The biomarker suPAR and neurology
The suPAR level is associated with:
- Traumatic brain injury3
- Adverse childhood experiences4
In recent years, it has become evident that there is a biological link between chronic inflammation and psychological disorders. As suPAR is a stable marker of chronic inflammation, there has been a number of papers investigating suPAR as a marker of psychological disorders.
In a Danish study including 9305 blood donors with 5-years follow-up, there was a significant association between suPAR and getting medication against depression. For men, the risk of first use of antidepressants increased by 72% from the 1st to the 4th quartile (HR = 1.72, 95% CI: 1.11-2.69). For women, it increased by 108% from the 1st to the 4th quartile (HR = 2.08, 95% CI: 1.45-2.98)1.
Elevated suPAR was also observed in a Swedish study of depressed patients (n = 19) and suicide attempters (n = 54), compared to healthy controls (n = 19). Both the depressed patients and suicide attempters had increased plasma suPAR. The levels of suPAR discriminated better between controls and suicide attempters than CRP did2.
A prospective observational study aimed to explore the relationship between the suPAR plasma concentration and traumatic brain injury (TBI)3. The study showed that the suPAR levels were strongly associated with the severity of TBI patients. The suPAR levels increased in association with the severity of brain injury, significance being found among all three groups: severe, moderate and mild TBI. The suPAR levels in non-survivals were significantly increased compared to the survivals (P < 0.05). Thus, the authors conclude that the prognosis was worse in the patients with elevated suPAR levels3.
“It has become clear that suPAR is a very strong prognostic marker, exceeding the prognostic value of all other routinely measured biomarkers in our hospital.”
Prof. Ove Andersen,
MD, PhD, DmSc, Copenhagen University Hospital Hvidovre, Denmark
suPAR News Vol. 3, June 2020
Finally, a study of childhood risk factors and the suPAR level at age 38 was carried out in the Dunedin study4. After controlling for sex, body mass index (BMI), and smoking, children who experienced more adverse childhood experiences, had lower IQ, or had poorer selfcontrol showed elevated adult suPAR levels. The authors conclude that exposure to more childhood risk factors was associated with higher suPAR levels, independent of CRP and that suPAR is a useful addition to studies connecting childhood risk to adult inflammatory burden4.
1. Haastrup E et al.Soluble urokinase plasminogen activator receptor as a marker for use of antidepressants. PLoS One. 2014 ;9(10):e110555.
2. Ventorp F et al. Increased Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in Plasma of Suicide Attempters. PLoS One. 2015 9;10(10):e0140052.
3. Yu L Et al. Diagnostic and prognostic significance 0f suPAR in traumatic brain injury. Neurol India. 2014 Sep-Oct;62(5):498-502
4. Rasmussen LJHH et al, Cumulative childhood risk is associated with a new measure of chronic inflammation in adulthood. J Child Psychol Psychiatry. 2019 60(2):199-208