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. 2023 May 13:30:100631.
doi: 10.1016/j.bbih.2023.100631. eCollection 2023 Jul.

Glial suppression and post-traumatic stress disorder: A cross-sectional study of 1,520 world trade center responders

Ginny Natale  1 , Minos Kritikos  1 , Pei-Fen Kuan  2 , Melissa A Carr  3 , Xiaohua Yang  4 , Yuan Yang  1 , Roman Kotov  5 , Evelyn J Bromet  5 , Sean A P Clouston  1 , Benjamin J Luft  3   4
Affiliations

Glial suppression and post-traumatic stress disorder: A cross-sectional study of 1,520 world trade center responders

Ginny Natale et al. Brain Behav Immun Health. .

Abstract

Background: Chronically re-experiencing the memory of a traumatic event might cause a glial response. This study examined whether glial activation would be associated with PTSD in a study of responders present after the 9/11 World Trade Center attacks without comorbid cerebrovascular disease.

Methods: Plasma was retrieved from 1,520 WTC responders and stored for a cross-sectional sample of responders of varying levels of exposure and PTSD. Plasma levels (pg/ml) of glial fibrillary acidic protein (GFAP) were assayed. Because stroke and other cerebrovascular diseases cause distributional shifts in GFAP levels, multivariable-adjusted finite mixture models analyzed GFAP distributions in responders with and without possible cerebrovascular disease.

Results: Responders were aged 56.3 years and primarily male; 11.07% (n = 154) had chronic PTSD. Older age was associated with increased GFAP, whereas higher body mass was associated with decreased GFAP. Multivariable-adjusted finite mixture models revealed that severe re-experiencing trauma from 9/11 was associated with lower GFAP (B = -0.558, p = 0.003).

Conclusion: This study presents evidence of reduced plasma GFAP levels among WTC responders with PTSD. Results suggest re-experiencing traumatic events might cause glial suppression.

Keywords: Disasters; Glial fibrillary acidic protein; Neuroinflammation; Post-traumatic stress disorder; World trade center.

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Conflict of interest statement

This is an epidemiological study examining biomarkers associated with posttraumatic stress disorder. The authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Raincloud plots showing data distribution (cloud), jittered raw data (rain), and central tendency boxplots for glial fibrillary acidic protein (GFAP) [pg/ml] as stratified by post-traumatic stress disorder classification (PTSD) groups from Table 2 in responders classified as belonging to the normal class. Note: Asterisk * denotes a significantly different pairwise comparison using a Welch's T-test (p = 0.005). The results here exclude responders with estimates of the probability of pathological class membership ≥0.10 consistent with Table 1.
Fig. 2
Fig. 2
Regression models showing the relationship between age and glial fibrillary acidic protein volumes for responders with and without post-traumatic stress disorder in responders lacking evidence of glial pathology. Results show expectations derived from finite mixture models for responders in the normal class. Results for responders with probable PTSD are shown using a dashed line (with 95% confidence interval) and dark gray dots in the scatterplot; results for responders without probable PTSD are shown using a solid black line (with 95% confidence interval) and unfilled gray dots in the scatterplot.
See this image and copyright information in PMC

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