title: Correlation between depression, anxiety, and polymorphonuclear cells' resilience in ulcerative colitis: the mediating role of heat shock protein 70.
abstract: BACKGROUND
  To investigate whether anxiety and depression levels are associated with Heat Shock Protein 70 (HSP70) induction in the colon of patients with ulcerative colitis (UC).
  
  
  METHODS
  The design was cross-sectional. Clinical activity was assessed by the Rachmilewitz Index (CAI). Three psychometric questionnaires were used: Zung Depression Rating Scale (ZDRS), Spielberg State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS). Colon biopsies were obtained from each affected anatomical site. Severity of inflammation was assessed by eosin/hematoxylin. Constitutive (HSP70c) and inducible (HSP70i) HSP70 expression were immunohistochemically studied.
  
  
  RESULTS
  29 UC patients were enrolled (69% men). Mean age was 46.5 years (SD: 19.5). Inflammation severity was moderate in 17 patients, severe in 6, and mild in 6. The mean number of years since diagnosis was 7.9 (SD: 6.5). The mean CAI was 6.4 (SD: 3.1). In active UC, there was downregulation of HSP70c in inflamed epithelium, without significant HSP70 induction. In 22/29 cases of active cryptitis, polymorphonuclear cells (PMN) clearly expressed HSP70i, with weak, focal positivity in the other 7 cases. Except for the hospital anxiety scale, scores in all psychometric tools were higher in patients with strong HSP70i immunoreactivity in the PMN. Logistic regression showed a strong positive relationship between HSP70i immunoreactivity in the PMN cells and scores in the trait anxiety, ZDRS, and hospital depression scales, (Odds ratios 1.3, 1.3, and 1.5; P = 0.018, 0.023, and 0.038; Wald test, 5.6, 5.2, and 4.3 respectively) and a weaker but significant positive correlation with the CAI (Odds ratio 1.654; P = 0.049; Wald test 3.858).
  
  
  CONCLUSIONS
  HSP70 is induced in PMN cells of UC patients and its induction correlates with depression and anxiety levels.
authors.affiliation: First Department of Pathology, Medical School, Athens University, Athens, Greece. vlachos.ilias@gmail.com.
authors.forename: Ilias I
authors.initials: II
authors.lastname: Vlachos
authors.forename: Calypso
authors.initials: C
authors.lastname: Barbatis
authors.forename: Maria
authors.initials: M
authors.lastname: Tsopanomichalou
authors.forename: Lydia
authors.initials: L
authors.lastname: Abou-Assabeh
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Goumas
authors.forename: Maria
authors.initials: M
authors.lastname: Ginieri-Coccossis
authors.forename: Marina
authors.initials: M
authors.lastname: Economou
authors.forename: George N
authors.initials: GN
authors.lastname: Papadimitriou
authors.forename: Efstratios
authors.initials: E
authors.lastname: Patsouris
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Nicolopoulou-Stamati
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000378:metabolism* / Q000523:psychology; D003093:Colitis, Ulcerative / Q000378:metabolism* / Q000523:psychology; D003106:Colon / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003863:Depression / Q000378:metabolism* / Q000523:psychology; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D018840:HSP70 Heat-Shock Proteins
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