Evaluataion of serum inflammatory parameters in drug naive comorbidity free childhood obsessive compulsive disorder
Abstract
Aim: There is growing data on the possible role of inflammatory processes in the etiopathogenesis of obsessive and compulsive disorder (OCD). In this study based on these data, we aimed to evaluate serum inflammatory parameters in children and adolescents with the OCD, compare results with healthy controls, and evaluate the relationship between these parameters and the severity of the disorder. Method: The number of white blood cell counts, ferritin, c-reactive protein (CRP), procalcitonin, interleukin 1(IL-1), interleukin 2 (IL-2), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10) and tumor necrosis factor-alpha (TNF- α) levels were studied in children and adolescents with the OCD without comorbid disorder and the results were compared with the results from the healthy children and adolescents. Also, the relationship between levels of inflammatory parameters and the symptom severity of OCD was evaluated. Results: No sociodemographic differences were found between groups. While no significant difference was found between the groups in terms of other parameters, IL-10 levels were significantly higher in the patient group. No relation was found between symptom severity and any parameters. While ferritin levels did not show any difference between the groups, the rate of detection of low ferritin levels that show iron deficiency was higher in the patient group and this difference was statistically significant. Furthermore, a negative correlation was found between ferritin levels and compulsion scores of OCD patients. Conclusion: The results of this study do not support the availability of white blood cell count, CRP, and procalcitonin levels to detect possible inflammation status in the etiopathogenesis of OCD. This study reiterated the need for further studies to evoluate changes in serum cytokine levels may be important for the etiological evaluation. On the other hand, it is the first study in the literature showing that iron deficiency may be seen more in OCD patients than healthy individuals and this may increase the severity of OCD. Thus, iron deficiancy may effect the symptom severity of OCD, further studies are needed on this area.
References
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition. American Psychiatric Press. Washington DC, 2013.
- Bebbington PE. Epidemiology of obsessive-compulsive disorder. The British Journal of Psychiatry. Vol 173(Suppl 35), Aug 1998, 2-6.
- Fontenelle LF, Barbosa IG, Luna JV, et al. A cytokine study of adult patients with obsessive-compulsive disorder. Comprehensive Psychiatry. Volume 53, Issue 6, August 2012, Pages 797–804
- Rao NP, Venkatasubramanian G, Ravi V, et al. Plasma cytokine abnormalities in drug-naïve, comorbidity-free obsessive–compulsive disorder. Psychiatry Research. Volume 229, Issue 3, 30 October 2015, Pages 949–952
- Swedo ES. From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatrics & Therapeutics. 2012; 02(02). https://doi.org/10.4172/2161-0665.1000113
- Rothwell NJ, Strijbos PJLM. Cytokines in neurodegeneration and repair. International Journal of Developmental Neuroscience. Volume 13, Issues 3–4, June–July 1995, Pages 179–185
- Brough D, Tyrrell PJ, Allan SM. Regulation of interleukin-1 in acute brain injury. Trends Pharmacol Sci. 2011 Oct;32(10):617-22. doi: 10.1016/j.tips.2011.06.002. Epub 2011 Jul 23.
- Gray SM, Bloch MH. Systematic Review of Proinflammatory Cytokines in Obsessive-Compulsive Disorder. Curr Psychiatry Rep. 2012 Jun; 14(3): 220–228.
- Schuetz P, Albrich W, Mueller B. Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future. BMC Med. 2011 Sep 22;9:107. doi: 10.1186/1741-7015-9-107. 1 de Campos SM, Barbosa IG, Ribeiro-Santos R, et al. Procalcitonin levels in schizophrenic patients and patients with sepsis. Schizophr Res. 2015 Oct;168(1-2):575-6. doi: 10.1016/j.schres.2015.07.010. Epub 2015 Jul 18.
- Brynska A, Wolanczyk T. Epidemiology and Phenomelogy Obsessive-Compulsive Disorder İn Non –Referrad Young Adolescents: A Polish Perspective. Eur Child Adolesc Psychiatry. 2005;14(6):319-27.
- Diler RS, Avcı A. Çocuk ve Ergenlerde Obsesif Kompulsif Bozukluklar. Adana. Çukurova Üniversitesi Basımevi,1999.
- Rapoport JL, Swedo S. Obsessive-compulsive disorder. Child and Adolescent Psychiatry içinde, M Rutter ve E Taylor (ed) Blackwell Publishing, Massachusetts, 2003: p:571-92.
- Atmaca M., Kilic F., Koseoglu F., Ustundag B. (2011). Neutrophils are decreased in obsessive-compulsive disorder: Preliminary investigation. Psychiatry Investigation. 8(4), 362–365. https://doi.org/10.4306/pi.2011.8.4.362
- Özyurt G, Binici NG. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in adolescent obsessive-compulsive disorder: Does comorbid anxiety disorder affect inflammatory response? Psychiatry Res. 2018 Dec 25;272:311-315. doi: 10.1016/j.psychres.2018.12.131.
- Wang W, Knovich MA, Coffman LG, Torti FM, & Torti SV. Serum Ferritin: Past, Present and Future (2011). NIH Public Access. 1800(8), 760–769. https://doi.org/10.1016/j.bbagen.2010.03.011.Serum
- Hergüner S, Keleşoǧlu F., TanIdIr C, & Çöpür M (2012). Ferritin and iron levels in children with autistic disorder. European Journal of Pediatrics. 171(1), 143–146. https://doi.org/10.1007/s00431-011-1506-6
- Ghosh D, Burkman E (2017). Relationship of serum ferritin level and tic severity in children with Tourette syndrome. Child’s Nervous System. 33(8), 1373–1378. https://doi.org/10.1007/s00381-017-3424-z
- Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, et al. (2013). Association between psychiatric disorders and iron deficiency anemia among children and adolescents: A nationwide population-based study. BMC Psychiatry. 13(1), 1. https://doi.org/10.1186/1471-244X-13-161
- World Health Organization, Dept. of Nutrition for Health and Development: Iron deficiency anaemia: assessment, prevention and control: a guide for programme managers. Geneva: World Health Organization; 2001
- Luo F, Leckman JF, Katsovich L, Findley D, Grantz H, Tucker DM, et al. (2004). Obsessive-compulsive disorder : Relationship of symptom exacerbations to newly acquired streptococcal infections. Pediatrics. 113(6), 578–585.
- Çolak Sivri R, Bilgiç A, Kılınç İ. Cytokine, chemokine and BDNF levels in medication-free pediatric patients with obsessive-compulsive disorder. Eur Child Adolesc Psychiatry. 2018 Aug;27(8):977-984. doi: 10.1007/s00787-017-1099-3. Epub 2018 Jan 4.
- Erbay LG, Kavuran NA, Taşkapan Ç, İnce LU, Yoloğlu S, Temelli HG, & Ünal S (2018). Serum IL-1, IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ levels in drugfree, comorbidity-free obsessive-compulsive disorder patients. Anadolu Psikiyatri Derg. 2018;19(2), 157–162. https://doi.org/10.5455/apd.274680
- Saxena A, Khosraviani S, Noel S, Mohan D, Donner T, & Hamad ARA (2016). Interleukin-10 paradox: A potent immunoregulatory cytokine that has been difficult to harness for immunotherapy. Cytokine. 2015 July ; 74(1): 27–34. doi:10.1016/j.cyto.2014.10.031.
- Şimşek Ş, Yüksel T, Çim A, Kaya S. Serum Cytokine Profiles of Children with Obsessive- Compulsive Disorder Shows the Evidence of Autoimmunity. Int J Neuropsychopharmacol. 2016 Aug 12;19(8):1-6
- Luleyap HU, Onatoglu D, Yilmaz MB, Alptekin D, Tahiroglu AY, Cetiner S, et al. Association between pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections disease and tumor necrosis factor-α gene-308 g/a, -850 c/t polymorphisms in 4-12-year-old children in Adana/Turkey. Indian J Hum Genet. 2013;19(2):196-201.
- Marconi D, Limpido L, Bersani I, Giordano A, Bersani G. PANDAS: a possible model for adult OCD pathogenesis. Riv Psichiatr. 2009;44(5):285-98.
- Vgontzas AN, Bixler EO, Lin HM, Prolo P, Trakada G, Chrousos GP. IL-6 and Its Circadian Secretion in Humans. Neuroimmunomodulation. 2005; 12:131–140. [PubMed: 15905620]
- Cassatella BMA., Meda L, Bonora S, Ceska M, & Constantin G. (1993). Interleukin 10 (II.-10) Inhibits the Release of Proinflammatory Cytokines from Human Polymorphonuclear Leukocytes. Evidence for an Autocrine Role of Tumor Necrosis Factor and II,-10 in Mediating the Production of II.-8 Triggered by Lipopolysaccharide. J Exp Med. 178(December), 2207-2211
İlaç kullanmayan ve komorbı̇dı̇tesı̇z çocukluk çağı obsesı̇f kompulsı̇f bozukluğunda serum enflamatuar parametrelerı̇nı̇n değerlendı̇rı̇lmesı̇
Abstract
Amaç: Obsesif ve kompulsif bozukluğun etiyopatogenezinde inflamatuar süreçlerin olası rolüne ilişkin veriler giderek artmaktadır. Bu verilere dayanarak yaptığımız bu çalışmada, obsesif kompulsif bozukluğu olan çocuk ve ergenlerde serum inflamatuar parametrelerini değerlendirmeyi, sonuçları sağlıklı kontrollerle karşılaştırmayı ve bu parametreler ile bozukluğun şiddeti arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntem: DSM-V tanı kriterlerine göre komorbid bozukluğu olmaksızın obsesif kompulsif bozukluk tanısı alan çocuk ve ergenlerde beyaz kan hücresi sayısı, ferritin, c-reaktif protein (CRP), prokalsitonin, interlökin 1 (IL-1), interlökin 2 (IL-2), interlökin 6 (IL-6), interlökin 8 (IL-8), interlökin 10 (IL-10) ve tümör nekroz faktörü-alfa (TNF- α) düzeyleri incelenmiş ve sonuçlar sağlıklı çocuk ve ergenlerden elde edilen sonuçlarla karşılaştırılmıştır. Ayrıca, çalışmaya dahil edilen tüm bireylere Yale-Brown Obsesif Kompulsif Bozukluk Ölçeği uygulanmış ve saptanan inflamatuvar parametre düzeyleri ile çalışma grubunun semptom şiddeti arasındaki ilişki değerlendirilmiştir. Bulgular: Gruplar arasında sosyodemografik farklılık bulunmadı. Diğer parametreler açısından gruplar arasında anlamlı bir fark bulunmazken, IL-10 düzeyleri hasta grubunda anlamlı olarak daha yüksekti. Semptom şiddeti ile herhangi bir parametre arasında ilişki bulunmadı. Ferritin seviyeleri gruplar arasında farklılık göstermezken, demir eksikliğini gösteren düşük ferritin seviyelerinin tespit edilme oranı hasta grubunda daha yüksekti ve bu fark istatistiksel olarak anlamlıydı. Ayrıca, OKB hastalarının ferritin düzeyleri ile kompulsiyon skorları arasında negatif bir korelasyon bulunmuştur. Sonuç: Bu çalışmanın sonuçları, OKB etyolojisinde olası inflamasyon durumunu saptamak için beyaz kan hücresi sayımı, CRP ve prokalsitonin düzeylerinin kullanılabilirliğini desteklememektedir. Bu çalışma, serum sitokin seviyelerindeki değişikliklerin etiyolojik değerlendirme için önemli olabileceğini ortaya koyacak daha ileri çalışmalara duyulan ihtiyacı yinelemiştir. Öte yandan, literatürde OKB hastalarında demir eksikliğinin sağlıklı bireylere göre daha fazla görülebileceğini ve bu durumun OKB'nin şiddetini artırabileceğini gösteren ilk çalışmadır. Dolayısıyla, demir eksikliği OKB'nin semptom şiddetini etkileyebilir, bu alanda daha fazla çalışmaya ihtiyaç vardır.
Ethical Statement
yazıda belirtilen tüm etik kurallara uyulmuştur. yazarlar arasında çıkar çatışması yoktur
Supporting Institution
mersin üniversitesi
References
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition. American Psychiatric Press. Washington DC, 2013.
- Bebbington PE. Epidemiology of obsessive-compulsive disorder. The British Journal of Psychiatry. Vol 173(Suppl 35), Aug 1998, 2-6.
- Fontenelle LF, Barbosa IG, Luna JV, et al. A cytokine study of adult patients with obsessive-compulsive disorder. Comprehensive Psychiatry. Volume 53, Issue 6, August 2012, Pages 797–804
- Rao NP, Venkatasubramanian G, Ravi V, et al. Plasma cytokine abnormalities in drug-naïve, comorbidity-free obsessive–compulsive disorder. Psychiatry Research. Volume 229, Issue 3, 30 October 2015, Pages 949–952
- Swedo ES. From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatrics & Therapeutics. 2012; 02(02). https://doi.org/10.4172/2161-0665.1000113
- Rothwell NJ, Strijbos PJLM. Cytokines in neurodegeneration and repair. International Journal of Developmental Neuroscience. Volume 13, Issues 3–4, June–July 1995, Pages 179–185
- Brough D, Tyrrell PJ, Allan SM. Regulation of interleukin-1 in acute brain injury. Trends Pharmacol Sci. 2011 Oct;32(10):617-22. doi: 10.1016/j.tips.2011.06.002. Epub 2011 Jul 23.
- Gray SM, Bloch MH. Systematic Review of Proinflammatory Cytokines in Obsessive-Compulsive Disorder. Curr Psychiatry Rep. 2012 Jun; 14(3): 220–228.
- Schuetz P, Albrich W, Mueller B. Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future. BMC Med. 2011 Sep 22;9:107. doi: 10.1186/1741-7015-9-107. 1 de Campos SM, Barbosa IG, Ribeiro-Santos R, et al. Procalcitonin levels in schizophrenic patients and patients with sepsis. Schizophr Res. 2015 Oct;168(1-2):575-6. doi: 10.1016/j.schres.2015.07.010. Epub 2015 Jul 18.
- Brynska A, Wolanczyk T. Epidemiology and Phenomelogy Obsessive-Compulsive Disorder İn Non –Referrad Young Adolescents: A Polish Perspective. Eur Child Adolesc Psychiatry. 2005;14(6):319-27.
- Diler RS, Avcı A. Çocuk ve Ergenlerde Obsesif Kompulsif Bozukluklar. Adana. Çukurova Üniversitesi Basımevi,1999.
- Rapoport JL, Swedo S. Obsessive-compulsive disorder. Child and Adolescent Psychiatry içinde, M Rutter ve E Taylor (ed) Blackwell Publishing, Massachusetts, 2003: p:571-92.
- Atmaca M., Kilic F., Koseoglu F., Ustundag B. (2011). Neutrophils are decreased in obsessive-compulsive disorder: Preliminary investigation. Psychiatry Investigation. 8(4), 362–365. https://doi.org/10.4306/pi.2011.8.4.362
- Özyurt G, Binici NG. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in adolescent obsessive-compulsive disorder: Does comorbid anxiety disorder affect inflammatory response? Psychiatry Res. 2018 Dec 25;272:311-315. doi: 10.1016/j.psychres.2018.12.131.
- Wang W, Knovich MA, Coffman LG, Torti FM, & Torti SV. Serum Ferritin: Past, Present and Future (2011). NIH Public Access. 1800(8), 760–769. https://doi.org/10.1016/j.bbagen.2010.03.011.Serum
- Hergüner S, Keleşoǧlu F., TanIdIr C, & Çöpür M (2012). Ferritin and iron levels in children with autistic disorder. European Journal of Pediatrics. 171(1), 143–146. https://doi.org/10.1007/s00431-011-1506-6
- Ghosh D, Burkman E (2017). Relationship of serum ferritin level and tic severity in children with Tourette syndrome. Child’s Nervous System. 33(8), 1373–1378. https://doi.org/10.1007/s00381-017-3424-z
- Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, et al. (2013). Association between psychiatric disorders and iron deficiency anemia among children and adolescents: A nationwide population-based study. BMC Psychiatry. 13(1), 1. https://doi.org/10.1186/1471-244X-13-161
- World Health Organization, Dept. of Nutrition for Health and Development: Iron deficiency anaemia: assessment, prevention and control: a guide for programme managers. Geneva: World Health Organization; 2001
- Luo F, Leckman JF, Katsovich L, Findley D, Grantz H, Tucker DM, et al. (2004). Obsessive-compulsive disorder : Relationship of symptom exacerbations to newly acquired streptococcal infections. Pediatrics. 113(6), 578–585.
- Çolak Sivri R, Bilgiç A, Kılınç İ. Cytokine, chemokine and BDNF levels in medication-free pediatric patients with obsessive-compulsive disorder. Eur Child Adolesc Psychiatry. 2018 Aug;27(8):977-984. doi: 10.1007/s00787-017-1099-3. Epub 2018 Jan 4.
- Erbay LG, Kavuran NA, Taşkapan Ç, İnce LU, Yoloğlu S, Temelli HG, & Ünal S (2018). Serum IL-1, IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ levels in drugfree, comorbidity-free obsessive-compulsive disorder patients. Anadolu Psikiyatri Derg. 2018;19(2), 157–162. https://doi.org/10.5455/apd.274680
- Saxena A, Khosraviani S, Noel S, Mohan D, Donner T, & Hamad ARA (2016). Interleukin-10 paradox: A potent immunoregulatory cytokine that has been difficult to harness for immunotherapy. Cytokine. 2015 July ; 74(1): 27–34. doi:10.1016/j.cyto.2014.10.031.
- Şimşek Ş, Yüksel T, Çim A, Kaya S. Serum Cytokine Profiles of Children with Obsessive- Compulsive Disorder Shows the Evidence of Autoimmunity. Int J Neuropsychopharmacol. 2016 Aug 12;19(8):1-6
- Luleyap HU, Onatoglu D, Yilmaz MB, Alptekin D, Tahiroglu AY, Cetiner S, et al. Association between pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections disease and tumor necrosis factor-α gene-308 g/a, -850 c/t polymorphisms in 4-12-year-old children in Adana/Turkey. Indian J Hum Genet. 2013;19(2):196-201.
- Marconi D, Limpido L, Bersani I, Giordano A, Bersani G. PANDAS: a possible model for adult OCD pathogenesis. Riv Psichiatr. 2009;44(5):285-98.
- Vgontzas AN, Bixler EO, Lin HM, Prolo P, Trakada G, Chrousos GP. IL-6 and Its Circadian Secretion in Humans. Neuroimmunomodulation. 2005; 12:131–140. [PubMed: 15905620]
- Cassatella BMA., Meda L, Bonora S, Ceska M, & Constantin G. (1993). Interleukin 10 (II.-10) Inhibits the Release of Proinflammatory Cytokines from Human Polymorphonuclear Leukocytes. Evidence for an Autocrine Role of Tumor Necrosis Factor and II,-10 in Mediating the Production of II.-8 Triggered by Lipopolysaccharide. J Exp Med. 178(December), 2207-2211
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Services and Systems (Other) |
| Journal Section | Articles |
| Authors | |
| Early Pub Date | December 5, 2023 |
| Publication Date | December 18, 2023 |
| Submission Date | September 24, 2023 |
| Acceptance Date | October 19, 2023 |
| Published in Issue | Year 2023 Volume: 16 Issue: 3 |
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