PTSD is Associated With an Excess of Inflammatory Immune Activities

Gill, Jessica; Saligan, Leo; Woods, Stephanie J.; Page, Gayle G.

doi:10.1111/j.1744-6163.2009.00229.x

Cited by 242 publications

(198 citation statements)

References 81 publications

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“…Another meta-analysis of CBT with a sleep focus that included CBT-I, as well as IRT and ERRT, found medium to large effects for improved subjective insomnia and PTSD symptoms and small to medium effects for depression [79]. Successful CBT-I treatment in active-duty military personnel with PTSD was also associated with decreased inflammatory gene expression and depression severity [80], supporting previous work indicating inflammatory response as an important physiological mechanism in both arousal and negative valence systems [81]. Overall, recent data suggest that sleep treatment, and CBT-I specifically, improves sleep as well as PTSD and depression with maintenance of improvements over time.…”

Section: Recent Treatment Studiessupporting

confidence: 58%

Understanding Recent Insights in Sleep and Posttraumatic Stress Disorder from a Research Domain Criteria (RDoC) Framework

Kelly

Killgore

Haynes

2016

Curr Sleep Medicine Rep

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Posttraumatic stress disorder (PTSD) is associated with sleep disturbances, including insomnia, nightmares, sleep-disordered breathing, and REM abnormalities. Recent studies have expanded our knowledge of the neurobiology of trauma and sleep. In addition, intervention research has provided valuable information about how sleep treatments affect PTSD symptoms and how PTSD treatments affect sleep symptoms. This review of recent literature aims to move away from the categorical approach that currently dominates our conceptualization of trauma response and sleep disorders. Possible mechanisms of both trauma and sleep disturbance are posed within the framework put forth by the National Institute of Mental Health's (NIMH) Research Domain Criteria (RDoC) project. By examining domains of dysfunction that cut across disorders, RDoC may guide future research and treatment of the maladaptive neurobiological and behavioral correlates of both trauma and sleep disturbances.

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Section: Recent Treatment Studiessupporting

confidence: 58%

Understanding Recent Insights in Sleep and Posttraumatic Stress Disorder from a Research Domain Criteria (RDoC) Framework

Kelly

Killgore

Haynes

2016

Curr Sleep Medicine Rep

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“…Further evidence of altered immune function in PTSD has been demonstrated in studies showing that the numbers of leukocytes and lymphocytes, as well as early activation markers of T lymphocytes such as CD45RA, are elevated in PTSD (29,61,107). Moreover, numbers of T regulatory cells, which are involved in suppressing inflammatory T lymphocyte responses, are significantly reduced (99).…”

Section: Autonomic-immune Dysfunction In Ptsdmentioning

confidence: 97%

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Brudey

Park

Wiaderkiewicz

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

105

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-Stressand anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated longterm comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed. posttraumatic stress disorder; cardiovascular disease; renin-angiotensin system POSTTRAUMATIC STRESS DISORDER (PTSD) is a psychiatric illness characterized by persistent emotional and mental stress following a traumatic event. Symptoms of PTSD include hyperarousal, flashbacks, intrusive thoughts, or nightmares, and avoidance of activities that trigger memories of the traumatic event. The health consequences of PTSD are substantial, affecting multiple organ systems, with evidence linking PTSD to diseases such as cancer, arthritis, digestive disease, and cardiovascular disease (CVD) (13,14,112). The evidence demonstrating increased risk for CVD in PTSD (9,15,19,49,57,58) is compelling, and several excellent recent review articles have highlighted this association (20,23,52,63,112). While this association could certainly be due, in part, to related unhealthy behaviors, such as increased prevalence of smoking, poor diet, and physical inactivity (46,119). Yet even after adjustments for lifestyle, comorbid conditions, and combat engagements in multivariate models, PTSD remains a significant and independent risk factor for the development of CVD and CVD-related mortality (15).Increased CVD risk in PTSD has been demonstrated in both military (21) and civilian populations (44,82). A co-twin study design (monozygotic and dizygotic), which controlled for genetic and familial confounders, demonstrated that the incidence of coronary heart disease was more than double in Vietnam War veteran twins with PTSD (22.6%) compared with those without PTSD (8.9%) (106). Most recently, one of the largest longitudinal studies examining the association between PTSD and heart failure was completed, and veterans with PTSD were shown to be nearly 50% more likely to develop heart failure than veterans without PTSD (91). This remained significant after adjustments for age, sex, diabetes, hyperlipidemia, hypertension, body mass index, combat, and military service. Civilian PTSD populations are also at greater risk for CVD. Following life-threatening traumatic events such as earthquakes (82), the 9 -11 World Trade Center attack (45), and living in urban dis...

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“…29 For example, proinflammatory biomarkers such as interleukin-6 and C-reactive protein decrease in response to exercise interventions. 56,57 Treatment with statins also reduces inflammatory biomarker levels and adverse CVD outcomes.…”

Section: Possible Interventions To Reduce Cvd Riskmentioning

confidence: 99%

Posttraumatic Stress Disorder and Cardiovascular Disease

Edmondson¹,

Hiti²,

Kronish³

2015

Prevention of Cardiovascular Diseases

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Posttraumatic stress disorder (PTSD) is an anxiety disorder initiated by exposure to a traumatic event and characterized by intrusive thoughts about the event, attempts to avoid reminders of the event, and physiological hyperarousal. In a number of large prospective observational studies, PTSD has been associated with incident cardiovascular disease (CVD) and mortality. Also, in recent years, a number of studies have shown that cardiovascular events can themselves cause PTSD in more than 1 in 8 patients with acute coronary syndrome. Further, a few small studies suggest that PTSD secondary to an acute CVD event then places patients at increased risk for subsequent CVD events and mortality. In this article, we review the evidence for a link between PTSD and CVD, and discuss potential mechanisms for that association as well as future directions for research.Posttraumatic stress disorder is an anxiety disorder initiated by an exposure to a traumatic event, such as combat, natural disaster, or sexual assault, and is characterized by symptoms such as re-experiencing the traumatic event (e.g., intrusive thoughts, nightmares), cognitive or behavioral avoidance of reminders of the event, and physiological hyperarousal. It is associated with abnormal amygdala, prefrontal cortex, and hippocampal function 1 as well as abnormal neuroendocrinologic characteristics. 2 Increasingly, PTSD is also being recognized as an independent risk factor for cardiovascular disease (CVD). [3][4][5] This paper outlines our current understanding of the association of PTSD and CVD, and considers 2 propositions concerning the association: (1) PTSD due to traumatic life events increases risk for incident CVD, and (2) the experience of life-threatening CVD may cause PTSD, and increase recurrent CVD risk. PTSD and risk for incident CVD/mortalityIn recent years, evidence has accumulated that PTSD due to various types of traumatic experiences, including exposure to combat, the World Trade Center attacks, and other similar life-threatening events is associated with development of cardiovascular disease, acute coronary syndromes, and cardiac-specific mortality. To date, 5 prospective cohort

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PTSD is Associated With an Excess of Inflammatory Immune Activities

Cited by 242 publications

References 81 publications

Understanding Recent Insights in Sleep and Posttraumatic Stress Disorder from a Research Domain Criteria (RDoC) Framework

Understanding Recent Insights in Sleep and Posttraumatic Stress Disorder from a Research Domain Criteria (RDoC) Framework

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Posttraumatic Stress Disorder and Cardiovascular Disease

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