Inflammatory markers in opioid maintenance therapy. The role of major depression and psychosocial stressors
The projects will give basic knowledge on psychiatric comorbidity among OMT patients, but will also point to possible risk factors, places for intervention and strategies for interventions, thus representing translational research. The project also aims to improve inter-disciplinary integrated psychiatric and somatic care.This research project is translational and has scientific and clinical relevance. It could contribute to our understanding of the etiology and pathogenesis of major depressive disorder amongst patients in opioid maintenance treatment (OMT). It could also establish whether there is a relationship between depressive symptoms and the respective drugs used in OMT, and further, the impact of psychosocial stress. This, in turn, may lead to improved and integrated psychiatric and substance use disorder (SUD) health care. In this study among patients treated for HCV, we want to investigate the impact of opioids (by looking at OMT-patients) on the level of inflammatory markers. We have the following research questions: 1. Does the level of inflammatory markers differ between patients on OMT vs. that of nonOMT patients, and are there differences between patients on methadone vs. buprenorphine? 2. Are the known differences in the levels of inflammatory markers, in depressed vs. nondepressed patients also present in patients within OMT? 3. Is the level of inflammatory markers on patients on OMT, influenced by psychosocial stressors? The projects will give basic knowledge on psychiatric comorbidity among OMT patients, but will also point to possible risk factors, places for intervention and strategies for interventions, thus representing translational research. The project also aims to improve inter-disciplinary integrated psychiatric and somatic care. A project like this requires cooperation between several disciplines: psychiatric, somatic, drug - and addiction medicine and statistical knowledge. It gives a unique possibility to establish a biological oriented research group in the Psychiatric Division at the Nordland Hospital thus expanding the important work already established at the Somatic division, as described later. This will pave the way for further translational research. In this context, our international contacts are of importance. The project will, beyond doubt strengthen the academia at the Nordland Hospital and in Helse Nord.
This research project is translational and has scientific and clinical relevance. It could contribute to our understanding of the etiology and pathogenesis of major depressive disorder amongst patients in opioid maintenance treatment (OMT), and give clues for the choice of treatment.Patients on opioid maintenance therapy (OMT) have a high prevalence of major depression and somatic co morbidity such as hepatitis C virus infection (HCV). In addition, they are subjected to a high level of psychosocial stressors, all of which are known to increase the level of inflammatory markers. OMT formulations containing either buprenorphine or methadone have different pharmacokinetic properties with different impact on the immune –and central nervous system. Buprenorphine has ?-receptor antagonistic properties causing anti-depressant-like effect with a different impact on the immune system as compared to methadone. However, studies thus far have only investigated limited amount of cytokines and their association with major depression, HCV and psychosocial stressors, respectively, and none have incorporated all of these factors in patient on OMT. The aim of this project is to investigate the role inflammatory markers play in patients on OMT with HCV on depression and psychosocial stressors. The study is a cross-sectional study where patients on OMT with HCV will undergo blood-sampling analyzing 27 different cytokines using a multiplex approach and psychometric evaluation using SF-36, Scl-90 and Europ-ASI. Each patient will be matched with non-OMT controls with HCV matched for age and gender. Prosjektet er fortsatt i datainnsamlingsfasen. det er sdnart inkludert 100 pasienter og skal i alt inkluderes ca 120. Vi regner med at det er gjort før sommeren. Da vil analysen av data starte opp.