Correlation between depression, anxiety, and polymorphonuclear cells' resilience in ulcerative colitis: The mediating role of heat shock protein 70
Vlachos, I.I Barbatis, C Tsopanomichalou, M Abou-Assabeh, L Goumas, K Ginieri-Coccossis, M Economou, M Papadimitriou, G.N Patsouris, E Nicolopoulou-Stamati, P
Vlachos, I.I
Barbatis, C
Abou-Assabeh, L
Goumas, K
Ginieri-Coccossis, M
Economou, M
Papadimitriou, G.N
Patsouris, E
Nicolopoulou-Stamati, P
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Alternative Title
Abstract
Background: To investigate whether anxiety and depression levels are associated with Heat Shock Protein 70 (HSP70) induction in the colon of patients with ulcerative colitis (UC).Methods: The design was cross-sectional. Clinical activity was assessed by the Rachmilewitz Index (CAI). Three psychometric questionnaires were used: Zung Depression Rating Scale (ZDRS), Spielberg State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS). Colon biopsies were obtained from each affected anatomical site. Severity of inflammation was assessed by eosin/hematoxylin. Constitutive (HSP70c) and inducible (HSP70i) HSP70 expression were immunohistochemically studied.Results: 29 UC patients were enrolled (69% men). Mean age was 46.5 years (SD: 19.5). Inflammation severity was moderate in 17 patients, severe in 6, and mild in 6. The mean number of years since diagnosis was 7.9 (SD: 6.5). The mean CAI was 6.4 (SD: 3.1). In active UC, there was downregulation of HSP70c in inflamed epithelium, without significant HSP70 induction. In 22/29 cases of active cryptitis, polymorphonuclear cells (PMN) clearly expressed HSP70i, with weak, focal positivity in the other 7 cases. Except for the hospital anxiety scale, scores in all psychometric tools were higher in patients with strong HSP70i immunoreactivity in the PMN. Logistic regression showed a strong positive relationship between HSP70i immunoreactivity in the PMN cells and scores in the trait anxiety, ZDRS, and hospital depression scales, (Odds ratios 1.3, 1.3, and 1.5; P = 0.018, 0.023, and 0.038; Wald test, 5.6, 5.2, and 4.3 respectively) and a weaker but significant positive correlation with the CAI (Odds ratio 1.654; P = 0.049; Wald test 3.858).Conclusion: HSP70 is induced in PMN cells of UC patients and its induction correlates with depression and anxiety levels. © 2014 Vlachos et al.; licensee BioMed Central Ltd.
Keywords
heat shock protein 70, heat shock protein 70, adult, anxiety, article, clinical article, colon biopsy, controlled study, cross-sectional study, depression, disease severity, down regulation, epithelium, female, Hospital Anxiety and Depression Scale, human, human cell, human tissue, immunohistochemistry, immunoreactivity, male, polymorphonuclear cell, protein expression, protein induction, psychological rating scale, questionnaire, Rachmilewitz Index, scoring system, Spielberg State Trait Anxiety Inventory, ulcerative colitis, Zung Depression Rating Scale, aged, anxiety, colon, depression, metabolism, middle aged, neutrophil, psychology, severity of illness index, statistical model, ulcerative colitis, Adult, Aged, Anxiety, Colitis, Ulcerative, Colon, Cross-Sectional Studies, Depression, Female, HSP70 Heat-Shock Proteins, Humans, Logistic Models, Male, Middle Aged, Neutrophils, Questionnaires, Severity of Illness Index
Source Title
BMC Gastroenterology
Publisher
Series/Report No.
Collections
Rights
Attribution 4.0 International
Date
2014
DOI
10.1186/1471-230X-14-77
Type
Article