Rachel Yehuda1, Janine D Flory2, Linda M Bierer2, Clare Henn-Haase3, Amy Lehrner2, Frank Desarnaud2, Iouri Makotkine2, Nikolaos P Daskalakis2, Charles R Marmar3, Michael J Meaney4. 1. Mental Health Care Center (RY, JDF, LMB, AL, FD, IM, NPD), James J. Peters Veterans Affairs Medical Center, Bronx, New York; Traumatic Stress Studies Division (RY, JDF, LMB, AL, FD, IM, NPD), Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry (RY, JDF, LMB, AL, FD, IM, NPD), Icahn School of Medicine at Mount Sinai, NewYork, NewYork. Electronic address: rachel.yehuda@va.gov. 2. Mental Health Care Center (RY, JDF, LMB, AL, FD, IM, NPD), James J. Peters Veterans Affairs Medical Center, Bronx, New York; Traumatic Stress Studies Division (RY, JDF, LMB, AL, FD, IM, NPD), Icahn School of Medicine at Mount Sinai, New York, New York. 3. Department of Neuroscience (RY), Icahn School of Medicine at Mount Sinai, NewYork, NewYork; Steven and Alexandra Cohen Veterans Center for the Study of Posttraumatic Stress and Traumatic Brain Injury (CH-H, CRM), New York University School of Medicine, New York, New York. 4. Department of Psychiatry (CH-H, CRM), New York University School of Medicine, New York, New York; Sackler Program for Epigenetics Psychobiology (MJM), McGill University, Montreal, Canada; Departments of Psychiatry and Neurology &Neurosurgery (MJM), McGill University, Montreal, Canada; and Singapore Institute for Clinical Sciences (MJM), Singapore, Singapore.
Abstract
BACKGROUND: Enhanced glucocorticoid receptor (GR) sensitivity is present in people with posttraumatic stress disorder (PTSD), but the molecular mechanisms of GR sensitivity are not understood. Epigenetic factors have emerged as one potential mechanism that account for how trauma exposure leads to sustained PTSD symptoms given that PTSD develops in only a subset of trauma survivors. METHODS: Cytosine methylation of a relevant promoter of the GR gene (NR3C1-1F promoter) and three functional neuroendocrine markers of hypothalamic-pituitary-adrenal axis function were examined in a sample of 122 combat veterans. RESULTS: Lower NR3C1-1F promoter methylation in peripheral blood mononuclear cells (PBMCs) was observed in combat veterans with PTSD compared with combat-exposed veterans who did not develop PTSD. NR3C1-1F promoter methylation was also associated with three functional measures of glucocorticoid activity that have been associated with PTSD in combat veterans: PBMCs' lysozyme inhibition on the lysozyme suppression test, plasma cortisol decline on the low-dose (.50 mg) dexamethasone suppression test, and 24-hour urinary cortisol excretion. Finally, NR3C1-1F promoter methylation was inversely correlated with clinical markers and symptoms associated with PTSD. CONCLUSIONS: Alterations in NR3C1-1F promoter methylation may reflect enduring changes resulting from combat exposure that lead to functional neuroendocrine alterations. Because epigenetic measures are thought to reflect enduring effects of environmental exposures, they may be useful in distinguishing combat-exposed veterans who do or do not develop PTSD. Published by Elsevier Inc.
BACKGROUND: Enhanced glucocorticoid receptor (GR) sensitivity is present in people with posttraumatic stress disorder (PTSD), but the molecular mechanisms of GR sensitivity are not understood. Epigenetic factors have emerged as one potential mechanism that account for how trauma exposure leads to sustained PTSD symptoms given that PTSD develops in only a subset of trauma survivors. METHODS:Cytosine methylation of a relevant promoter of the GR gene (NR3C1-1F promoter) and three functional neuroendocrine markers of hypothalamic-pituitary-adrenal axis function were examined in a sample of 122 combat veterans. RESULTS: Lower NR3C1-1F promoter methylation in peripheral blood mononuclear cells (PBMCs) was observed in combat veterans with PTSD compared with combat-exposed veterans who did not develop PTSD. NR3C1-1F promoter methylation was also associated with three functional measures of glucocorticoid activity that have been associated with PTSD in combat veterans: PBMCs' lysozyme inhibition on the lysozyme suppression test, plasma cortisol decline on the low-dose (.50 mg) dexamethasone suppression test, and 24-hour urinary cortisol excretion. Finally, NR3C1-1F promoter methylation was inversely correlated with clinical markers and symptoms associated with PTSD. CONCLUSIONS: Alterations in NR3C1-1F promoter methylation may reflect enduring changes resulting from combat exposure that lead to functional neuroendocrine alterations. Because epigenetic measures are thought to reflect enduring effects of environmental exposures, they may be useful in distinguishing combat-exposed veterans who do or do not develop PTSD. Published by Elsevier Inc.
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