Association between posttraumatic stress disorder and inflammation: A twin study
Open accessAbstract
The association of posttraumatic stress disorder (PTSD) with cardiovascular disease risk may be mediated by inflammation. Our objective was to examine the association between PTSD and measures of inflammation and to determine whether these associations are due to shared familial or genetic factors. We measured lifetime history of PTSD using the Structured Clinical Interview for DSM-IV in 238 male middle-aged military veteran twin pairs (476 individuals), selected from the Vietnam Era Twins Registry, who were free of cardiovascular disease at baseline. We assessed inflammation using levels of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), fibrinogen, white blood cells, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 (ICAM-1). Geometric mean levels and percent differences by PTSD were obtained from mixed-model linear regression analyses with adjustment for potential confounders. Within-pair analysis was conducted to adjust for shared family environment and genetics (monozygotic pairs). Overall, 12.4% of participants had a lifetime history of PTSD. Adjusted mean levels of hsCRP and ICAM-1 were significantly higher among those with vs. without PTSD [hsCRP: 1.75 vs. 1.31mg/l (33% difference); ICAM-1: 319 vs. 293ng/ml (9% difference)]. Adjustment for depression rendered the association of PTSD with hsCRP non-statistically significant. For IL-6, no consistent association was seen. Within-pair analysis produced associations that were similar in direction for all three markers but lesser in magnitude for hsCRP and IL-6. There was no evidence of interaction by zygosity. Elevated hsCRP and ICAM-1 are associated with PTSD, and these associations may be confounded by shared non-genetic, antecedent familial and environmental factors.
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Peripheral intercellular adhesion molecule-1 and interferon (INF)-γ are elevated in individuals with PTSD.
“In addition, peripheral intercellular adhesion molecule-1 (Guo et al, 2012;Hoge et al, 2009;Plantinga et al, 2013) and interferon (INF)-γ (Hoge et al, 2009) are elevated in individuals with PTSD.”
From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Plantinga et al, 2013
There is evidence of increased CRP, decreased anti-inflammatory markers such as IL-8 and IL-2, and alterations in cell function and genes related to inflammation in populations with PTSD.
“There is also evidence to suggest that there is increased c-reactive protein (CRP), decreased anti-inflammatory markers (e.g., interleukin-8 [IL-8], interleukin-2 [IL-2]) as well as alterations in cell function and genes related to inflammation in populations with PTSD”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [123]
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“There is also evidence to suggest that there is increased c-reactive protein (CRP), decreased anti-inflammatory markers (e.g., interleukin-8 [IL-8], interleukin-2 [IL-2]) as well as alterations in cell function and genes related to inflammation in populations with PTSD (119, 121–123).”
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- Authors
- Plantinga, L., Bremner, J. D., Miller, A. H., Jones, D. P., Veledar, E., Goldberg, J., & Vaccarino, V.
- Affiliations
- Emory University (US)
- University of Washington (US)
- Corresponding author
- Vaccarino, Viola
- ORCID
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 30
- Pages
- 125-132
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC3641167
- OpenAlex
- W2002309367
- Cited by
- 99
- References
- 49
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 6 · 2023: 9 · 2022: 5 · 2021: 5 · 2020: 6 · 2019: 7 · 2018: 6 · 2017: 13 · 2016: 14 · 2015: 8 · 2014: 8 · 2013: 3
- FWCI
- 12.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Florida International University Digital Commons (Florida International University) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- FIU - Digital Commons (Florida International University) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000454)
- National Institute on Aging (R01AG026255)
- National Heart, Lung, and Blood Institute (R01HL068630, K24HL077506, R01HL088726)
- National Institute of Mental Health (R01MH056120, K24MH076955)
- National Institute of General Medical Sciences (K12GM000680)
- National Center for Research Resources (MO-1-RR-00039, M01RR000039)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- post-traumatic stress disorder, inflammation, C-reactive protein, interleukin-6, ICAM-1, VCAM-1, fibrinogen, military veterans, monozygotic twins, shared family environment, genetic factors, cardiovascular risk, depression
- MeSH terms
- C-Reactive Protein, Disease Susceptibility, Diseases in Twins, Humans, Inflammation, Male, Middle Aged, Registries, Stress Disorders, Post-Traumatic, Veterans, Interleukin-6, Intercellular Adhesion Molecule-1, Vascular Cell Adhesion Molecule-1
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