engleski

Endocrine and immune interactions in war related trauma

Neuroendocrine and immune systems make a complex, bidirectional communication network. This communiction is based upon signaling molecules such as catecholamines, glucocorticoid hormones, proinflammatory cytokines and their receptors. In stress response or different psychiatric disturbances hormones will modulate functional capacities of immune cells and, on the other hand, proinflammatory cytokines will activate the HPA axis and promote alternatins in behaviour trough impact on the brain. The aim of this study was to examine the impact of post traumatic stress disorder (PTSD) on: serum level of stress hormones and proinflammatory cytokines, as well as peripheral blood immune cell populations and their functions. We examined a group of professional soldiers (N=194) exposed to combat associated traumatic events and a control group of 65 persons without trauma. Soldiers, examined two years after trauma, were divided in three subgroups according to severity of psychiatric symptoms assessed by Croatian Stress Scale (CROSS), 52 with no symptoms of PTSD, 70 with mild symptoms and 72 with severe symptoms. In order to examine immune status we studied percentage of main lymphocytes subpopulations and their activation markers by flow cytometry and immune functions: in vitro NK cytotoxic activity and phagocyte functions (ingestion and digestion). Serums were collected for analysis of cytokines (TNF-alpha), IL-1-beta, IL-6, IFN-gamma) and hormones (cortisol, prolactin, T3, T4). All three tested groups showed the same pattern of immune and hormonal changes in comparison to control group. Trauma survivors had decreased percentages of total T (CD3) cells, both helper (CD4) and cytotoxic (CD8), as well as T helper memory cells (CD4+CD45RO+) in comparison to controls. In contrast, in trauma exposed group B cell (CD20) were increased, as well as NK cell cytotoxicity. Serum TNF-alpha level was lower, but IL-6 and thyroid hormones, T3 and T4, were higher than in controls. There were no differences in any of examined parameters between three groups of soldiers. In conclusion, immune and endocrine alternations are more associated with traumatic experience than with PTSD itself, at least two years after trauma. The follow up of the same PTSD patients will provide evidence for dynamics and direction of neuroendocrine and immune alternations.

PTSD; lymphocyte subpopulations; immunophenotyping; flow cytometry; proinflammatory cytokines; stress hormones; NK activity; phagocyte functions

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