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Effects of SSRIs on peripheral inflammatory cytokines in patients with Generalized Anxiety Disorder

Effects of SSRIs on peripheral inflammatory cytokines in patients with Generalized Anxiety Disorder
Effects of SSRIs on peripheral inflammatory cytokines in patients with Generalized Anxiety Disorder
Background Extensive research into psychoneuroimmunology has led to substantial advances in our understanding of the reciprocal interactions between the central nervous system and the immune system in neuropsychiatric disorders. To date, inflammation has been implicated in the pathogenesis of depression and anxiety. The immunomodulating effects of antidepressants on depression have been reported, however, there is no evidence of the similar effects of antidepressants on anxiety. The aim of the study was to investigate the effects of selective serotonin reuptake inhibitors (SSRIs) on peripheral inflammatory cytokines in patients with first episode generalized anxiety disorder (GAD). Methods A prospective cohort design was employed: 42 patients with first episode GAD were treated with either escitalopram or sertraline for 12 weeks. Anxiety was measured by the Generalized Anxiety Disorder Scale and the State Trait Anxiety Inventory, serum pro-inflammatory cytokine levels were measured by the enzyme-linked immunosorbent assay (ELISA), and CRP determined by an immunoturbidimetric method before and after SSRIs treatment Results Baseline levels of anxiety and pro-inflammatory cytokines including IL-1α, IL-6, IL-8, IL-12, IFN-γ, and CRP were significantly reduced after treatment of SSRIs (p < 0.05 in all cases). In addition, the change of anxiety measures co-vary with the change of peripheral cytokine levels (p < 0.05 in all cases). The regression model revealed that log transformed baseline levels of CRP and IL-6 predicted treatment response (p < 0.05 in both cases). Conclusions This study is the first to investigate the effects of SSRIs on pro-inflammatory cytokines in patients with first episode GAD. The findings indicate moderate acute anti-inflammatory effects of SSRIs in GAD, and suggest that these anti-inflammatory effects may underlie anxiolytic effects of SSRIs. The study also indicates that serum levels of CRP and IL-6 may predict treatment response. However, data from randomized controlled trials is warranted to confirm these findings.
0889-1591
105-110
Hou, Ruihua
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Ye, Gang
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Liu, Yansong
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Chen, Xinyun
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Pan, Mingzhi
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Zhu, Feng
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Fu, Jialin
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Fu, Tian
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Liu, Qichun
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Gao, Zhenyong
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Baldwin, David S.
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Tang, Zhen
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Hou, Ruihua
470bdcbc-93a9-4dad-aac5-26d455c34376
Ye, Gang
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Liu, Yansong
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Chen, Xinyun
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Pan, Mingzhi
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Zhu, Feng
f50d7d99-42e3-4442-9649-02fa6ddacda0
Fu, Jialin
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Fu, Tian
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Liu, Qichun
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Gao, Zhenyong
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Baldwin, David S.
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Tang, Zhen
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Hou, Ruihua, Ye, Gang, Liu, Yansong, Chen, Xinyun, Pan, Mingzhi, Zhu, Feng, Fu, Jialin, Fu, Tian, Liu, Qichun, Gao, Zhenyong, Baldwin, David S. and Tang, Zhen (2019) Effects of SSRIs on peripheral inflammatory cytokines in patients with Generalized Anxiety Disorder. Brain, Behavior and Immunity, 81, 105-110. (doi:10.1016/j.bbi.2019.06.001).

Record type: Article

Abstract

Background Extensive research into psychoneuroimmunology has led to substantial advances in our understanding of the reciprocal interactions between the central nervous system and the immune system in neuropsychiatric disorders. To date, inflammation has been implicated in the pathogenesis of depression and anxiety. The immunomodulating effects of antidepressants on depression have been reported, however, there is no evidence of the similar effects of antidepressants on anxiety. The aim of the study was to investigate the effects of selective serotonin reuptake inhibitors (SSRIs) on peripheral inflammatory cytokines in patients with first episode generalized anxiety disorder (GAD). Methods A prospective cohort design was employed: 42 patients with first episode GAD were treated with either escitalopram or sertraline for 12 weeks. Anxiety was measured by the Generalized Anxiety Disorder Scale and the State Trait Anxiety Inventory, serum pro-inflammatory cytokine levels were measured by the enzyme-linked immunosorbent assay (ELISA), and CRP determined by an immunoturbidimetric method before and after SSRIs treatment Results Baseline levels of anxiety and pro-inflammatory cytokines including IL-1α, IL-6, IL-8, IL-12, IFN-γ, and CRP were significantly reduced after treatment of SSRIs (p < 0.05 in all cases). In addition, the change of anxiety measures co-vary with the change of peripheral cytokine levels (p < 0.05 in all cases). The regression model revealed that log transformed baseline levels of CRP and IL-6 predicted treatment response (p < 0.05 in both cases). Conclusions This study is the first to investigate the effects of SSRIs on pro-inflammatory cytokines in patients with first episode GAD. The findings indicate moderate acute anti-inflammatory effects of SSRIs in GAD, and suggest that these anti-inflammatory effects may underlie anxiolytic effects of SSRIs. The study also indicates that serum levels of CRP and IL-6 may predict treatment response. However, data from randomized controlled trials is warranted to confirm these findings.

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Effects of SSRIs on inflammation in GAD_Hou_revision final clean version - Accepted Manuscript
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Accepted/In Press date: 1 June 2019
e-pub ahead of print date: 1 June 2019
Published date: October 2019

Identifiers

Local EPrints ID: 431474
URI: http://eprints.soton.ac.uk/id/eprint/431474
ISSN: 0889-1591
PURE UUID: abb2fc1c-8377-41a5-8ed1-520e46db9c9e
ORCID for Ruihua Hou: ORCID iD orcid.org/0000-0001-6127-1478
ORCID for David S. Baldwin: ORCID iD orcid.org/0000-0003-3343-0907

Catalogue record

Date deposited: 05 Jun 2019 16:30
Last modified: 26 Nov 2021 05:14

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Contributors

Author: Ruihua Hou ORCID iD
Author: Gang Ye
Author: Yansong Liu
Author: Xinyun Chen
Author: Mingzhi Pan
Author: Feng Zhu
Author: Jialin Fu
Author: Tian Fu
Author: Qichun Liu
Author: Zhenyong Gao
Author: Zhen Tang

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