{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T11:24:45Z","timestamp":1781349885057,"version":"3.54.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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\u2013brain 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 baseline and after a 6-week follow-up and to compare them with those of the healthy control (HC) group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-seven PD subjects (17 women and 10 men) and 25 HC subjects (15 women and 10 men) were included in this prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pre-treatment claudin-5 (p = 0.021), C-reactive protein (CRP) (p &amp;lt; 0.001), CRP\/albumin ratio (p &amp;lt; 0.001), and neutrophil count (p &amp;lt; 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 &amp;lt; 0.001) of the PD group decreased significantly after 6 weeks of follow-up compared to those at baseline. Post-treatment claudin-5 levels of the PD group were similar to those of 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 (BMI), 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 modeling attempts, a hierarchical model (controlling for age, gender, and BMI) was created using pre-treatment claudin-5 level and the aggregate index of systemic inflammation (sensitivity = 70.4%, specificity = 76.0%; Nagelkerke R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.468). The area under the receiver operating characteristic (ROC) curve of pre-treatment claudin-5 level for PD was 0.687 (p = 0.021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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 6-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 explained 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1703509","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T06:36:35Z","timestamp":1765434995000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Claudin-5 and inflammatory biomarkers in panic disorder: a 6-week follow-up study"],"prefix":"10.3389","volume":"16","author":[{"given":"Dilek","family":"\u00d6r\u00fcm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zekiye","family":"\u00c7atak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Baran","family":"Tanr\u0131kulu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murad","family":"Atmaca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s11064-009-0081-y","article-title":"Cellular elements of the blood-brain barrier","volume":"34","author":"Correale","year":"2009","journal-title":"Neurochem Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2202-12-40","article-title":"The role of shear stress in Blood-Brain Barrier endothelial physiology","volume":"12","author":"Cucullo","year":"2011","journal-title":"BMC Neurosci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1186\/s12987-019-0123-z","article-title":"Claudin-5: gatekeeper of neurological 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Proc Natl Acad Sci U S A."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1703509\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T06:36:36Z","timestamp":1765434996000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1703509\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,11]]},"references-count":24,"alternative-id":["10.3389\/fpsyt.2025.1703509"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1703509","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,11]]},"article-number":"1703509"}}