Home Challenges of post-traumatic stress disorder (PTSD) in Iraq: biochemical network and methodologies. A brief review
Article
Licensed
Unlicensed Requires Authentication

Challenges of post-traumatic stress disorder (PTSD) in Iraq: biochemical network and methodologies. A brief review

  • Daniele Suzete Persike ORCID logo EMAIL logo and Suad Yousif Al-Kass
Published/Copyright: November 6, 2020
Become an author with De Gruyter Brill
Submit Manuscript Author Information
Hormone Molecular Biology and Clinical Investigation
From the journal Hormone Molecular Biology and Clinical Investigation Volume 41 Issue 4

Abstract

Post-traumatic stress disorder (PTSD) is a multifaceted syndrome due to its complex pathophysiology. Signals of illness include alterations in genes, proteins, cells, tissues, and organism-level physiological modifications. Specificity of sensitivity to PTSD suggests that response to trauma depend on gender and type of adverse event being experienced. Individuals diagnosed with PTSD represent a heterogeneous group, as evidenced by differences in symptoms, course, and response to treatment. It is clear that the biochemical mechanisms involved in PTSD need to be elucidated to identify specific biomarkers. A brief review of the recent literature in Pubmed was made to explore the major biochemical mechanisms involved in PTSD and the methodologies applied in the assessment of the disease. PTSD shows pre-exposure vulnerability factors in addition to trauma-induced alterations. The disease was found to be associated with dysfunctions of the hypothalamic–pituitary–adrenal axis (HPA) and hypothalamus–pituitary–thyroid axis. Sympathetic nervous system (SNS) activity play a role in PTSD by releasing norepinephrine and epinephrine. Cortisol release from the adrenal cortex amplifies the SNS response. Cortisol levels in PTSD patients, especially women, are later reduced by a negative feedback mechanism which contributes to neuroendocrine alterations and promotes structural changes in the brain leading to PTSD. Gender differences in normal HPA responsiveness may be due to an increased vulnerability in women to PTSD. Serotonin and dopamine levels were found to be abnormal in the presence of PTSD. Mechanisms such as the induction of neuroinflammation and alterations of mitochondrial energy processing were also associated with PTSD.

Keywords: anxiety; biomarkers; diagnosis; psychosomatic disturbance; PTSD; trauma
Corresponding author: Daniele Suzete Persike, Department of Medicinal Chemistry, College of Pharmacy, University of Dohuk, Kurdistan Region, Iraq, Phone: +964 750 288 0486, E-mail:

Acknowledgments

The authors are grateful for the encouragement and support given by the College of Pharmacy, University of Dohuk, Kurdistan Region-Iraq.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: The authors declare no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

References

1. Wimalawansa, SJ. Mechanisms of developing post-traumatic stress disorder: new targets for drug development and other potential interventions. CNS Neurol Disord-Drug Targets 2014;13:807–16, https://doi.org/10.2174/1871527313666140711091026.10.2174/1871527313666140711091026Search in Google Scholar PubMed

2. Hanna, VN, Ahmad, Abdulbaghi. Suicide in the Kurdistan region of Iraq, state of the art. Nord J Psychiatry 2009;63. https://doi.org/10.1080/08039480802610016.10.1080/08039480802610016Search in Google Scholar PubMed

3. Ibrahim, H, Ertl, V, Catani, C, Ismail, AA, Frank, N. Trauma and perceived social rejection among Yazidi women and girls who survived enslavement and genocide. BMC Med 2018;16:154, https://doi.org/10.1186/s12916-018-1140-5.10.1186/s12916-018-1140-5Search in Google Scholar PubMed PubMed Central

4. Available from: https://www.iom.int/countries/iraq [Accessed 3 Jun 2020].Search in Google Scholar

5. Breslau, N, Kessler, RC, Chilcoat, HD, Schultz, LR, Davis, GC, Andreski, P. Trauma and posttraumatic stress disorder in the community: the 1996 detroit area survey of trauma. Arch Gen Psychiatry 1998;55:626–32, https://doi.org/10.1001/archpsyc.55.7.626.10.1001/archpsyc.55.7.626Search in Google Scholar PubMed

6. Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB. Post-traumatic stress disorder in the National comorbidity survey. Arch Gen Psychiatry 1995;52:1048–60, https://doi.org/10.1001/archpsyc.1995.03950240066012.10.1001/archpsyc.1995.03950240066012Search in Google Scholar PubMed

7. Breslau, N. Epidemiologic studies of trauma, posttraumatic stress disorder, and other psychiatric disorders.Can J Psychiatry 2002;47:923–9, https://doi.org/10.1177/070674370204701003.10.1177/070674370204701003Search in Google Scholar PubMed

8. Dean, KR, Hammamieh, R, Mellon, SH, Abu-Amara, D, Flory, JD, Guffanti, G, et al. Multi-omic biomarker identification and validation for diagnosing warzone-related post-traumatic stress disorder. Mol Psychiatry 2019 Sep 10. https://doi.org/10.1038/s41380-019-0496-z [Epub ahead of print].10.1038/s41380-019-0496-zSearch in Google Scholar PubMed PubMed Central

9. Pitman, RK, Rasmusson, AM, Koenen, KC, Shin, LM, Orr, SP, Gilbertson, MW, et al. Biological studies of post-traumatic stress disorder. Nat Rev Neurosci 2012;13:769–87, https://doi.org/10.1038/nrn3339.10.1038/nrn3339Search in Google Scholar PubMed PubMed Central

10. Smoller, JW. The genetics of stress-related disorders: PTSD, depression, and anxiety disorders. Neuropsychopharmacology 2016;41:297–319, https://doi.org/10.1038/npp.2015.266.10.1038/npp.2015.266Search in Google Scholar PubMed PubMed Central

11. Mehta, D, Klengel, T, Conneely, KN, Smith, AK, Altmann, A, Pace, TW, et al. Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder. PNAS 2013;110:8302–7, https://doi.org/10.1073/pnas.1217750110.10.1073/pnas.1217750110Search in Google Scholar PubMed PubMed Central

12. Yehuda, R. Post-traumatic stress disorder. N Engl J Med 2002;346:108–14, https://doi.org/10.1056/nejmra012941.10.1002/0470018860.s00415Search in Google Scholar

13. Passos, IC, Vasconcelos-Moreno, MP, Costa, LG, Kunz, M, Brietzke, E, Quevedo, J, et al. Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression. Lancet Psychiatry 2015;2:1002–12, https://doi.org/10.1016/S2215-0366(15)00309-0.10.1016/S2215-0366(15)00309-0Search in Google Scholar

14. Minassian, A, Maihofer, AX, Baker, DG, Nievergelt, CM, Geyer, MA, Risbrough, VB, et al. Association of predeployment heart rate variability with risk of postdeployment posttraumatic stress disorder in active-duty marines. JAMA Psychiatry 2015;72:979–86, https://doi.org/10.1001/jamapsychiatry.2015.0922.10.1001/jamapsychiatry.2015.0922Search in Google Scholar PubMed

15. Germain, A. Sleep disturbances as the hallmark of PTSD: where are we now? Am J Psychiatry 2013;170:372–82, https://doi.org/10.1176/appi.ajp.2012.12040432.10.1176/appi.ajp.2012.12040432Search in Google Scholar PubMed PubMed Central

16. Binder, EB, Bradley, RG, Liu, W, Epstein, MP, Deveau, TC, Mercer, KB, et al. Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults. J Am Med Assoc 2008;299:1291–305, https://doi.org/10.1001/jama.299.11.1291.10.1001/jama.299.11.1291Search in Google Scholar PubMed PubMed Central

17. Eraly, SA, Nievergelt Caroline, M, Maihofer, AX, Barkauskas, DA, Biswas, N, Agorastos, A, et al. Assessment of plasma C-reactive protein as a biomarker of PTSD risk. JAMA Psychiatry 2014;71:423–31, https://doi.org/10.1001/jamapsychiatry.2013.4374.10.1001/jamapsychiatry.2013.4374Search in Google Scholar PubMed PubMed Central

18. Breen, MS, Tylee, DS, Maihofer, AX, Neylan, TC, Mehta, D, Binder, EB, et al. PTSD blood transcriptome mega-analysis: shared Inflammatory pathways across biological sex and modes of trauma. Neuropsychopharmacology 2018;43:469–81, https://doi.org/10.1038/npp.2017.220.10.1038/npp.2017.220Search in Google Scholar PubMed PubMed Central

19. Morris, MC, Rao, U. Psychobiology of PTSD in the acute aftermath of trauma: integrating research on coping, HPA function and sympathetic nervous system activity. Asian J Psychiatry 2013;6:3–21, https://doi.org/10.1016/j.ajp.2012.07.012.10.1016/j.ajp.2012.07.012Search in Google Scholar PubMed PubMed Central

20. Shalev, AY, Videlock, EJ, Peleg, T, Segman, R, Pitman, RK, Yehuda, R. Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part I: HPA axis responses. Int J Neuropsychopharmacol 2008;11:365–72, https://doi.org/10.1017/s1461145707008127.10.1017/S1461145707008127Search in Google Scholar PubMed

21. de Kloet, CS, Vermetten, E, Geuze, E, Kavelaars, A, Heijnen, CJ, Westenberg, HG. Assessment of HPA-axis function in posttraumatic stress disorder: pharmacological and non-pharmacological challenge tests, a review. J Psychiatr Res 2006;40:550–67, https://doi.org/10.1016/j.jpsychires.2005.08.002.10.1016/j.jpsychires.2005.08.002Search in Google Scholar PubMed

22. Bremner, JD, Vythilingam, M, Vermetten, E, Southwick, SM, McGlashan, T, Nazeer, A, et al. MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. Am J Psychiatry 2003;160:924–32, https://doi.org/10.1176/appi.ajp.160.5.924.10.1176/appi.ajp.160.5.924Search in Google Scholar PubMed

23. Olff, M, Güzelcan, Y, de Vries, GJ, Assies, J, Gersons, BP. HPA- and HPT-axis alterations in chronic posttraumatic stress disorder. Psychoneuroendocrinology 2006;31:1220–30, https://doi.org/10.1016/j.psyneuen.2006.09.003.10.1016/j.psyneuen.2006.09.003Search in Google Scholar PubMed

24. Freidenberg, BM, Gusmano, R, Hickling, EJ, Blanchard, EB, Bremner, JD, Frye, C. Women with PTSD have lower basal salivary cortisol levels later in the day than do men with PTSD: a preliminary study. Physiol Behav 2010;99:234–6, https://doi.org/10.1016/j.physbeh.2009.06.002.10.1016/j.physbeh.2009.06.002Search in Google Scholar PubMed PubMed Central

25. Yehuda, R, Alexander, C. Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. Am J Psychiatry 1995;152:1705–13. https://doi.org/10.1176/ajp.152.12.1705.10.1176/ajp.152.12.1705Search in Google Scholar PubMed

26. Geracioti, TDJr, Baker, DG, Ekhator, NN, West, SA, Hill, KK, Bruce, AB, et al. CSF norepinephrine concentrations in posttraumatic stress disorder. Am J Psychiatry 2001;158:1227–30, https://doi.org/10.1176/appi.ajp.158.8.1227.10.1176/appi.ajp.158.8.1227Search in Google Scholar PubMed

27. Charney, DS, Deutch, AY, Krystal, JH, Southwick, SM, Davis, M. Psychobiologic mechanisms of posttraumatic stress disorder. Arch Gen Psychiatry 1993;50:295–305, https://doi.org/10.1001/archpsyc.1993.01820160064008.10.1001/archpsyc.1993.01820160064008Search in Google Scholar PubMed

28. Southwick, SM, Krystal, JH, Morgan, CA, Johnson, D, Nagy, LM, Nicolaou, A, et al. Abnormal noradrenergic function in posttraumatic stress disorder. Arch Gen Psychiatry 1993;50:266–74, https://doi.org/10.1001/archpsyc.1993.01820160036003.10.1001/archpsyc.1993.01820160036003Search in Google Scholar PubMed

29. Yehuda, R, Southwick, S, Giller, EL, Ma, X, Mason, JW. Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans. J Nerv Ment Dis 1992;180:321–5, https://doi.org/10.1097/00005053-199205000-00006.10.1097/00005053-199205000-00006Search in Google Scholar PubMed

30. Videlock, EJ, Peleg, T, Segman, R, Yehuda, R, Pitman, RK, Shalev, AY. Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part II: the adrenergic response. Int J Neuropsychopharmacol 2008;11:373–80, https://doi.org/10.1017/s1461145707008139.10.1017/S1461145707008139Search in Google Scholar PubMed

31. Pole, N. The psychophysiology of posttraumatic stress disorder: a meta-analysis. Psychol Bull 2007;133:725–46, https://doi.org/10.1037/0033-2909.133.5.725.10.1037/0033-2909.133.5.725Search in Google Scholar PubMed

32. Steudte-Schmiedgen, S, Stalder, T, Schönfeld, S, Wittchen, HU, Trautmann, S, Alexander, N, et al. Hair cortisol concentrations and cortisol stress reactivity predict PTSD symptom increase after trauma exposure during military deployment. Psychoneuroendocrinology 2015;59:123–33, https://doi.org/10.1016/j.psyneuen.2015.05.007.10.1016/j.psyneuen.2015.05.007Search in Google Scholar

33. Yehuda, RM, Alexander, C. Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. Am J Psychiatry 1995;152:1705–13. https://doi.org/10.1176/ajp.152.12.1705.10.1176/ajp.152.12.1705Search in Google Scholar

34. Ruiz, JE, Barbosa Neto, J, Schoedl, AF, Mello, MF. Psychoneuroendocrinology of posttraumatic stress disorder. Br J Psychiatry 2007;29(Suppl 1):S7–12, https://doi.org/10.1590/s1516-44462007000500003.10.1590/S1516-44462007000500003Search in Google Scholar

35. Rey, J. Proposed changes to the psychiatric classification: towards DSM5. Australas Psychiatry 2010;18:309–13, https://doi.org/10.3109/10398562.2010.498518.10.3109/10398562.2010.498518Search in Google Scholar

36. Rohleder, N, Joksimovic, L, Wolf, JM, Kirschbaum, C. Hypocortisolism and increased glucocorticoid sensitivity of pro-Inflammatory cytokine production in Bosnian war refugees with posttraumatic stress disorder. Biol Psychiatry 2004;55:745–51, https://doi.org/10.1016/j.biopsych.2003.11.018.10.1016/j.biopsych.2003.11.018Search in Google Scholar

37. Ohayon, MM, Shapiro, CM. Sleep disturbances and psychiatric disorders associated with posttraumatic stress disorder in the general population. Compr Psychiatry 2000;41:469–78, https://doi.org/10.1053/comp.2000.16568.10.1053/comp.2000.16568Search in Google Scholar

38. Eves, FF, Gruzelier, JH. Individual differences in the cardiac response to high intensity auditory stimulation. Psychophysiology 1984;21:342–52, https://doi.org/10.1111/j.1469-8986.1984.tb02946.x.10.1111/j.1469-8986.1984.tb02946.xSearch in Google Scholar

39. Heim, C, Ehlert, U, Hellhammer, DH. The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology 2000;25:1–35, https://doi.org/10.1016/s0306-4530(99)00035-9.10.1016/S0306-4530(99)00035-9Search in Google Scholar

40. McHugh, PR, Treisman, G. PTSD: a problematic diagnostic category. J Anxiety Disord 2007;21:211–22, https://doi.org/10.1016/j.janxdis.2006.09.003.10.1016/j.janxdis.2006.09.003Search in Google Scholar PubMed

41. Oquendo, MA, Friend, JM, Halberstam, B, Brodsky, BS, Burke, AK, Grunebaum, MF, et al. Association of comorbid posttraumatic stress disorder and major depression with greater risk for suicidal behavior. Am J Psychiatry 2003;160:580–2, https://doi.org/10.1176/appi.ajp.160.3.580.10.1176/appi.ajp.160.3.580Search in Google Scholar PubMed

42. Oquendo, M, Brent, DA, Birmaher, B, Greenhill, L, Kolko, D, Stanley, B, et al. Posttraumatic stress disorder comorbid with major depression: factors mediating the association with suicidal behavior. Am J Psychiatry 2005;162:560–6, https://doi.org/10.1176/appi.ajp.162.3.560.10.1176/appi.ajp.162.3.560Search in Google Scholar

43. Wimalawansa, S. Post-Traumatic stress disorder: an under-diagnosed and under-treated entity. Compr Res J Med Med Sci 2013;1:1–12. http://crjournals.org/CRJMMS/Index.htm.10.3126/ajms.v5i2.8537Search in Google Scholar

44. Frijling, JL, van Zuiden, M, Nawijn, L, Koch, SB, Neumann, ID, Veltman, DJ, et al. Salivary oxytocin and vasopressin levels in police Officers with and without post-traumatic stress disorder. J Neuroendocrinol 2015;27:743–51, https://doi.org/10.1111/jne.12300.10.1111/jne.12300Search in Google Scholar

45. Hawk, LW, Dougall, AL, Ursano, RJ, Baum, A. Urinary catecholamines and cortisol in recent-onset posttraumatic stress disorder after motor vehicle accidents. Psychosom Med 2000;62:423–34, https://doi.org/10.1097/00006842-200005000-00016.10.1097/00006842-200005000-00016Search in Google Scholar

46. Atli, A, Bulut, M, Bez, Y, Kaplan, I, Ozdemir, PG, Uysal, C, et al. Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors. Eur Arch Psychiatry Clin Neurosci 2015;1–8. https://doi.org/10.1007/s00406-015-0638-5.10.1007/s00406-015-0638-5Search in Google Scholar

47. Dringen, R. Metabolism and functions of glutathione in brain. Prog Neurobiol 2000;62:649–71, https://doi.org/10.1016/s0301-0082(99)00060-x.10.1016/S0301-0082(99)00060-XSearch in Google Scholar

48. Ji, X, Liu, W, Xie, K, Liu, W, Qu, Y, Chao, X, et al. Beneficial effects of hydrogen gas in a rat model of traumatic brain injury via reducing oxidative stress. Brain Res 2010;1354:196–205, https://doi.org/10.1016/j.brainres.2010.07.038.10.1016/j.brainres.2010.07.038Search in Google Scholar PubMed

49. Solaroglu, I, Okutan, O, Kaptanoglu, E, Beskonakli, E, Kilinc, K. Increased xanthine oxidase activity after traumatic brain injury in rats. J Clin Neurosci 2005;12:273–5, https://doi.org/10.1016/j.jocn.2004.12.002.10.1016/j.jocn.2004.12.002Search in Google Scholar PubMed

50. Sullivan, PG, Keller, JN, Mattson, MP, Scheff, SW. Traumatic brain injury alters synaptic homeostasis: implications for impaired mitochondrial and transport function. J Neurotrauma 1998;15:789–98, https://doi.org/10.1089/neu.1998.15.789.10.1089/neu.1998.15.789Search in Google Scholar PubMed

51. Adibhatla, RM, Hatcher, JF. Altered lipid metabolism in brain Injury and disorders. Subcell Biochem 2008;49:241–68, https://doi.org/10.1007/978-1-4020-8831-5_9.10.1007/978-1-4020-8831-5_9Search in Google Scholar PubMed PubMed Central

52. Wilson, CB, McLaughlin, LD, Nair, A, Ebenezer, PJ, Dange, R, Francis, J. Inflammation and oxidative stress are elevated in the brain, blood, and adrenal glands during the progression of post-traumatic stress disorder in a predator exposure animal model. PLoS One 2013;8:e76146, https://doi.org/10.1371/journal.pone.0076146. eCollection 2013.10.1371/journal.pone.0076146Search in Google Scholar

53. Pratico, D, Smyth, EM, Violi, F, FitzGerald, GA. Local amplification of platelet function by 8-epi prostaglandin F2α is not mediated by thromboxane receptor isoforms. J Biol Chem 1996;271:14916–22. https://doi.org/10.1074/jbc.271.25.14916.10.1074/jbc.271.25.14916Search in Google Scholar

54. Clausen, F, Marklund, N, Lew´en, A, Enblad, P, Basu, S, Hillered, L. Interstitial F2-isoprostane 8-Iso-PGF2α as a biomarker of oxidative stress after severe human traumatic brain injury. J Neurotrauma 2012;29:766–75, https://doi.org/10.1089/neu.2011.1754.10.1089/neu.2011.1754Search in Google Scholar

55. Moghaddam, B, Bolinao, ML, Stein-Behrens, B, Sapolsky, R. Glucocortcoids mediate the stress-induced extracellular accumulation of glutamate. Brain Res 1994;655:251–4, https://doi.org/10.1016/0006-8993(94)91622-5.10.1016/0006-8993(94)91622-5Search in Google Scholar

56. Cortese, BM, Phan, KL. The role of glutamate in anxiety and related disorders. CNS Spectr 2005;10:820–30, https://doi.org/10.1017/s1092852900010427.10.1017/S1092852900010427Search in Google Scholar PubMed

57. Reul, JMHM, Nutt, DJ. Glutamate and cortisol - a critical confluence in PTSD? J Psychopharmacol 2008;22:469–72, https://doi.org/10.1177/0269881108094617.10.1177/0269881108094617Search in Google Scholar PubMed

58. Liu, PK, Hsu, CY, Dizdaroglu, M, Floyd, RA, Kow, YW, Karakaya, A, et al. Damage, repair, and mutagenesis in nuclear genes after mouse forebrain ischemia reperfusion. J Neurosci 1996;16:6795–806, https://doi.org/10.1523/jneurosci.16-21-06795.1996.10.1523/JNEUROSCI.16-21-06795.1996Search in Google Scholar

59. Lemineur, T, Deby-Dupont, G, Preiser, JC. Biomarkers of oxidative stress in critically ill patients: what should be measured, when and how? Curr Opin Clin Nutr Metab Care 2006;9:704–10, https://doi.org/10.1097/01.mco.0000247467.41661.f3.10.1097/01.mco.0000247467.41661.f3Search in Google Scholar PubMed

60. Abdulsamie, H, Al-Khayat, TH, Al-Ameedy, WA, Majeed, LA. Oxidative stress in post-traumatic stress disorders for terror attack victims in Iraq. J Babylon Univ/Pure Appl Sci 2012;22:408.Search in Google Scholar

61. Glass, CK, Olefsky, JM. Inflammation and lipid signaling in the etiology of insulin resistance. Cell Metab 2012;15:635–45, https://doi.org/10.1016/j.cmet.2012.04.001.10.1016/j.cmet.2012.04.001Search in Google Scholar PubMed PubMed Central

62. Bonne, O, Gill, JM, Luckenbaugh, DA, Collins, C, Owens, MJ, Alesci, S, et al. Corticotropin-releasing factor, interleukin-6, brain-derived neurotrophic factor, insulin-like growth factor-1, and substance P in the cerebrospinal fluid of civilians with posttraumatic stress disorder before and after treatment with paroxetine. J Clin Psychiatry 2011;72:1124–8, https://doi.org/10.4088/jcp.09m05106blu.10.4088/JCP.09m05106bluSearch in Google Scholar PubMed

63. Hoge, EA, Brandstetter, K, Moshier, S, Pollack, MH, Wong, KK, Simon, NM. Broad spectrum of cytokine abnormalities in panic disorder and posttraumatic stress disorder. Depress Anxiety 2009;26:447–55, https://doi.org/10.1002/da.20564.10.1002/da.20564Search in Google Scholar

64. Aurer, A, Aurer-Kozelj, J, Stavljenić-Rukavina, A, Kalenić, S, Ivić-Kardum, M, Haban, V. Inflammatory mediators in saliva of patients with rapidly progressive periodontitis during war stress induced incidence increase. Coll Antropol 1999;23:117–24. PMID 10402713.Search in Google Scholar

65. Yang, JJ, Jiang, W. Immune biomarkers alterations in post-traumatic stress disorder: a systematic review and meta-analysis. J Affect Disord. 2020;268:39–46, https://doi.org/10.1016/j.jad.2020.02.044.10.1016/j.jad.2020.02.044Search in Google Scholar

66. Gill, JM, Saligan, L, Woods, S, Page, G. PTSD is associated with an excess of inflammatory immune activities. Psychiatr Care 2009;45:262–77, https://doi.org/10.1111/j.1744-6163.2009.00229.x.10.1111/j.1744-6163.2009.00229.xSearch in Google Scholar

67. Jiang, JX. Posttraumatic stress and immune dissonance. Chin J Traumatol. 2008;11:203–8, https://doi.org/10.1016/s1008-1275(08)60044-9.10.1016/S1008-1275(08)60044-9Search in Google Scholar

68. Wisco, BE, Marx, BP, Keane, TM. Screening, diagnosis, and treatment of post-traumatic stress disorder. Mil Med 2012;177:7–13, https://doi.org/10.7205/milmed-d-12-00111.10.7205/MILMED-D-12-00111Search in Google Scholar

69. Buckley, TC, Kaloupek, DG. A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosom Med 2001;63:585–94, https://doi.org/10.1097/00006842-200107000-00011.10.1097/00006842-200107000-00011Search in Google Scholar

70. Keane, TM, Kolb, LC, Kaloupek, DG, Orr, SP, Blanchard, EB, Thomas, RG, et al. Utility of psychophysiological measurement in the diagnosis of posttraumatic stress disorder: results from a Department of Veterans Affairs Cooperative Study. J Consult Clin Psychol 1998;66:914–23, https://doi.org/10.1037/0022-006x.66.6.914.10.1037/0022-006X.66.6.914Search in Google Scholar

71. Keeshin, BR, Strawn, JR, Out, D, Granger, DA, Putnam, FW. Elevated salivary alpha amylase in adolescent sexual abuse survivors with posttraumatic stress disorder symptoms. J Child Adolesc Psychopharmacol 2015;25:344–50, https://doi.org/10.1089/cap.2014.0034.10.1089/cap.2014.0034Search in Google Scholar

72. Sádecký, E, Brezina, R, Kazár, J, Urvölgyi, J. Immunization against Q-fever of naturally infected dairy cows. Acta Virol 1975;19:486–8. https://doi.org/10.1037//0033-2909.116.1.75.10.1037//0033-2909.116.1.75Search in Google Scholar

73. Pryor, WA, Porter, NA. Suggested mechanisms for the production of 4-hydroxy-2-nonenal from the autoxidation of polyunsaturated fatty acids. Free Radic Biol Med 1990;8:541–3, https://doi.org/10.1016/0891-5849(90)90153-a.10.1016/0891-5849(90)90153-ASearch in Google Scholar

74. Esterbauer, H, Schaur, RJ, Zollner, H. Chemistry and Biochemistry of 4-hydroxynonenal,malonaldehyde and related aldehydes. Free Radic Biol Med 1991;11:81–128, https://doi.org/10.1016/0891-5849(91)90192-6.10.1016/0891-5849(91)90192-6Search in Google Scholar

Received: 2020-06-04
Accepted: 2020-09-10
Published Online: 2020-11-06

© 2020 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Letter to the Editor
  2. Evidence-based medicine is a valuable tool for a successful decision-making on risk-reducing bilateral mastectomy
  3. Original Articles
  4. Melatonin inhibits high glucose-induced ox-LDL/LDL expression and apoptosis in human umbilical endothelial cells
  5. Effects of metformin and insulin therapy regimens on postpartum oral glucose tolerance test results in pregnant women with gestational diabetes mellitus: a comparative study
  6. Association of IL-33 gene rs16924159 polymorphism and recurrent pregnancy loss in Iranian Azeri women
  7. Greater effects of high- compared with moderate-intensity interval training on thyroid hormones in overweight/obese adolescent girls
  8. Effect of Artemisia absinthium ethanolic extract on oxidative stress markers and the TLR4, S100A4, Bax and Bcl-2 genes expression in the kidney of STZ-induced diabetic rats
  9. Associations of endothelial biomarkers, nitric oxide metabolites and endothelin, with blood pressure and coronary lesions depend on cardiovascular risk and sex to mark endothelial dysfunction on the SCORE scale
  10. Association of nitric oxide synthase 3 gene rs1799983 G/T polymorphism with idiopathic asthenozoospermia in Iranian Azeri males: a case-control study
  11. Adiponectin and leptin levels in normal weight women with polycystic ovary syndrome
  12. Review Articles
  13. Association between vitamin D deficiency and prevalence of metabolic syndrome in female population: a systematic review
  14. Vitamin D and sleep duration: Is there a bidirectional relationship?
  15. Challenges of post-traumatic stress disorder (PTSD) in Iraq: biochemical network and methodologies. A brief review
  16. Female urine incontinence: vaginal erbium laser (VEL) effectiveness and safety
  17. Breast cancer risk factors in Iran: a systematic review & meta-analysis
  18. Effects of melatonin supplementation on oxidative stress: a systematic review and meta-analysis of randomized controlled trials
https://doi.org/10.1515/hmbci-2020-0037
Keywords for this article
anxiety; biomarkers; diagnosis; psychosomatic disturbance; PTSD; trauma

Articles in the same Issue

  1. Letter to the Editor
  2. Evidence-based medicine is a valuable tool for a successful decision-making on risk-reducing bilateral mastectomy
  3. Original Articles
  4. Melatonin inhibits high glucose-induced ox-LDL/LDL expression and apoptosis in human umbilical endothelial cells
  5. Effects of metformin and insulin therapy regimens on postpartum oral glucose tolerance test results in pregnant women with gestational diabetes mellitus: a comparative study
  6. Association of IL-33 gene rs16924159 polymorphism and recurrent pregnancy loss in Iranian Azeri women
  7. Greater effects of high- compared with moderate-intensity interval training on thyroid hormones in overweight/obese adolescent girls
  8. Effect of Artemisia absinthium ethanolic extract on oxidative stress markers and the TLR4, S100A4, Bax and Bcl-2 genes expression in the kidney of STZ-induced diabetic rats
  9. Associations of endothelial biomarkers, nitric oxide metabolites and endothelin, with blood pressure and coronary lesions depend on cardiovascular risk and sex to mark endothelial dysfunction on the SCORE scale
  10. Association of nitric oxide synthase 3 gene rs1799983 G/T polymorphism with idiopathic asthenozoospermia in Iranian Azeri males: a case-control study
  11. Adiponectin and leptin levels in normal weight women with polycystic ovary syndrome
  12. Review Articles
  13. Association between vitamin D deficiency and prevalence of metabolic syndrome in female population: a systematic review
  14. Vitamin D and sleep duration: Is there a bidirectional relationship?
  15. Challenges of post-traumatic stress disorder (PTSD) in Iraq: biochemical network and methodologies. A brief review
  16. Female urine incontinence: vaginal erbium laser (VEL) effectiveness and safety
  17. Breast cancer risk factors in Iran: a systematic review & meta-analysis
  18. Effects of melatonin supplementation on oxidative stress: a systematic review and meta-analysis of randomized controlled trials
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 18.11.2025 from https://www.degruyterbrill.com/document/doi/10.1515/hmbci-2020-0037/pdf?lang=en
Scroll to top button