The inflammatory markers C-reactive protein and serum amyloid A in refugees with and without posttraumatic stress disorder.

BACKGROUND

"Stress" is associated with changes in many systems of the body. The aim was to study the markers of the innate immune system, Serum amyloid A (SAA) and C-reactive protein (CRP), in subjects with and without posttraumatic stress disorder (PTSD).

METHODS

Subjects were refugees from Iraq in the age range of 18-48 years who participated in a longitudinal study focusing on life events. Blood samples were taken in the morning and analysed for Serum amyloid A and high sensitivity C-reactive protein (hsCRP).

RESULTS

Contrary to expectations, serum SAA and hsCRP were lower in PTSD than in non-PTSD subjects. Levels of SAA and CRP were further inversely correlated with serum DHEA-s, but not with cortisol. In cases with PTSD at baseline, there was an inverse relationship between difference in self-rated symptoms of PTSD and difference in log-transformed SAA-thus increasing PTSD intensity was associated with decreasing SAA. No such patterns were obvious with regard to CRP.

CONCLUSIONS

Changes in the innate immune system, as measured by acute phase proteins of hepatic origin, seem to be a feature of PTSD. Further, the inverse correlation between DHEA-s, which has been shown to be changed in PTSD, and the acute phase proteins is of interest.