OBJECTIVE Although several reports have documented heightened systemic inflammation in posttraumatic stress disorder (PTSD), few studies have assessed whether inflammatory markers serve as prospective biomarkers for PTSD risk. The present study aimed to characterize whether peripheral immune factors measured in blood samples collected in an emergency department immediately after trauma exposure would predict later chronic development of PTSD. METHODS Participants (N=505) were recruited from a hospital emergency department and underwent a 1.5-hour assessment. Blood samples were drawn, on average, about 3 hours after trauma exposure. Follow-up assessments were conducted 1, 3, 6, and 12 months after trauma exposure. Latent growth mixture modeling was used to identify classes of PTSD symptom trajectories. RESULTS Three distinct classes of PTSD symptom trajectories were identified: chronic (N=28), resilient (N=160), and recovery (N=85). Multivariate analyses of covariance revealed a significant multivariate main effect of PTSD symptom trajectory class membership on proinflammatory cytokines. Univariate analyses showed a significant main effect of trajectory class membership on plasma concentrations of proinflammatory tumor necrosis factor α (TNFα) and interferon-γ (IFNγ). Concentrations of proinflammatory TNFα and IFNγ were significantly lower in individuals in the chronic PTSD class compared with those in the recovery and resilient classes. There were no significant differences in interleukin (IL) 1β and IL-6 concentrations by PTSD symptom trajectory class. Anti-inflammatory and other cytokines, as well as chemokines and growth factor concentrations, were not associated with development of chronic PTSD. CONCLUSIONS Overall, the study findings suggest that assessing the proinflammatory immune response to trauma exposure immediately after trauma exposure, in the emergency department, may help identify individuals most at risk for developing chronic PTSD in the aftermath of trauma.

中文翻译：

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创伤暴露后立即产生低TNFα和IFNγ浓度的慢性PTSD症状的预期风险关联。

目的尽管有几篇报道记录了创伤后应激障碍（PTSD）中全身炎症的加剧，但很少有研究评估炎症标记物是否可作为PTSD风险的前瞻性生物标记物。本研究旨在确定创伤暴露后立即在急诊科采集的血液样本中测量的外周免疫因子是否可以预测PTSD的慢性发展。方法从医院急诊科招募参与者（N = 505）并进行1.5小时的评估。平均在创伤暴露后约3小时抽取血样。创伤暴露后1、3、6和12个月进行了随访评估。潜在生长混合物建模用于识别PTSD症状轨迹的类别。结果确定了三种不同的PTSD症状轨迹：慢性（N = 28），弹性（N = 160）和恢复（N = 85）。协方差的多变量分析显示，PTSD症状轨迹类别成员对促炎细胞因子具有重要的多变量主要影响。单因素分析显示，轨迹类别成员对促炎性肿瘤坏死因子α（TNFα）和干扰素-γ（IFNγ）的血浆浓度具有重大的主要影响。慢性PTSD组个体的促炎性TNFα和IFNγ的浓度显着低于恢复组和恢复系的个体。按PTSD症状轨迹分类，白介素（IL）1β和IL-6浓度无显着差异。抗炎和其他细胞因子，以及趋化因子和生长因子的浓度与慢性PTSD的发生无关。结论总体而言，研究结果表明，在急诊科评估暴露于创伤后立即对创伤暴露的促炎免疫反应，可能有助于确定在创伤后最有可能发展为慢性PTSD的个体。