Supplementary Material for: Long-Term Immune Alterations Accompanying Chronic Posttraumatic Stress Disorder following Exposure to Suicide Bomb Terror Incidents during Childhood

Background and Aim: Long-term immune alterations have been proposed to play a mechanistic role in posttraumatic stress disorder (PTSD) as well as in its associated increase in medical morbidity and mortality. Better characterization of altered immune function may help identify diagnostic and prognostic biomarkers and potentially targets for preventive intervention. Methods: As part of an ongoing study, we conducted a preliminary case-control comparison of resting immune inflammatory profiles between terror victims treated in childhood at the emergency department over the previous decade, who developed chronic PTSD upon long-term follow-up, and healthy controls. Results: Our preliminary results in a subsample of this ongoing study support and extend elevated resting levels of granulocyte colony-stimulating factor, interleukin-4, and regulated on activation, normal T cell expressed and secreted in childhood onset chronic PTSD. Conclusion: Chronic immune alterations may participate in inflammatory activation and signal to the CNS through the neurovascular unit, as well as modulate the neuroendocrine axis. Better characterization and understanding of these preliminary findings may point to diagnostic and prognostic biomarkers and potentially elucidate mechanistic involvement of immune activation in PTSD.

研究背景与目的：已有研究提出，长期免疫改变在创伤后应激障碍（posttraumatic stress disorder, PTSD）及其相关的医疗共病风险与死亡率升高过程中发挥了潜在的机制性作用。对免疫功能改变进行更精准的特征刻画，或有助于识别诊断性与预后性生物标志物，并为预防性干预提供潜在靶点。研究方法：作为一项正在进行的研究的组成部分，我们针对过去十年间于急诊科接受救治的童年时期受恐怖袭击的受害者开展了初步病例对照比较，对比了其中经长期随访后发展为慢性创伤后应激障碍者与健康对照者的静息状态免疫炎症谱。研究结果：本项正在进行的研究的亚队列初步结果支持并拓展了相关结论，即童年起病的慢性创伤后应激障碍患者静息状态下的粒细胞集落刺激因子（granulocyte colony-stimulating factor）、白细胞介素-4（interleukin-4）以及活化正常T细胞表达和分泌的调节因子（regulated on activation, normal T cell expressed and secreted）水平均存在升高。研究结论：慢性免疫改变可能参与炎症激活过程，并通过神经血管单元向中枢神经系统（central nervous system, CNS）传递信号，同时可调控神经内分泌轴。对这些初步发现进行更深入的特征刻画与理解，或可助力发掘诊断与预后性生物标志物，并有望阐明免疫激活在创伤后应激障碍发病机制中的作用。