Posttraumatic stress disorder is associated with an enhanced spontaneous production of pro-inflammatory cytokines by peripheral blood mononuclear cells
- 6k Downloads
Posttraumatic stress disorder (PTSD) is associated with an enhanced risk for cardiovascular and other inflammatory diseases. Chronic low-level inflammation has been suggested as a potential mechanism linking these conditions.
We investigated plasma cytokine levels as well as spontaneous and lipopolysaccharide (LPS)-stimulated cytokine production by peripheral blood mononuclear cells (PBMCs) in a group of 35 severely traumatized PTSD patients compared to 25 healthy controls.
Spontaneous production of interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α by isolated PBMCs was significantly higher in the PTSD compared to the control group and even correlated with PTSD symptom severity within the PTSD group. In contrast, circulating plasma levels of pro- and anti-inflammatory cytokines such as IL-6, IL-8, IL-10, TNF-α, or monocyte chemotactic protein (MCP)-1 were not significantly altered in PTSD patients compared to healthy controls.
Our findings indicate that PBMCs of PTSD patients are already pre-activated in vivo, providing further evidence for low-grade inflammation in PTSD. This might possibly represent one psychobiological pathway from PTSD to poor physical health.
KeywordsPosttraumatic stress disorder Immune system Cytokines Pro-inflammatory cytokines Traumatic stress Inflammation
Below detection limit
Clinician Administered PTSD Scale
Hamilton Depression Rating Scale
Monocyte chemotactic protein
Mini International Neuropsychiatric Interview
Peripheral blood mononuclear cells
Posttraumatic stress disorder
Screening for Somatoform Symptoms-7
Tumor necrosis factor
White blood cell.
We thank Dr. Claudia Catani, Dr. Maggie Schauer, Dr. Martina Ruf and Prof. Dr. Frank Neuner for clinical supervision and treatment of patients as well as Heike Riedke and Christiane Wolf for technical assistance. This research was conducted at the University of Konstanz. Hannah Gola and Iris-Tatjana Kolassa are now at the University of Ulm.
This study was funded by the German Research Foundation (DFG) FOR751 and the European Refugee Fund. The DFG and the European Refugee Fund had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
- 2.Neuner F, Schauer M, Karunakara U, Klaschik C, Robert C, Elbert T: Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry. 2004, 4: 34-10.1186/1471-244X-4-34.CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Kolassa IT, Kolassa S, Ertl V, Papassotiropoulos A, De Quervain DJ: The risk of posttraumatic stress disorder after trauma depends on traumatic load and the catechol-o-methyltransferase Val(158)Met polymorphism. Biol Psychiatry. 2010, 67: 304-308. 10.1016/j.biopsych.2009.10.009.CrossRefPubMedGoogle Scholar
- 4.American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 1994, Washington DC: American Psychiatric AssociationGoogle Scholar
- 15.Tucker P, Ruwe WD, Masters B, Parker DE, Hossain A, Trautman RP, Wyatt DB: Neuroimmune and cortisol changes in selective serotonin reuptake inhibitor and placebo treatment of chronic posttraumatic stress disorder. Biol Psychiatry. 2004, 56: 121-128. 10.1016/j.biopsych.2004.03.009.CrossRefPubMedGoogle Scholar
- 17.Maes M, Lin AH, Delmeire L, Van Gastel A, Kenis G, De Jongh R, Bosmans E: Elevated serum interleukin-6 (IL-6) and IL-6 receptor concentrations in posttraumatic stress disorder following accidental man-made traumatic events. Biol Psychiatry. 1999, 45: 833-839. 10.1016/S0006-3223(98)00131-0.CrossRefPubMedGoogle Scholar
- 19.Spitzer C, Barnow S, Volzke H, Wallaschofski H, John U, Freyberger HJ, Lowe B, Grabe HJ: Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: evidence from the general population. J Psychiatr Res. 2010, 44: 15-21. 10.1016/j.jpsychires.2009.06.002.CrossRefPubMedGoogle Scholar
- 22.Rohleder N, Joksimovic L, Wolf JM, Kirschbaum C: Hypocortisolism and increased glucocorticoid sensitivity of pro-Inflammatory cytokine production in Bosnian war refugees with posttraumatic stress disorder. Biol Psychiatry. 2004, 55: 745-751. 10.1016/j.biopsych.2003.11.018.CrossRefPubMedGoogle Scholar
- 27.Schauer M, Neuner F, Elbert T: Narrative Exposure Therapy. 2011, Göttingen, Germany: Hogrefe & Huber, 2ndGoogle Scholar
- 28.Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC: The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998, 59 (Suppl 20): 22-33. quiz 34–57PubMedGoogle Scholar
- 30.R Development Core Team: R: A language and environment for statistical computing. 2010, Vienna, Austria: R Foundation for Statistical ComputingGoogle Scholar
- 31.Good PI: Permutation, Parametric and Bootstrap Tests of Hypotheses. 2005, New York, NY: Springer, 3rdGoogle Scholar
- 35.Holm S: A simple sequentially rejective multiple test procedur. Scand J Stat. 1979, 6: 65-70.Google Scholar
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-244X/13/40/prepub
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.