ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Molecular Psychiatry
Claudin-5 and Inflammatory Biomarkers in Panic Disorder: A Six-Week Follow-Up Study
Provisionally accepted
- 1Elazig Fethi Sekin City Hospital, Elazığ, Türkiye
- 2Elazig Fethi Sekin Sehir Hastanesi, Elâzığ, Türkiye
- 3TC Saglik Bakanligi Elazig Ruh Sagligi ve Hastaliklari Hastanesi, Elâzığ, Türkiye
- 4Firat Universitesi, Elâzığ, Türkiye
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Background:Claudin-5 is an important cell adhesion molecule of tight junctions in brain endothelial cells and plays an important role in the permeability of the blood-brain barrier (BBB).Panic disorder (PD) is a disorder characterized by increased neuroinflammatory processes that may result in increased BBB permeability.This study aimed to examine claudin-5 levels in PD at the baseline and after a six-week follow-up and to compare them with the healthy control (HC) group. Methods:Twenty-seven PD subjects (17 females, 10 males) and 25 HC subjects (15 females, 10 males) were included in this prospective cohort study. Results:Pre-treatment claudin-5 (p=0.021),C-reactive protein (CRP) (p<0.001),CRP/albumin ratio (p<0.001) and neutrophil count (p<0.001) were higher in the PD group than in the HC group. Claudin-5 levels (p=0.001) and Panic Disorder Scale (PDS) scores (p<0.001) of the PD group decreased significantly compared to baseline after six weeks of follow-up. Post-treatment claudin-5 levels of the PD group were similar to the HC group (p=0.230).In the PD group, partial correlation analysis was performed by controlling for the effects of age, gender, body mass index, smoking status, antidepressant and benzodiazepine status, and a significant relationship was found between the pre-treatment PDS score and pre-treatment claudin-5 level (r=0.474, p=0.030).After various modelling, a hierarchical model (controlling for age, gender, and BMI) was created using pre-treatment claudin-5 level and aggregate index of systemic inflammation (sensitivity=70.4%, specificity=76.0%; Nagelkerke R2 0.468).The area under the ROC curve of pre-treatment claudin-5 level for PD was 0.687 (p=0.021). Conclusion:In subjects presenting with PD symptoms, increased parameters that may be associated with increased inflammation, such as CRP, CRP/albumin ratio and neutrophil count, along with claudin-5 levels, and the association between them, and the decrease in claudin-5 levels after a six-week follow-up following a decrease in PD symptom severity, suggest that alterations in claudin-5 level in PD may be related to PD symptomatology.The high level of claudin-5 at the initial clinical presentation may be explain as a direct consequence of neuroinflammation in PD and/or as a compensatory change that occurs secondary to the neuroinflammation in PD.It can be assumed that as PD symptom severity decreases, neuroinflammation decreases and claudin-5 production slows down.
Keywords: Panic Disorder, Claudin-5, tight junction, Blood-Brain Barrier, Neuroinflammation
Received: 12 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Örüm, Çatak, Tanrıkulu and Atmaca. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dilek Örüm, dr.dilekulukan@gmail.com
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