitney-U: 1315.0; p = 0.046). Contradicting the inflammatory theory, the concentrations of kynurenine (t: -0.945; df = 116; p = 0.347) and quinolinic acid (Mann-Whitney-U: 1376.5; p = 0.076) in depressive patients were not significantly different between depressed and healthy controls. Our findings tend to support the tryptophan-serotonin deficiency hypothesis of major depression, as the deficiency of the serotonin precursor tryptophan in depressive patients (t: -3.931; df = 116; p < 0.001) suggests dysfunction of serotonin neurotransmission. A two-step hierarchical linear regression model showed that low tryptophan concentrations, low social support (SSS), occupational requirements (FLZ), personality traits (FLZ), impaired physical role (SF-36), and impaired vitality (SF-36) predict higher Beck Depression Inventory (BDI-II) scores. Discussion Our study results argue for the validity of a biopsychosocial model of major depression with multiple pathophysiological mechanisms involved.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Dirk von Lewinski
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Maria Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Simon Theokas
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Baranyi A, Amouzadeh-Ghadikolai O, Lewinski DV, Breitenecker RJ, Stojakovic T, März W, Robier C, Rothenhäusler HB, Mangge H, Meinitzer A. Beta-trace Protein as a new non-invasive immunological Marker for Quinolinic Acid-induced impaired Blood-Brain Barrier Integrity. Sci Rep 2017; 7:43642. [PMID: 28276430 PMCID: PMC5343478 DOI: 10.1038/srep43642] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/26/2017] [Indexed: 12/27/2022] Open
Abstract
Quinolinic acid, a macrophage/microglia-derived excitotoxin fulfills a plethora of functions such as neurotoxin, gliotoxin, and proinflammatory mediator, and it alters the integrity and cohesion of the blood-brain barrier in several pathophysiological states. Beta-trace protein (BTP), a monomeric glycoprotein, is known to indicate cerebrospinal fluid leakage. Thus, the prior aim of this study was to investigate whether BTP might non-invasively indicate quinolinic acid-induced impaired blood-brain barrier integrity. The research hypotheses were tested in three subsamples with different states of immune activation (patients with HCV-infection and interferon-α, patients with major depression, and healthy controls). BTP has also been described as a sensitive marker in detecting impaired renal function. Thus, the renal function has been considered. Our study results revealed highest quinolinic acid and highest BTP- levels in the subsample of patients with HCV in comparison with the other subsamples with lower or no immune activation (quinolinic acid: F = 21.027, p < 0.001 [ANOVA]; BTP: F = 6.792, p < 0.01 [ANOVA]). In addition, a two-step hierarchical linear regression model showed that significant predictors of BTP levels are quinolinic acid, glomerular filtration rate and age. The neurotoxin quinolinic acid may impair blood-brain barrier integrity. BTP might be a new non-invasive biomarker to indicate quinolinic acid-induced impaired blood-brain barrier integrity.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.,Institute for International Management Practice, ARU Cambridge, Cambridge, UK
| | | | - Dirk von Lewinski
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Robert J Breitenecker
- Department of Innovation Management and Entrepreneurship, Alpen-Adria-Universität Klagenfurt, Klagenfurt, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Synlab Academy, Synlab Services LLC, Mannheim, Germany.,Medical Clinic V (Nephrology, Hypertensiology, Endocrinology), Medical Faculty Mannheim, Ruperto Carola University Heidelberg, Mannheim, Germany
| | - Christoph Robier
- Hospital of the Brothers of St. John of God, Graz, Austria.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Meinitzer A, Zelzer S, Mangge H, Almer G, Prassl R, Amouzadeh-Ghadikolai O, Robier C, Baranyi A. Nitric oxide-related cardiovascular risk factors in patients with major depression. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Baranyi A, Amouzadeh-Ghadikolai O, von Lewinski D, Rothenhäusler HB, Theokas S, Robier C, Mangge H, Reicht G, Hlade P, Meinitzer A. Branched-Chain Amino Acids as New Biomarkers of Major Depression - A Novel Neurobiology of Mood Disorder. PLoS One 2016; 11:e0160542. [PMID: 27490818 PMCID: PMC4973973 DOI: 10.1371/journal.pone.0160542] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/21/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The proteinogenic branched-chain amino acids (BCAAs) valine, leucine and isoleucine might play an unrecognised crucial role in the development of depression through their activation of the mammalian target of rapamycin (mTor) pathway. The aim of this research project is to evaluate whether BCAAs are altered in patients with major depression and might thus be appropriate biomarkers for major depression. METHODS The concentrations of valine, leucine and isoleucine were determined in 71 in-patients with major depression and 48 healthy controls by high-pressure liquid chromatography. Psychiatric and laboratory assessments were obtained at the time of in-patient admittance. RESULTS The BCAAs are significantly decreased in patients with major depression in comparison with healthy subjects (valine: Mann-Whitney-U: 968.0; p <0.0001, leucine: Mann-Whitney-U: 1246.5; p = 0.013, isoleucine: Mann-Whitney-U: 1252.5; p = 0.014). Furthermore, as shown by Spearman's rank correlation coefficients, there is a significant negative correlation between valine, leucine and isoleucine concentrations and the Hamilton Depression Rating Scale (HAMD-17) as well as Beck Depression Inventory (BDI-II) scores. CONCLUSIONS Our study results are strong evidence that in patients with major depression, BCAAs might be appropriate biomarkers for depression. Reduced activation of the mammalian target of rapamycin (mTor) due to a reduction of BCAAs might play a crucial unrecognised factor in the etiology of depression and may evoke depressive symptomatology and lower energy metabolism in patients with major depression. In the future, mTor and its up- and downstream signalling partners might be important targets for the development of novel antidepressants.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- Institute for International Management Practice, ARU Cambridge, Cambridge, UK
| | | | - Dirk von Lewinski
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Simon Theokas
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Christoph Robier
- Hospital of the Brothers of St. John of God, Graz, Austria
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Gerhard Reicht
- Hospital of the Brothers of St. John of God, Graz, Austria
| | - Peter Hlade
- Hospital of the Brothers of St. John of God, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Baranyi A, Amouzadeh-Ghadikolai O, Rothenhäusler HB, Theokas S, Robier C, Baranyi M, Koppitz M, Reicht G, Hlade P, Meinitzer A. Nitric Oxide-Related Biological Pathways in Patients with Major Depression. PLoS One 2015; 10:e0143397. [PMID: 26581044 PMCID: PMC4651499 DOI: 10.1371/journal.pone.0143397] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/04/2015] [Indexed: 11/19/2022] Open
Abstract
Background Major depression is a well-known risk factor for cardiovascular diseases and increased mortality following myocardial infarction. However, biomarkers of depression and increased cardiovascular risk are still missing. The aim of this prospective study was to evaluate, whether nitric-oxide (NO) related factors for endothelial dysfunction, such as global arginine bioavailability, arginase activity, L-arginine/ADMA ratio and the arginine metabolites asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) might be biomarkers for depression-induced cardiovascular risk. Methods In 71 in-patients with major depression and 48 healthy controls the Global Arginine Bioavailability Ratio (GABR), arginase activity (arginine/ornithine ratio), the L-arginine/ADMA ratio, ADMA, and SDMA were determined by high-pressure liquid chromatography. Psychiatric and laboratory assessments were obtained at baseline at the time of in-patient admittance and at the time of hospital discharge. Results The ADMA concentrations in patients with major depression were significantly elevated and the SDMA concentrations were significantly decreased in comparison with the healthy controls. Even after a first improvement of depression, ADMA and SDMA levels remained nearly unchanged. In addition, after a first improvement of depression at the time of hospital discharge, a significant decrease in arginase activity, an increased L-arginine/ADMA ratio and a trend for increased global arginine bioavailability were observed. Conclusions Our study results are evidence that in patients with major depression ADMA and SDMA might be biomarkers to indicate an increased cardiovascular threat due to depression-triggered NO reduction. GABR, the L-arginine/ADMA ratio and arginase activity might be indicators of therapy success and increased NO production after remission.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, Medical University of Graz, Graz, Austria
- Institute for International Management Practice at ARU Cambridge, Cambridge, United Kingdom
- * E-mail:
| | | | | | - Simon Theokas
- Department of Psychiatry, Medical University of Graz, Graz, Austria
| | - Christoph Robier
- Hospital of the Brothers of St. John of God, Graz, Austria
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Maria Baranyi
- Department of Psychiatry, Medical University of Graz, Graz, Austria
| | - Michael Koppitz
- Department of Psychiatry, Medical University of Graz, Graz, Austria
| | - Gerhard Reicht
- Hospital of the Brothers of St. John of God, Graz, Austria
| | - Peter Hlade
- Hospital of the Brothers of St. John of God, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Baranyi A, Meinitzer A, Breitenecker RJ, Amouzadeh-Ghadikolai O, Stauber R, Rothenhäusler HB. Quinolinic Acid Responses during Interferon-α-Induced Depressive Symptomatology in Patients with Chronic Hepatitis C Infection - A Novel Aspect for Depression and Inflammatory Hypothesis. PLoS One 2015; 10:e0137022. [PMID: 26368809 PMCID: PMC4569409 DOI: 10.1371/journal.pone.0137022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/11/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of this exploratory study is to gain for the first time a more comprehensive picture of the impact of changes of quinolinic acid concentrations on depressive symptomatology during and after IFN-α therapy. METHODS The quinolinic acid concentrations of 35 HCV patients are examined in a prospective survey over the entire period of IFN-α treatment as well as three months later at six different times (baseline, one, three, six and nine months after the beginning of IFN-α treatment, and after the end of treatment). RESULTS During IFN-α treatment Hamilton Depression Rating Scale scores rise significantly. At the same time there is greater activity of indoleamine 2,3-dioxygenase, with a resulting increase in plasma kynurenine concentrations. Compared to baseline values quinolinic acid concentrations increase significantly during therapy, reflecting an increased neurotoxic challenge. In addition, patients with higher scores in the Hamilton Depression Rating Scale at six and nine months after starting therapy show significantly higher levels of quinolinic acid concentration. CONCLUSIONS The increase of quinolinic acid during IFN-α therapy might contribute to depressive symptomatology through the neurotoxic challenge caused by quinolinic acid. Subsequently, our exploratory study results support the inflammatory hypothesis of depression. The awareness of relevant risk factors of IFN-α treatment-induced depression is essential to develop preventative treatment strategies.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Robert J. Breitenecker
- Alpen-Adria Universität Klagenfurt, Department of Innovation Management and Entrepreneurship, Klagenfurt, Austria
| | | | - Rudolf Stauber
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Baranyi A. Interferon-alpha-induced depression: A reply to the letters to the editor by Mahajan et al. and Porcelli et al. Psychother Psychosom 2015; 83:312. [PMID: 25116854 DOI: 10.1159/000362765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 04/03/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, Medical University of Graz, Graz, Austria
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Baranyi A, Meinitzer A, Stepan A, Putz-Bankuti C, Breitenecker RJ, Stauber R, Kapfhammer HP, Rothenhäusler HB. A biopsychosocial model of interferon-alpha-induced depression in patients with chronic hepatitis C infection. Psychother Psychosom 2014; 82:332-40. [PMID: 23942342 DOI: 10.1159/000348587] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 01/21/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this prospective study was to gain a more comprehensive picture of the biopsychosocial effects of interferon-α (IFN-α) treatment of patients with chronic hepatitis C (HCV). The predictors of depressive development and changes in health-related quality of life, life satisfaction and cognitive ability were measured with the inclusion of the social context. Furthermore, the effects of IFN-α treatment on indoleamine 2,3-dioxygenase, the level of tryptophan supply in the brain, the development of neurotoxic kynurenine metabolites and the thyroid glands were investigated. Therefore, for the first time the conditions for the development of depressive episodes in HCV patients treated with IFN-α were examined over the entire period of treatment as well as 3 months later, applying a holistic biopsychosocial model. METHOD Psychiatric and biological assessments were carried out at 6 different times: before, during (at 1, 3, 6 and 9 months) and after the end of IFN-α treatment. RESULTS During IFN-α treatment 22 (53.7%) of 41 patients fulfilled the criteria for a treatment-related depressive disorder at least once during treatment. Contributing factors are tryptophan depletion (tryptophan to competing amino acids quotient), increased neurotoxic challenge (kynurenine to kynurenic acid quotient), less social support, female gender, preexisting psychiatric vulnerability, means of transmission, low financial security, impaired sexual satisfaction, small circle of friends, impaired physical role, strong body pain, low general health and vitality, reduced social functioning, impaired mental health and impaired emotional role. CONCLUSIONS The awareness of relevant risk factors of IFN-α treatment-induced depression is essential to develop preventative treatment strategies.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, Medical University of Graz, Graz, Austria.
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Baranyi A, Rothenhäusler HB. The Impact of Soluble Interleukin-2 Receptor as a Biomarker of Delirium. Psychosomatics 2014; 55:51-60. [DOI: 10.1016/j.psym.2013.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 06/04/2013] [Accepted: 06/04/2013] [Indexed: 01/04/2023]
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Baranyi A, Krauseneck T, Rothenhäusler HB. Posttraumatic stress symptoms after solid-organ transplantation: preoperative risk factors and the impact on health-related quality of life and life satisfaction. Health Qual Life Outcomes 2013; 11:111. [PMID: 23822659 PMCID: PMC3717120 DOI: 10.1186/1477-7525-11-111] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 07/01/2013] [Indexed: 01/18/2023] Open
Abstract
Background Solid-organ transplantations (SOT) are usually life-saving high-tech medical procedures. The transplantation itself and the intensive care unit stay could be traumatic stressors triggering posttraumatic stress symptoms (PTSS). Our retrospective follow-up study aimed to explore preoperative risk factors of PTSS in a cohort of SOT recipients, and we investigated how PTSS are associated with health-related quality of life (HRQOL) and life satisfaction. Methods 126 SOT recipients were enrolled in this investigation. Psychiatric examination of all SOT candidates based on the Transplant Evaluation Rating Scale was carried out before SOT, and after SOT, recipients completed the PTSS-10, the SF-36 and the FLZ. Results After the surgical intervention 19 (15.1%) SOT recipients had clinical significant PTSS. Preoperative risk factors for developing postoperative PTSS were: 1.) preexisting psychiatric morbidity, 2.) history of retransplantation, 3.) chronic benzodiazepine consumption, 4.) age, and 5.) type of transplantation. SOT-related PTSS were associated with maximal decrements in HRQOL and life satisfaction. The following HRQOL and life satisfaction domains were affected: Physical Functioning, Role Physical, Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health, Occupation/Work and Character/Own Skills. Conclusion SOT recipients may face a major risk of transplantation- and treatment-related PTSS and the development of impairments to HRQOL and life satisfaction.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, Graz 8036, Austria.
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Rothenhäusler HB, Stepan A, Baranyi A. [Areas of work of a biopsychosocial oriented psychiatric consultation-liaison service: results from a prospective 2-year survey]. Neuropsychiatr 2013; 27:129-41. [PMID: 23797381 DOI: 10.1007/s40211-013-0072-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since the establishment of the European Association of Consultation-Liaison Psychiatry and Psychosomatics in 1992, C/L psychiatry in European countries has been increasingly recognized as a subspecialty of clinical psychiatry and psychosomatic medicine. The study explored the areas of work of the biopsychosocial oriented psychiatric consultation - liaison (C/L) service at the university hospital LKH Graz (Austria). METHODS We conducted two prospective 1-year surveys over two years of observation. Survey I comprised 1,505 consecutive new consultations, and the more recent Survey II extended over 1,478 consecutive new referrals to our C/L service. Psychiatric referrals were analyzed with regard to demographic characteristics, referring departments, principal reasons for referral, diagnostic characteristics, and intervention patterns. RESULTS In both surveys, the most common patient to be referred was a middle-aged woman. Internal medicine consistently accounted for almost one third of all referrals, followed by neurology. The most prominent reasons for biopsychosocial referral were any signs of abnormal mood, behaviour, psychotic symptoms or cognitive impairments. The most common mental disorders according to ICD-10 were adjustment disorders, depressive disorders, and delirium. Psychopharmacotherapy and combined psycho- and pharmacotherapy were the most frequent actions in both surveys, followed by biopsychosocial evaluation pretransplant. CONCLUSIONS To ameliorate the provision of biopsychosocial care for general hospital patients, the need for specially planned biopsychosocial C/L services with equal involvement of specialists in medical psychology, C/L psychiatry, and clinical psychology should be underscored.
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Affiliation(s)
- Hans-Bernd Rothenhäusler
- Universitätsklinik für Psychiatrie, Medizinische Universität Graz, Auenbruggerplatz 31, 8036 Graz, Österreich.
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Baranyi A, Rothenhäusler HB. The impact of S100b and persistent high levels of neuron-specific enolase on cognitive performance in elderly patients after cardiopulmonary bypass. Brain Inj 2013; 27:417-24. [DOI: 10.3109/02699052.2012.750751] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Baranyi A, Krauseneck T, Rothenhäusler HB. Overall mental distress and health-related quality of life after solid-organ transplantation: results from a retrospective follow-up study. Health Qual Life Outcomes 2013; 11:15. [PMID: 23391215 PMCID: PMC3579763 DOI: 10.1186/1477-7525-11-15] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 02/04/2013] [Indexed: 12/26/2022] Open
Abstract
Background Our retrospective follow-up study aimed to explore the degree of overall mental distress in a cohort of solid-organ transplantation (SOT) recipients after liver, heart or lung transplantation. Furthermore, we investigated how overall mental distress is linked to health-related quality of life. Methods 123 SOT patients treated during the study period were enrolled in this investigation at a mean of 24.6 months (SD=11.6) after transplantation. Before transplantation, the Transplant Evaluation Rating Scale (TERS) was used to classify the level of adjustment in psychosocial functioning among transplantation candidates. After transplantation, recipients completed a research battery, which included the SCL-90-R, and the SF-36. Results 39 (31.7%) transplantation recipients had clinically significant overall mental distress as measured on the Global Severity Index of the SCL-90-R. Obsessive-compulsive symptoms (92.3%), somatization symptoms (87.2%), anxiety symptoms (84.6%), depression symptoms (82.1%) and phobic anxiety symptoms (69.2%) were a frequent finding. Transplantation recipients with overall mental distress had significant lower levels of adjustment in psychosocial functioning before transaplantation than those without overall mental distress as measured in the TERS. Transplantation-related overall mental distress symptomatology was associated with maximal decrements in health-related quality of life. Conclusion Transplantation recipients may face major transplantation- and treatment-related overall mental distress and impairments to their health-related quality of life. Further, overall mental distress is a high-risk factor in intensifying impairments to patients’ overall quality of life.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, 8036, Graz, Austria.
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Baranyi A, Meinitzer A, Stepan A, Matejka J, Stauber R, Kapfhammer HP, Rothenhäusler HB. [Interferon α therapy in patients with chronic hepatitis C infection: biopsychosocial consequences]. Nervenarzt 2013; 83:1169-77. [PMID: 22033579 DOI: 10.1007/s00115-011-3302-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Interferon α (IFN-alpha) is widely used in the treatment of viral infections, including hepatitis C. Unfortunately depression is a common side effect of IFN-alpha therapy. The presence of depressive symptoms is important because they have an adverse effect on the course of the illness and reduce the quality of life and the treatment adherence. The current prospective study examines the effects of IFN-alpha on the development of depressive disorders, on cognitive functioning and on quality of life. METHOD A total of 25 patients with chronic hepatitis C infection were investigated. All patients were treated in the Department of Gastroenterology and Hepatology, University of Medicine of Graz, Austria. Psychometric observer rating and self-rating scales were administered 1 month and 3 months after the beginning of the antiviral treatment to evaluate depressive symptoms [Beck Depression Inventory (BDI); Hamilton Depression Scale]. The data on life satisfaction before therapy and health-related quality of life were obtained from the Fragebogen zur Lebenszufriedenheit (FLZ) and the SF-36 (Health Status Questionnaire). Cognitive function was based on the SKT (Syndrom Kurztest). All patients completed the Social Support Questionnaire (SSS), a multidimensional self-report measure of social support. RESULTS Three months after the initial IFN-alpha administration in the whole sample significant impairments in health-related quality of life were found in the health-related domains "physical functioning", "role physical", "role emotional", "social functioning" and "vitality". The whole sample showed cognitive impairments. No changes in social support were recorded. Three months after the first INF-alpha administration, 48% (n=12) of the sample suffered from moderate clinical depression. In comparison to patients without pathological affective findings, patients with INF-alpha-induced clinical depression showed decreased life satisfaction before the initial antiviral therapy. Impairments in health-related quality of life (SF-36) were found in the sample with clinical depression in the health-related domains "general health", "social functioning", "role emotional", "vitality" and "mental health". CONCLUSION Hepatitis C is associated with an increased prevalence of psychiatric disorders, particularly depression. INF-alpha patients having low levels of life satisfaction in the domains "self-concept" (skills, appearance, self-confidence, vitality …), "employment" and "physical health and constitution" seem to face a major risk of depression.
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Affiliation(s)
- A Baranyi
- Universitätsklinik für Psychiatrie, Medizinische Universität Graz, Auenbruggerplatz 31, 8036 Graz, Österreich.
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Baranyi A, Meinitzer A, Stepan A, Putz-Bankuti C, Stauber R, Kapfhammer HP, Rothenhäusler HB. 1115 – A biopsychosocial model of interferon-α-induced depression in patients with chronic hepatitis C infection. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76219-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Baranyi A, Rothenhäusler HB. 1119 – The impact of soluble interleukin-2 receptor as a biomarker of delirium. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76222-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Baranyi A, Rothenhäusler HB. The impact of intra- and postoperative albumin levels as a biomarker of delirium after cardiopulmonary bypass: results of an exploratory study. Psychiatry Res 2012; 200:957-63. [PMID: 22749153 DOI: 10.1016/j.psychres.2012.05.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 02/20/2012] [Accepted: 05/25/2012] [Indexed: 12/18/2022]
Abstract
In this prospective study the frequency of delirium after cardiac surgery with cardiopulmonary bypass (CPB) was determined. Furthermore, we investigated the impact of intra- and postoperative levels of albumin as a biomarker of delirium. Thirty-four patients who underwent elective CPB at the Department of Cardiac Surgery, Ludwig-Maximilians-University of Munich, Germany, were enroled in this prospective study. During the intensive care unit (ICU) stay and shortly after discharge from the ICU, delirious state was evaluated daily using the Delirium-Rating-Scale. Albumin was assayed pre-anaesthesia, immediately after induction of anaesthesia, at the beginning of the heart-lung-apparatus period, immediately before the opening and 5min after the opening of the aortic clamp, 24h and 48h postoperatively and on the day before discharge. After CPB, a clinical significant delirious state was observed in 11 patients (32.4%). The albumin level decreased during the surgical intervention and increased postoperatively with a maximum level at the time of discharge. CPB patients with delirious state showed a significantly lower albumin level 24h and 48h postoperatively than those without delirium. A low level of postoperative albumin seems to be a useful biomarker to identify patients with high risk of delirious state after CPB.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, 8036 Graz, Austria.
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Kreiner B, Baranyi A, Stepan A, Rothenhäusler HB. [Psychoeducation and quality of life: an amplification of the evaluation study in Graz (Part 1). Psychoeducation with psychotic patients]. Neuropsychiatr 2012; 26:7-14. [PMID: 22718417 DOI: 10.1007/s40211-012-0004-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 02/23/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND This study is an amplification of the evaluation study in Graz and aimed at evaluating the effects of psychoeducation (PE) on psychotic patients. METHODS 26 psychotic patients participated in nine PE-group sessions and observer as well as self-rating scales were completed before and after PE. RESULTS A significant increase in psychological wellbeing, in psychosis-related knowledge and a reduction of psychopathology was found. The degree of psychopathology influenced life-quality and psychosis - related knowledge but still patients with severe psychopathology benefit from PE. Using regression analyses further variables fostering the PE-success were tried to be identified. CONCLUSION A multidimensional consideration of the lifequality-concept is necessary for evaluation of PE. In clinical practice PE groups with patients suffering from different psychotic diseases can be well implemented and are very effective. The results underline the relevance of PE in an inpatient psychiatric setting.
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Affiliation(s)
- Barbara Kreiner
- Universitätsklinik für Psychiatrie der Medizinischen Universität Graz, Wagner Jauregg Platz 1, 8053, Graz, Österreich,
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Kreiner B, Baranyi A, Stepan A, Rothenhäusler HB. [Psychoeducation and quality of life: an amplification of the evaluation study in Graz (Part 2). A comparison of psychoeducation with psychotic and depressive patients]. Neuropsychiatr 2012; 26:15-22. [PMID: 22718418 DOI: 10.1007/s40211-012-0005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 02/23/2011] [Indexed: 06/01/2023]
Abstract
BACKGROUND This study aimed at comparing psychoeducation (PE) on depressive and psychotic patients, describe differences and identify variables fostering patients' satisfaction with PE. METHODS 75 patients (49 depressive and 26 psychotic patients) participated in nine PE-group sessions and observer as well as self-rating scales were completed before and after PE. RESULTS Depressive patients were able to improve their mental health quality and reduce their general psychic pressure in a greater extent than psychotic patients. Both samples improved their illness-related knowledge at the same amount. In general both samples were highly satisfied with PE but still depressive patients were still more satisfied. Using regression and discrimination analyses further differentiating variables could be found. CONCLUSIONS Psychotic patients are an inhomogeneous sample and adaption of the PE contents is required. Depressive patients show more enhancement than psychotic patients. Nevertheless both samples benefit from PE. Compared to depressive patients psychotic patients experienced better subjective life quality but less objective life quality. The results underline the relevance of PE in an inpatient psychiatric setting. Individual preliminary information adjusted to the patients' sample is essential.
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Affiliation(s)
- Barbara Kreiner
- Landesnervenklinik Sigmund Freud, Universitätsklinik für Psychiatrie der Medizinischen Universität Graz, Wagner Jauregg Platz 1, 8053, Graz, Österreich,
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Baranyi A, Meinitzer A, Stepan A, Matejka J, Stauber R, Rothenhäusler HB. Biopsychosocial consequences of interferon-alpha (IFN-alpha) therapy in patients with chronic hepatitis c infection. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72313-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Depressionis a common side effect of IFN-alpha therapy. The current prospective study examines the effects of Interferon-alpha on the prevalence of depressive disorders, on cognitive functioning and on quality of life. Life Satisfaction before and the social support during the therapy were considered.Method25 patients with chronic hepatitis C infection were investigated. One month and three months after the beginning of the treatment psychometric observer-rating and self-rating scales were administered to evaluate depressive symptoms (BDI; HAMD). The data on life satisfaction before therapy and health-related quality of life were obtained from the FLZ and the SF-36. Cognitive function was based on the SKT.ResultsThree months after the initial Interferon-alpha administration in the whole sample significant impairments in health-related quality of life were found in the domains “physical functioning”, “role physical”, “role emotional”, “social functioning” and “vitality”. The whole sample showed cognitive impairements.Three months after the first Interferon-alpha administration 48% (n = 12) suffered from moderate clinical depression.Patients with Interferon-alpha induced clinical depression showed decreased life satisfaction before the initial antiviral therapy - especially in the domains “self-concept”, “employment” and “physical health&constitution”. Impairments in health-related quality of life (SF-36) were found in the clinical depressive sample in the domains “general health”, “social functioning”, “role emotional”,“vitality” and “mental health”.ConclusionHepatitis C is associated with an increased prevalence of depression.Interferon-alpha patients having low levels of life satisfaction in the domains “self concept”, “employment” and “physical health&constitution” seem to face a major risk of depression.
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Baranyi A, Leithgöb O, Kreiner B, Tanzer K, Ehrlich G, Hofer HP, Rothenhäusler HB. Relationship between posttraumatic stress disorder, quality of life, social support, and affective and dissociative status in severely injured accident victims 12 months after trauma. Psychosomatics 2010; 51:237-47. [PMID: 20484722 DOI: 10.1176/appi.psy.51.3.237] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Many survivors of severe injuries develop significant psychiatric morbidity, especially trauma-related psychiatric disorders, anxiety, and depressive disorders. OBJECTIVE The authors examined accident-related partial and full posttraumatic stress disorder (PTSD), including dimensions such as dissociation and depression and health-related quality of life in 52 severely injured accident victims 12 months after trauma. METHOD Respondents were given a questionnaire battery, as well as structured clinical interviews, a brief author-compiled questionnaire, self-report questionnaires, and psychometric observer-rated scales. RESULTS One-fourth of respondents met all criteria for PTSD, and another 21.2% had subsyndromal PTSD. Patients with PTSD showed higher severity of dissociative and depressive symptoms and major impairments in some dimensions of quality of life. Injury severity and symptoms of cognitive dysfunction did not influence accident-related PTSD or depressive or dissociative symptoms. CONCLUSION Severely injured accident victims seem to face a major risk of PTSD and impairments in health-related quality of life. For patients with polytrauma, there is a need for a biopsychosocial conceptual framework at the interface of psychiatry and trauma surgery in general hospitals.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, A - 8036 Graz, Austria
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Baranyi A, Leithgöb O, Kreiner B, Tanzer K, Ehrlich G, Hofer HP, Rothenhäusler HB. Relationship Between Posttraumatic Stress Disorder, Quality of Life, Social Support, and Affective and Dissociative Status in Severely Injured Accident Victims 12 Months After Trauma. Psychosomatics 2010. [DOI: 10.1016/s0033-3182(10)70691-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Baranyi A, Piber D, Rothenhäusler HB. Mann-zu-Frau-Transsexualismus. Ergebnisse geschlechtsangleichender Operationen in einer biopsychosozialen Perspektive. Wien Med Wochenschr 2009; 159:548-57. [DOI: 10.1007/s10354-009-0693-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 03/26/2009] [Indexed: 01/09/2023]
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Rothenhäusler HB, Scherr M, Putz-Bankuti C, Kapper A, Stepan A, Baranyi A, Haas-Krammer A, Haas B, Stauber R. [The relationship between emotional distress, cognitive performance and health - related quality of life in patients with hepatitis C prior to antiviral treatment]. Fortschr Neurol Psychiatr 2009; 77:457-63. [PMID: 19676008 DOI: 10.1055/s-0028-1109574] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Recent epidemiologic studies suggest that more than 175 million individuals are infected with hepatitis C virus (HCV) worldwide. In the past few years, outcome studies in chronic HCV patients are no longer focusing solely on traditional end points such as mortality rates but on psychosocial well-being such as health-related quality of life (HRQoL), emotional states, and neuropsychological functioning. The purpose of our exploratory study was to assess cross sectionally the frequency of depression, posttraumatic stress symptoms, cognitive deficits, and impairments in HRQoL in chronic HCV patients prior to antiviral treatment, and to investigate how cognitive impairments and emotional distress were related to quality of life. We recruited 34 chronic HCV patients who had presented for initial assessment of the need for antiviral therapy. Psychometric observer-rating and self-rating scales were administered to evaluate posttraumatic stress symptoms (PTSS-10), depressive symptoms (BDI), HRQoL (SF-36 Health Status Questionnaire), and cognitive functioning (SKT). 32.4 % (n = 11) of the sample suffered from clinical depression, and 8.8 % (n = 3) had a posttraumatic stress syndrome. 8.8 % (n = 3) of the sample showed cognitive impairments. Significant impairments in HRQoL were found in the health-related domains vitality, role-emotional, and role-physical. The severity of emotional distress as measured on the BDI and PTSS-10 was associated with decrements in HRQoL. However, lower cognitive function scores on the SKT were not associated with lower HRQoL SF-36 values. Chronic HCV patients seem to face a major risk of depression, posttraumatic stress symptoms, and cognitive dysfunction, and the presence of emotional distress is associated with impairments in quality of life. We therefore underscore the need for early and comprehensive bio-psycho-social diagnosis and therapy of chronic HCV patients in order to treat emotional distress and enhance patients; quality of life at an early stage before initiating antiviral therapy, as well as to expand the pool of patients eligible to receive antiviral therapy.
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Kreiner B, Baranyi A, Stepan A, Rothenhäusler HB. [The effect of psychoeducation on quality of life in depressive disorders - results of an evaluation study in Graz]. Neuropsychiatr 2009; 23:101-114. [PMID: 19573503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION This study aimed to evaluate the effect of psychoeducation (PE) on quality of life in depressive patients at the Department of Psychiatry, University of Medicine of Graz. METHOD We tested 49 depressive patients who participated in 9 PE group sessions at twice weekly intervals. Psychometric observer-rating and self-rating scales were conducted before and after PE completion. RESULTS Our evaluation study found significant improvement in mental health status, life satisfaction, psychopathology, specific knowledge about depression and compliance. Using multiple regression analyses, we identified variables predicting a more favourable outcome in the participating patients. The vast majority of our sample would highly recommend PE to other depressive patients, and found an increase in knowledge about depression to be supportive. CONCLUSION Our results with PE for depressive patients are encouraging, but the inclusion of appropriate control groups needs to be considered in forthcoming studies. Future research should also focus on comparison studies of PE in depressive patients with PE in schizophrenic patients, particularly as PE has proven to be an effective treatment in schizophrenia.
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Affiliation(s)
- Barbara Kreiner
- Universitätsklinik für Psychiatrie der Medizinischen Universität Graz
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Rothenhäusler HB, Stepan A, Kreiner B, Baranyi A, Kapfhammer HP. Patterns of psychiatric consultation in an Austrian tertiary care center - results of a systematic analysis of 3,307 referrals over 2 years. Psychiatr Danub 2008; 20:301-309. [PMID: 18827755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the phenomenology of a newly structured Austrian tertiary - care hospital consultation - liaison (C - L) psychiatry service. SUBJECTS AND METHODS We compared two 1 - year surveys over two years of observation (2003 - 2005). Survey A (August 1, 2003, until July 31, 2004) comprised 1474 consecutive new consultations, and the more recent Survey B (August 1, 2004, until July 31, 2005) extended over 1833 consecutive new referrals to our C - L service. Psychiatric referrals were analyzed with regard to consultation rate, demographic characteristics, referring departments, principal reasons for referral, diagnostic characteristics, and intervention patterns. RESULTS The consultation rate increased by 0.61% from 2.69% in Survey A to 3.30% in Survey B. Internal medicine consistently accounted for almost 31% of all referrals in both surveys. In Survey A, the most common psychiatric diagnoses were adjustment disorders (21.4%), depressive disorders (18.5%), and delirium (18.1%). The most prevalent diagnoses in Survey B were adjustment disorders (24.5%), delirium (18.8%), and depressive disorders (14.3%). Pharmacotherapy was the most frequent action in both surveys and accounted for between 45% and 49% of all actions. CONCLUSION This study underscores the need for specially planned C - L services in Austria that provide both psychiatric and psychosocial care for patients who are medically ill.
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Krammer A, Stepan A, Baranyi A, Kapfhammer HP, Rothenhäusler HB. [The effects of stalking on psychiatrists, psychotherapists and psychologists. Prevalence of stalking and its emotional impact]. Nervenarzt 2007; 78:809-17. [PMID: 17106727 DOI: 10.1007/s00115-006-2203-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Stalking in the psychiatric context describes a pathological behaviour which is characterized by repeated persecution, harassment, or menacing of or assault on a person. Because of the association between stalking and mental disorders, psychiatrists, psychologists and psychotherapists belong to particularly exposed professions. If they fall victim to stalking during their career, disruptive impacts up to posttraumatic stress disorder (PTSD) can be the consequence. A total of 117 psychiatrists, psychologists or psychotherapists in Graz participated in an anonymous interview. To register possible experiences with stalking defined behaviour, a modified version of the questionnaire of Kamleiter was used. The prevalence and severity of posttraumatic stress symptoms were determined using the Impact of Event Scale of Horowitz. The study showed an incidence of stalking of 38.5%. The rate of female stalkers (60%) was extraordinary high. Most victims (68.9%) experienced non-violent threats. Most of the offenders (41.9%) were diagnosed as suffering from schizophrenia, schizotype and delusional disorders (F2) followed by disorders of adult personality and behaviour (F6) (30.2%). Some 44.4% of the victims developed symptoms of PTSD, which were usually only slight. The analyses suggest that stalking, in the psychiatric field of activity, is a common and serious phenomenon, and that strategies for the prevention and protection of potentially affected professions have to be developed.
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Affiliation(s)
- A Krammer
- Universitätsklinik für Psychiatrie, Medizinische Universität Graz, Auenbruggerplatz 31, 8010 Graz, Osterreich.
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Baranyi A, Yazdani R, Haas-Krammer A, Stepan A, Kapfhammer HP, Rothenhäusler HB. Atypische Neuroleptika und metabolisches Syndrom. Wien Med Wochenschr 2007; 157:255-70. [PMID: 17915438 DOI: 10.1007/s10354-007-0379-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The introduction of atypical antipsychotics in psychopharmacology represented a major advance in the treatment of psychotic disorders. However, there have been numerous studies that certain atypical antipsychotics may be associated with a greater risk of metabolic abnormalities than others, including weight gain, hyperlipidemia and new-onset typ 2 diabetes mellitus. A G-Protein beta3 subunit Gen (C825T) polymorphism, an increased carbohydrate metabolism and dyshormonism are discussed as pathogenetic mechanisms. High risk patients (adiposity, hyperlipidaemia, hyperglycaemia, preexisting diabetes) should maintain an antipsychotic agent with a favourable side effect profile. In these cases a periodical diabetes screening and blood lipid controls are required. Clinicans must balance the significant benefits of atypical antipsychotics against the risk of metabolic disturbances. In this article recent findings are reviewed.
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Affiliation(s)
- Andreas Baranyi
- Universitätsklinik für Psychiatrie Graz, Medizinische Universität Graz, Graz, Osterreich.
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Abstract
The neuroprotective/neuronal rescue effects of selegiline are not exactly understood, and show great variability in clinical trials. In this study, the dose-dependence of neuronal rescue potency of selegiline and its analogue para-fluoro-selegiline (PFS) was investigated in gerbils. The compounds were tested in a transient global cerebral ischemia model. Selegiline expressed a bell-shaped, dose-response curve with high intrinsic activity (with greatest effect at 0.001 mg/kg), as opposed to PFS which shows a saturation profile. These findings indicate possible therapeutic differences between PFS and selegiline in the treatment of neurodegenerative disorders. Inhibition of progression of the disease (neuroprotective effect) and improvements of symptoms (MAO-B inhibition) may occur at the same dose level using PFS, while these doses are separated in case of selegiline.
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Affiliation(s)
- F Erdö
- Discovery Research Department, Sanofi-Synthelabo-CHINOIN Pharmaceutical and Chemical Works Co. Ltd., Budapest, Hungary
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