Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2024; 14(9): 1308-1318
Published online Sep 19, 2024. doi: 10.5498/wjp.v14.i9.1308
Predictive effect of lipopolysaccharide-stimulated inflammatory cytokines on symptoms of generalized anxiety disorder
Wen-Yuan Wang, Na Liu, Xiao-Xiao Qi, Bing Han, Jing-Na Sun, Zheng-Li Chen, Ming-Wei Wang, Yan-Yong Wang
Wen-Yuan Wang, Na Liu, Bing Han, Ming-Wei Wang, Yan-Yong Wang, Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Wen-Yuan Wang, Na Liu, Bing Han, Ming-Wei Wang, Yan-Yong Wang, Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang 050000, Hebei Province, China
Xiao-Xiao Qi, Department of Neurological Examination at Treatment Center, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Jing-Na Sun, Zheng-Li Chen, Department of Clinical Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Author contributions: Wang WY made significant contributions to research design, specific experimental process management, data analysis, and manuscript writing; Liu N, Qi XX, and Han B made significant contributions to research design and data analysis; Wang WY, Han B, and Sun JN made significant contributions to research support and results section preparation; Chen ZL, Wang MW, and Wang YY contributed to research design; Liu N and Qi XX contributed to data collection; Wang YY made significant contributions to research design and manuscript review; all authors have read and approved the final manuscript.
Supported by The 2023 Scientific Research Fund Project of Hebei Provincial Health and Family Planning Commission, No. 20231081; and The "Spark" Youth Research Project, The First Hospital of Hebei Medical University, No. XH202302.
Institutional review board statement: The study protocol received ethical approval from the hospital's ethics committee (approval No. 20220581).
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: The authors declared that they have no conflicts of interest regarding this work.
Data sharing statement: The experimental data used to support the findings of this study are available from the corresponding author upon request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Yong Wang, MD, Chief Doctor, Department of Neurology, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang 050000, Hebei Province, China. 57600267@hebmu.edu.cn
Received: May 21, 2024
Revised: August 9, 2024
Accepted: August 20, 2024
Published online: September 19, 2024
Processing time: 112 Days and 23.9 Hours
Abstract
BACKGROUND

Generalized anxiety disorder (GAD) is a relatively common mental disorder. Recently, inflammation, an important factor for the development of depression, has attracted increasing attention. Several studies have shown that inflammatory cytokines can affect the pathophysiological processes of several nervous system diseases. We hypothesized that there is a correlation between the levels of lipopolysaccharide (LPS)-stimulated inflammatory cytokines and the clinical symptoms of GAD.

AIM

To investigate the predictive effect of LPS-stimulated inflammatory cytokines on symptoms of GAD.

METHODS

This was a cross-sectional study in which 89 patients with GAD diagnosed at The First Hospital of Hebei Medical University from January 2022 to December 2022 and 70 individuals without anxiety and depression (controls) during the same period were included. Fasting venous blood was collected from all the subjects in heparin tubes, and another 3 ml of blood was supplemented with LPS (10 ng/ml). The plasma levels of 12 cytokines [Interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IL-17A, IL-12p70, and IFN-α] were detected.

RESULTS

Post-LPS stimulation, the levels of IL-1β, IL-6, IL-8, IL-10, and TNF-α in both the control and GAD groups were significantly elevated above those in the nonstimulated groups, with IL-6 and IL-8 showing marked increases. Increases in IL-8 and TNF-α were statistically significant in the GAD group (P < 0.05). IL-1β, IL-6, IL-8, IL-10, and TNF-α were found to be significantly correlated with Hamilton Anxiety Rating Scale (HAMA) scores (P < 0.05). A negative correlation was observed between IL-10 levels and HAMA scores. Further analysis revealed that TNF-α was associated with mental anxiety, whereas IL-1β, IL-8, and IL-10 were associated with physical anxiety symptoms, with IL-10 showing a negative correlation with physical anxiety. IL-6 was associated with both mental and physical aspects of anxiety.

CONCLUSION

The physical symptoms of GAD are related to inflammatory factors. IL-1β, IL-8, IL-10, and TNF-a can be used as predictors of physical or mental anxiety in patients with GAD.

Keywords: Lipopolysaccharide; Cytokine; Generalized anxiety disorder; Inflammatory cytokines; Anxiety

Core Tip: In this study, the physical symptoms of generalized anxiety disorder (GAD) were found to be related to inflammatory factors and the innate ability of the body to produce inflammation in vivo. Interleukin (IL)-1β, IL-8, IL-10, and tumor necrosis factor-α can be used as predictors of physical or mental anxiety in patients with GAD. This study provides evidence that lipopolysaccharide-induced inflammatory cytokines can be used to monitor the mental state of GAD patients. Strategies for generalized anxiety disorder that can benefit from personalized treatment with anti-inflammatory drugs may be promising.