Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
University Medical Center Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Transl Psychiatry. 2022 Nov 9;12(1):472. doi: 10.1038/s41398-022-02230-3.
PTSD patients show alterations of the immune system, mainly a 'low-grade inflammation'. Psychotherapeutic treatments are meant to reduce symptom burden of PTSD patients but 30-50% of PTSD patients do not benefit from psychotherapy. Therefore, in this study, the predictive effect of cytokine levels on therapy outcome are investigated. Pro- (IL-6) and anti-inflammatory (IL-10) cytokines in female PTSD patients (N = 17) were assessed under acute stress during a Trier social stress test (TSST) before therapeutic treatment. The predictive effects of IL-6 and IL-10 on therapy outcome (SCL_GSI, BDI) after an inpatient psychotherapeutic treatment at the University Medical Center Carl Gustav Carus, Technische Universität Dresden was investigated. Areas under the curve with respect to ground (AUC) and increase (AUC) for IL-6 and IL-10 levels during the TSST were calculated and used as predictors in regression analyses with pre-treatment scores. Models including all three predictors show good model fits (R = 0.255 to 0.744). Models including AUC and AUC scores show superior fits compared with models including pre-treatment scores alone (ΔR = 0.196 to 0.444). IL-6 AUC and AUC scores are significant predictors for post-treatment SCL-GSI and BDI (β = -0.554 to 0.853), whereas IL-10 AUC significantly predicts SCL-GSI and BDI (β = -0.449 to -0.509). Therefore, pro- and anti-inflammatory IL-6 and IL-10 levels under acute stress before therapy predict therapy outcome of female PTSD patients regarding general symptom burden and depressive symptoms. Future studies should further address the link between inflammation and therapy outcome, especially underlying mechanisms and influencing factors.
创伤后应激障碍患者的免疫系统发生改变，主要表现为“低度炎症”。心理治疗旨在减轻创伤后应激障碍患者的症状负担，但 30-50%的创伤后应激障碍患者并未从心理治疗中受益。因此，在这项研究中，研究人员调查了细胞因子水平对治疗结果的预测作用。在治疗前，通过特里尔社会应激测试（TSST）评估了 17 名女性创伤后应激障碍患者在急性应激下的促炎（IL-6）和抗炎（IL-10）细胞因子水平。研究人员还调查了这些患者在德累斯顿工业大学卡尔古斯塔夫卡鲁斯大学医学中心接受住院心理治疗后的治疗结果（SCL_GSI、BDI）。计算了 TSST 过程中 IL-6 和 IL-10 水平的曲线下面积（AUC）和增加量（AUC），并将其作为回归分析中治疗前评分的预测因子。包括所有三个预测因子的模型具有较好的模型拟合度（R=0.255 至 0.744）。与仅包括治疗前评分的模型相比，包括 AUC 和 AUC 评分的模型具有更好的拟合度（ΔR=0.196 至 0.444）。IL-6 AUC 和 AUC 评分是治疗后 SCL-GSI 和 BDI 的显著预测因子（β=-0.554 至 0.853），而 IL-10 AUC 显著预测 SCL-GSI 和 BDI（β=-0.449 至-0.509）。因此，治疗前急性应激下促炎和抗炎性的 IL-6 和 IL-10 水平可以预测女性创伤后应激障碍患者的整体症状负担和抑郁症状的治疗结果。未来的研究应进一步探讨炎症与治疗结果之间的联系，特别是潜在机制和影响因素。
