Proinflammatory mediators and their associations with medication and comorbid traits in children and adults with ADHD
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Peripheral immune activation can influence neurodevelopment and is increased in autism, but is less explored in attention deficit hyperactivity disorder (ADHD). Patients with ADHD often display comorbid autism traits and gastrointestinal (GI) symptoms. Plasma protein levels of two acute phase reactants, C-reactive protein (CRP) and serum amyloid A (SAA), and two endothelial adhesion molecules, soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vascular cell adhesion molecule 1 (sVCAM-1), which share important roles in inflammation, were analyzed in 154 patients with ADHD and 61 healthy controls. Their associations with ADHD diagnosis, severity, medication and comorbid autistic symptoms, emotion dysregulation and GI symptoms were explored. The ADHD patients had increased levels of sICAM-1 and sVCAM-1 compared to healthy controls (p = 8.6e-05, p = 6.9e-07, respectively). In children with ADHD, the sICAM-1 and sVCAM-1 levels were higher among those with ADHD medication than among children (p = 0.0037, p = 0.0053, respectively) and adults (p = 3.5e-09, p = 1.9e-09, respectively) without ADHD medication. Among the adult ADHD patients, higher sICAM-1 levels were associated with increased comorbid autistic symptoms in the domains attention to detail and imagination (p = 0.0081, p = 0.00028, respectively), and higher CRP levels were associated with more GI symptoms (p = 0.014). sICAM-1 and sVCAM-1 levels were highly correlated with each other, and so were CRP and SAA levels. To conclude, vascular inflammatory activity may be overrepresented in ADHD, with elevated sICAM-1 and sVCAM-1 levels and this may in children be a consequence of current ADHD medication, and in adults relate to increased comorbid autistic symptoms. Replication is warranted.
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Individuals affected with autoimmune disorders are more likely to display comorbid depressive symptomatology.
“Accordingly, it has been well documented that individual affected with autoimmune disorders (e.g., rheumatoid arthritis, psoriasis, diabetes mellitus, chronic inflammatory bowel disease, and autoimmune thyroiditis) are more likely to display comorbid depressive symptomatology [17,18,19,20,21,22,23].”
From C-Reactive protein as a biomarker for major depressive disorder? (2022) · cites this paper as [19]
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References 99 · Cited by 29
- Authors
- Yang, L. L., Stiernborg, M., Skott, E., Söderström, Å., Giacobini, M., & Lavebratt, C.
- Affiliations
- Karolinska University Hospital (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Lavebratt, Catharina
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 41
- Pages
- 118-131
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W3096990284
- Cited by
- 29
- References
- 99
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 10 · 2022: 7 · 2021: 3
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Neuropsychopharmacology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Vetenskapsrådet (2014-10171)
- China Scholarship Council (2016-6193)
- Karolinska Institutet (2016-47, SLL20170292)
- Hjärnfonden (FO2017-0129, FO2018-0141, FO2019-0201)
- Stockholms Läns Landsting
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- attention deficit hyperactivity disorder, peripheral immune activation, inflammation, sICAM-1, sVCAM-1, C-reactive protein, serum amyloid A, acute phase proteins, ADHD medication, autism comorbidity, gastrointestinal symptoms, emotional dysregulation, children and adults
- MeSH terms
- Adolescent, Adult, Central Nervous System Stimulants, Anti-Bacterial Agents, Attention Deficit Disorder with Hyperactivity, Autistic Disorder, Child, Child, Preschool, Female, Gastrointestinal Diseases, Humans, Male, Melatonin, Middle Aged, Sweden, Biomarkers, Comorbidity, Case-Control Studies, Inflammation Mediators, Young Adult
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