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The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D)

Identifieur interne : 000B63 ( Ncbi/Merge ); précédent : 000B62; suivant : 000B64

The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D)

Auteurs : C L Raison [États-Unis] ; A H Miller [États-Unis]

Source :

RBID : PMC:3532038

Abstract

Given the manifold ways that depression impairs Darwinian fitness, the persistence in the human genome of risk alleles for the disorder remains a much debated mystery. Evolutionary theories that view depressive symptoms as adaptive fail to provide parsimonious explanations for why even mild depressive symptoms impair fitness-relevant social functioning, whereas theories that suggest that depression is maladaptive fail to account for the high prevalence of depression risk alleles in human populations. These limitations warrant novel explanations for the origin and persistence of depression risk alleles. Accordingly, studies on risk alleles for depression were identified using PubMed and Ovid MEDLINE to examine data supporting the hypothesis that risk alleles for depression originated and have been retained in the human genome because these alleles promote pathogen host defense, which includes an integrated suite of immunological and behavioral responses to infection. Depression risk alleles identified by both candidate gene and genome-wide association study (GWAS) methodologies were found to be regularly associated with immune responses to infection that were likely to enhance survival in the ancestral environment. Moreover, data support the role of specific depressive symptoms in pathogen host defense including hyperthermia, reduced bodily iron stores, conservation/withdrawal behavior, hypervigilance and anorexia. By shifting the adaptive context of depression risk alleles from relations with conspecifics to relations with the microbial world, the Pathogen Host Defense (PATHOS-D) hypothesis provides a novel explanation for how depression can be nonadaptive in the social realm, whereas its risk alleles are nonetheless represented at prevalence rates that bespeak an adaptive function.


Url:
DOI: 10.1038/mp.2012.2
PubMed: 22290120
PubMed Central: 3532038

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PMC:3532038

Le document en format XML

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<p>Given the manifold ways that depression impairs Darwinian fitness, the persistence in the human genome of risk alleles for the disorder remains a much debated mystery. Evolutionary theories that view depressive symptoms as adaptive fail to provide parsimonious explanations for why even mild depressive symptoms impair fitness-relevant social functioning, whereas theories that suggest that depression is maladaptive fail to account for the high prevalence of depression risk alleles in human populations. These limitations warrant novel explanations for the origin and persistence of depression risk alleles. Accordingly, studies on risk alleles for depression were identified using PubMed and Ovid MEDLINE to examine data supporting the hypothesis that risk alleles for depression originated and have been retained in the human genome because these alleles promote pathogen host defense, which includes an integrated suite of immunological and behavioral responses to infection. Depression risk alleles identified by both candidate gene and genome-wide association study (GWAS) methodologies were found to be regularly associated with immune responses to infection that were likely to enhance survival in the ancestral environment. Moreover, data support the role of specific depressive symptoms in pathogen host defense including hyperthermia, reduced bodily iron stores, conservation/withdrawal behavior, hypervigilance and anorexia. By shifting the adaptive context of depression risk alleles from relations with conspecifics to relations with the microbial world, the Pathogen Host Defense (PATHOS-D) hypothesis provides a novel explanation for how depression can be nonadaptive in the social realm, whereas its risk alleles are nonetheless represented at prevalence rates that bespeak an adaptive function.</p>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Mol Psychiatry</journal-id>
<journal-id journal-id-type="iso-abbrev">Mol. Psychiatry</journal-id>
<journal-title-group>
<journal-title>Molecular Psychiatry</journal-title>
</journal-title-group>
<issn pub-type="ppub">1359-4184</issn>
<issn pub-type="epub">1476-5578</issn>
<publisher>
<publisher-name>Nature Publishing Group</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">22290120</article-id>
<article-id pub-id-type="pmc">3532038</article-id>
<article-id pub-id-type="pii">mp20122</article-id>
<article-id pub-id-type="doi">10.1038/mp.2012.2</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Hypothesis</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D)</article-title>
<alt-title alt-title-type="running">Pathogen Host Defense and depression</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Raison</surname>
<given-names>C L</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff2">2</xref>
<xref ref-type="corresp" rid="caf1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Miller</surname>
<given-names>A H</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<aff id="aff1">
<label>1</label>
<institution>Department of Psychiatry, College of Medicine, University of Arizona</institution>
, Tucson, AZ,
<country>USA</country>
</aff>
<aff id="aff2">
<label>2</label>
<institution>John and Doris Norton School of Family and Consumer Sciences, University of Arizona</institution>
, Tucson, AZ,
<country>USA</country>
</aff>
<aff id="aff3">
<label>3</label>
<institution>Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine</institution>
, Atlanta, GA,
<country>USA</country>
</aff>
</contrib-group>
<author-notes>
<corresp id="caf1">
<label>*</label>
<institution>Department of Psychiatry, College of Medicine, University of Arizona</institution>
, 1501 North Campbell Avenue, PO Box 245002, Tucson, AZ 85724-5137,
<country>USA</country>
. E-mail:
<email>craison@medadmin.arizona.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>01</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub">
<day>31</day>
<month>01</month>
<year>2012</year>
</pub-date>
<volume>18</volume>
<issue>1</issue>
<fpage>15</fpage>
<lpage>37</lpage>
<history>
<date date-type="received">
<day>15</day>
<month>08</month>
<year>2011</year>
</date>
<date date-type="rev-recd">
<day>21</day>
<month>11</month>
<year>2011</year>
</date>
<date date-type="accepted">
<day>03</day>
<month>01</month>
<year>2012</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2013 Macmillan Publishers Limited</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>Macmillan Publishers Limited</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/">
<pmc-comment>author-paid</pmc-comment>
<license-p>This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/</license-p>
</license>
</permissions>
<abstract>
<p>Given the manifold ways that depression impairs Darwinian fitness, the persistence in the human genome of risk alleles for the disorder remains a much debated mystery. Evolutionary theories that view depressive symptoms as adaptive fail to provide parsimonious explanations for why even mild depressive symptoms impair fitness-relevant social functioning, whereas theories that suggest that depression is maladaptive fail to account for the high prevalence of depression risk alleles in human populations. These limitations warrant novel explanations for the origin and persistence of depression risk alleles. Accordingly, studies on risk alleles for depression were identified using PubMed and Ovid MEDLINE to examine data supporting the hypothesis that risk alleles for depression originated and have been retained in the human genome because these alleles promote pathogen host defense, which includes an integrated suite of immunological and behavioral responses to infection. Depression risk alleles identified by both candidate gene and genome-wide association study (GWAS) methodologies were found to be regularly associated with immune responses to infection that were likely to enhance survival in the ancestral environment. Moreover, data support the role of specific depressive symptoms in pathogen host defense including hyperthermia, reduced bodily iron stores, conservation/withdrawal behavior, hypervigilance and anorexia. By shifting the adaptive context of depression risk alleles from relations with conspecifics to relations with the microbial world, the Pathogen Host Defense (PATHOS-D) hypothesis provides a novel explanation for how depression can be nonadaptive in the social realm, whereas its risk alleles are nonetheless represented at prevalence rates that bespeak an adaptive function.</p>
</abstract>
<kwd-group>
<kwd>major depression</kwd>
<kwd>evolution</kwd>
<kwd>immune</kwd>
<kwd>inflammation</kwd>
<kwd>infection</kwd>
<kwd>genetic</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="fig1">
<label>Figure 1</label>
<caption>
<p>The integrated suite of immunological and behavioral responses to infection and wounding that comprise pathogen host defense. Upon encountering a pathogen or cellular debris from tissue damage or destruction, the body reacts with an orchestrated local and systemic response that recruits both immunological and nervous system elements. The response is initiated by interaction of pathogens and/or cellular debris with pattern recognition receptors such as Toll-like receptors on relevant immune cells including macrophages that in turn are linked to inflammatory signaling pathways such as nuclear factor-κB (NF-κB), a lynchpin transcription factor in the host defense cascade. Release of cytokines (including tumor necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6 and interferon-α (IFN-α)) and chemokines as well as the induction of adhesion molecules attracts and activates cells such as T cells at the site of infection/wounding, leading to the cardinal signs of inflammation (redness, heat, swelling and pain) and ultimately promoting local pathogen elimination and wound healing. Cytokines and cells in the peripheral circulation mediate the systemic host response that engages neurocircuits in the brain that mediate hypervigilance (dorsal anterior cingulate cortex (dACC)) to avoid further wounding and pathogen exposure and conservation/withdrawal (basal ganglia), which promotes the shunting of energy resources to pathogen elimination and wound healing.</p>
</caption>
<graphic xlink:href="mp20122f1"></graphic>
</fig>
<table-wrap id="tbl1">
<label>Table 1</label>
<caption>
<title>Pathogen Host Defense (PATHOS-D) theory of depression: foundational hypotheses</title>
</caption>
<table frame="hsides" rules="groups" border="1">
<colgroup>
<col align="left"></col>
</colgroup>
<tbody valign="top">
<tr>
<td align="left" valign="top" charoff="50">(1) Depression should be associated with increased inflammation and inflammatory activation should induce depression.</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">(2) Allelic variants that increase the risk for major depressive disorder (MDD) should enhance host defense mechanisms in general and innate immune inflammatory responses in particular.</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">(3) Environmental risk factors for MDD should be associated with increased risk of infection and attendant inflammatory activation.</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">(4) On the whole, patterns of increased immune activity associated with MDD should have decreased mortality from infection in ancestral environments.</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">(5) Depressive symptoms should enhance survival in the context of acute infection and in situations in which risk of infection from wounding is high.</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tbl2">
<label>Table 2</label>
<caption>
<title>Immune/host defense functions of single-nucleotide polymorphisms (SNPs) associated with major depression based on the largest meta-analysis of genome-wide association studies (GWASs) conducted to date for major depression (MDD)</title>
</caption>
<table frame="hsides" rules="groups" border="1">
<colgroup>
<col align="left"></col>
<col align="left"></col>
<col align="char" char="."></col>
<col align="left"></col>
</colgroup>
<thead valign="bottom">
<tr>
<th align="left" valign="top" charoff="50">
<italic>Gene ID</italic>
</th>
<th align="left" valign="top" charoff="50">
<italic>Gene name</italic>
</th>
<th align="center" valign="top" char="." charoff="50">
<italic>SNP with minimum</italic>
P
<italic>-value</italic>
</th>
<th align="left" valign="top" charoff="50">
<italic>Immune/host defense function of gene</italic>
</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left" valign="top" charoff="50">
<italic>SEL1L2</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Sel-1 suppressor of lin-12-like 2</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs17226852</td>
<td align="left" valign="top" charoff="50">No specific immune or host defense functions identified for
<italic>SEL1L2</italic>
. However, the other member of the sel1 gene family,
<italic>SEL1L</italic>
, has been shown to be important for quality control of IgM,
<sup>
<xref ref-type="bibr" rid="bib100">100</xref>
</sup>
and the infectious capacity of several viruses,
<sup>
<xref ref-type="bibr" rid="bib101">101</xref>
</sup>
including human cytomegalovirus,
<sup>
<xref ref-type="bibr" rid="bib102">102</xref>
</sup>
a microsatellite polymorphism of
<italic>SEL1L</italic>
, is associated with autoimmune thyroid diseases
<sup>
<xref ref-type="bibr" rid="bib103">103</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>ADCY3</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Adenylate cyclase 3</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs2384061</td>
<td align="left" valign="top" charoff="50">
<italic>ADCY3</italic>
is integral to a rapid, NF-κB-independent, signaling cascade initiated by microbial stimulation of TLR4.
<sup>
<xref ref-type="bibr" rid="bib104">104</xref>
</sup>
<italic>ADCY3</italic>
also regulates crosstalk between FP prostanoid and prostaglandin E2 receptors.
<sup>
<xref ref-type="bibr" rid="bib105">105</xref>
</sup>
This crosstalk regulates expression of
<italic>SAT1</italic>
gene, which has been reported to be underexpressed in prefrontal cortex of suicide completers.
<sup>
<xref ref-type="bibr" rid="bib106">106</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>UNC93A</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Unc-93 homolog A</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs2076008</td>
<td align="left" valign="top" charoff="50">No specific immune or host defense functions identified for
<italic>UNC93A</italic>
, but a closely related homolog, UNC93B, plays a crucial role in antigen presentation and TLR functioning, and deficiency in its expression reduces TNF-α production and increases vulnerability to a number of infections.
<sup>
<xref ref-type="bibr" rid="bib107">107</xref>
,
<xref ref-type="bibr" rid="bib108">108</xref>
,
<xref ref-type="bibr" rid="bib109">109</xref>
</sup>
Blockade of
<italic>UNC93B</italic>
may protect against autoimmunity.
<sup>
<xref ref-type="bibr" rid="bib110">110</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>TEX10</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Testis expressed 10</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs1930243</td>
<td align="left" valign="top" charoff="50">No specific immune or host defense functions identified.</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>TTLL2</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Tubulin tyrosine ligase-like family, member 2</italic>
</td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50">No specific immune or host defense functions identified for
<italic>TTLL2</italic>
; however, other TTLL family members have been shown to be essential for proper cilliary structure and function and with this ability to clear pathogens and other harmful substances from the airway.
<sup>
<xref ref-type="bibr" rid="bib111">111</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>GAL</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Galanin</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs2156464</td>
<td align="left" valign="top" charoff="50">Signaling through either type 1 or type 2 receptors,
<italic>GAL</italic>
has numerous anti-inflammatory effects;
<sup>
<xref ref-type="bibr" rid="bib112">112</xref>
,
<xref ref-type="bibr" rid="bib113">113</xref>
,
<xref ref-type="bibr" rid="bib114">114</xref>
,
<xref ref-type="bibr" rid="bib115">115</xref>
</sup>
Consistent with PATHOS-D, multiple lines of evidence indicate
<italic>GAL</italic>
signaling is reduced in MDD;
<sup>
<xref ref-type="bibr" rid="bib116">116</xref>
,
<xref ref-type="bibr" rid="bib117">117</xref>
,
<xref ref-type="bibr" rid="bib118">118</xref>
</sup>
GMAP, which is produced by cleavage of the same precursor as galanin, has direct antifungal activity
<sup>
<xref ref-type="bibr" rid="bib119">119</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>PDK4</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Pyruvate dehydrogenase kinase, isozyme 4</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs11531570</td>
<td align="left" valign="top" charoff="50">
<italic>PDK4</italic>
gene expression is upregulated by IFN-α and by LPS and contributes to muscle glycogen breakdown and lactate accumulation;
<sup>
<xref ref-type="bibr" rid="bib120">120</xref>
,
<xref ref-type="bibr" rid="bib121">121</xref>
</sup>
conversely,
<italic>PDK4</italic>
is inhibited by TNF-α via p38 MAPK and NF-κB signaling, leading to increased glucose oxidation;
<sup>
<xref ref-type="bibr" rid="bib122">122</xref>
</sup>
anti-inflammatory omega-3 fatty acids increase
<italic>PDK4</italic>
in immature dendritic cells via enhanced PPAR-γ signaling
<sup>
<xref ref-type="bibr" rid="bib123">123</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>NPM1</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Nucleophosmin</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs11134697</td>
<td align="left" valign="top" charoff="50">Functions as an endogenous ‘alarmin' that activates proinflammatory cytokines;
<sup>
<xref ref-type="bibr" rid="bib124">124</xref>
,
<xref ref-type="bibr" rid="bib125">125</xref>
,
<xref ref-type="bibr" rid="bib126">126</xref>
</sup>
identified as a host virulence factor in viral infection;
<sup>
<xref ref-type="bibr" rid="bib127">127</xref>
,
<xref ref-type="bibr" rid="bib128">128</xref>
</sup>
may aid in HIV and HSV1 virus dispersal within cells;
<sup>
<xref ref-type="bibr" rid="bib129">129</xref>
,
<xref ref-type="bibr" rid="bib130">130</xref>
</sup>
complexes with, and inhibits, PKR, which has important antiviral properties
<sup>
<xref ref-type="bibr" rid="bib131">131</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>USP3</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Ubiquitin-specific peptidase 3</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs7183892</td>
<td align="left" valign="top" charoff="50">Embedding of
<italic>USP</italic>
genes in the copy number variable β-defensin cluster on chromosome 8p23.1 suggests a close tie with innate immunity;
<sup>
<xref ref-type="bibr" rid="bib132">132</xref>
</sup>
<italic>USP3</italic>
is activated by IL-4 and IL-6 and has antiproliferative and apoptotic properties;
<sup>
<xref ref-type="bibr" rid="bib133">133</xref>
</sup>
highly homologous
<italic>USP17</italic>
necessary for type I IFN production in response to virus infection;
<sup>
<xref ref-type="bibr" rid="bib134">134</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="char" valign="top" char="." charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">
<italic>ASB4</italic>
</td>
<td align="left" valign="top" charoff="50">
<italic>Ankyrin repeat and SOCS box-containing 4</italic>
</td>
<td align="char" valign="top" char="." charoff="50">rs11531570</td>
<td align="left" valign="top" charoff="50">No specific immune or host defense functions identified.</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="t2-fn1">
<p>Abbreviations: FP, prostaglandin F; GMAP, galanin message associated peptide; HSV1, herpes simplex virus type 1; IFN-α, interferon-α IgM, immunoglobulin M; IL, interleukin; LPS, lipopolysaccharide; MAPK, mitogen-activated protein kinase; MDD, major depressive disorder; NF-κB, nuclear factor-κβ PATHOS-D, Pathogen Host Defense; PKR, protein kinase R; PPAR-γ, peroxisome proliferator-activated receptor-γ TLR, Toll-like receptor; TNF-α, tumor necrosis factor-α.</p>
</fn>
<fn id="t2-fn2">
<p>Reference numbers in
<xref rid="tbl2" ref-type="table">Table 2</xref>
correspond to reference numbers in paper bibliography.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tbl3">
<label>Table 3</label>
<caption>
<title>Inflammation and infectious outcomes in industrialized societies</title>
</caption>
<table frame="hsides" rules="groups" border="1">
<colgroup>
<col align="left"></col>
<col align="left"></col>
<col align="left"></col>
</colgroup>
<thead valign="bottom">
<tr>
<th align="left" valign="top" charoff="50">
<italic>Biological factor</italic>
</th>
<th align="left" valign="top" charoff="50">
<italic>Immune effect</italic>
</th>
<th align="left" valign="top" charoff="50">
<italic>Host defense findings</italic>
</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left" valign="top" charoff="50">Plasma concentration of interleukin (IL)-10; ratio of plasma IL-10 to tumor necrosis factor-α (TNF-α IL-10/TNF-α)</td>
<td align="left" valign="top" charoff="50">IL-10 is a powerful anti-inflammatory cytokine that suppresses innate immunity and T helper type I (Th1) immune responses; TNF-α is an innate immune potent proinflammatory cytokine that produces sickness behavior and acutely plays important role in facilitating activation of the adaptive immune system.</td>
<td align="left" valign="top" charoff="50">In a large study of consecutive patients admitted to hospital with fever, elevations in plasma concentrations of the anti-inflammatory cytokine IL-10—as well as the ratio of IL-10/TNF-α—were associated with increased mortality;
<sup>
<xref ref-type="bibr" rid="bib3">3</xref>
</sup>
Increased IL-10 production late in the disease course predicted reduced survival following infection with the pandemic A/H1N1/2009 influenza virus.
<sup>
<xref ref-type="bibr" rid="bib4">4</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">Plasma concentration of C-reactive protein (CRP) via high-sensitivity assay</td>
<td align="left" valign="top" charoff="50">CRP is an acute-phase reactant primarily stimulated by IL-6 shown in multiple studies to predict the development of multiple illness associated with chronic inflammation</td>
<td align="left" valign="top" charoff="50">CRP has been associated with increased survival in children with meningococcal sepsis.
<sup>
<xref ref-type="bibr" rid="bib276">276</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">Stimulated production of pro- and anti-inflammatory cytokines</td>
<td align="left" valign="top" charoff="50">
<italic>In vitro</italic>
measure of ability of immune cells to produce/release cytokines in response to an immune stimulus.</td>
<td align="left" valign="top" charoff="50">Families with a member who died from meningococcal disease were characterized by increased production of IL-10 and reduced production of TNF-α when compared with families with a member who had bacterial meningitis but survived.
<sup>
<xref ref-type="bibr" rid="bib5">5</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">Th1 and Th2 cytokine concentrations in the supernatant of cultured peripheral blood mononuclear cells (PBMCs)</td>
<td align="left" valign="top" charoff="50">
<italic>In vitro</italic>
measure of ability of PBMCs to promote either Th1 or Th2 immunity</td>
<td align="left" valign="top" charoff="50">Reduced PBMC production of IFN-γ and IL-12 is associated with increased severity of respiratory syncytial virus symptoms in infants under 1 year of age.
<sup>
<xref ref-type="bibr" rid="bib277">277</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">Increased activity alleles of the IL-10 gene (i.e., −1082G)</td>
<td align="left" valign="top" charoff="50">Associated with higher levels of IL-10</td>
<td align="left" valign="top" charoff="50">−1082G allele is associated with increased symptom severity and mortality in the context of community-acquired pneumonia,
<sup>
<xref ref-type="bibr" rid="bib278">278</xref>
</sup>
−1082G allele is associated with reduced antibody responses to tetanus, influenza and hepatitis B virus (HBV) vaccines.
<sup>
<xref ref-type="bibr" rid="bib279">279</xref>
,
<xref ref-type="bibr" rid="bib280">280</xref>
,
<xref ref-type="bibr" rid="bib281">281</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">Increased activity alleles of the interferon-γ (IFN-γ) gene (i.e., +874T)</td>
<td align="left" valign="top" charoff="50">The +874T allele increases Th1 immunity via increased IFN-γ production as a result of enhanced binding of nuclear factor-κβ (NF-κB)
<sup>
<xref ref-type="bibr" rid="bib283">283</xref>
,
<xref ref-type="bibr" rid="bib284">284</xref>
</sup>
</td>
<td align="left" valign="top" charoff="50">+874T allele has been associated with protection against Mediterranean Spotted fever.
<sup>
<xref ref-type="bibr" rid="bib282">282</xref>
</sup>
Multiple studies and a large meta-analysis find that the +874T allele is associated with protection against the development of tuberculosis at the individual
<sup>
<xref ref-type="bibr" rid="bib285">285</xref>
</sup>
and population levels.
<sup>
<xref ref-type="bibr" rid="bib50">50</xref>
</sup>
In individuals with active tuberculosis, the T allele is associated with reduced severity and risk of disseminated disease.
<sup>
<xref ref-type="bibr" rid="bib286">286</xref>
</sup>
+874T allele has been associated with reduced risk of leprosy,
<sup>
<xref ref-type="bibr" rid="bib287">287</xref>
</sup>
severe acute respiratory syndrome (SARS),
<sup>
<xref ref-type="bibr" rid="bib288">288</xref>
</sup>
and Chagas disease.
<sup>
<xref ref-type="bibr" rid="bib289">289</xref>
</sup>
</td>
</tr>
<tr>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr>
<td align="left" valign="top" charoff="50">Reduced activity alleles of the IFN-γ gene (i.e., +874A)</td>
<td align="left" valign="top" charoff="50">An allele at +874 is associated with reduced IFN-γ production and consequent reductions in Th1 activity</td>
<td align="left" valign="top" charoff="50">+874 A predisposes for hepatitis B and C persistence and negatively affects clinical course of these diseases.
<sup>
<xref ref-type="bibr" rid="bib290">290</xref>
</sup>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="t3-fn1">
<p>Reference numbers in
<xref rid="tbl3" ref-type="table">Table 3</xref>
correspond to reference numbers in paper bibliography.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>États-Unis</li>
</country>
</list>
<tree>
<country name="États-Unis">
<noRegion>
<name sortKey="Raison, C L" sort="Raison, C L" uniqKey="Raison C" first="C L" last="Raison">C L Raison</name>
</noRegion>
<name sortKey="Miller, A H" sort="Miller, A H" uniqKey="Miller A" first="A H" last="Miller">A H Miller</name>
<name sortKey="Raison, C L" sort="Raison, C L" uniqKey="Raison C" first="C L" last="Raison">C L Raison</name>
</country>
</tree>
</affiliations>
</record>

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