Influence of depression and anxiety on circulating endothelial progenitor cells in patients with acute coronary syndromes

Felice, Francesca; Stefano, Rossella Di; Pini, Stefano; Mazzotta, Gianfranco; Bovenzi, Francesco; Bertoli, Daniele; Abelli, Marianna; Borelli, Lucia; Cardini, Alessandra; Lari, Lisa; Gesi, Camilla; Michi, Paola; Morrone, Doralisa; Gnudi, Luigi; Balbarini, Alberto

doi:10.1002/hup.2470

Cited by 21 publications

(17 citation statements)

References 27 publications

(33 reference statements)

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“…Several studies have reported elevated concentrations of CRP in MDD even after controlling for potential confounders, such as cigarette smoking [43]. Recent data showed a reduced number of endothelial progenitor cells, a marker of ED, in patients with MDD acute coronary syndrome [44]. Circulating oxidative stress markers have also been found among patients with MDD [45,46].…”

Section: Discussionmentioning

confidence: 99%

Regional Brain Perfusion Is Associated with Endothelial Dysfunction Markers in Major Depressive Disorder

et al. 2020

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Background: Major depressive disorder (MDD) is an important independent risk factor for cardiovascular disease. Cumulative data suggest that depressive patients exhibit derangement in regional cerebral blood flow (rCBF), although underlying mechanisms remain mostly unknown. Endothelial dysfunction (ED), defined as different forms of abnormal endothelial activity, plays a key role in the pathogenesis of vascular disease. ED is associated with several clinical conditions characterized by high cardiovascular risk. Diverse ED markers have been found in mood disorders. Purpose: To evaluate the association between rCBF and peripheral ED markers in MDD patients, at baseline and after selective serotonin receptor inhibitors (SSRIs) therapy. Patients and Methods: Twenty-seven untreated unipolar MDD patients in their first episode were evaluated with the Hamilton Depression Rating Scale (HAM-D) and brain perfusion SPECT at baseline and after 2 months of SSRIs. Statistical Parametric Mapping (SPM) was employed to evaluate rCBF; circulating endothelial cells (CECs), plasma soluble intercellular adhesion molecule (sICAM), and high-sensitivity C-reactive protein (hsCRP) were used as independent covariates. Results: Baseline CECs and sICAM were increased in MDD patients compared with matching controls (p = 0.0001) and hsCRP (p = 0.03). HAM-D scores (21 items) and CECs diminished after SSRI therapy in MDD patients (p < 0.0001). There was a significant rCBF decrease, mainly in deep central structures. HAM-D change was associated with rCBF decrease at the left amygdala, right striatum levels, and Brodmann area 25. CEC change was associated with rCBF at deep brain level and sICAM with large rCBF areas at the left caudate and tectum; hsCRP was associated, to a lesser extent, with the left dorsal striatum and mesencephalic tectum. Conclusion: ED markers in patients with MDD are associated with significant changes in rCBF which are features of depression. These findings suggest that systemic damage/activation of the endothelium may contribute to the abnormal rCBF observed in MDD patients.

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Section: Discussionmentioning

confidence: 99%

Regional Brain Perfusion Is Associated with Endothelial Dysfunction Markers in Major Depressive Disorder

et al. 2020

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“…Patients with anxiety have impaired flow-mediated dilation of the vasculature, which suggests greater endothelial dysfunction [66-69]. Patients with GAD, PD, and obsessive compulsive disorder have decreased levels of circulating endothelial progenitor cells that are vital to healthy endothelial function and prevent progression of CAD [70]. Furthermore, patients with PTSD—especially those with active symptoms—have increased levels of soluble tissue factor and von Willebrand Factor, two substances that are secreted by endothelial cells and have been implicated in inflammation, thrombosis, and ultimately the development of atherosclerosis [71].…”

Section: Mechanisms Mediating the Relationships Between Anxiety Disormentioning

confidence: 99%

Anxiety Disorders and Cardiovascular Disease

Celano

Daunis

Lokko

et al. 2016

Curr Psychiatry Rep

270

173

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Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated with the onset and progression of cardiac disease, and in many instances have been linked to adverse cardiovascular outcomes, including mortality. Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation) and health behavior mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease. Given the associations between anxiety disorders and poor cardiac health, the timely and accurate identification and treatment of these conditions is of the utmost importance. Fortunately, pharmacologic and psychotherapeutic interventions for the management of anxiety disorders are generally safe and effective. Further study is needed to determine whether interventions to treat anxiety disorders ultimately impact both psychiatric and cardiovascular health.

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“… 15 , 16 , 17 In this regard, there is recent evidence on reduced levels of circulating EPCs in patients with depression and acute coronary syndromes. 18 , 19 Oxidative stress, measured by circulating markers (superoxide dismutase, glutathione, oxLDL, among others) in plasma and platelets, 10 vascular relaxation 20 and animal models, 21 , 22 has been closely associated with major depression. 23 , 24 Studies in a depression model with chronic mild stress rats demonstrated associations between endothelial dysfunction, oxidative stress and depression-like symptoms that were modulated by chronic SSRI.…”

Section: Introductionmentioning

confidence: 99%

Endothelial damage in major depression patients is modulated by SSRI treatment, as demonstrated by circulating biomarkers and an in vitro cell model

et al. 2016

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There is a link between depression, cardiovascular events and inflammation. We have explored this connection through endothelial dysfunction, using in vivo and in vitro approaches. We evaluated circulating biomarkers of endothelial dysfunction in patients with major depression at their diagnosis (MD-0) and during antidepressant treatment with the selective serotonin reuptake inhibitor escitalopram, for 8 and 24 weeks (MD-8 and MD-24). Results were always compared with matched healthy controls (CON). We measured in vivo circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs) in blood samples, and assessed plasma levels of soluble von Willebrand factor (VWF) and vascular cell adhesion molecule-1 (VCAM-1). CEC counts, soluble VWF and VCAM-1 were statistically elevated in MD-0 (P<0.01 versus CON) and gradually decreased during treatment. Conversely, EPC levels were lower in MD-0, tending to increase throughout treatment. In vitro studies were performed in human endothelial cells cultured in the presence of sera from each study group. Elevated expression of the inflammation marker intercellular adhesion molecule-1 and oxidative stress, with lower presence of endothelial nitric oxide synthase and higher reactive oxygen species production, were found in cells exposed to MD-0 sera (P<0.05 versus CON). These results were normalized in cells exposed to MD-24 sera. Thrombogenicity of extracellular matrices generated by these cells, measured as expression of VWF, tissue factor and platelet reactivity, showed non-significant differences. We provide a model of cultured endothelial cells reproducing endothelial dysfunction in naive patients with major depression, demonstrating endothelial damage and inflammation at diagnosis, and recovering with selective serotonin reuptake inhibitor treatment for 24 weeks.

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Influence of depression and anxiety on circulating endothelial progenitor cells in patients with acute coronary syndromes

Abstract: The current study indicates that EPCs circulate in decreased numbers in ACS patients with depression or anxiety and, therefore, contribute to explore new perspectives in the pathophysiology of the association between cardiovascular disorders and affective disorders.

Cited by 21 publications

References 27 publications

Regional Brain Perfusion Is Associated with Endothelial Dysfunction Markers in Major Depressive Disorder

Regional Brain Perfusion Is Associated with Endothelial Dysfunction Markers in Major Depressive Disorder

Anxiety Disorders and Cardiovascular Disease

Endothelial damage in major depression patients is modulated by SSRI treatment, as demonstrated by circulating biomarkers and an in vitro cell model

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