Immune Profile in the Immediate Aftermath of MVC and its Prediction of APNS
Barton CE, Mauck MC, Linnstaedt SD, Kurz MC, Hendry PL, Pearson C, O'Neil BJ, Lewandowski C, Datner E, Liberzon I, Domeier RM, and McLean SA. Immune Profile in the Immediate Aftermath of MVC and its Prediction of APNS. Biological Psychiatry 2020; 87(9):S296.
Background: African Americans (AAs) experience an increased burden of motor vehicle collision (MVC) and rates of adverse posttraumatic neuropsychiatric sequelae (APNS) after MVC, versus non-Hispanic whites. Accumulating evidence suggests that immune cells play an important role in APNS development. Methods: AAs presenting to the Emergency Department (ED) within 24 hours of MVC were enrolled. ED assessment included measurement of pain symptoms (0-10 scale), severity of life threat (0-10 scale) and blood RNA sample (PAXgene) collection. Post-traumatic depressive (CES-D), stress (IES-R), and pain symptoms were assessed at six weeks, six months, and one year. Repeated measures linear regression analyses were performed evaluating whether circulating peritraumatic immune cell subtypes (i.e., neutrophils, monocytes, B-cells, CD4+ T-cells, estimated via application of CIBERSORT method to ED blood sample total RNA sequencing data) predicted APNS outcomes. False discovery rate threshold was set at 5%. Results: After adjustment for sociodemographic characteristics and perceived life threat within this study sample (n=183), the peritraumatic CD4+ T immune cell proportion predicted depressive (β = 19.5, p = 0.031), stress (β = 51.7, p = 0.008), and pain (β = 6.3, p = 0.002) symptom severity, and peritraumatic neutrophil proportion predicted pain (β = -2.9, p = 0.047). Conclusions: Among AAs experiencing MVC, an increased proportion of peritraumatic CD4+ T immune cells predicted more severe depressive, stress, and pain symptoms over time. Studies examining associations between peritraumatic immune phenotypes and APNS may provide pathogenic insights.