{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:40:03Z","timestamp":1792392003922,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Generalized anxiety disorder (GAD) is a mental health disorder that affects many people in all aspects of their lives. It is characterized by persistent and excessive worry that the affected person finds difficult to control. The actual pathophysiology and mechanisms underlying GAD are still elusive. However, cytokines and cell signaling proteins are hypothesized to contribute to the pathogenesis of anxiety. The present study aimed to understand the association of tumor necrosis factor\u2010\u03b1 (TNF\u2010\u03b1) in the pathophysiology of GAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case\u2010control study recruited 43 GAD patients and 26 healthy controls (HCs) matched by age, sex, and other demographic factors. A clinical psychiatrist diagnosed patients and evaluated controls according to DSM\u20105 criteria. The GAD\u20107 scale was used to measure the severity of GAD symptoms. Serum TNF\u2010\u03b1 levels were measured using enzyme\u2010linked immunosorbent assay (ELISA), and appropriate statistical methods were applied to find the associations among the analyzed parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results showed that TNF\u2010\u03b1 levels in GAD patients were significantly elevated than in HCs. The increased TNF\u2010\u03b1 levels were positively correlated with the severity of GAD symptoms. Moreover, the ROC curve reveals the AUC, sensitivity, and specificity as 0.888 (95% CI: 0.810\u20130.966), 84.6%, and 83.3%, respectively, at a cut\u2010off value of 50.86\u2009pg\/ml. These results suggest a potential role of TNF\u2010\u03b1 in the pathophysiology and development of GAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings indicate the role of cytokine dysregulation in GAD pathogenesis. This research advances the understanding of the immune system's association with GAD. However, as this was a cross\u2010sectional case\u2010control study, TNF\u2010\u03b1 should at present be regarded as a candidate biomarker that needs validation in larger and longer\u2010term studies before it can be used clinically.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73277","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T03:40:42Z","timestamp":1792381242000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increased Serum TNF\u2010\u03b1 Levels Are Associated With Generalized Anxiety Disorder: A Case\u2010Control Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2486-7493","authenticated-orcid":false,"given":"Tasnu Ara","family":"Nur","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra Labiba","family":"Ahmed","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9719-4857","authenticated-orcid":false,"given":"Faisal Abdullah","family":"Emon","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taslima Jamal","family":"Urmi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Masud","family":"Parves","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Chemistry University of Dhaka Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2820-3144","authenticated-orcid":false,"given":"Md. 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