title: Increased plasma levels of circulating cell-free mitochondrial DNA in suicide attempters: associations with HPA-axis hyperactivity.
abstract: Preclinical data suggest that chronic stress may cause cellular damage and mitochondrial dysfunction, potentially leading to the release of mitochondrial DNA (mtDNA) into the bloodstream. Major depressive disorder has been associated with an increased amount of mtDNA in leukocytes from saliva samples and blood; however, no previous studies have measured plasma levels of free-circulating mtDNA in a clinical psychiatric sample. In this study, free circulating mtDNA was quantified in plasma samples from 37 suicide attempters, who had undergone a dexamethasone suppression test (DST), and 37 healthy controls. We hypothesized that free circulating mtDNA would be elevated in the suicide attempters and would be associated with hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity. Suicide attempters had significantly higher plasma levels of free-circulating mtDNA compared with healthy controls at different time points (pre- and post-DST; all P-values<2.98E-12, Cohen's d ranging from 2.55 to 4.01). Pre-DST plasma levels of mtDNA were positively correlated with post-DST cortisol levels (rho=0.49, P<0.003). Suicide attempters may have elevated plasma levels of free-circulating mtDNA, which are related to impaired HPA-axis negative feedback. This peripheral index is consistent with an increased cellular or mitochondrial damage. The specific cells and tissues contributing to plasma levels of free-circulating mtDNA are not known, as is the specificity of this finding for suicide attempters. Future studies are needed in order to better understand the relevance of increased free-circulating mtDNA in relation to the pathophysiology underlying suicidal behavior and depression.
authors.affiliation: Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.|Department of Psychiatry, School of Medicine, University of California San Francisco, School of Medicine, San Francisco, CA, USA.|Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Lindqvist
authors.affiliation: Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.|Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Fernström
authors.affiliation: Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Grudet
authors.affiliation: Department of Biomedical Science, Malmö University,Health and Society, Malmö, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Ljunggren
authors.affiliation: Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Träskman-Bendz
authors.affiliation: Department of Biomedical Science, Malmö University,Health and Society, Malmö, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Ohlsson
authors.affiliation: Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.|Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden.
authors.forename: Å
authors.initials: Å
authors.lastname: Westrin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D000073888:Cell-Free Nucleic Acids / Q000097:blood*; D004272:DNA, Mitochondrial / Q000097:blood*; D003865:Major Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D013406:Suicide, Attempted / Q000523:psychology*
chemical_list: D000073888:Cell-Free Nucleic Acids; D004272:DNA, Mitochondrial