Sinéad O'Brien

Increased tumor necrosis factor-alpha concentrations with interleukin-4 concentrations in exacerbations of schizophrenia.

Several studies have indicated that cytokines may be involved in the pathophysiology of schizophrenia. Previous studies, however, have yielded contradictory results; in this study we assess the plasma levels of both T-helper-1 (Th1) and T-helper-2 (Th2) cytokines in patients with acute exacerbations of schizophrenia. Plasma concentrations of interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha) and soluble receptor of interleukin-6 (sIL-6R) were measured with high sensitivity, enzyme-linked immunosorbent assays (ELISA) in patients with acute exacerbations of schizophrenia as compared with healthy controls. Patients with an acute exacerbation of schizophrenia had significantly increased production of TNF-alpha and significantly reduced production of IL-4 as compared with healthy subjects. No significant difference was observed in IL-6, sIL-6R, IL-8 and IL-10. Acute exacerbations of schizophrenia are associated with increased TNF-alpha concentrations (Th1) with concomitantly reduced concentrations of IL-4 (Th2) and a resulting increased TNF-alpha/IL-4 ratio.

Cutaneous glucocorticoid receptor sensitivity and pro-inflammatory cytokine levels in antidepressant-resistant depression

BACKGROUND There is evidence to indicate that peripheral glucocorticoid receptor (GR) function is reduced in major depression, and a possible molecular explanation for this is the impact of raised pro-inflammatory cytokines. The topical steroid vasoconstriction assay provides a convenient probe of peripheral GR function. The present study sought to assess the sensitivity of peripheral GRs in antidepressant-resistant major depressives and investigate the association between GR sensitivity and circulating plasma cytokines. METHOD Nineteen antidepressant-resistant depressives together with age- and sex-matched healthy controls underwent the steroid vasoconstriction assay using three commercial preparations of corticosteroids containing clobetasol propionate 0.05%, betamethasone valerate 0.1%, and clobetasone butyrate 0.05%, corresponding to very potent, potent, and moderately potent steroid creams respectively. The pro-inflammatory cytokines, tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured using enzyme-linked immunosorbent assays. The severity of the depressive episode was assessed using the Hamilton Depression Scale (HAMD). RESULTS Depressed subjects had a significantly reduced vasoconstriction response across all three strengths of steroid. They also had significantly higher concentrations of TNF-alpha and IL-6. There was a significant inverse correlation between TNF-alpha concentration and vasoconstriction response and also between the HAMD score and vasoconstriction response. CONCLUSIONS These findings suggest that cutaneous GR function is abnormal in antidepressant-resistant depression, that circulating TNF-alpha may play a significant role in this abnormality and that the efficacy of topical steroids in antidepressant-resistant depressives is reduced.

Further neuroendocrine evidence of enhanced vasopressin V3 receptor responses in melancholic depression.

BACKGROUND In situations of chronic stress vasopressin plays an important role in regulating the hypothalamic-pituitary adrenal axis. The aim of the current study was to investigate the role of anterior pituitary vasopressin V3 receptors in maintaining the hypercortisolism seen in melancholic depression. METHOD Fourteen patients with major depression and 14 age- and sex-matched healthy comparison subjects were recruited. Desmopressin (ddAVP) 10 microg was given intravenously and ACTH and cortisol release was monitored for 120 min. RESULTS The mean +/- S.E.M. ACTH response in the depressives was 28.4 +/- 4.3 ng/l and in the healthy subjects was 18.8 +/- 4.9 ng/l (P = 0.04). The mean +/- S.E.M. cortisol response in the depressives was 261.8 +/- 46.5 nmol/l and in the healthy subjects was 107.3 +/- 26.1 nmol/l (P < 0.01). CONCLUSIONS Patients with major depression have augmented ACTH and cortisol responses to desmopressin indicating enhanced V3 responsivity.

The Irish national stroke awareness campaign: a stroke of success?

INTRODUCTION Mass media campaigns are widely used to expose large populations to health-risk behaviour messages through routine uses of media. The Act F.A.S.T stroke campaign, which highlights the symptoms of stroke, has been endorsed globally. The aim of this study was to identify the influence of the campaign on the general public in Ireland. METHODS Descriptive pre and post comparative study design was conducted. Phase one was conducted in April 2010 prior to the campaign. Data were collected on a cross-section of the public (n=1925) to obtain baseline information on stroke warning signs. Phase two involved collecting data from participants (n=688) 18 months after the campaign launch. RESULTS The majority of participants from both phases were between 30 and 50 years of age. Results from phase two reported that 93% heard or saw the campaign yet only 37% could recall the campaign name or the slogan. Post the campaign over 80% recognized the warning signs of stroke. The increase in symptom recognition is evident from pre campaign to post campaign with an increase in knowledge across all the stroke symptoms. Post the campaign there was an increase of 54% of who stated that they would go straight to hospital for stroke symptoms. CONCLUSION Findings suggest the campaign was well executed given the high percentage of participants recall and the increase in the recognition of stroke symptoms. However, the influence of the campaign in changing behaviour was not as evident. Further research is needed to examine factors that influence behaviour when a stroke strikes.