engleski

Immune status in posttraumatic stress disorder (PTSD).

Objective. General stress response includes activation of integrated neuroendocrine and immune systems. A bi-directional (auto)regulatory circuits exist between the two systems, communicating through common signalling molecules. These comprise neuropeptides, hormones and cytokines, and their receptors. Sympathetic nervous system directly innervates lymphoid organs where leukocytes respond to locally released catecholamines. Activated HPA axis, through plethora of its hormones also modulate functional capacities of immune cells. On the other hand afferent, immune-to-brain, communication is achieved through immunopeptides, cytokines, that reach CNS by systemic humoral route or bind to receptors expressed by vagus and sympathetic nonciceptive afferents. The influence of acute and chronic exposure to physical and/or psychological stress on immune system has been well established. Changes in both proportions of the immune cell subpopulations and their functions has been reported. Although extensive work on psychophysiological and neuroendocrine changes in PTSD has been undertaken, investigations of immune status in PTSD sufferers has been scarce. Method. In an attempt to assess possible changes of immune factors related to PTSD, we examined a group (N=191) of professional soldiers exposed to traumatic events associated with war (60 with severe symptoms of PTSD, 68 with mild PTSD symptoms, and 63 with no symptoms of PTSD assessed by a Croatian Stress Scale - CROSS), and a control group of persons (N=40) not exposed to traumatic events. Immune status was evaluated through analysing the lymphocyte subpopulations and PMNs phagocytic, and NK cell cytotoxic functions. The absolute number and proportions of total T (CD3), B (CD20) and NK (CD3-CD16,56+) cells, helper (CD3+CD4+) and cytotoxic (CD3+CD8+) T lymphocytes, naive (CD45RA) and memory (CD45RO) subpopulations of these lymphocytes as well as activated T (HLA-DR, CD71) and B (CD23) lymphocytes was measured by flow cytometry. Results. The absolute number and percentages of B lymphocytes in trauma survivors who developed PTSD were increased as compared to those without PTSD, and controls. All three groups of trauma survivors had decreased percentages of T lymphocytes in comparison to the controls. The percentage of memory T helper (CD4+CD45RO+) cells, though not different from controls, was lower in trauma survivors without PTSD than in persons with PTSD. The negative correlation (r=-.26, p<.001) between proportion of this cells and severity of PTSD symptoms was found. Although the percentage of NK cells in trauma survivors did not differ from controls, their cytotoxic function was enhanced compared to that of controls. Conclusion. Some of the main immunological parameters concerning B and T lymphocyte populations and NK cells function are altered in professional soldiers exposed to combat-associated traumatic events. Some of these alterations (increase in B lymphocyte population and NK activity) are specifically related to PTSD, while the others (decrease in regulatory T lymphocytes population) are related to trauma without PTSD symptoms.

PTSP; imunostatus

nije evidentirano