Emory University, Department of Gynecology and Obstetrics, Atlanta, GA, USA.
Department of Psychiatry & Behavioral Health, and Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA.
Neuropsychopharmacology. 2023 Apr;48(5):773-780. doi: 10.1038/s41386-023-01537-z. Epub 2023 Feb 1.
Epigenetic alterations in DNA methylation might mediate gene expression effects of trauma underlying PTSD symptoms, or effects of PTSD on related health problems. PTSD is associated with all-cause morbidity and premature mortality, suggesting accelerated biological aging. We measured genome-wide DNA methylation (Illumina MethylationEPIC BeadChip) in whole blood in a treatment study for combat-related PTSD - "PROGrESS", a multisite RCT comparing sertraline plus enhanced medication management (SERT + EMM), prolonged exposure (PE) therapy plus placebo (PE + PLB), and the combination (SERT + PE). DNA methylation was measured in 140 US military veterans who served in Iraq and/or Afghanistan (112 current PTSD cases enrolled in a PTSD treatment study and 28 veterans without PTSD history controls), and also 59 non-trauma exposed controls at baseline posttreatment (24 weeks after baseline). Increased DNA methylation GrimAge acceleration (p = 8.8e-09) was observed in patients with PTSD compared to a pooled control group (trauma exposed and non-trauma exposed), suggesting a higher risk of premature mortality in those with PTSD. There was no difference in GrimAge acceleration between combat trauma and non-trauma exposed controls. No treatment-related changes in GrimAge acceleration were found in within-subject comparisons of PTSD patients pre- to post-treatment.
DNA 甲基化的表观遗传改变可能介导创伤导致 PTSD 症状的基因表达效应,或 PTSD 对相关健康问题的影响。PTSD 与全因发病率和过早死亡率相关,表明生物衰老加速。我们在一项与战斗相关 PTSD 的治疗研究中——“PROGrESS”,一项比较舍曲林加强化药物管理(SERT+EMM)、延长暴露(PE)治疗加安慰剂(PE+PLB)和联合治疗(SERT+PE)的多中心 RCT 中,测量了全血的全基因组 DNA 甲基化(Illumina MethylationEPIC BeadChip)。在基线治疗后(基线后 24 周),我们测量了 140 名曾在伊拉克和/或阿富汗服役的美国退伍军人(112 名目前患有 PTSD 的患者参加了 PTSD 治疗研究,28 名没有 PTSD 病史的退伍军人对照组)和 59 名非创伤暴露对照组的 DNA 甲基化。与创伤暴露和非创伤暴露对照组相比,PTSD 患者的 DNA 甲基化 GrimAge 加速(p=8.8e-09)增加,表明 PTSD 患者过早死亡的风险更高。在 PTSD 患者治疗前后的个体内比较中,未发现 GrimAge 加速的治疗相关变化。