Salivary inflammatory biomarkers as a predictor of post-traumatic stress disorder and depressive symptom severity in trauma patients: A prospective study

Theodore F Robles; Dennis Rünger; Jennifer A Sumner; David Elashoff; Vivek Shetty

doi:10.1016/j.bbi.2024.05.011

Salivary inflammatory biomarkers as a predictor of post-traumatic stress disorder and depressive symptom severity in trauma patients: A prospective study

Brain Behav Immun. 2024 Jul:119:792-800. doi: 10.1016/j.bbi.2024.05.011. Epub 2024 May 5.

Authors

Theodore F Robles¹, Dennis Rünger², Jennifer A Sumner³, David Elashoff², Vivek Shetty⁴

Affiliations

¹ Department of Psychology, University of California, Los Angeles, United States. Electronic address: robles@psych.ucla.edu.
² Department of Medicine Statistics Core, David Geffen School of Medicine at University of California, Los Angeles, United States.
³ Department of Psychology, University of California, Los Angeles, United States.
⁴ School of Dentistry, University of California, Los Angeles, United States.

PMID: 38714269
DOI: 10.1016/j.bbi.2024.05.011

Abstract

Background: Although post-traumatic stress disorder (PTSD) and depression screening are recommended for traumatic injury patients, routine screening is still uncommon. Salivary inflammatory biomarkers have biological plausibility and potential feasibility and acceptability for screening. This study tested prospective associations between several salivary inflammatory biomarkers (proinflammatory cytokines interleukin-1β, interleukin-6, tumor necrosis factor-α; and C-reactive protein), collected during hospitalization and PTSD and depressive symptoms at 5-month follow-up.

Methods: Adult traumatic injury patients (N = 696) at a major urban Level 1 trauma center provided salivary samples and completed PTSD and depressive symptom measures during days 0-13 of inpatient hospitalization. At 5-month follow-up, 368 patients (77 % male, 23 % female) completed the Clinician-Administered PTSD Scale for DSM-IV and the Self-rated Inventory of Depressive Symptomatology. Analyses focused on a latent inflammatory cytokine factor and C-reactive protein at baseline predicting 5-month PTSD and depression symptom outcomes and included baseline symptom levels as covariates.

Results: A latent factor representing proinflammatory cytokines was not related to 5-month PTSD or depressive symptom severity. Higher salivary CRP was related to greater PTSD symptom severity (β = .10, p = .03) at 5-month follow-up and more severity in the following depressive symptoms: changes in weight and appetite, bodily complaints, and constipation/diarrhea (β's from .14 to .16, p's from .004 -.03).

Conclusion: In a primarily Latine and Black trauma patient sample, salivary CRP measured after traumatic injury was related to greater PTSD symptom severity and severity in several depressive symptom clusters. Our preliminary findings suggest that salivary or systemic CRP may be useful to include in models predicting post-trauma psychopathology.

Keywords: C-reactive protein; Depression; Inflammation; Post-traumatic stress disorder; Saliva; Traumatic injury.

MeSH terms

Adult
Biomarkers* / metabolism
C-Reactive Protein* / analysis
C-Reactive Protein* / metabolism
Cytokines / analysis
Cytokines / metabolism
Depression* / metabolism
Female
Humans
Inflammation / metabolism
Interleukin-1beta / analysis
Interleukin-1beta / metabolism
Interleukin-6 / analysis
Interleukin-6 / metabolism
Male
Middle Aged
Prospective Studies
Saliva* / chemistry
Saliva* / metabolism
Severity of Illness Index
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / metabolism
Tumor Necrosis Factor-alpha / analysis
Tumor Necrosis Factor-alpha / metabolism
Wounds and Injuries / complications
Wounds and Injuries / metabolism
Wounds and Injuries / psychology
Young Adult

Substances

Biomarkers
C-Reactive Protein
Cytokines
Tumor Necrosis Factor-alpha
Interleukin-6
Interleukin-1beta