CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans

Background and Objective Posttraumatic stress disorder (PTSD) is a serious and frequently debilitating psychiatric condition that can occur in people who have experienced traumatic stressors, such as war, violence, sexual assault and other life‐threatening events. Treatment of PTSD and traumatic bra...

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Autores principales:	Jaime Ramos‐Cejudo, Afia Genfi, Duna Abu‐Amara, Ludovic Debure, Meng Qian, Eugene Laska, Carole Siegel, Nicholas Milton, Jennifer Newman, Esther Blessing, Meng Li, Amit Etkin, Charles R. Marmar, Silvia Fossati
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/1c4afccd41ed4a41b4c2238e08b813fd
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spelling	oai:doaj.org-article:1c4afccd41ed4a41b4c2238e08b813fd2021-12-02T13:52:49ZCRF serum levels differentiate PTSD from healthy controls and TBI in military veterans2575-560910.1176/appi.prcp.20210017https://doaj.org/article/1c4afccd41ed4a41b4c2238e08b813fd2021-12-01T00:00:00Zhttps://doi.org/10.1176/appi.prcp.20210017https://doaj.org/toc/2575-5609Background and Objective Posttraumatic stress disorder (PTSD) is a serious and frequently debilitating psychiatric condition that can occur in people who have experienced traumatic stressors, such as war, violence, sexual assault and other life‐threatening events. Treatment of PTSD and traumatic brain injury (TBI) in veterans is challenged by diagnostic complexity, partially due to PTSD and TBI symptoms overlap and to the fact that subjective self‐report assessments may be influenced by a patient's willingness to share their traumatic experiences and resulting symptoms. Corticotropin‐releasing factor (CRF) is one of the main mediators of hypothalamic pituitary adrenal (HPA)‐axis responses in stress and anxiety. Methods and Results We analyzed serum CRF levels in 230 participants including heathy controls (64), and individuals with PTSD (53), TBI (70) or PTSD + TBI (43) by enzyme immunoassay (EIA). Significantly lower CRF levels were found in both the PTSD and PTSD + TBI groups compared to healthy control (PTSD vs. Controls: P = 0.0014, PTSD + TBI vs. Controls: P = 0.0011) and chronic TBI participants (PTSD vs. TBI: P < 0.0001, PTSD + TBI vs. TBI: P < 0.0001), suggesting a PTSD‐related mechanism independent from TBI and associated with CRF reduction. CRF levels negatively correlated with PTSD severity on the Clinically Administered PTSD Scale (CAPS‐5) scale in the whole study group. Conclusions Hyperactivation of the HPA axis has been classically identified in acute stress. However, the recognized enhanced feedback inhibition of the HPA axis in chronic stress supports our findings of lower CRF in PTSD patients. This study suggests that reduced serum CRF in PTSD should be further investigated. Future validation studies will establish if CRF is a possible blood biomarker for PTSD and/or for differentiating PTSD and chronic TBI symptomatology.Jaime Ramos‐CejudoAfia GenfiDuna Abu‐AmaraLudovic DebureMeng QianEugene LaskaCarole SiegelNicholas MiltonJennifer NewmanEsther BlessingMeng LiAmit EtkinCharles R. MarmarSilvia FossatiWileyarticlePsychiatryRC435-571ENPsychiatric Research and Clinical Practice, Vol 3, Iss 4, Pp 153-162 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Psychiatry RC435-571
spellingShingle	Psychiatry RC435-571 Jaime Ramos‐Cejudo Afia Genfi Duna Abu‐Amara Ludovic Debure Meng Qian Eugene Laska Carole Siegel Nicholas Milton Jennifer Newman Esther Blessing Meng Li Amit Etkin Charles R. Marmar Silvia Fossati CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans
description	Background and Objective Posttraumatic stress disorder (PTSD) is a serious and frequently debilitating psychiatric condition that can occur in people who have experienced traumatic stressors, such as war, violence, sexual assault and other life‐threatening events. Treatment of PTSD and traumatic brain injury (TBI) in veterans is challenged by diagnostic complexity, partially due to PTSD and TBI symptoms overlap and to the fact that subjective self‐report assessments may be influenced by a patient's willingness to share their traumatic experiences and resulting symptoms. Corticotropin‐releasing factor (CRF) is one of the main mediators of hypothalamic pituitary adrenal (HPA)‐axis responses in stress and anxiety. Methods and Results We analyzed serum CRF levels in 230 participants including heathy controls (64), and individuals with PTSD (53), TBI (70) or PTSD + TBI (43) by enzyme immunoassay (EIA). Significantly lower CRF levels were found in both the PTSD and PTSD + TBI groups compared to healthy control (PTSD vs. Controls: P = 0.0014, PTSD + TBI vs. Controls: P = 0.0011) and chronic TBI participants (PTSD vs. TBI: P < 0.0001, PTSD + TBI vs. TBI: P < 0.0001), suggesting a PTSD‐related mechanism independent from TBI and associated with CRF reduction. CRF levels negatively correlated with PTSD severity on the Clinically Administered PTSD Scale (CAPS‐5) scale in the whole study group. Conclusions Hyperactivation of the HPA axis has been classically identified in acute stress. However, the recognized enhanced feedback inhibition of the HPA axis in chronic stress supports our findings of lower CRF in PTSD patients. This study suggests that reduced serum CRF in PTSD should be further investigated. Future validation studies will establish if CRF is a possible blood biomarker for PTSD and/or for differentiating PTSD and chronic TBI symptomatology.
format	article
author	Jaime Ramos‐Cejudo Afia Genfi Duna Abu‐Amara Ludovic Debure Meng Qian Eugene Laska Carole Siegel Nicholas Milton Jennifer Newman Esther Blessing Meng Li Amit Etkin Charles R. Marmar Silvia Fossati
author_facet	Jaime Ramos‐Cejudo Afia Genfi Duna Abu‐Amara Ludovic Debure Meng Qian Eugene Laska Carole Siegel Nicholas Milton Jennifer Newman Esther Blessing Meng Li Amit Etkin Charles R. Marmar Silvia Fossati
author_sort	Jaime Ramos‐Cejudo
title	CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans
title_short	CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans
title_full	CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans
title_fullStr	CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans
title_full_unstemmed	CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans
title_sort	crf serum levels differentiate ptsd from healthy controls and tbi in military veterans
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/1c4afccd41ed4a41b4c2238e08b813fd
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CRF serum levels differentiate PTSD from healthy controls and TBI in military veterans

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