Post-traumatic stress disorder and serum cytokine and chemokine concentrations in patients with rheumatoid arthritis

P. M. Maloley, B. R. England, H. Sayles, G. M. Thiele, K. Michaud, J. Sokolove, G. W. Cannon, Andreas M Reimold, G. S. Kerr, J. F. Baker, L. Caplan, A. J. Case, T. R. Mikuls

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Although post-traumatic stress disorder (PTSD) is identified as a risk factor in the development of rheumatoid arthritis (RA), associations of PTSD with disease progression are less clear. To explore whether PTSD might influence disease-related measures of systemic inflammation in RA, we compared serum cytokine/chemokine (cytokine) concentrations in RA patients with and without PTSD. Methods: Participants were U.S. Veterans with RA and were categorized as having PTSD, other forms of depression/anxiety, or neither based on administrative diagnostic codes. Multiplex cytokines were measured using banked serum. Associations of PTSD with cytokine parameters (including a weighted cytokine score) were assessed using multivariable regression, stratified by anti-CCP status and adjusted for age, sex, race, and smoking status. Results: Among 1,460 RA subjects with mean (SD) age of 64 (11) years and disease duration of 11 (11) years, 91% were male, 77% anti-CCP positive, and 80% ever smokers. Of these, 11.6% had PTSD, 23.7% other depression/anxiety, and 64.7% had neither. PTSD, but not depression/anxiety, was associated with a higher cytokine score and number of high-concentration analytes in adjusted models, though this was limited to anti-CCP positive subjects. PTSD was associated with heightened expression of several individual cytokines including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-12, IL-17, IFN-γ, GM-CSF, MCP-1, and TNF-α. Conclusion: Anti-CCP positive RA patients with PTSD have higher serum cytokine concentrations than those without PTSD, demonstrating that systemic inflammation characteristic of RA is heightened in the context of this relatively common psychiatric comorbidity.

Original languageEnglish (US)
JournalSeminars in Arthritis and Rheumatism
DOIs
StatePublished - Jan 1 2019

Fingerprint

Post-Traumatic Stress Disorders
Chemokines
Rheumatoid Arthritis
Cytokines
Serum
Anxiety
Depression
Inflammation
Interleukin-7
Macrophage Colony-Stimulating Factor
Interleukin-17
Interleukin-5
Veterans
Interleukin-12
Granulocyte-Macrophage Colony-Stimulating Factor
Interleukin-1
Interleukin-4
Interleukin-10
Interleukin-2
Psychiatry

Keywords

  • Anti-citrullinated protein antibody
  • Anxiety
  • Cytokines
  • Depression
  • Post-traumatic stress disorder
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine

Cite this

Post-traumatic stress disorder and serum cytokine and chemokine concentrations in patients with rheumatoid arthritis . / Maloley, P. M.; England, B. R.; Sayles, H.; Thiele, G. M.; Michaud, K.; Sokolove, J.; Cannon, G. W.; Reimold, Andreas M; Kerr, G. S.; Baker, J. F.; Caplan, L.; Case, A. J.; Mikuls, T. R.

In: Seminars in Arthritis and Rheumatism, 01.01.2019.

Research output: Contribution to journalArticle

Maloley, PM, England, BR, Sayles, H, Thiele, GM, Michaud, K, Sokolove, J, Cannon, GW, Reimold, AM, Kerr, GS, Baker, JF, Caplan, L, Case, AJ & Mikuls, TR 2019, ' Post-traumatic stress disorder and serum cytokine and chemokine concentrations in patients with rheumatoid arthritis ', Seminars in Arthritis and Rheumatism. https://doi.org/10.1016/j.semarthrit.2019.02.002
Maloley, P. M. ; England, B. R. ; Sayles, H. ; Thiele, G. M. ; Michaud, K. ; Sokolove, J. ; Cannon, G. W. ; Reimold, Andreas M ; Kerr, G. S. ; Baker, J. F. ; Caplan, L. ; Case, A. J. ; Mikuls, T. R. / Post-traumatic stress disorder and serum cytokine and chemokine concentrations in patients with rheumatoid arthritis In: Seminars in Arthritis and Rheumatism. 2019.
@article{88a84f30f9f8409a823b450b74eb73c5,
title = "Post-traumatic stress disorder and serum cytokine and chemokine concentrations in patients with rheumatoid arthritis ✰",
abstract = "Objective: Although post-traumatic stress disorder (PTSD) is identified as a risk factor in the development of rheumatoid arthritis (RA), associations of PTSD with disease progression are less clear. To explore whether PTSD might influence disease-related measures of systemic inflammation in RA, we compared serum cytokine/chemokine (cytokine) concentrations in RA patients with and without PTSD. Methods: Participants were U.S. Veterans with RA and were categorized as having PTSD, other forms of depression/anxiety, or neither based on administrative diagnostic codes. Multiplex cytokines were measured using banked serum. Associations of PTSD with cytokine parameters (including a weighted cytokine score) were assessed using multivariable regression, stratified by anti-CCP status and adjusted for age, sex, race, and smoking status. Results: Among 1,460 RA subjects with mean (SD) age of 64 (11) years and disease duration of 11 (11) years, 91{\%} were male, 77{\%} anti-CCP positive, and 80{\%} ever smokers. Of these, 11.6{\%} had PTSD, 23.7{\%} other depression/anxiety, and 64.7{\%} had neither. PTSD, but not depression/anxiety, was associated with a higher cytokine score and number of high-concentration analytes in adjusted models, though this was limited to anti-CCP positive subjects. PTSD was associated with heightened expression of several individual cytokines including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-12, IL-17, IFN-γ, GM-CSF, MCP-1, and TNF-α. Conclusion: Anti-CCP positive RA patients with PTSD have higher serum cytokine concentrations than those without PTSD, demonstrating that systemic inflammation characteristic of RA is heightened in the context of this relatively common psychiatric comorbidity.",
keywords = "Anti-citrullinated protein antibody, Anxiety, Cytokines, Depression, Post-traumatic stress disorder, Rheumatoid arthritis",
author = "Maloley, {P. M.} and England, {B. R.} and H. Sayles and Thiele, {G. M.} and K. Michaud and J. Sokolove and Cannon, {G. W.} and Reimold, {Andreas M} and Kerr, {G. S.} and Baker, {J. F.} and L. Caplan and Case, {A. J.} and Mikuls, {T. R.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.semarthrit.2019.02.002",
language = "English (US)",
journal = "Seminars in Arthritis and Rheumatism",
issn = "0049-0172",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Post-traumatic stress disorder and serum cytokine and chemokine concentrations in patients with rheumatoid arthritis ✰

AU - Maloley, P. M.

AU - England, B. R.

AU - Sayles, H.

AU - Thiele, G. M.

AU - Michaud, K.

AU - Sokolove, J.

AU - Cannon, G. W.

AU - Reimold, Andreas M

AU - Kerr, G. S.

AU - Baker, J. F.

AU - Caplan, L.

AU - Case, A. J.

AU - Mikuls, T. R.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Although post-traumatic stress disorder (PTSD) is identified as a risk factor in the development of rheumatoid arthritis (RA), associations of PTSD with disease progression are less clear. To explore whether PTSD might influence disease-related measures of systemic inflammation in RA, we compared serum cytokine/chemokine (cytokine) concentrations in RA patients with and without PTSD. Methods: Participants were U.S. Veterans with RA and were categorized as having PTSD, other forms of depression/anxiety, or neither based on administrative diagnostic codes. Multiplex cytokines were measured using banked serum. Associations of PTSD with cytokine parameters (including a weighted cytokine score) were assessed using multivariable regression, stratified by anti-CCP status and adjusted for age, sex, race, and smoking status. Results: Among 1,460 RA subjects with mean (SD) age of 64 (11) years and disease duration of 11 (11) years, 91% were male, 77% anti-CCP positive, and 80% ever smokers. Of these, 11.6% had PTSD, 23.7% other depression/anxiety, and 64.7% had neither. PTSD, but not depression/anxiety, was associated with a higher cytokine score and number of high-concentration analytes in adjusted models, though this was limited to anti-CCP positive subjects. PTSD was associated with heightened expression of several individual cytokines including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-12, IL-17, IFN-γ, GM-CSF, MCP-1, and TNF-α. Conclusion: Anti-CCP positive RA patients with PTSD have higher serum cytokine concentrations than those without PTSD, demonstrating that systemic inflammation characteristic of RA is heightened in the context of this relatively common psychiatric comorbidity.

AB - Objective: Although post-traumatic stress disorder (PTSD) is identified as a risk factor in the development of rheumatoid arthritis (RA), associations of PTSD with disease progression are less clear. To explore whether PTSD might influence disease-related measures of systemic inflammation in RA, we compared serum cytokine/chemokine (cytokine) concentrations in RA patients with and without PTSD. Methods: Participants were U.S. Veterans with RA and were categorized as having PTSD, other forms of depression/anxiety, or neither based on administrative diagnostic codes. Multiplex cytokines were measured using banked serum. Associations of PTSD with cytokine parameters (including a weighted cytokine score) were assessed using multivariable regression, stratified by anti-CCP status and adjusted for age, sex, race, and smoking status. Results: Among 1,460 RA subjects with mean (SD) age of 64 (11) years and disease duration of 11 (11) years, 91% were male, 77% anti-CCP positive, and 80% ever smokers. Of these, 11.6% had PTSD, 23.7% other depression/anxiety, and 64.7% had neither. PTSD, but not depression/anxiety, was associated with a higher cytokine score and number of high-concentration analytes in adjusted models, though this was limited to anti-CCP positive subjects. PTSD was associated with heightened expression of several individual cytokines including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-12, IL-17, IFN-γ, GM-CSF, MCP-1, and TNF-α. Conclusion: Anti-CCP positive RA patients with PTSD have higher serum cytokine concentrations than those without PTSD, demonstrating that systemic inflammation characteristic of RA is heightened in the context of this relatively common psychiatric comorbidity.

KW - Anti-citrullinated protein antibody

KW - Anxiety

KW - Cytokines

KW - Depression

KW - Post-traumatic stress disorder

KW - Rheumatoid arthritis

UR - http://www.scopus.com/inward/record.url?scp=85061547053&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061547053&partnerID=8YFLogxK

U2 - 10.1016/j.semarthrit.2019.02.002

DO - 10.1016/j.semarthrit.2019.02.002

M3 - Article

JO - Seminars in Arthritis and Rheumatism

JF - Seminars in Arthritis and Rheumatism

SN - 0049-0172

ER -