RESUMO
Posttraumatic Stress Disorder (PTSD) is an anxiety disorder which occurs after a traumatic event. The NR3C1 gene codes for the Glucocorticoid Receptor, which participate in the Hypothalamic-Pituitary-Adrenal (HPA) axis and is altered in PTSD patients. To evaluate whether the NR3C1 gene expression in peripheral blood could be useful as a diagnosis biomarker, a total of 32 PTSD patients and 59 healthy controls were analyzed with quantitative RT-PCR. Also, to assess if NR3C1 dysregulation is associated with hypocortisolism in PTSD patients, serum cortisol was quantified by ELISA in a subset of these samples. Significant NR3C1 over-expression was found in PTSD patients compared with controls, and this was higher in patients with acute PTSD. The Area Under the Curve (AUC) of NR3C1 gene expression was 0.797. The sensibility and specificity of NRC1 gene expression to diagnose PTSD was 62.5% and 89.8%, respectively. We also found that an up-regulation of NR3C1 increased the risk for being diagnosed with PTSD (OR= 12.8, 95%, CI 4-41.4). Finally, the NR3C1 gene expression was inversely related with serum cortisol in PTSD patients. The present results suggest that NR3C1 gene expression could be a promising biomarker for PTSD diagnosis and estimate the risk for disease development.
Assuntos
Marcadores Genéticos/genética , Receptores de Glucocorticoides/genética , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/genética , Adulto , Feminino , Expressão Gênica , Humanos , Hidrocortisona/genética , Sistema Hipotálamo-Hipofisário/fisiologia , Masculino , México/epidemiologia , Sistema Hipófise-Suprarrenal/fisiologia , Receptores de Glucocorticoides/biossíntese , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Regulação para Cima/fisiologiaRESUMO
OBJECTIVES: To identify blood lead predictors and the prevalence of neuropsychiatric symptoms in firearm users of public security in Mexico. MATERIAL AND METHODS: A cross-sectional study was performed on 65 males. We obtained socio-occupational data and determined venous blood lead (blood (B), lead (Pb) - BPb), as well as neuropsychiatric symptoms using the Q-16 questionnaire. A multiple linear regression model was constructed to assess determinants of BPb. RESULTS: The mean age in the study group was 34.8 years (standard deviation (SD) = 6.9, range: 21-60); the mean number of years spent in the company amounted to 14 years (SD = 8.5, range: 1-48). Twenty percent of the respondents (N = 13) used leaded glazed clay pottery (lead (Pb), glazed (G), and clay pottery (C) - PbGC) in the kitchen. During practice they fired a mean of 72 shots (SD = 60, range: 20-250), and during their whole duration of employment 5483 shots (SD = 8322.5, range: 200-50 000). The mean BPb was 7.6 µg/dl (SD = 6.8, range: 2.7-51.7). Two caretakers from the firing range had 29.6 µg/dl and 51.7 µg/dl BPb. The subjects who had shooting practice sessions ≥ 12 times a year reported a greater percentage of miscarriages in their partners (24% vs. 0%). Twelve percent of the respondents showed an increase in neuropsychiatric symptoms. The BPb multiple linear regression model explained R2 = 44.15%, as follows: those who had ≥ 12 practice sessions per year - ß = 0.5339 and those who used PbGC - ß = 0.3651. CONCLUSIONS: Using firearms and PbGC contributes to the increased BPb in the studied personnel. The determinants of BPb were: shooting practices >12 times a year and using PbGC. Blood lead concentrations reported in the study, despite being low, are a health risk, as evidenced by the prevalence of neuropsychiatric symptoms.