Neuromediator metabolism and inflammation markers in posttraumatic stress disorder in the modern war Veterans

Abstract: Development of posttraumatic stress disorder in combatants proceeds via occurence of systemic maladaptive allostatic reactions. It is accompanied by disorders at the somatic and mental levels, based on recurrent experiences of past psychotraumatic events, with unexplained anxiety, anger, guilt, cognitive disorders, psychosomatic astheno-vegetative manifestations. Our objective was to study neurotransmitter metabolism and proinflammatory cytokines in posttraumatic stress disorder in veterans of modern wars. The study included 45 veterans of a special military operation in Ukraine with a confirmed diagnosis of PTSD. The comparison group consisted of 25 veterans of 2nd Chechen military campaign. The control group included 20 healthy servicemen who did not take part in hostilities. The levels of neurotransmitter metabolic components in blood were determined using test systems from Cloud-Clone Corp. (China); kynurenine levels (ngmL) were measured by test systems from Immunodiagnostic AG (Germany). IL-1β concentration (pgmL) was assayed with Luminex Magpix 100 immunoanalyzer (USA). Data comparison was performed using SPSS program. In PTSD group, the concentration of blood serotonin, tryptophan and kynurenine was significantly decreased in veterans of Special Military Operation (SMO), along with increase in serotonin transporter and IL-1β levels. Among veterans of the 2nd Chechen campaign, a decrease in serotonin and an increase in serotonin transporter were noted if compared with reference group, along with clinical manifestations of maladaptation which manifested with asthenovegetative and somatoform disorders. Discussion: serotonin deficiency is a key factor in development of anxiety, depression, affective disorders in combatants with PTSD. Serotonin concentration in stress-induced disorders decreases due to tryptophan deficiency and its inactivation by the transporter in synaptic space. Activation of meta-inflammatory CNS reactions leads to decreased kynurenine level, induction of neurotoxic reactions due to factors causing apoptosis of astroglia, neurons and oxidative cellular stress. Development of stress-induced pathology in veterans of modern wars is accompanied by changing contents of neurotransmitter metabolic products which occur in presence of a proinflammatory blood profile.