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Elevated C-reactive protein and posttraumatic stress pathology among survivors of the 9/11 World Trade Center attacks

Published on Jun 1, 2017in Journal of Psychiatric Research 3.92
· DOI :10.1016/j.jpsychires.2017.01.007
Rebecca L. Rosen2
Estimated H-index: 2
(NYU: New York University),
Nomi Levy-Carrick5
Estimated H-index: 5
(NYU: New York University)
+ 9 AuthorsIsaac R. Galatzer-Levy23
Estimated H-index: 23
(NYU: New York University)
Cite
Abstract
Abstract Background Systemic inflammation has emerged as a promising marker and potential mechanism underlying post-traumatic stress disorder (PTSD). The relationship between posttraumatic stress pathology and systemic inflammation has not, however, been consistently replicated and is potentially confounded by comorbid illness or injury, common complications of trauma exposure. Methods We analyzed a large naturalistic cohort sharing a discrete physical and mental health trauma from the destruction of the World Trade Center (WTC) towers on September 11, 2001 (n = 641). We evaluated the relationship between multiple physical and mental health related indices collected through routine evaluations at the WTC Environmental Health Center (WTC EHC), a treatment program for community members exposed to the disaster. C-Reactive Protein (CRP), a marker of systemic inflammation, was examined in relation to scores for PTSD, PTSD symptom clusters (re-experiencing, avoidance, negative cognitions/mood, arousal), depression and anxiety, while controlling for WTC exposures, lower respiratory symptoms, age, sex, BMI and smoking as potential risks or confounders. Results CRP was positively associated with PTSD severity ( p 0 .001), trending toward association with depression ( p  = 0.06), but not with anxiety ( p  = 0.27). CRP was positively associated with re-experiencing ( p 0 .001) and avoidance ( p 0 .05) symptom clusters, and trended toward associations with negative cognitions/mood ( p  = 0.06) and arousal ( p  = 0.08). Conclusions In this large study of the relationship between CRP and posttraumatic stress pathology, we demonstrated an association between systemic inflammation and stress pathology (PTSD; trending with depression), which remained after adjusting for potentially confounding variables. These results contribute to research findings suggesting a salient relationship between inflammation and posttraumatic stress pathology.
  • References (56)
  • Citations (14)
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References56
Newest
Published on Jan 1, 2017in Neuropsychopharmacology 7.16
Michopoulos1
Estimated H-index: 1
,
Abigail Powers14
Estimated H-index: 14
+ 2 AuthorsTanja Jovanovic30
Estimated H-index: 30
Abstract The study of inflammation in fear- and anxiety-based disorders has gained interest as growing literature indicates that pro-inflammatory markers can directly modulate affective behavior. Indeed, heightened concentrations of inflammatory signals, including cytokines and C-reactive protein, have been described in posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), and phobias (agoraphobia, social phobia, etc.). However, not all reports indicate a...
Published on May 1, 2016in Annals of the American Thoracic Society
Joan Reibman35
Estimated H-index: 35
,
Nomi Levy-Carrick5
Estimated H-index: 5
+ 4 AuthorsRoberto Lucchini31
Estimated H-index: 31
The assault and subsequent collapse of the World Trade Center towers in New York City on September 11, 2001 (9/11), released more than a million tons of debris and dust into the surrounding area, engulfing rescue workers as they rushed to aid those who worked in the towers, and the thousands of nearby civilians and children who were forced to flee. In December 2015, almost 15 years after the attack, and 5 years after first enactment, Congress reauthorized the James Zadroga 9/11 Health and Compen...
Published on Mar 7, 2016in Pharmacopsychiatry 2.74
Harris A. Eyre13
Estimated H-index: 13
(University of Adelaide),
Helen Lavretsky35
Estimated H-index: 35
(Semel Institute for Neuroscience and Human Behavior)
+ 2 AuthorsBernhard T. Baune59
Estimated H-index: 59
(University of Adelaide)
Current reviews exploring for unique immune-modulatory profiles of antidepressant classes are limited by focusing mainly on cytokine modulation only and neglecting other aspects of the innate and adaptive immune system. These reviews also do not include recent comparative clinical trials, immune-genetic studies and therapeutics with unique neurotransmitter profiles (e. g., agomelatine). This systematic review extends the established literature by comprehensively reviewing the effects of antidepr...
Published on Nov 1, 2015in International Journal of Psychophysiology 2.41
Seth D. Norrholm33
Estimated H-index: 33
(Emory University),
Ebony M. Glover12
Estimated H-index: 12
(KSU: Kennesaw State University)
+ 5 AuthorsTanja Jovanovic30
Estimated H-index: 30
(Emory University)
Abstract Psychophysiological measures of fear expression provide observable intermediate phenotypes of fear-related symptoms. Research Domain Criteria (RDoC) advocate using neurobiological intermediate phenotypes that provide dimensional correlates of psychopathology. Negative Valence Systems in the RDoC matrix include the construct of acute threat, which can be measured on a physiological level using potentiation of the acoustic startle reflex assessed via electromyography recordings of the orb...
Published on Nov 1, 2015in The Lancet Psychiatry 18.33
Ives Cavalcante Passos13
Estimated H-index: 13
(UFRGS: Universidade Federal do Rio Grande do Sul),
Mirela Paiva Vasconcelos-Moreno8
Estimated H-index: 8
(UFRGS: Universidade Federal do Rio Grande do Sul)
+ 7 AuthorsMárcia Kauer-Sant'Anna28
Estimated H-index: 28
(UFRGS: Universidade Federal do Rio Grande do Sul)
Summary Background Studies investigating inflammatory markers in post-traumatic stress disorder (PTSD) have yielded mixed results. The aim of our study was to compare concentrations of inflammatory markers in patients with PTSD compared with healthy controls. Methods We did a meta-analysis and meta-regression of studies comparing inflammatory markers between patients with PTSD and healthy controls by searching PubMed, Embase, Scopus, Web of Science, and PsycINFO for articles published between Ja...
Published on Sep 1, 2015in Psychiatry Research-neuroimaging 2.21
Melissa Furtado5
Estimated H-index: 5
,
Martin A. Katzman19
Estimated H-index: 19
Abstract Recent findings have established a connection between inflammation and major depression and specifically the role of the hypothalamic–pituitary–adrenal (HPA) axis in depression. This article reviews clinical and experimental studies examining the role of the HPA axis, HPA hyperactivity (resulting in increased cortisol levels), as well as the proinflammatory cytokines tumor necrosis factor, C-reactive protein, and the interleukins, in depressed patients. Similarly this paper will review ...
Published on Jul 3, 2015in Critical Reviews in Toxicology 4.77
Morton Lippmann54
Estimated H-index: 54
(NYU: New York University),
Mitchell D. Cohen20
Estimated H-index: 20
(NYU: New York University),
Lung Chi Chen48
Estimated H-index: 48
(NYU: New York University)
AbstractThe World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings’ huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80–90% of the settled WTC Dust, ranging in particle size from ∼2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity...
Published on Jun 1, 2015in Dialogues in clinical neuroscience 4.87
Janine D. Flory35
Estimated H-index: 35
,
Rachel Yehuda88
Estimated H-index: 88
Approximately half of people with post-traumatic stress disorder (PTSD) also suffer from Major Depressive Disorder (MDD). The current paper examines evidence for two explanations of this comorbidity. First, that the comorbidity reflects overlapping symptoms in the two disorders. Second, that the co-occurrence of PTSD and MDD is not an artifact, but represents a trauma-related phenotype, possibly a subtype of PTSD. Support for the latter explanation is inferred from literature that examines risk ...
Published on Jun 1, 2015in Journal of Occupational and Environmental Medicine 1.59
Angeliki Kazeros8
Estimated H-index: 8
,
Enhan Zhang2
Estimated H-index: 2
+ 13 AuthorsMuhammad Ghumman1
Estimated H-index: 1
Background:Destruction of the World Trade Center (WTC) towers on September 11, 2001, released massive dust, gas, and fumes with environmental exposures for community members. Many community members have lower respiratory symptoms (LRSs) that began after September 11, 2001, and remain persistent. We
Published on Apr 1, 2015in American Journal of Psychiatry 13.65
Vasiliki Michopoulos19
Estimated H-index: 19
,
Alex O. Rothbaum7
Estimated H-index: 7
+ 5 AuthorsKerry J. Ressler77
Estimated H-index: 77
Objective:Increased systemic inflammation is associated with stress-related psychopathology. Specifically, levels of the proinflammatory marker C-reactive protein (CRP) are elevated in individuals with posttraumatic stress disorder (PTSD). Furthermore, single-nucleotide polymorphisms (SNPs) in the CRP gene are associated with CRP level, risk for cardiovascular disease, and obesity. The authors examined whether polymorphisms within the CRP gene and increased CRP levels are associated with PTSD sy...
Cited By14
Newest
Published on Dec 1, 2019in Scientific Reports 4.01
Sean Clouston13
Estimated H-index: 13
(SBU: Stony Brook University),
Norman H. Edelman2
Estimated H-index: 2
(SBU: Stony Brook University)
+ 2 AuthorsBenjamin J. Luft44
Estimated H-index: 44
(SBU: Stony Brook University)
The objective of this study was to examine whether shorter leukocyte telomere length (LTL) is associated with more rapid pulmonary function decline in a longitudinal study of World Trade Center (WTC) responders. WTC responders (N = 284) participating in a monitoring study underwent blood sampling and were followed prospectively for spirometric outcomes. A single blood sample was taken to measure LTL using southern blotting. Outcomes included percent-predicted one-second forced expiratory volume ...
Published on Jan 15, 2019in Translational Psychiatry 5.18
Pei Fen Kuan23
Estimated H-index: 23
(SBU: Stony Brook University),
Xiaohua Yang12
Estimated H-index: 12
(SBU: Stony Brook University)
+ 9 AuthorsJianmin Wang22
Estimated H-index: 22
Posttraumatic stress disorder (PTSD), a chronic disorder resulting from severe trauma, has been linked to immunologic dysregulation. Gene expression profiling has emerged as a promising tool for understanding the pathophysiology of PTSD. However, to date, all but one gene expression study was based on whole blood or unsorted peripheral blood mononuclear cell (PBMC), a complex tissue consisting of several populations of cells. The objective of this study was to utilize RNA sequencing to simultane...
Sujata Thawani1
Estimated H-index: 1
,
Bin Wang1
Estimated H-index: 1
+ 2 AuthorsMichael Marmor4
Estimated H-index: 4
We examined whether time to onset of paresthesia was associated with indicators of severity of World Trade Center (WTC) exposure. We analyzed data from 3411 patients from the Bellevue Hospital—WTC Environmental Health Center. Paresthesia was defined as present if the symptom occurred in the lower extremities with frequency “often” or “almost continuous.” We plotted hazard functions and used the log-rank test to compare time to onset of paresthesia between different exposure groups. We also used ...
Rebecca F. Rosen12
Estimated H-index: 12
,
Rebecca L. Rosen2
Estimated H-index: 2
+ 4 AuthorsJoan Reibman35
Estimated H-index: 35
The World Trade Center (WTC) Environmental Health Center (EHC) is a treatment program for community members with exposure to the 9/11 terrorist attack and its physical and emotional aftermath. Compared to the general responders program, the WTC EHC is diverse with equal gender distribution, representation of many races and ethnicities, and a wide range of social economic status. Patients in the WTC EHC were initially enrolled for physical symptoms, most of which were respiratory, however a large...
Filomene G. Morrison5
Estimated H-index: 5
(BU: Boston University),
Mark W. Miller44
Estimated H-index: 44
(BU: Boston University)
+ 2 AuthorsErika J. Wolf23
Estimated H-index: 23
(BU: Boston University)
Abstract There is increasing evidence that epigenetic factors play a critical role in posttraumatic stress disorder (PTSD), by mediating the impact of environmental exposures to trauma on the regulation of gene expression. DNA methylation is one epigenetic process that has been highly studied in PTSD. This review will begin by providing an overview of DNA methylation (DNAm) methods, and will then highlight two major biological systems that have been identified in the epigenetic regulation in PTS...
Published on Jul 1, 2018in Journal of Psychiatric Research 3.92
Risa Imai3
Estimated H-index: 3
(Nagoya City University),
Hiroaki Hori20
Estimated H-index: 20
+ 11 AuthorsMie Matsui2
Estimated H-index: 2
(Kanazawa University)
Abstract Posttraumatic stress disorder (PTSD) has been associated with increased inflammation, albeit with some controversy. Another key feature of PTSD is compromised function in wide-ranging cognitive domains. Increased peripheral inflammation can contribute to cognitive dysfunction, although this relationship has not been studied in patients with PTSD. Here, we examined blood inflammatory markers in adult patients with PTSD compared to healthy controls taking account of potentially confoundin...
Published on Jul 1, 2018in General Hospital Psychiatry 3.22
Hannes Bielas1
Estimated H-index: 1
(UZH: University of Zurich),
Rebecca E. Meister-Langraf3
Estimated H-index: 3
(University of Bern)
+ 5 AuthorsRoland von Känel45
Estimated H-index: 45
(University of Bern)
BACKGROUND: Acute coronary syndrome (ACS) may cause clinically relevant posttraumatic stress disorder symptoms (PTSS). An inflammatory state might be one mechanism linking PTSS with poor prognosis after ACS. We tested the hypothesis that a change in C-reactive protein (CRP) between hospital admission and 3-month follow-up is an independent predictor of ACS-triggered PTSS. METHODS: We assessed 183 patients (median age 59 years; 84% men) with verified myocardial infarction (MI) within 48 h of an a...
Published on Apr 1, 2018in Current Psychiatry Reports 3.82
Diego De La Vega2
Estimated H-index: 2
,
Lucas Giner12
Estimated H-index: 12
(University of Seville),
Philippe Courtet37
Estimated H-index: 37
(University of Montpellier)
Purpose of Review Historically, anxiety disorders have not been considered as important determinants of suicide, but in the last years, many works have challenged this assumption. Here, we will review the available evidence on the relationship between suicide and anxiety disorders (e.g., obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, panic disorder, and body dysmorphic disorder), with special emphasis on findings published in the last years.
Published on Feb 1, 2018in Biological Psychiatry 11.50
Synthia H. Mellon46
Estimated H-index: 46
(UCSF: University of California, San Francisco),
Aarti Gautam2
Estimated H-index: 2
(DA: United States Department of the Army)
+ 2 AuthorsOwen M. Wolkowitz58
Estimated H-index: 58
(UCSF: University of California, San Francisco)
Author(s): Mellon, Synthia H; Gautam, Aarti; Hammamieh, Rasha; Jett, Marti; Wolkowitz, Owen M | Abstract: Posttraumatic stress disorder (PTSD) is defined by classic psychological manifestations, although among the characteristics are significantly increased rates of serious somatic comorbidities, such as cardiovascular disease, immune dysfunction, and metabolic syndrome. In this review, we assess the evidence for disturbances that may contribute to somatic pathology in inflammation, metabolic sy...
Published on Jan 1, 2018in Cellular and Molecular Neurobiology 3.81
Svetlana S. Lazuko1
Estimated H-index: 1
,
Olga P. Kuzhel1
Estimated H-index: 1
+ 5 AuthorsVadim E. Tseilikman2
Estimated H-index: 2
(SUSU: South Ural State University)
Posttraumatic stress disorder (PTSD) is associated with myocardial injury, but changes in coronary regulatory mechanisms in PTSD have not been investigated. This study evaluated the effect of PTSD-inducing stress on coronary tone and its regulation by nitric oxide (NO) and voltage-gated K+ channels. PTSD was induced by exposing rats to predator stress, 15 min daily for 10 days, followed by 14 stress-free days. Presence of PTSD was confirmed by the elevated plus-maze test. Coronary tone was evalu...