Neurocytokine blood profile of veterans of modern combat conflicts with post-traumatic stress disorder

Abstract

The formation of post-stress disorders in veterans of modern military conflicts is due to the peculiarities of the mutual influence of mental and immuno-endocrine processes aimed at maintaining the stability of the body in conditions of chronic activation of physiological systems through a process known as allostasis. The purpose of the study was to study the levels of stress mediators of hypothalamic-pituitary and adrenal origin, the cytokine profile of blood of veterans of modern wars with PTSD. 38 veterans of a special military operation in Ukraine with a diagnosis according to ICD 10: PTSD (F43.1) took part in the study. The diagnosis was verified on the basis of neuropsychological and pathopsychological examination. The comparison group included 30 veterans of the Chechen military campaign of the same age. The levels of stress hormones in the blood were determined by ELISA using the following method: ACTH (IBL, Germany); norepinephrine (Cloud-Clone, China); cortisol (HemaMedica, Russia); dihydroepiandrosterone (DBC, Canada). The blood cytokine profile was determined using a multiplex analysis using the Bio-Plex test system (MERZ, Germany). Evidence of the accumulation of “allostatic load” during the formation of PTSD in SVO veterans was an increase in the blood concentrations of ACTH, norepinephrine, and cortisol, which are plastic constants of the catatoxic strategy of adaptation to the effects of prolonged combat stress. Allostatic reactions in PTSD included changes in the cytokine profile of the blood in the form of increased levels of pro-inflammatory cytokines (IL- 1β, IL-6, IL-12 TNFα) and decreased anti-inflammatory and regulatory cytokines (IL-4, IL-10, TGF-β, IL-2). This neuroinflammatory status may be associated with the development of psycho-behavioral symptoms of PTSD. The formation of maladaptive changes with the accumulation of “allostatic load” was clinically expressed in the form of PTSD and was accompanied by changes in the neurocytokine blood profile in the form of increased levels of ACTH, norepinephrine, cortisol, IL-lβ, IL-6, IL-12 TNFα, against the background of a decrease in the concentration of dehydroepiandrosterone, TGF-β, IL-4, IL-10, IL-2, which generally reflects the prevalence of the catatoxic adaptation strategy in combatants.