Inflammatory and oxidative stress markers in post-traumatic stress disorder: a systematic review and meta-analysis

Peruzzolo, Tatiana Lauxen; Pinto, Jairo Vinícius; Roza, Thiago Henrique; Shintani, Augusto Ossamu; Anzolin, Ana Paula; Gnielka, Vanessa; Kohmann, André Moura; Marin, Amanda Salvador; Lorenzon, Vitória Ruschel; Brunoni, André R.; Kapczinski, Flávio; Passos, Ives Cavalcante

doi:10.1038/s41380-022-01564-0

Cited by 29 publications

(15 citation statements)

References 105 publications

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“…In addition, childhood trauma was associated with elevated CRP, IL-6, and TNF-α levels with small effects in a meta-analysis of 25 studies [ 79 ]. Several systematic reviews and meta-analyses examining PTSD and inflammatory markers have also been conducted [ 74 , 80 – 82 ]. In the most recent meta-analysis of 54 studies examining over 15 inflammatory markers, elevated levels of CRP (moderate effect), IL-6 (large effect), and TNF-α (large effect) were observed in individuals with PTSD compared to controls; there was also weak evidence of a small effect for PTSD and IL-1β [ 82 ].…”

Section: Biological Mechanisms Linking Trauma With Cvd Riskmentioning

confidence: 99%

“…Several systematic reviews and meta-analyses examining PTSD and inflammatory markers have also been conducted [ 74 , 80 – 82 ]. In the most recent meta-analysis of 54 studies examining over 15 inflammatory markers, elevated levels of CRP (moderate effect), IL-6 (large effect), and TNF-α (large effect) were observed in individuals with PTSD compared to controls; there was also weak evidence of a small effect for PTSD and IL-1β [ 82 ]. Together, these results suggest that trauma and PTSD are associated with elevations in peripheral inflammatory markers.…”

Section: Biological Mechanisms Linking Trauma With Cvd Riskmentioning

confidence: 99%

“…Whereas the research on trauma and oxidative stress has been limited, numerous studies have assessed oxidative stress in individuals with PTSD. A recent meta-analysis did not find an association between PTSD with malondialdehyde (a product of lipid peroxidation) or two antioxidant enzymes (catalase, paraoxonase-1) [ 82 ], although only five studies were included and three drew participants from the same sample [ 110 – 114 ]. Overall, additional studies of PTSD and oxidative stress—most conducted among combat veterans [ 115 – 118 ]—have had mixed results [ 119 – 121 ].…”

Section: Biological Mechanisms Linking Trauma With Cvd Riskmentioning

confidence: 99%

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Psychological and biological mechanisms linking trauma with cardiovascular disease risk

et al. 2023

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Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, and experiences of psychological trauma have been associated with subsequent CVD onset. Identifying key pathways connecting trauma with CVD has the potential to inform more targeted screening and intervention efforts to offset elevated cardiovascular risk. In this narrative review, we summarize the evidence for key psychological and biological mechanisms linking experiences of trauma with CVD risk. Additionally, we describe various methodologies for measuring these mechanisms in an effort to inform future research related to potential pathways. With regard to mechanisms involving posttraumatic psychopathology, the vast majority of research on psychological distress after trauma and CVD has focused on posttraumatic stress disorder (PTSD), even though posttraumatic psychopathology can manifest in other ways as well. Substantial evidence suggests that PTSD predicts the onset of a range of cardiovascular outcomes in trauma-exposed men and women, yet more research is needed to better understand posttraumatic psychopathology more comprehensively and how it may relate to CVD. Further, dysregulation of numerous biological systems may occur after trauma and in the presence of posttraumatic psychopathology; these processes of immune system dysregulation and elevated inflammation, oxidative stress, mitochondrial dysfunction, renin-angiotensin system dysregulation, and accelerated biological aging may all contribute to subsequent cardiovascular risk, although more research on these pathways in the context of traumatic stress is needed. Given that many of these mechanisms are closely intertwined, future research using a systems biology approach may prove fruitful for elucidating how processes unfold to contribute to CVD after trauma.

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Section: Biological Mechanisms Linking Trauma With Cvd Riskmentioning

confidence: 99%

Section: Biological Mechanisms Linking Trauma With Cvd Riskmentioning

confidence: 99%

Section: Biological Mechanisms Linking Trauma With Cvd Riskmentioning

confidence: 99%

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Psychological and biological mechanisms linking trauma with cardiovascular disease risk

et al. 2023

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“…However, determining precise system level changes in disorders such as PTSD needed to ascertain the accuracy of models has proven to be incredibly difficult. Variations in results across studies of PTSD patients may involve demographic heterogeneity (e.g., age and gender), clinical variables (e.g., PTSD severity, comorbidities and medication status), trauma-related factors (e.g., trauma type, duration and number of trauma exposures, and the time between trauma and sleep and neuroimmune assessment) ( Mellman et al, 2002 , 2014 ; Hall Brown et al, 2015 ; Shalev et al, 2017 ; Mysliwiec et al, 2018 ; Peruzzolo et al, 2022 ), and experimental methodology (e.g., whether there was an adaptation night and sleep scoring rules). The relative influence of these factors can be examined with meta-analytic procedures, but requires sufficient data for given variables, which is not always available.…”

Section: Relevance Of Integrated Models For Understanding Trauma and ...mentioning

confidence: 99%

Modeling integrated stress, sleep, fear and neuroimmune responses: Relevance for understanding trauma and stress-related disorders

Sanford

Wellman

Adkins

et al. 2023

Neurobiology of Stress

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“…In a recent metadata analysis analyzing 54 human studies for bloodborne inflammatory and redox biomarkers of PTSD, only C-reactive protein, interleukin 6, and tumor necrosis factor reached statistical significance in patients with PTSD compared with healthy controls ( Peruzzolo et al, 2022 ). Because of these results, the authors concluded that no oxidative stress marker associated with PTSD.…”

Section: Redox and Non-redox Biomarkers Of Ptsdmentioning

confidence: 99%

Defining the nuanced nature of redox biology in post-traumatic stress disorder

Reed

Case

2023

Front. Physiol.

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Post-traumatic stress disorder (PTSD) is a mental health disorder that arises after experiencing or witnessing a traumatic event. Despite affecting around 7% of the population, there are currently no definitive biological signatures or biomarkers used in the diagnosis of PTSD. Thus, the search for clinically relevant and reproducible biomarkers has been a major focus of the field. With significant advances of large-scale multi-omic studies that include genomic, proteomic, and metabolomic data, promising findings have been made, but the field still has fallen short. Amongst the possible biomarkers examined, one area is often overlooked, understudied, or inappropriately investigated: the field of redox biology. Redox molecules are free radical and/or reactive species that are generated as a consequence of the necessity of electron movement for life. These reactive molecules, too, are essential for life, but in excess are denoted as “oxidative stress” and often associated with many diseases. The few studies that have examined redox biology parameters have often utilized outdated and nonspecific methods, as well as have reported confounding results, which has made it difficult to conclude the role for redox in PTSD. Herein, we provide a foundation of how redox biology may underlie diseases like PTSD, critically examine redox studies of PTSD, and provide future directions the field can implement to enhance standardization, reproducibility, and accuracy of redox assessments for the use of diagnosis, prognosis, and therapy of this debilitating mental health disorder.

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Inflammatory and oxidative stress markers in post-traumatic stress disorder: a systematic review and meta-analysis

Cited by 29 publications

References 105 publications

Psychological and biological mechanisms linking trauma with cardiovascular disease risk

Psychological and biological mechanisms linking trauma with cardiovascular disease risk

Modeling integrated stress, sleep, fear and neuroimmune responses: Relevance for understanding trauma and stress-related disorders

Defining the nuanced nature of redox biology in post-traumatic stress disorder

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