Depression and Endothelial Dysfunction in Psoriatic Arthritis: Is There Any Possible Relationship?

Background: Cardiovascular events (CVEs) are the first cause of death in patients with psoriatic arthritis (PsA). Depression is a recognized risk factor in cardiovascular events and is frequently associated with PsA. Flow-mediated dilatation (FMD) is a widely used method for assessing endothelial dysfunction, a parameter with strong prognostic implications for CVEs. The study aims to explore the relationship between FMD, depressive symptoms and serum cytokines in a cohort of patients with PsA.Patients and Methods: FMD was assessed in 50 consecutive PsA patients aged between 30 and 75 years without known cerebrovascular and coronary heart disease or diabetes. Depressive symptoms were reported using the related subscale of the Hospital Anxiety and Depression Scale (HDS). Disease features, activity indexes, and adjusted Framingham risk score (aFRS) were calculated. Serum level of IL-6, TNF-α, and IL-17A were also assessed.Results: In PsA patients (age 50.7 ± 10.2 years, male 42%, disease duration 5.9 ± 3.3 years, Disease Activity in PSoriatic Arthritis (DAPSA) score 14.0 ± 9.4) FMD inversely correlated with the severity of depressive symptoms according to HDS (ρ = −0.339, p = 0.016), age (ρ = −0.507, p = 0.001), aFRS (rs = −0.453, p < 0.001), duration of PsA (ρ = −0.507, p = 0.001), intensity of pain (ρ = −0.507, p = 0.001), and DAPSA (ρ = −0.507, p = 0.001). No statistically significant correlation was found between FMD or HDS and serum cytokines concentrations. HDS predicted FMD in a model adjusted for age, aFRS, PsA duration, and pain intensity (β = −0.271, p = 0.008), with depressive symptoms contributing directly to 6.4% of the variance.Conclusions: Depressive symptoms correlate with endothelial dysfunction with an exposure-response pattern in our cohort of PsA patients.

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Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population: the Hoorn Study

Psychological Medicine ◽

10.1017/s0033291713002043 ◽

2013 ◽

Vol 44 (7) ◽

pp. 1403-1416 ◽

Cited By ~ 29

Author(s):

T. T. van Sloten ◽

M. T. Schram ◽

M. C. Adriaanse ◽

J. M. Dekker ◽

G. Nijpels ◽

...

Keyword(s):

Depressive Symptoms ◽

Endothelial Dysfunction ◽

Glucose Metabolism ◽

Adhesion Molecule ◽

Dietary Habits ◽

Depression Scale ◽

Lipid Lowering ◽

Low Grade ◽

Standard Deviation Increase ◽

Amyloid A

BackgroundEndothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other.MethodWe used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9% female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders).ResultsAfter adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95% confidence interval (CI) 0.7–3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score.ConclusionsED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.

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USE OF RESVERATROL IN CARDIOVASCULAR DISEASES PREVENTION: A SYSTEMATIC REVIEW

Brazilian Journal of Medicine and Human Health ◽

10.17267/2317-3386bjmhh.v5i2.1309 ◽

2017 ◽

Vol 5 (2) ◽

pp. 75-85

Author(s):

Gabriela Marujo Góes ◽

Amanda Silva Fraga ◽

Ana Marice Teixeira Ladeia

Keyword(s):

Systematic Review ◽

Endothelial Function ◽

Randomized Controlled Trials ◽

Cardiovascular Events ◽

Controlled Trials ◽

Reactive Protein ◽

Randomized Controlled ◽

Final Sample ◽

Tnf Α ◽

Flow Mediated Dilatation

Resveratrol, a polyphenolic compound found in blackberry and red wine, has properties that prevent the development of atherosclerosis, and therefore, cardiovascular disease. The aim of this study was, through a systematic review, to assess whether resveratrol reduces the incidence of cardiovascular events and improves inflammation and endothelial dysfunction in individuals at risk. Searches were conducted in databases such as LILACS, PubMed,SCIELO and selected randomized controlled trials in humans, including the use of resveratrol in the prevention of cardiovascular events or in the improvement of inflammation and endothelial function. The final sample consisted of 10 items. Of the four studies that analyzed the flow-mediated dilatation of the brachial artery, all showed significant improvement in endothelial function after the use of resveratrol, compared with placebo.In the 7 studies that evaluated subclinical inflammation, there were differences, 3 studies showed significant decreases in the values of TNF-α, 2 showed significant changes in plasma levels of C-reactive protein and interleukin 6 (IL-6), while 1 didn't showed changes in TNF-α and IL-6. In conclusion, resveratrol is capable of improving endothelial function when compared with placebo. However, it was not possible to infer an improvement or not in the parameters concerning endothelial inflammation, since the data extracted from the studies were insufficient. Moreover, it was not possible to evaluate the use of resveratrol in the improvement of survival, infarction or reduction in mortality, since there were no records in the literature of randomized controlled trials that analyzed the effect of resveratrol use on clinical outcomes in humans.

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Paranoid Hostility but Not Depressive Symptoms Associated with Cytokines During the Premenstrual Phase in Young Women

10.53902/sojnn.2021.01.000505 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Syros Ioannis

Keyword(s):

Depressive Symptoms ◽

Menstrual Cycle ◽

Young Women ◽

Proinflammatory Cytokines ◽

Luteal Phase ◽

Depression Scale ◽

Rank Correlation ◽

Hormonal Changes ◽

Mean Values ◽

Tnf Α

It is well known that some women, during their premenstrual phase, express Hostility (Ho) and Depressive symptoms (De). Various studies indicate that Ho and De correlate with circulating concentrations of cytokines. These data support the hypothesis of an inflammation-sensitive mechanism linked to certain psychological states. The aim of this study was to correlate Ho and De with selective proinflammatory cytokines during the menstrual cycle in young women. Twenty-two physically healthy medical students, mean age 22.95+2.83(SD), were studied. All reported regular menses that ranged between 27-33 days. Blood was drawn three times across a single cycle: at follicular phase (FL), at mid luteal phase (ML) and at late luteal phase (LL) corresponding to the premenstrual phase. The following proinflammatory cytokines were determined at each sample: Interleukin 8 (IL-8), Interleukin 6 (IL-6), Interleukin 1α (IL-1α), and Tumor Necrosis Factor-α (TNF-α). Immediately before blood sampling the women completed the Zung self-rating depression scale and the hostility and direction of hostility questionnaire (HDHQ), which comprises five subscales: urge to act out hostility, criticism of others, paranoid hostility, self-criticism and delusional guilt. Spearman’s rank correlation was used to determine the relation between variables at the specific time points; ρ<0.05 was considered significant. Mean values of cytokines did not change significantly throughout the menstrual cycle. Paranoid hostility was positively correlated with IL-8 (Rs=0.476, p=0.046), IL-1α (Rs=0.458, p=0.048) and TNF-α (Rs=0.518, p=0.023) in LLphase. No other significant correlation was found. Cytokines correlate with paranoid hostility and this correlation is probably related with the premenstrual hormonal changes. It is difficult to evaluate the clinical significance of our findings, nevertheless, when exploring the above association, it is necessary to take into consideration the phase of the cycle as well as the special aspects of Ho we seek to study.

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Comparison of exercise treadmill test, flow mediated dilatation, and inflammation in individuals with low risk of adverse cardiovascular events

Asian Biomedicine ◽

10.5372/1905-7415.0902.380 ◽

2015 ◽

Vol 9 (2) ◽

Author(s):

Muhammed Sait Toprak ◽

Zeynep Gungor Ozturk ◽

Ozlem Balci Ekmekci ◽

Hakan Ekmekci ◽

Baris Ikitimur ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Cardiovascular Events ◽

Low Risk ◽

Treadmill Test ◽

Exercise Treadmill Test ◽

Flow Mediated Dilatation ◽

Exercise Treadmill ◽

Test Flow ◽

Artery Disease ◽

The Relationship

AbstractBackgroundThe relationship between endothelial dysfunction, a risk factor for coronary artery disease, and the incidence of cardiovascular disease (CVD) in the general population is not well known.ObjectivesTo determine the utility of an exercise treadmill test (ETT) combined with inflammatory markers to show endothelial dysfunction for individuals with a low risk of adverse cardiovascular (CV) events.MethodsBiomarkers of inflammation (lipoprotein-related phospholipase AResultsLp-PLAConclusionThe elevation of Lp-PLA

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Is bullying in adolescence associated with the development of depressive symptoms in adulthood?: A longitudinal cohort study

BMC Psychology ◽

10.1186/s40359-020-00491-5 ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Trine Nøhr Winding ◽

Lisbeth Astrid Skouenborg ◽

Vibeke Lie Mortensen ◽

Johan Hviid Andersen

Keyword(s):

Mental Health ◽

Cohort Study ◽

Depressive Symptoms ◽

Mental Health Problems ◽

Depression Scale ◽

Epidemiological Studies ◽

Negative Consequences ◽

Response Relationship ◽

Exposure Response ◽

Being Bullied

Abstract Background Being bullied in adolescence is linked to mental health problems like anxiety, depressive- and somatic symptoms and can have negative consequences on both an individual and a societal level. However, evidence regarding the long-term mental health consequences of bullying in adolescence is limited. The aim of this study was to examine whether being bullied at age 15 or 18 was associated with experiencing depressive symptoms at age 28, and to examine whether being bullied at both ages 15 and 18 increased the risk of experiencing depressive symptoms at age 28. Methods A prospective cohort study, which applied data from the West Jutland Cohort Study, was conducted. Bullying and depressive symptoms were measured on the basis of self-reported data from surveys in 2004, 2007 and 2017. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale. A total of 1790 participants were included in the study, and analyzed by multiple logistic regressions. Results The results showed associations between being bullied at age 15 or 18 and the reporting of depressive symptoms at age 28 when adjusted for potential confounders. An exposure–response relationship was seen in those who were bullied at both ages 15 and 18. This group had the highest risk of developing depressive symptoms at age 28. Conclusions Being bullied in adolescence was associated with developing depressive symptoms in adulthood and there was an exposure–response relationship between being bullied over time and the later reporting of depressive symptoms. The results highlight the need to provide more detailed information to schools and local communities about the negative consequences of bullying. Such increased awareness may help reduce the risk of young people developing depressive symptoms later in life.

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Walking-induced endothelial dysfunction predicts ischemic cardiovascular events in patients with intermittent claudication

Vascular Medicine ◽

10.1177/1358863x211001927 ◽

2021 ◽

pp. 1358863X2110019

Author(s):

Rino Migliacci ◽

Giuseppe Guglielmini ◽

Chiara Busti ◽

Emanuela Falcinelli ◽

Pietro Minuz ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Intermittent Claudication ◽

Cardiovascular Events ◽

Treadmill Exercise ◽

Ischemia Reperfusion Injury ◽

Ischemia Reperfusion ◽

Major Cardiovascular Events ◽

Flow Mediated Dilatation ◽

Exercise Treadmill ◽

Exercise Induced

Endothelial dysfunction, evaluated by flow-mediated dilatation (FMD), predicts adverse cardiovascular events in patients with intermittent claudication (IC). IC is an example of repeated ischemia/reperfusion injury that may contribute to the progression of vascular disease by worsening endothelial function, a trigger for acute cardiovascular events. The predictive value of effort-induced endothelial dysfunction for cardiovascular events in patients with IC has not been studied previously. The objective of this study was to assess whether exercise-induced endothelial dysfunction is predictive of adverse cardiovascular outcome in IC. In 44 patients with IC, we measured brachial artery FMD by B-mode ultrasonography at rest and 10 minutes after a maximal treadmill exercise. Treadmill exercise halved the FMD (from 3.5 ± 0.6% to 1.45 ± 0.46%, p < 0.05). After a follow-up period of 85 (72–98) months, a total of 20 major cardiovascular events occurred. In a multivariate analysis, a post-exercise reduction of brachial FMD > 1.3% was predictive for cardiovascular events. Maximal exercise-induced endothelial dysfunction is predictive of cardiovascular events in patients with IC.

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AB0757 ASSOCIATION BETWEEN DEPRESSIVE SYMPTOMS AND ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH PSORIATIC ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4943 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1675.2-1676

Author(s):

E. De Lorenzis ◽

A. DI Giorgio ◽

G. Natalello ◽

A. Nesci ◽

D. Bruno ◽

...

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

Cardiovascular Risk ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Cardiovascular Events ◽

Tnf Alpha ◽

Major Cardiovascular Events ◽

The Mean ◽

The Relationship

Background:Cardiovascular complications are the leading cause of death in patients with psoriatic arthritis (PsA), but current strategies for reducing cardiovascular risk are still inadequate. Depression is a common comorbidity in PsA patients and it is recognized as an independent cardiovascular risk factor in the general population. Endothelial dysfunction, assessed as a reduction in brachial artery Flow Mediated Dilation (FMD), is a predictor of major cardiovascular events in high and low risk populations.Objectives:To investigate the relationship between endothelial function and depressive symptoms in a cohort of patients with PsA.Methods:Sixty consecutive patients with PsA, aged between 30 and 79 years, with no history of major cardiovascular events, were characterized for traditional cardiovascular risk factors and features of psoriatic disease. The risk of cardiovascular events according to traditional risk factors was calculated using the Framingham Risk Score (FRS) and the presence of depressive symptoms was defined through the Hospital Anxiety and Depression Scale (HDS) using the validated cut-off of 8. Endothelial function was assessed by FMD. Serum IL-6 was quantified by ELISA, IL-17 and TNF-α levels by Luminex method.Results:Patients had an average age of 52.1±11.0 years, 43.3% of them were male, 23.3% obese and 25.0% active smokers; 38.3%, 25.0% and 11.7% were treated for high blood pressure, dyslipidemia and diabetes mellitus, respectively. The 10-year risk of major cardiovascular events estimated by FRS was 10.4%. The mean duration of PsA was 9.4 years, 30.0% of patients were in minimal disease activity (MDA) and 61.7% and 46.7% were treated with conventional and biotechnological DMARDs, respectively. The mean HDS value was 6.9±3.2 and 43.4% of patients had significant depressive symptoms. The severity of depressive symptoms according to HDS correlated with disease activity according to DAPSA (r=0.449, p=0.001). The mean FMD was 7.8±3.8%, this value correlated inversely with age (r=-0.408,p<0.001), risk of major cardiovascular events according to FRS (r=-0.327, p=0.011) and severity of depressive symptoms according to HDS (r=-0.285, p=0.027). The correlation between FMD and serum IL-6, IL-17 and TNF-alpha levels was not statistically significant. In multivariate linear regression models, the relationship between FMD and HDS was significant also when corrected for age (β=-0.26, p=0.03, R2=0.23) and FRS normalized through logarithmic transformation (β=-0.32, p=0.009, R2=0.22).Conclusion:The degree of endothelial dysfunction quantified by FRS correlates with the severity of the depressive symptoms in patients with PsA, independently of the cardiovascular risk attributable to classical risk factors. The weak relationship between FRS and serum levels of IL-6, IL-17 and TNF-alpha suggests a role of factors independent of inflammation in the regulation of endothelial function in patients with PsA. Systematic research and treatment of depressive symptoms could contribute to a more complete stratification and a better management of cardiovascular risk in patients with PsA.Disclosure of Interests:Enrico De Lorenzis: None declared, Angela Di Giorgio: None declared, Gerlando Natalello: None declared, Antonio Nesci: None declared, Dario Bruno: None declared, Donatella Lucchetti: None declared, Giacomo Tanti: None declared, Clara Di Mario: None declared, Pietro Rubortone: None declared, Maria Rosaria Magurano: None declared, Barbara Tolusso: None declared, Angelo Santoliquido: None declared, Giusy Peluso: None declared, Elisa Gremese Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer

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Ascorbic Acid does not Improve Endothelium-Dependent Flow-mediated Dilatation of the Brachial Artery in Patients with Raynaud’s Phenomenon Secondary to Systemic Sclerosis

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.73.1.3 ◽

2003 ◽

Vol 73 (1) ◽

pp. 3-7 ◽

Cited By ~ 22

Author(s):

M. E. Mavrikakis ◽

J. P. Lekakis ◽

M. Papamichael ◽

K. S. Stamatelopoulos ◽

Ch. C. Kostopoulos ◽

...

Keyword(s):

Ascorbic Acid ◽

Smooth Muscle ◽

Systemic Sclerosis ◽

Endothelial Dysfunction ◽

Brachial Artery ◽

Raynaud’S Phenomenon ◽

Raynaud's Phenomenon ◽

Water Soluble ◽

Placebo Administration ◽

Flow Mediated Dilatation

Previous studies have shown that patients with Raynaud’s phenomenon secondary to systemic sclerosis present abnormal endothelial function; the mechanisms responsible for the endothelial dysfunction are unknown but increased vascular oxidative stress could be a possible cause. The hypothesis that a potent water-soluble antioxidant can reverse endothelial dysfunction in these patients was tested in the present study. We examined 11 female patients with Raynaud’s phenomenon secondary to systemic sclerosis and ten healthy control women by ultrasound imaging of the brachial artery to assess flow-mediated (endothelium-dependent) and nitrate-induced (endothelium-independent) vasodilatation. Flow-mediated dilatation and nitrate-induced dilatation were significantly reduced in patients with Raynaud’s phenomenon, indicating abnormal endothelial and smooth muscle cell function. Patients with Raynaud’s phenomenon entered a double-blind, randomized, crossover placebo-controlled trial and received orally 2 g of ascorbic acid or placebo; vascular studies were repeated two hours after ascorbic acid or placebo administration. Flow-mediated dilatation did not improve after ascorbic acid (1.6 ± 2.2% to 2.2 ± 2.5%, ns) or placebo administration (1.2 ± 1,9% to 1.7 ± 1.4%, ns); also nitrate-induced dilatation was similar after ascorbic acid or placebo (16 ± 7.4% vs 17 ± 8%, ns), suggesting no effect of ascorbic acid on endothelial and vascular smooth muscle function. In conclusion, ascorbic acid does not reverse endothelial vasomotor dysfunction in the brachial circulation of patients with Raynaud’s phenomenon secondary to systemic sclerosis. The use of different antioxidants or different dosing of ascorbic acid may be required to show a beneficial effect on endothelial vasodilator function.

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Maternal anxiety and depression in pregnancy and DNA methylation of the NR3C1 glucocorticoid receptor gene

Epigenomics ◽

10.2217/epi-2020-0022 ◽

2020 ◽

Author(s):

Alexandra E Dereix ◽

Rachel Ledyard ◽

Allyson M Redhunt ◽

Tessa R Bloomquist ◽

Kasey JM Brennan ◽

...

Keyword(s):

Dna Methylation ◽

Depressive Symptoms ◽

Trait Anxiety ◽

Cpg Island ◽

Depression Scale ◽

Maternal Anxiety ◽

Anxiety And Depression ◽

Pregnancy Anxiety ◽

Glucocorticoid Receptor Gene ◽

Island Shore

Aim: To quantify associations of anxiety and depression during pregnancy with differential cord blood DNA methylation of the glucorticoid receptor ( NR3C1). Materials & methods: Pregnancy anxiety, trait anxiety and depressive symptoms were collected using the Pregnancy Related Anxiety Scale, State-Trait Anxiety Index and Edinburgh Postnatal Depression Scale, respectively. NR3C1 methylation was determined at four methylation sites. Results: DNA methylation of CpG 1 in the NR3C1 CpG island shore was higher in infants born to women with high pregnancy anxiety (β 2.54, 95% CI: 0.49–4.58) and trait anxiety (β 1.68, 95% CI: 0.14–3.22). No significant association was found between depressive symptoms and NR3C1 methylation. Conclusion: We found that maternal anxiety was associated with increased NR3C1 CpG island shore methylation.

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