Post Trauma Center, Chaim Sheba Medical Center, Ramat Gan, Israel.
The Data Science Institution, Reichman University, Herzliya, Israel.
World J Biol Psychiatry. 2023 Sep-Oct;24(7):578-586. doi: 10.1080/15622975.2023.2177342. Epub 2023 Mar 13.
The ability to identify persons at elevated risk for post-traumatic stress disorder (PTSD) soon after exposure to trauma, could aid clinical decision-making and treatment. In this study, we explored whether cytosine methylation of the 1 F promoter of the (glucocorticoid receptor [GR]) gene obtained immediately following a trauma could predict PTSD.
Our sample comprised 52 trauma survivors (28 women, 24 men), presenting to the Emergency Department (ED) within six hours of a traumatic event and followed for 13 months. Blood samples were taken at intake ( = 42) and again at the end of the study (13 months later, = 27) to determine promoter methylation as well as plasma levels of cortisol, adrenocorticotropic-hormone (ACTH), and neuropeptide-Y (NPY).
At the 13-month follow-up, participants who met the PTSD criteria ( = 4) showed significantly lower promoter sum percent methylation compared to the non-PTSD group ( = 38). Further, methylation at ED intake was inversely correlated with PTSD severity 13 months later, indicating that lower promoter methylation in the immediate aftermath of trauma was associated with the development of PTSD.
To the extent that reduced promoter methylation is associated with greater GR expression and responsivity, this finding is consistent with the hypothalamic-pituitary-adrenal dysregulation previously described for PTSD.
在创伤后尽快识别出患有创伤后应激障碍(PTSD)风险较高的个体,有助于临床决策和治疗。在这项研究中,我们探讨了创伤后立即获得的 1F 启动子的胞嘧啶甲基化是否可以预测 PTSD。
我们的样本包括 52 名创伤幸存者(28 名女性,24 名男性),在创伤后 6 小时内到急诊室就诊,并在 13 个月内进行随访。在摄入时( = 42)和研究结束时(13 个月后, = 27)采集血液样本,以确定 启动子甲基化以及皮质醇、促肾上腺皮质激素(ACTH)和神经肽-Y(NPY)的血浆水平。
在 13 个月的随访中,符合 PTSD 标准的参与者( = 4)的 启动子总和百分比甲基化明显低于非 PTSD 组( = 38)。此外,ED 摄入时的 甲基化与 13 个月后的 PTSD 严重程度呈负相关,表明创伤后立即降低 启动子甲基化与 PTSD 的发展有关。
在某种程度上,启动子甲基化减少与 GR 表达和反应性增加有关,这一发现与 PTSD 之前描述的下丘脑-垂体-肾上腺失调一致。