The inflammatory markers C-reactive protein and serum amyloid A in refugees with and without posttraumatic stress disorder.
BACKGROUND
"Stress" is associated with changes in many systems of the body. The aim was to study the markers of the innate immune system, Serum amyloid A (SAA) and C-reactive protein (CRP), in subjects with and without posttraumatic stress disorder (PTSD).


METHODS
Subjects were refugees from Iraq in the age range of 18-48 years who participated in a longitudinal study focusing on life events. Blood samples were taken in the morning and analysed for Serum amyloid A and high sensitivity C-reactive protein (hsCRP).


RESULTS
Contrary to expectations, serum SAA and hsCRP were lower in PTSD than in non-PTSD subjects. Levels of SAA and CRP were further inversely correlated with serum DHEA-s, but not with cortisol. In cases with PTSD at baseline, there was an inverse relationship between difference in self-rated symptoms of PTSD and difference in log-transformed SAA-thus increasing PTSD intensity was associated with decreasing SAA. No such patterns were obvious with regard to CRP.


CONCLUSIONS
Changes in the innate immune system, as measured by acute phase proteins of hepatic origin, seem to be a feature of PTSD. Further, the inverse correlation between DHEA-s, which has been shown to be changed in PTSD, and the acute phase proteins is of interest.
Söndergaard
Hans Peter
HP
Department of Public Health, Karolinska Institutet, National Swedish Institute for Psychosocial Factors and Health, P.O. Box 230, S-171 77 Stockholm, Sweden. hans.peter.sondergaard@phs.ki.se
Hansson
Lars-Olof
LO
Theorell
Töres
T
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007493:Iraq; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012036:Refugees; D000685:Serum Amyloid A Protein / Q000032:analysis*; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000175:diagnosis
D015415:Biomarkers; D000685:Serum Amyloid A Protein; D019314:Dehydroepiandrosterone Sulfate; D002097:C-Reactive Protein; D006854:Hydrocortisone