The acute phase response in panic disorder

Area of Science:

• Neuroscience
• Psychiatry
• Immunology

Background:

• Major depression is linked to an acute-phase response (APR), characterized by elevated acute-phase proteins.
• Panic disorder (PD) may share etiological pathways with depression, but APR has not been investigated in PD.
• Understanding APR in PD could reveal shared pathophysiological mechanisms between these conditions.

Purpose of the Study:

• To investigate the presence of an acute-phase response (APR) in patients with panic disorder (PD).
• To compare levels of specific acute-phase proteins (APPs) and cortisol in PD patients versus healthy controls.
• To assess the impact of selective serotonin reuptake inhibitor (SSRI) treatment on APR markers in PD.

Main Methods:

• Compared 41 early-stage PD patients with 32 healthy controls, matched for sex, age, and BMI.
• Assessed clinical diagnosis using the Mini International Neuropsychiatric Interview and severity with PDSS and CGI scales.
• Measured serum albumin, gammaglobulins, fibrinogen, C-reactive protein (CRP), and basal cortisol levels at baseline and after 8-week SSRI treatment.

Main Results:

• PD patients exhibited lower gammaglobulin levels and higher cortisol and C-reactive protein (CRP) levels compared to controls.
• No significant differences in acute-phase proteins (APPs) were observed between PD patients with or without agoraphobia.
• Responders to SSRI treatment showed decreased albumin levels and a trend toward reduced cortisol and CRP post-treatment.

Conclusions:

• This study demonstrates an acute-phase response (APR) in patients with panic disorder (PD).
• The observed APR in PD tends to diminish following successful treatment with SSRIs.
• Findings suggest a potential role for inflammatory processes in PD pathophysiology and treatment response.