An immunogenomic phenotype predicting behavioral treatment response: Toward precision psychiatry for mothers and children with trauma exposure.
Brain Behav Immun
; 99: 350-362, 2022 01.
Article
em En
| MEDLINE
| ID: mdl-34298096
ABSTRACT
Inflammatory pathways predict antidepressant treatment non-response among individuals with major depression; yet, this phenomenon may have broader transdiagnostic and transtherapeutic relevance. Among trauma-exposed mothers (Mageâ¯=â¯32â¯years) and their young children (Mageâ¯=â¯4â¯years), we tested whether genomic and proteomic biomarkers of pro-inflammatory imbalance prospectively predicted treatment response (PTSD and depression) to an empirically-supported behavioral treatment. Forty-three mother-child dyads without chronic disease completed Child Parent Psychotherapy (CPP) for roughly 9â¯months. Maternal blood was drawn pre-treatment, CD14â¯+â¯monocytes isolated, gene expression derived from RNA sequencing (nâ¯=â¯34; Illumina HiSeq 4000;TruSeqcDNA library), and serum assayed (nâ¯=â¯43) for C-Reactive Protein (CRP) and interleukin-1ß (IL-1ß). Symptoms of PTSD and depression decreased significantly from pre- to post-treatment for both mothers and children (all p'sâ¯<â¯0.01). Nonetheless, a higher pre-treatment maternal pro-inflammatory imbalance of M1-like versus M2-like macrophage-associated RNA expression (M1/M2) (ßâ¯=â¯0.476, pâ¯=â¯.004) and IL-1ß (ß=0.333, pâ¯=â¯.029), but not CRP, predicted lesser improvements in maternal PTSD symptoms, unadjusted and adjusting for maternal age, BMI, ethnicity, antidepressant use, income, education, and US birth. Only higher pre-treatment M1/M2 predicted a clinically-relevant threshold of PTSD non-response among mothers (ORâ¯=â¯3.364, pâ¯=â¯.015; ROC-AUCâ¯=â¯0.78). Additionally, higher M1/M2 predicted lesser decline in maternal depressive symptoms (ßâ¯=â¯0.556, pâ¯=â¯.001), though not independent of PTSD symptoms. For child outcomes, higher maternal IL-1ß significantly predicted poorer PTSD and depression symptom trajectories (ß'sâ¯=â¯0.318-0.429, p'sâ¯<â¯0.01), while M1/M2 and CRP were marginally associated with poorer PTSD symptom improvement (ß'sâ¯=â¯0.295-0.333, p'sâ¯<â¯0.056). Pre-treatment pro-inflammatory imbalance prospectively predicts poorer transdiagnostic symptom response to an empirically-supported behavioral treatment for trauma-exposed women and their young children.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Psiquiatria
/
Transtornos de Estresse Pós-Traumáticos
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Female
/
Humans
Idioma:
En
Revista:
Brain Behav Immun
Assunto da revista:
ALERGIA E IMUNOLOGIA
/
CEREBRO
/
PSICOFISIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article