Inflammatory cytokines, behaviour and age as determinants of self-rated health in women

Abstract

Self-rated health is a powerful and independent predictor of long-term health, but its biological basis is unknown. We have shown previously that self-rated health is associated with increased levels of circulating cytokines in women. The main aim of the present study was to increase the understanding of the association between markers of wellbeing, such as self-rated health, and cytokines and to investigate the impact of age on these associations. In 174 female consecutive primary health care patients divided into three age groups, we examined subjective ratings of health and aspects of wellbeing and circulating levels of IL (interleukin)-1beta, IL-1ra (IL-1 receptor antagonist), IL-6 and TNF-alpha (tumour necrosis factor-alpha). Poor self-rated health was significantly associated with higher levels of TNF-alpha in all of the age groups. For IL-1beta and IL-1ra, the correlations with self-rated health were significant only in the oldest age group. Lower ratings of other measurements of health and wellbeing were related to higher levels of cytokines, most pronounced for TNF-alpha and IL-1beta, and in the middle and olderst age groups. More symptoms resembling a sickness response induced by inflammation were implicated to be associated with lower self-rated health. The strength of the association between inflammatory cytokines and poor health perception increased with advanced age, indicating an increased vulnerability for inflammatory activity during aging. It is suggested that higher levels of TNF-alpha are connected to a sickness response that, in turn, is connected to self-rated health. The results provide a possible psychobiological basis to understand better diffuse subjective symptoms and poor subjective health in women.

Is Self-Rated Health Associated with Blood Immune Markers in Healthy Individuals?

“…Several previous studies have reported a positive relationship between poor SRH and increased cytokines such as IL-6 [17,35], IL-1β [15], IL-1ra [15], or TNF-α [15,16]. However, these findings are not always consistent when the studies are compared to each other.…”

“…For instance, Janszky et al [17] found a positive relationship between poor SRH and IL-6, but not with IL-1ra, while Lekander et al [15] observed a positive relationship between poor SRH and IL1ra and TNF-α, but not with IL-6. A recent study by Unden et al [16] observed that the relationship between poor SRH and cytokines (TNF-α and IL-1β) was significant in elderly women (aged over 65 years), but not in younger women (aged <50 years). They also reported that the relationship between SRH and IL-6 or IL-1ra was not significant in any age group.…”

“…The study confirmed that SRH was an independent and more robust predictor of those cytokine levels than physician-rated health even after controlling for confounders. More recently, the same research group found that the association between SRH and inflammatory cytokines became stronger with advancing age [16]. A study reported from Sweden suggested that poor SRH was positively associated with interleukin-6 (IL-6) in a sample of women hospitalized for acute myocardial infarction [17].…”

The human ovarian follicular fluid level of interleukin-8 is associated with follicular size and patient age

“…The only reports of differential cytokine concentration by patient age involve serum levels of other cytokines as markers of inflammation and possible risk factors for morbidity and mortality (24)(25)(26). The addition of leukocytes to in vitro perfused rat ovaries has been found to increase the rate of ovulation (27) and exogenous IL-8 has been shown to effect follicular maturation in rabbits (28) and rats (29) similar to the administration of LH or hCG.…”

Inflammation and Traumatic Stress

“…For example, a recent study in male veterans of behavioral activation, a psychological therapy that involves physical exposure to reminders of a trauma while being provided positive reinforcement, reduced PTSD symptoms as well as increased health-related quality of life (Jakupcak et al, 2010). Higher health-related quality of life has been linked to reductions in inflammation in other studies (Baturone et al, 2009;Booker, Olson, Pilarski, Noon, & Bahlis, 2009;Mommersteeg, Kupper, Schoormans, Emons, & Pedersen, 2010;Unden et al, 2007). Smoking cessation, which has been linked to reductions in peripheral inflammation (Goncalves et al, 2011), reduced PTSD symptoms and increased perceived health quality in male veterans .…”