BACKGROUND Previous studies on the association between chemokines concentrations and post-traumatic stress disorder (PTSD) yielded inconsistent results. Therefore, the purpose of this network meta-analysis was to summarize these results. METHODS The databases of PubMed, Web of Science, Psyc-ARTICLES, Embase and Cochrane Library were searched for relevant articles published not later than January 15, 2020. Then, eligible studies were selected based on predefined study selection criteria. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated as group differences in chemokines concentrations. Moreover, network meta-analysis was used to rank chemokines effect values according to their respective surface under cumulative ranking curve (SUCRA) probabilities. FINDINGS A total of 18 eligible studies that investigated the association between 9 different chemokines and PTSD were identified. They involved 1,510 patients and 2,012 controls. Results of the meta-analysis showed that the concentrations of CCL3, CCL4 and CCL5 in the PTSD patients were significantly higher than that in the controls (SMDs of 4.12, 6.11 and 1.53 respectively). However, although not statistically significant, concentrations of CCL2 tended to be lower in PTSD patients than in the controls (SMD=-0.76); whereas concentrations of CXCL12 tended to be higher in PTSD patients than in the controls (SMD=0.37). SUCRA probabilities showed that, among all the chemokines studied, the effect of CCL5 was the highest in PTSD patients. INTERPRETATION Concentrations of CCL3, CCL4 and CCL5 may be associated with a trauma and/or PTSD. Also, CXCL12 and CCL2 may be the underlying biomarkers for trauma and/or PTSD. Thus, future studies with large population based samples are needed to further assess these associations. In addition, future research should explore possible mechanisms underlying these associations, with the aim to develop new diagnostics for PTSD. PROSPERO CRD42019147703.

中文翻译：

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创伤后应激障碍中的趋化因子：网络荟萃分析

背景 先前关于趋化因子浓度与创伤后应激障碍 (PTSD) 之间关联的研究产生了不一致的结果。因此，该网络荟萃分析的目的是总结这些结果。方法 在 PubMed、Web of Science、Psyc-ARTICLES、Embase 和 Cochrane Library 的数据库中搜索不迟于 2020 年 1 月 15 日发表的相关文章，然后根据预先确定的研究选择标准选择符合条件的研究。具有 95% 置信区间 (CI) 的标准化平均差异 (SMD) 计算为趋化因子浓度的组间差异。此外，使用网络荟萃分析根据累积排名曲线 (SUCRA) 概率下的各自表面对趋化因子效应值进行排名。结果 共确定了 18 项符合条件的研究，这些研究调查了 9 种不同的趋化因子与 PTSD 之间的关联。他们涉及 1,510 名患者和 2,012 名对照者。荟萃分析结果显示，PTSD 患者的 CCL3、CCL4 和 CCL5 浓度显着高于对照组（SMD 分别为 4.12、6.11 和 1.53）。然而，虽然没有统计学意义，但 PTSD 患者的 CCL2 浓度往往低于对照组（SMD=-0.76）；而 PTSD 患者的 CXCL12 浓度往往高于对照组（SMD=0.37）。SUCRA 概率显示，在所有研究的趋化因子中，CCL5 对 PTSD 患者的影响最高。解释 CCL3、CCL4 和 CCL5 的浓度可能与创伤和/或 PTSD 相关。还，CXCL12 和 CCL2 可能是创伤和/或 PTSD 的潜在生物标志物。因此，未来需要对大量基于人群的样本进行研究，以进一步评估这些关联。此外，未来的研究应该探索这些关联背后的可能机制，旨在开发新的 PTSD 诊断方法。PROSPERO CRD42019147703。