Immunological correlates of suicidality among adolescents with internalizing symptoms

Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has...

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Published in:Brain, behavior, & immunity. Health Vol. 41; p. 100866
Main Authors: Roske, Chloe, Nguyen, Tram N.B., Schwartz, Joshua J., Erulker, Ava, Nie, Kai, Xie, Hui, Kim-Schulze, Seunghee, Ely, Benjamin A., Tobe, Russell H., Mowrey, Wenzhu, Gabbay, Vilma
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Published: United States Elsevier Inc 01-11-2024
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Abstract Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has implicated inflammation in depression, we sought to investigate relationships between suicidality and immune markers in youth experiencing diverse mood and anxiety symptoms. We hypothesized that adolescents with suicidality would exhibit a unique immune signature. Adolescents underwent semi-structured interviews and completed self-reported measures to assess psychopathology, including suicidality (suicidal ideation, plans, or attempts). Fasting blood samples were collected, cultured with and without lipopolysaccharide (LPS) to stimulate an inflammatory response, and analyzed for 41 immune analytes. To assess how immune function related to suicidality categorically and dimensionally, we conducted group comparisons and correlations while controlling for multiple comparisons using false discovery rate (FDR). To further uncover subtle immune-suicidality relationships, we employed a data-driven approach using factor analysis to extract major immune factors, each of which was subsequently correlated with suicidality measures. Among 126 participants, 29 were healthy controls and 97 participants had internalizing symptoms; within the clinical group, 57 experienced suicidality. Three immune analytes differed between healthy controls, suicidal, and non-suicidal adolescents with internalizing symptoms in the LPS condition: Flt-3L (pFDR = 0.0246), GM-CSF (pFDR = 0.0246), and IFN-γ (pFDR = 0.0246). These analytes were negatively correlated with the Beck Scale for Suicide Ideation (BSSI): Flt-3L (ρ = −0.19, p = 0.04); GM-CSF (ρ = −0.26, p = 0.004); IFN-γ (ρ =−0.33, p = 0.0003). GM-CSF also negatively correlated with number of suicide attempts (ρ = −0.39, p = 0.003). Factor analysis reduced 41 analytes to several common immune factors across experimental conditions, with Flt-3L, GM-CSF, and IFN-γ all loading heavily onto immune factors that were hypoactive in suicidality. Through this data-driven approach, we detected further associations between suicidality and immune factors across all conditions. Peripheral immune function may be distinctly altered in adolescent suicidality. Future work should examine immune-suicidality relationships longitudinally. •Peripheral immune function may be distinctly altered in adolescent suicidality.•Suppressed cytokines (incl. Flt-3L, GM-CSF, and IFN-γ) after an inflammatory stressor may reflect a pro-suicidal immune state.•Factor analysis showed Flt-3L, GM-CSF, and IFN-γ loading heavily onto immune factors that were hypoactive in suicidality.•Data-driven approach with factor analysis revealed subtle associations between suicidality and immune dysfunction.
AbstractList Background: Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has implicated inflammation in depression, we sought to investigate relationships between suicidality and immune markers in youth experiencing diverse mood and anxiety symptoms. We hypothesized that adolescents with suicidality would exhibit a unique immune signature. Methods: Adolescents underwent semi-structured interviews and completed self-reported measures to assess psychopathology, including suicidality (suicidal ideation, plans, or attempts). Fasting blood samples were collected, cultured with and without lipopolysaccharide (LPS) to stimulate an inflammatory response, and analyzed for 41 immune analytes. To assess how immune function related to suicidality categorically and dimensionally, we conducted group comparisons and correlations while controlling for multiple comparisons using false discovery rate (FDR). To further uncover subtle immune-suicidality relationships, we employed a data-driven approach using factor analysis to extract major immune factors, each of which was subsequently correlated with suicidality measures. Results: Among 126 participants, 29 were healthy controls and 97 participants had internalizing symptoms; within the clinical group, 57 experienced suicidality. Three immune analytes differed between healthy controls, suicidal, and non-suicidal adolescents with internalizing symptoms in the LPS condition: Flt-3L (pFDR = 0.0246), GM-CSF (pFDR = 0.0246), and IFN-γ (pFDR = 0.0246). These analytes were negatively correlated with the Beck Scale for Suicide Ideation (BSSI): Flt-3L (ρ = −0.19, p = 0.04); GM-CSF (ρ = −0.26, p = 0.004); IFN-γ (ρ =−0.33, p = 0.0003). GM-CSF also negatively correlated with number of suicide attempts (ρ = −0.39, p = 0.003). Factor analysis reduced 41 analytes to several common immune factors across experimental conditions, with Flt-3L, GM-CSF, and IFN-γ all loading heavily onto immune factors that were hypoactive in suicidality. Through this data-driven approach, we detected further associations between suicidality and immune factors across all conditions. Conclusions: Peripheral immune function may be distinctly altered in adolescent suicidality. Future work should examine immune-suicidality relationships longitudinally.
Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has implicated inflammation in depression, we sought to investigate relationships between suicidality and immune markers in youth experiencing diverse mood and anxiety symptoms. We hypothesized that adolescents with suicidality would exhibit a unique immune signature. Adolescents underwent semi-structured interviews and completed self-reported measures to assess psychopathology, including suicidality (suicidal ideation, plans, or attempts). Fasting blood samples were collected, cultured with and without lipopolysaccharide (LPS) to stimulate an inflammatory response, and analyzed for 41 immune analytes. To assess how immune function related to suicidality categorically and dimensionally, we conducted group comparisons and correlations while controlling for multiple comparisons using false discovery rate (FDR). To further uncover subtle immune-suicidality relationships, we employed a data-driven approach using factor analysis to extract major immune factors, each of which was subsequently correlated with suicidality measures. Among 126 participants, 29 were healthy controls and 97 participants had internalizing symptoms; within the clinical group, 57 experienced suicidality. Three immune analytes differed between healthy controls, suicidal, and non-suicidal adolescents with internalizing symptoms in the LPS condition: Flt-3L ( = 0.0246), GM-CSF ( = 0.0246), and IFN-γ ( = 0.0246). These analytes were negatively correlated with the Beck Scale for Suicide Ideation (BSSI): Flt-3L (ρ = -0.19,  = 0.04); GM-CSF ( 0.26,  = 0.004); IFN-γ ( 0.33,  = 0.0003). GM-CSF also negatively correlated with number of suicide attempts (ρ = -0.39,  = 0.003). Factor analysis reduced 41 analytes to several common immune factors across experimental conditions, with Flt-3L, GM-CSF, and IFN-γ all loading heavily onto immune factors that were hypoactive in suicidality. Through this data-driven approach, we detected further associations between suicidality and immune factors across all conditions. Peripheral immune function may be distinctly altered in adolescent suicidality. Future work should examine immune-suicidality relationships longitudinally.
• Peripheral immune function may be distinctly altered in adolescent suicidality. • Suppressed cytokines (incl. Flt-3L, GM-CSF, and IFN-γ) after an inflammatory stressor may reflect a pro-suicidal immune state. • Factor analysis showed Flt-3L, GM-CSF, and IFN-γ loading heavily onto immune factors that were hypoactive in suicidality. • Data-driven approach with factor analysis revealed subtle associations between suicidality and immune dysfunction.
Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has implicated inflammation in depression, we sought to investigate relationships between suicidality and immune markers in youth experiencing diverse mood and anxiety symptoms. We hypothesized that adolescents with suicidality would exhibit a unique immune signature. Adolescents underwent semi-structured interviews and completed self-reported measures to assess psychopathology, including suicidality (suicidal ideation, plans, or attempts). Fasting blood samples were collected, cultured with and without lipopolysaccharide (LPS) to stimulate an inflammatory response, and analyzed for 41 immune analytes. To assess how immune function related to suicidality categorically and dimensionally, we conducted group comparisons and correlations while controlling for multiple comparisons using false discovery rate (FDR). To further uncover subtle immune-suicidality relationships, we employed a data-driven approach using factor analysis to extract major immune factors, each of which was subsequently correlated with suicidality measures. Among 126 participants, 29 were healthy controls and 97 participants had internalizing symptoms; within the clinical group, 57 experienced suicidality. Three immune analytes differed between healthy controls, suicidal, and non-suicidal adolescents with internalizing symptoms in the LPS condition: Flt-3L (pFDR = 0.0246), GM-CSF (pFDR = 0.0246), and IFN-γ (pFDR = 0.0246). These analytes were negatively correlated with the Beck Scale for Suicide Ideation (BSSI): Flt-3L (ρ = −0.19, p = 0.04); GM-CSF (ρ = −0.26, p = 0.004); IFN-γ (ρ =−0.33, p = 0.0003). GM-CSF also negatively correlated with number of suicide attempts (ρ = −0.39, p = 0.003). Factor analysis reduced 41 analytes to several common immune factors across experimental conditions, with Flt-3L, GM-CSF, and IFN-γ all loading heavily onto immune factors that were hypoactive in suicidality. Through this data-driven approach, we detected further associations between suicidality and immune factors across all conditions. Peripheral immune function may be distinctly altered in adolescent suicidality. Future work should examine immune-suicidality relationships longitudinally. •Peripheral immune function may be distinctly altered in adolescent suicidality.•Suppressed cytokines (incl. Flt-3L, GM-CSF, and IFN-γ) after an inflammatory stressor may reflect a pro-suicidal immune state.•Factor analysis showed Flt-3L, GM-CSF, and IFN-γ loading heavily onto immune factors that were hypoactive in suicidality.•Data-driven approach with factor analysis revealed subtle associations between suicidality and immune dysfunction.
Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has implicated inflammation in depression, we sought to investigate relationships between suicidality and immune markers in youth experiencing diverse mood and anxiety symptoms. We hypothesized that adolescents with suicidality would exhibit a unique immune signature.BackgroundSuicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has implicated inflammation in depression, we sought to investigate relationships between suicidality and immune markers in youth experiencing diverse mood and anxiety symptoms. We hypothesized that adolescents with suicidality would exhibit a unique immune signature.Adolescents underwent semi-structured interviews and completed self-reported measures to assess psychopathology, including suicidality (suicidal ideation, plans, or attempts). Fasting blood samples were collected, cultured with and without lipopolysaccharide (LPS) to stimulate an inflammatory response, and analyzed for 41 immune analytes. To assess how immune function related to suicidality categorically and dimensionally, we conducted group comparisons and correlations while controlling for multiple comparisons using false discovery rate (FDR). To further uncover subtle immune-suicidality relationships, we employed a data-driven approach using factor analysis to extract major immune factors, each of which was subsequently correlated with suicidality measures.MethodsAdolescents underwent semi-structured interviews and completed self-reported measures to assess psychopathology, including suicidality (suicidal ideation, plans, or attempts). Fasting blood samples were collected, cultured with and without lipopolysaccharide (LPS) to stimulate an inflammatory response, and analyzed for 41 immune analytes. To assess how immune function related to suicidality categorically and dimensionally, we conducted group comparisons and correlations while controlling for multiple comparisons using false discovery rate (FDR). To further uncover subtle immune-suicidality relationships, we employed a data-driven approach using factor analysis to extract major immune factors, each of which was subsequently correlated with suicidality measures.Among 126 participants, 29 were healthy controls and 97 participants had internalizing symptoms; within the clinical group, 57 experienced suicidality. Three immune analytes differed between healthy controls, suicidal, and non-suicidal adolescents with internalizing symptoms in the LPS condition: Flt-3L (p FDR = 0.0246), GM-CSF (p FDR = 0.0246), and IFN-γ (p FDR = 0.0246). These analytes were negatively correlated with the Beck Scale for Suicide Ideation (BSSI): Flt-3L (ρ = -0.19, p = 0.04); GM-CSF (ρ = -0.26, p = 0.004); IFN-γ (ρ =-0.33, p = 0.0003). GM-CSF also negatively correlated with number of suicide attempts (ρ = -0.39, p = 0.003). Factor analysis reduced 41 analytes to several common immune factors across experimental conditions, with Flt-3L, GM-CSF, and IFN-γ all loading heavily onto immune factors that were hypoactive in suicidality. Through this data-driven approach, we detected further associations between suicidality and immune factors across all conditions.ResultsAmong 126 participants, 29 were healthy controls and 97 participants had internalizing symptoms; within the clinical group, 57 experienced suicidality. Three immune analytes differed between healthy controls, suicidal, and non-suicidal adolescents with internalizing symptoms in the LPS condition: Flt-3L (p FDR = 0.0246), GM-CSF (p FDR = 0.0246), and IFN-γ (p FDR = 0.0246). These analytes were negatively correlated with the Beck Scale for Suicide Ideation (BSSI): Flt-3L (ρ = -0.19, p = 0.04); GM-CSF (ρ = -0.26, p = 0.004); IFN-γ (ρ =-0.33, p = 0.0003). GM-CSF also negatively correlated with number of suicide attempts (ρ = -0.39, p = 0.003). Factor analysis reduced 41 analytes to several common immune factors across experimental conditions, with Flt-3L, GM-CSF, and IFN-γ all loading heavily onto immune factors that were hypoactive in suicidality. Through this data-driven approach, we detected further associations between suicidality and immune factors across all conditions.Peripheral immune function may be distinctly altered in adolescent suicidality. Future work should examine immune-suicidality relationships longitudinally.ConclusionsPeripheral immune function may be distinctly altered in adolescent suicidality. Future work should examine immune-suicidality relationships longitudinally.
ArticleNumber 100866
Author Gabbay, Vilma
Tobe, Russell H.
Roske, Chloe
Schwartz, Joshua J.
Nguyen, Tram N.B.
Nie, Kai
Mowrey, Wenzhu
Erulker, Ava
Kim-Schulze, Seunghee
Ely, Benjamin A.
Xie, Hui
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  givenname: Tram N.B.
  surname: Nguyen
  fullname: Nguyen, Tram N.B.
  organization: Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
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  givenname: Joshua J.
  surname: Schwartz
  fullname: Schwartz, Joshua J.
  organization: Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
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  givenname: Ava
  surname: Erulker
  fullname: Erulker, Ava
  organization: Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
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  givenname: Kai
  surname: Nie
  fullname: Nie, Kai
  organization: Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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  givenname: Seunghee
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  givenname: Benjamin A.
  surname: Ely
  fullname: Ely, Benjamin A.
  organization: Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
– sequence: 9
  givenname: Russell H.
  surname: Tobe
  fullname: Tobe, Russell H.
  organization: Department of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
– sequence: 10
  givenname: Wenzhu
  surname: Mowrey
  fullname: Mowrey, Wenzhu
  organization: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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  givenname: Vilma
  orcidid: 0000-0001-8819-5137
  surname: Gabbay
  fullname: Gabbay, Vilma
  email: vxg595@med.miami.edu
  organization: Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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Keywords BSSI
Adolescence
Cytokines
Suicide
Chemokines
Hematopoietic growth factors
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Snippet Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide...
• Peripheral immune function may be distinctly altered in adolescent suicidality. • Suppressed cytokines (incl. Flt-3L, GM-CSF, and IFN-γ) after an...
Background: Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past...
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StartPage 100866
SubjectTerms Adolescence
BSSI
Chemokines
Cytokines
Full Length
Hematopoietic growth factors
Suicide
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Title Immunological correlates of suicidality among adolescents with internalizing symptoms
URI https://dx.doi.org/10.1016/j.bbih.2024.100866
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