Oxidative–antioxidative balance and stromal cell-derived factor-4 in generalized anxiety disorder: implications for pathophysiology and biomarker potential

This study explores the relationship between oxidative – antioxidative balance and stromal cell-derived factor-4 (SDF-4) levels in individuals with Generalized Anxiety Disorder (GAD), aiming to clarify their roles in the disorder's pathophysiology. By examining these biomarkers, the research investigates whether oxidative stress mechanisms contribute to GAD. A cross-sectional study was conducted with 43 GAD patients and 40 age- and sex-matched healthy controls. Participants were assessed using the Beck Anxiety Inventory (BAI) and the Structured Clinical Interview for DSM-5. Serum levels of SDF-4, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were measured. GAD patients showed significantly higher levels of SDF-4, TAS, TOS, and OSI compared to controls (p < 0.001). No significant differences were found in other hematological parameters. In the GAD group, SDF-4 levels were not significantly correlated with anxiety severity or oxidative markers. ROC analysis indicated good diagnostic performance of SDF-4 for GAD (AUC = 0.870). The findings suggest that oxidative – antioxidative imbalance and elevated SDF-4 levels may play a role in GAD. SDF-4 might represent a compensatory response to oxidative stress. Elevated TAS levels may indicate enhanced antioxidant defense. Further studies are needed to clarify the mechanistic and therapeutic implications.