Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: Evidence from the general population

Spitzer, Carsten; Barnow, Sven; Völzke, Henry; Wallaschofski, Henri; John, Ulrich; Freyberger, Harald J.; Löwe, Bernd; Grabe, Hans J.

doi:10.1016/j.jpsychires.2009.06.002

Cited by 188 publications

(145 citation statements)

References 37 publications

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“…Veterans with PTSD had higher concentration of serum CRP compared to veterans without PTSD but difference was not statistically significant. Results obtained in our study are in accordance with results by Spitzer et al (2010) who have reported that PTSD positive subjects had higher chances of having increased levels of CRP compared to subjects without PTSP. Authors suggested that there is a close relation between PTSD and chronic low-grade inflammation which may represent one of the psychobiological pathways from PTSD to poorer physical health and development of different diseases.…”

Section: Resultssupporting

confidence: 93%

“…They are mainly reflected in its ability to increase release of anti-inflammatory cytokines such as IL-10, as well as, in its ability to stimulate expression of receptor IL-1 antagonists and in its ability to inhibit release of INF-(McDade 2012). The role of inflammation in the pathogenesis of PTSD is far from being fully understood and studies that evaluated concentration of CRP in PTSD patients have given inconclusive and discordant results (Spitzer et al 2010, Von Känel et al 2007). …”

Section: Introductionmentioning

confidence: 99%

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Elevated Serum C-Reactive Protein Level Is Not Associated With Serum Nitric Oxide in Patients With Posttraumatic Stress Disorder

et al. 2017

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SUMMARYBackground: The aim of the present study was to evaluate serum nitric oxide (NO) PTSD (r=0.118; p=0.727 mg/L). Serum NO concentration in veterans with (7.64±4.43 µmol/L) and without PTSD (7.12±2.60 µmol/L) was significantly lower (p<0.05) compared to control group (11.26±7.01 µmol/L). Statistically significant correlation between serum NO and CRP concentration was determined in veterans without PTSD (r=-0.473; p<0.01). No correlation was observed between serum NO and CRP concentration in veterans with

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Section: Resultssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Elevated Serum C-Reactive Protein Level Is Not Associated With Serum Nitric Oxide in Patients With Posttraumatic Stress Disorder

et al. 2017

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“…This discrepancy in the literature highlights the importance of other factors that may be influencing the association between inflammation and PTSD, such as type and chronicity of trauma exposure, clinician-administered vs self-reported measures of PTSD diagnosis, control group assessed (healthy vs traumaexposed), and sociodemographics of individuals studied. The association between PTSD and inflammation is also impacted by other adverse mental and physical health outcomes, including depression (Gill et al, 2010;Maes et al, 1999) and cardiovascular disease (Spitzer et al, 2010;von Kanel et al, 2007), indicating that taking these co-morbid conditions into account when studying the relationship between PTSD and inflammation is critical in future studies. Furthermore, preclinical studies have suggested that stressinduced inflammatory responses can be causally related to hypertension and other cardiovascular risk factors secondary to T-lymphocyte and inflammatory effects on the vascular cellular architecture .…”

Section: Ptsd and Inflammationmentioning

confidence: 99%

“…Obesity and high BMI are also associated with increased concentrations of inflammatory markers, such as CRP and IL-6 (Khaodhiar et al, 2004). However, at least with PTSD, increased inflammation levels have remained significant after adjusting for BMI in multiple studies (Heath et al, 2013;McCanlies et al, 2011;Spitzer et al, 2010). This suggests that although health risk factors such as smoking and BMI may contribute to inflammation, the relationship between inflammation and PTSD remains significant beyond these behavioral risk factors.…”

Section: Mechanisms Of Increased Inflammation In Fearand Anxiety-basementioning

confidence: 99%

Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond

Michopoulos

Powers

Gillespie

et al. 2016

Neuropsychopharmacol

544

376

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The study of inflammation in fear-and anxiety-based disorders has gained interest as growing literature indicates that proinflammatory markers can directly modulate affective behavior. Indeed, heightened concentrations of inflammatory signals, including cytokines and C-reactive protein, have been described in posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), and phobias (agoraphobia, social phobia, etc.). However, not all reports indicate a positive association between inflammation and fear-and anxiety-based symptoms, suggesting that other factors are important in future assessments of inflammation's role in the maintenance of these disorders (ie, sex, co-morbid conditions, types of trauma exposure, and behavioral sources of inflammation). The most parsimonious explanation of increased inflammation in PTSD, GAD, PD, and phobias is via the activation of the stress response and central and peripheral immune cells to release cytokines. Dysregulation of the stress axis in the face of increased sympathetic tone and decreased parasympathetic activity characteristic of anxiety disorders could further augment inflammation and contribute to increased symptoms by having direct effects on brain regions critical for the regulation of fear and anxiety (such as the prefrontal cortex, insula, amygdala, and hippocampus). Taken together, the available data suggest that targeting inflammation may serve as a potential therapeutic target for treating these fear-and anxiety-based disorders in the future. However, the field must continue to characterize the specific role pro-inflammatory signaling in the maintenance of these unique psychiatric conditions.

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“…It was suggested that these alterations lead to a pro-inflammatory state [1,14,49,50]. Thus, inflammation may be the link between trauma exposure and PTSD on the one hand and airflow limitation on the other, which itself is associated with inflammatory processes [51].…”

Section: Post-traumatic Stress Disorder and Respiratory Disease C Spmentioning

confidence: 99%

Association of airflow limitation with trauma exposure and post-traumatic stress disorder

Spitzer¹,

Koch²,

Grabe³

et al. 2010

Eur Respir J

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Trauma exposure and post-traumatic stress disorder (PTSD) are associated with self-reported asthma and chronic obstructive pulmonary disease. However, these conditions have not yet been related to objective measures of lung function.1,772 adults from the general population were assessed regarding their medical histories and spirometric lung function. Additionally, they were administered a PTSD interview, and assigned to three groups: no trauma; trauma, but no PTSD; and trauma with PTSD.Adjusting for sociodemographic, clinical and lifestyle factors, subjects with PTSD had significantly higher odds ratios for most asthma-related symptoms than PTSD-negative participants (OR 3.2-8.8). The mean ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) was lowest in the PTSD group and highest in those without trauma exposure. Traumatic stress was independently associated with FEV1 and FEV1/FVC. Participants with PTSD, compared with those without, had a significantly increased risk for airflow limitation independent of its definition .This is the first study relating traumatic stress and PTSD, respectively, to objective parameters of lung function. Our findings suggest an association of trauma exposure and PTSD with airflow limitation, which may be mediated by inflammatory processes.

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Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: Evidence from the general population

Cited by 188 publications

References 37 publications

Elevated Serum C-Reactive Protein Level Is Not Associated With Serum Nitric Oxide in Patients With Posttraumatic Stress Disorder

Elevated Serum C-Reactive Protein Level Is Not Associated With Serum Nitric Oxide in Patients With Posttraumatic Stress Disorder

Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond

Association of airflow limitation with trauma exposure and post-traumatic stress disorder

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