Long-Term Immune Alterations Accompanying Chronic Posttraumatic Stress Disorder following Exposure to Suicide Bomb Terror Incidents during Childhood

Abstract

Background and Aim: Long-term immune alterations have been proposed to play a mechanistic role in posttraumatic stress disorder (PTSD) as well as in its associated increase in medical morbidity and mortality. Better characterization of altered immune function may help identify diagnostic and prognostic biomarkers and potentially targets for preventive intervention. Methods: As part of an ongoing study, we conducted a preliminary case-control comparison of resting immune inflammatory profiles between terror victims treated in childhood at the emergency department over the previous decade, who developed chronic PTSD upon long-term follow-up, and healthy controls. Results: Our preliminary results in a subsample of this ongoing study support and extend elevated resting levels of granulocyte colony-stimulating factor, interleukin-4, and regulated on activation, normal T cell expressed and secreted in childhood onset chronic PTSD. Conclusion: Chronic immune alterations may participate in inflammatory activation and signal to the CNS through the neurovascular unit, as well as modulate the neuroendocrine axis. Better characterization and understanding of these preliminary findings may point to diagnostic and prognostic biomarkers and potentially elucidate mechanistic involvement of immune activation in PTSD.

Association of Prospective Risk for Chronic PTSD Symptoms With Low TNFα and IFNγ Concentrations in the Immediate Aftermath of Trauma Exposure

“…Increased basal concentrations of proinflammatory cytokines, including interleukin (IL) 1b, IL-6, and interferon-g (IFNg), have consistently been found to be associated with PTSD (8). Higher concentrations of chemokines and immune system growth factors have also been associated with trauma exposure (9) and chronic PTSD (10,11). Additionally, resilience to traumatic events (12) and PTSD are associated with higher concentrations of anti-inflammatory cytokines, such as IL- 10 (11, 13).…”

Reduced Expression of Immune Mediators by T-Cell Subpopulations of Combat-Exposed Veterans With Post-Traumatic Stress Disorder

“…Patients that had been exposed to a deadly earthquake had higher blood levels of pro-inflammatory cytokines IL-1 and TNF-α than subjects that were similarly exposed but did not have PTSD (8). Several immune mediators, including the pro-inflammatory mediators G-CSF and CCL5 and the anti-inflammatory mediator IL-4 were increased in plasma of individuals with long-term PTSD following childhood exposure to suicide bomb terror (9). A study from our laboratory comparing plasma cytokine levels in combat Veterans with PTSD versus combat Veterans without PTSD, showed increased levels of the pro-inflammatory mediators IL-2, IL-6 and IL-17, but decreased levels of the anti-inflammatory mediator IL-4 in those with PTSD (10).…”