북한이탈주민의 외상 후 스트레스 장애와 자연살해세포 활성
Natural Killer Cell Activity in North Korean Defectors with PTSD
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Objectives：The objective of this study was to evaluate an association between posttraumatic stress disorder (PTSD) and altered immunity in North Korean defectors who were more likely to develop medical conditions and other stress-related psychiatric disorders. Methods：Twenty-four North Korean defectors with PTSD and twenty-two controls without PTSD were recruited from the resettlement and training center for North Korean defectors in South Korea. Peripheral T lymphocyte subsets, natural killer (NK) cells, NK cell activity and plasma hormones (ACTH and cortisol) were obtained from all subjects. We also applied the Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) for all subjects. Results：We found NK cell activity was relatively lower than number of NK cells in North Korean defectors with PTSD. Subjects with PTSD had higher HAM-D and HAM-A scores than controls. However, there were no statistical differences in ACTH, cortisol, CD3, CD4, CD8, CD4/CD8 ratio, CD19 and CD56 between the two groups. Conclusion：These findings suggest North Korean defectors with PTSD show higher levels of depression, anxiety and impaired or weak immune function in NK cells. (J Korean Neuropsychiatr Assoc 2008;47(5):481-487)
Abstract
Objectives：The objective of this study was to evaluate an association between posttraumatic stress disorder (PTSD) and altered immunity in North Korean defectors who were more likely to develop medical conditions and other stress-related psychiatric disorders. Methods：Twenty-four North Korean defectors with PTSD and twenty-two controls without PTSD were recruited from the resettlement and training center for North Korean defectors in South Korea. Peripheral T lymphocyte subsets, natural killer (NK) cells, NK cell activity and plasma hormones (ACTH and cortisol) were obtained from all subjects. We also applied the Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) for all subjects. Results：We found NK cell activity was relatively lower than number of NK cells in North Korean defectors with PTSD. Subjects with PTSD had higher HAM-D and HAM-A scores than controls. However, there were no statistical differences in ACTH, cortisol, CD3, CD4, CD8, CD4/CD8 ratio, CD19 and CD56 between the two groups. Conclusion：These findings suggest North Korean defectors with PTSD show higher levels of depression, anxiety and impaired or weak immune function in NK cells. (J Korean Neuropsychiatr Assoc 2008;47(5):481-487)
참고문헌 (37)
- Lee YW, "Traumatic experience of North Korean refugees in China", Am J Pre Med, 20, pp.225~229 (2001)
- Hong CH, "Relationship between traumatic events and posttraumatic stress disorder among North Korean refugees", J Korean Neuropsychiatr Assoc, 44, pp.714~720 (2005)
- McEwen BS, "The neurobiology and neuroendocrinology of stress. Implication for post traumatic stress disorder from a basic science perspective", Pyschiatr Clin North Am, 25, pp.469~494 (2002)
- Herbert TB, "Depression and immunity: a meta-analytic review", Psychol Bull, 113, pp.472~486 (1993)
- Mosnaim AD, "In vitro studies of natural killer cell activity in post traumatic stress disorder patients. Response to methionine-enkephalin challenge", Immunopharmacology, 25, pp.107~116 (1993)
- Laudenslager ML, "Elevated cytotoxicity in combat veterans with longterm post-traumatic stress disorder: preliminary observations", Brain Behav Immun, 12, pp.74~79 (1998)
- Boscarino JA, "Higher abnormal leukocyte and lymphocyte counts 20 years after exposure to severe stress: research and clinical implication", Psychosom Med, 61, pp.378~386 (1999)
- Wilson SN, "Phenotype of blood lymphocytes in PTSD suggests chronic immune activation", Psychosomatics, 40, pp.222~225 (1999)
- Glover DA, "Preliminary evidence for lymphocyte distribution differences at rest and after acute psychological stress in PTSD-symptomatic women", Brain Behav Immun, 19, pp.243~251 (2005)
- Sabioncello A, "Immune, endocrine, and psychological responses in civilians displaced by war", Psychosom Med, 62, pp.502~508 (2000)
- Wong CM, "Post-traumatic stress disorder: advances in psychoneuroimmunology", Psychiatr Clin North Am, 25, pp.369~383 (2002)
- Blalock JE, "A molecular basis for bidirectional communication between the immune and neuroendocrine systems", Physiol Rev, 69, pp.1~32 (1989)
- Kiecolt-Glaser JK, "Psychoneuroimmunology and health consequences: data and shared mechanisms", Psychosom Med, 57, pp.269~274 (1995)
- Herberman RB, "Natural killer cells: their roles in defenses against disease", Science, 214, pp.24~30 (1981)
- Delahanty DL, "Time course of natural killer cell activity and lymphocyte proliferation in response to two acute stressors in healthy men", Health Psychol, 15, pp.48~55 (1996)
- Park EJ, "Natural killer T cells in acute and unmedicated patients with major depressive disorder", J Korean Neuropsychiatr Assoc, 45, pp.208~213 (2006)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders: DSM-IV. 4th ed" (2000), American Psychiatric Association
- Hahn OS, "Development of Korean version of structured clinical interview schedule for DSM-IV axis I disorder: Interrater reliability", J Korean Neuropsychiatr Assoc, 39, pp.362~372 (2000)
- Hamilton M, "The assessment of anxiety states by rating", Br J Med Pyschol, 32, pp.50~55 (1959)
- Hamilton M, "Development of a rating scale for primary depressive illness", Br J Soc Clin Psychol, 6, pp.278~296 (1967)
- Irwin M, "Impaired natural killer cell activity during bereavement", Brain Behav Immun, 1, pp.98~104 (1987)
- Kiecolt-Glaser JK, "Psychological influence on immunity", Psychosomatics, 27, pp.621~624 (1986)
- Delahanty DL, "Chronic stress and natural killer cell activity after exposure to traumatic death", Psychosom Med, 59, pp.467~476 (1997)
- Dekaris D, "Multiple changes of immunologic parameters in prisoners of war", JAMA, 270, pp.595~599 (1993)
- Kawamura N, "Suppression of cellular immunity in men with a past history of posttraumatic stress disorder", Am J Psychiatry, 158, pp.484~486 (2001)
- Dhabhar FS, "Effects of stress on immune cell distribution. Dynamics and hormonal mechanism", J Immunol, 154, pp.5511~5527 (1995)
- Vidović A, "Circulating lymphocyte subsets, natural killer cell cytotoxicity, and components of hypothalamic-pituitary-adrenal axis in Croatian war veterans with posttraumatic stress disorder. cross-sectional study", Croat Med J, 48, pp.198~206 (2007)
- Miller AH, "Neuroendocirne and immune system interactions in stress and depression", Psychiatr Clin North Am, 21, pp.443~463 (1998)
- Heim C, "The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders", Psychoneuroendocrinology, 25, pp.1~35 (2000)
- Hockings GI, "Hypersensitivity of the hypothalamic-pituitary-adrenal axis to naloxone in posttraumatic stress disorder", Biol Psychiatry, 33, pp.585~593 (1993)
- Kanter ED, "Glucocorticoid feedback sensitivity and adrenocortical resposnsiveness in posttraumatic stress disorder", Biol Psychiatry, 50, pp.238~245 (2001)
- Pitman RK, "Twenty-four hour urinary cortisol and cathecholamine excretion in combat-related post-traumatic stress disorder", Biol Psychiatry, 27, pp.245~247+ (1990)
- Wheler GH, "Cortisol production rate in posttraumatic stress disorder", J Clin Endocrinol Metab, 91, pp.3486~3489 (2006)
- McEwen BS, "The concept of allostasis in biology and biomedicine", Horm Behav, 43, pp.2~15 (2003)
- Davidson JET, "The epidemiology of posttraumatic stress disorder, in Posttraumatic Stress Disorder: DSM-IV and Beyond", pp.147~169 (1993), American Psychiatric Press
- Brady KT, "Comorbidity of psychiatric disorders and posttraumatic stress disorder", J Clin Psychiatry, 61, pp.22~32 (2000)
- Skarpa I, "Changes of cytolytic cells and perforin expression in patients with posttraumatic stress disorder", Croat Med J, 42, pp.551~555 (2001)