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Bourassa KJ, Caspi A, Brennan GM, Hall KS, Harrington H, Houts R, Kimbrel NA, Poulton R, Ramrakha S, Taylor GA, Moffitt TE. Which Types of Stress Are Associated With Accelerated Biological Aging? Comparing Perceived Stress, Stressful Life Events, Childhood Adversity, and Posttraumatic Stress Disorder. Psychosom Med 2023; 85:389-396. [PMID: 37053097 PMCID: PMC10239326 DOI: 10.1097/psy.0000000000001197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Stress and stressful events are associated with poorer health; however, there are multiple ways to conceptualize and measure stress and stress responses. One physiological mechanism through which stress could result in poorer health is accelerated biological aging. This study tested which types of stress were associated with accelerated biological aging in adulthood. METHODS Studying 955 participants from the Dunedin Longitudinal Study, we tested whether four types of stress assessed from ages 32 to 45 years-perceived stress, number of stressful life events, adverse childhood experiences, and posttraumatic stress disorder-were associated with accelerated biological aging. RESULTS Higher levels of all four measures of stress were significantly associated with accelerated aging in separate models. In a combined model, more perceived stress and more stressful life events remained associated with faster aging, and the stress measures explained 6.9% of the variance in aging. The magnitudes of the associations between the four measures of stress and biological aging were comparable to associations for smoking and low education, two established risk factors for accelerated aging. People with high levels of perceived stress, numerous adverse childhood experiences (4+), high stressful life event counts, or posttraumatic stress disorder were aging an additional estimated 2.4 months, 1.1 additional months, 1.4 months, and 1.4 months per year, respectively. CONCLUSIONS Assessing stress, particularly perceived stress, could help identify people at risk of accelerated aging. Intervening to treat stress or the health-relevant sequelae of stress could potentially slow the rate at which people are aging, improving their health as they age.
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Affiliation(s)
- Kyle J. Bourassa
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Center for the Study of Population Health & Aging, Duke University Population Research Institute
- Center for the Study of Aging and Human Development, Duke University
| | - Grace M. Brennan
- Department of Psychology and Neuroscience, Duke University
- Center for the Study of Aging and Human Development, Duke University
| | - Katherine S. Hall
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System
- Center for the Study of Aging and Human Development, Duke University
- Department of Medicine, Division of Geriatrics, Duke University
| | | | - Renate Houts
- Department of Psychology and Neuroscience, Duke University
| | - Nathan A. Kimbrel
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Healthcare System
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
| | - Richie Poulton
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Sandhya Ramrakha
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Gregory A. Taylor
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System
- Center for the Study of Aging and Human Development, Duke University
- Department of Medicine, Division of Geriatrics, Duke University
- Department of Immunology, Duke University Medical Center
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Center for the Study of Population Health & Aging, Duke University Population Research Institute
- Center for the Study of Aging and Human Development, Duke University
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Guo Y, Zhang XN, Su S, Ruan ZL, Hu MM, Shu HB. β-adrenoreceptor-triggered PKA activation negatively regulates the innate antiviral response. Cell Mol Immunol 2023; 20:175-188. [PMID: 36600052 PMCID: PMC9886936 DOI: 10.1038/s41423-022-00967-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Abstract
Upon viral infection, cytoplasmic pattern recognition receptors detect viral nucleic acids and activate the adaptor protein VISA/MAVS- or MITA/STING-mediated innate antiviral response. Whether and how the innate antiviral response is regulated by neuronal endocrine functions is unclear. Here, we show that viral infection reduced the serum levels of the β-adrenergic hormones epinephrine and norepinephrine as well as the cellular levels of their receptors ADRB1 and ADRB2. We further show that an increase in epinephrine/norepinephrine level inhibited the innate antiviral response in an ADRB1-/2-dependent manner. Mechanistically, epinephrine/norepinephrine stimulation activated the downstream kinase PKA, which catalyzed the phosphorylation of MITA at S241, S243 and T263, inhibiting MITA activation and suppressing the innate immune response to DNA virus. In addition, phosphorylation of VISA at T54 by PKA antagonized the innate immune response to RNA virus. These findings reveal the regulatory mechanisms of innate antiviral responses by epinephrine/norepinephrine and provide a possible explanation for increased host susceptibility to viral infection in stressful and anxiety-promoting situations.
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Affiliation(s)
- Yi Guo
- Department of Infectious Diseases, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, Wuhan University; College of Life Sciences, Taikang Center for Life and Medical Sciences, Wuhan University; Research Unit of Innate Immune and Inflammatory Diseases, Chinese Academy of Medical Sciences, Wuhan, China
| | - Xia-Nan Zhang
- Department of Infectious Diseases, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, Wuhan University; College of Life Sciences, Taikang Center for Life and Medical Sciences, Wuhan University; Research Unit of Innate Immune and Inflammatory Diseases, Chinese Academy of Medical Sciences, Wuhan, China
| | - Shan Su
- Department of Infectious Diseases, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, Wuhan University; College of Life Sciences, Taikang Center for Life and Medical Sciences, Wuhan University; Research Unit of Innate Immune and Inflammatory Diseases, Chinese Academy of Medical Sciences, Wuhan, China
| | - Zi-Lun Ruan
- Department of Infectious Diseases, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, Wuhan University; College of Life Sciences, Taikang Center for Life and Medical Sciences, Wuhan University; Research Unit of Innate Immune and Inflammatory Diseases, Chinese Academy of Medical Sciences, Wuhan, China
| | - Ming-Ming Hu
- Department of Infectious Diseases, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, Wuhan University; College of Life Sciences, Taikang Center for Life and Medical Sciences, Wuhan University; Research Unit of Innate Immune and Inflammatory Diseases, Chinese Academy of Medical Sciences, Wuhan, China.
| | - Hong-Bing Shu
- Department of Infectious Diseases, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, Wuhan University; College of Life Sciences, Taikang Center for Life and Medical Sciences, Wuhan University; Research Unit of Innate Immune and Inflammatory Diseases, Chinese Academy of Medical Sciences, Wuhan, China.
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3
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Yuan F, Ren H, Tan W, Wang Y, Luo H. Effect of phosphodiesterase-4 inhibitor rolipram on colonic hypermotility in water avoidance stress rat model. Neurogastroenterol Motil 2022; 34:e14317. [PMID: 35037375 PMCID: PMC9286810 DOI: 10.1111/nmo.14317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/01/2021] [Accepted: 12/20/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Phosphodiesterase (PDE) inhibition has been reported to play a role in regulating gut motility, but the evidence is insufficient, and the mechanism remains unknown. The aim of this study was to investigate the possible role of phosphodiesterase-4 (PDE4) inhibitor rolipram in water avoidance stress-induced colonic hypermotility. METHODS A rat model of irritable bowel syndrome (IBS) with diarrhea (IBS-D) was established by water avoidance stress (WAS). Intestinal motility was assessed by fecal pellets expulsion per hour. The cyclic adenosine monophosphate (cAMP) and nitric oxide (NO) level in colon tissue were detected using ELISA assay and the Griess test, respectively. Western blotting was performed to assess the protein level of PDE, PKA/p-CREB, and neuronal nitric oxide synthase (nNOS) in the colon. To determine the role of rolipram in gut motility, the rats of the WAS + Rolipram and Rolipram group were injected with rolipram intraperitoneally. The colonic contractile activity was recorded with a RM6240 multichannel physiological signal system. KEY RESULTS WAS-induced gastrointestinal hypermotility and increased defecation in rats. After repeated stress, protein levels of PDE4 in the colon were promoted while PKA/p-CREB and nNOS were highly decreased. cAMP content in colon tissue did not change significantly. However, NO content decreased after WAS, and rolipram partly enhanced NO in WAS-exposed rats. In addition, intraperitoneal injection of rolipram partly inhibited the colonic motility in vivo. Meanwhile, we observed rolipram inhibited the contraction of colonic smooth muscle strips, and this inhibitory effect was abolished by Nω-Nitro-L-arginine (L-NNA), a nitric oxide synthase (NOS) inhibitor, tetrodotoxin (TTX), a blocker of neuronal voltage-dependent Na+ channels, Rp-Adenosine 3',5'-cyclic monophosphorothioate triethylammonium salt hydrate (Rp-cAMPS), an antagonist of cAMP. CONCLUSIONS AND INFERENCES Rolipram could relieve stress-induced gastrointestinal hypermotility. This effect may be partly through the cAMP-PKA-p-CREB pathway and NO pathway.
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Affiliation(s)
- FangTing Yuan
- Department of GastroenterologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - HaiXia Ren
- Department of GastroenterologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Wei Tan
- Department of GastroenterologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Ying Wang
- Department of GastroenterologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina,Key Laboratory of Hubei Province for Digestive System DiseasesRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - HeSheng Luo
- Department of GastroenterologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
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Huang Y, Wang Y, Chen C, Gao Y, Kc A, Wang X, Zou S, Zhou H. Association Between Violent Discipline at Home and Risk of Illness and Injury in Children: Findings From a Cross-sectional Study in Rural Western China. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11413-NP11435. [PMID: 33576282 DOI: 10.1177/0886260521991895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
To estimate the prevalence of violent discipline at home against young children, and to explore the potential association between violent discipline at home and multifaceted health risks in children. A community-based cross-sectional survey was conducted in twenty rural counties of weight provinces in western China. The information about child neglect and socio-demographic factors, exposure to different forms of violent discipline at home and four health outcomes was collected by face-to-face interview. Before analysis, the included interviews were weighted by the double-weighted comprehensive weighting. The proportion of children reported by primary caregivers to have experienced different forms of violent discipline by gender were calculated. To adjust the clustering effect of the survey design, two-level univariate and multivariate logistic regression models were constructed to evaluate the potential association between a child's exposure to violent discipline at home and risk of suffering from diarrhea, fever, cough and injury. A total of 3,682 weighted interviews were finally included in the analysis. The prevalence of any violent discipline, psychological aggression, any physical punishment and severe physical punishment were 76.4%, 57.5%, 68.3% and 14.1%, respectively. In multivariate analysis, after adjusting for clustering, there was still a positive association between a child's exposure to psychological aggression and risk of diarrhea (adjusted OR: 1.47, 95%CI: 1.14-1.90) and injury (adjusted OR: 1.95, 95%CI: 1.36-2.80); a child's exposure to any physical punishment and risk of diarrhea (adjusted OR: 1.36, 95%CI: 1.04-1.77), cough (adjusted OR: 1.37, 95%CI: 1.14-1.66), and injury (adjusted OR: 2.05, 95%CI: 1.37-3.06); and a child's exposure to severe physical punishment and risk of injury (adjusted OR: 2.07, 95%CI: 1.41-3.05). Considering that using violent discipline at home is prevalent in rural western China, and it could threaten young children's health, effective measures to prevent young children from violent discipline are urgently needed.
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Affiliation(s)
| | | | | | | | | | - Xi Wang
- Children's Hospital of Philadelphia, PA, USA
| | - Siyu Zou
- Peking University, Beijing, China
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5
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Bourassa KJ, Sbarra DA. Cardiovascular reactivity, stress, and personal emotional salience: Choose your tasks carefully. Psychophysiology 2022; 59:e14037. [PMID: 35292974 PMCID: PMC9283235 DOI: 10.1111/psyp.14037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 01/13/2023]
Abstract
Both greater cardiovascular reactivity and lesser reactivity ("blunting") to laboratory stressors are linked to poor health outcomes, including among people who have a history of traumatic experiences. In a sample of recently separated and divorced adults (N = 96), this study examined whether differences in cardiovascular reactivity might be explained by differences in the personal emotional salience of the tasks and trauma history. Participants were assessed for trauma history, current distress related to their marital dissolution, and cardiovascular reactivity during two tasks, a serial subtraction math stressor task and a divorce-recall task. Participants with a greater trauma history evidenced less blood pressure reactivity to the serial subtraction task (a low personal emotional salience task) when compared to participants with less trauma history. In contrast, participants with a greater trauma history evidenced higher blood pressure reactivity to the divorce-recall task, but only if they also reported more divorce-related distress (high personal emotional salience). These associations were not significant for heart rate reactivity. Among people with a history of more traumatic experiences, a task with low personal salience was associated with a lower blood pressure response, whereas a task with higher personal emotional salience was associated with a higher blood pressure response. Future studies examining cardiovascular reactivity would benefit from determining the personal emotional salience of tasks, particularly for groups that have experienced stressful life events or trauma.
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Affiliation(s)
- Kyle J Bourassa
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, USA.,Geriatrics Research, Education, and Clinical Center, Durham VA Health Care System, Durham, North Carolina, USA
| | - David A Sbarra
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
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6
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Borgogna JLC, Anastario M, Firemoon P, Rink E, Ricker A, Ravel J, Brotman RM, Yeoman CJ. Vaginal microbiota of American Indian women and associations with measures of psychosocial stress. PLoS One 2021; 16:e0260813. [PMID: 34890405 PMCID: PMC8664215 DOI: 10.1371/journal.pone.0260813] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 11/17/2021] [Indexed: 12/12/2022] Open
Abstract
Molecular-bacterial vaginosis (BV) is characterized by low levels of vaginal Lactobacillus species and is associated with higher risk of sexually transmitted infections (STI). Perceived psychosocial stress is associated with increased severity and persistence of infections, including STIs. American Indians have the highest rates of stress and high rates of STIs. The prevalence of molecular-BV among American Indian women is unknown. We sought to evaluate measures of psychosocial stress, such as historic loss (a multigenerational factor involving slavery, forced removal from one's land, legally ratified race-based segregation, and contemporary discrimination) and their association with the vaginal microbiota and specific metabolites associated with BV, in 70 Northwestern Plains American Indian women. Demographics, perceived psychosocial stressors, sexual practices, and known BV risk factors were assessed using a modified version of the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project survey. Self-collected mid-vaginal swabs were profiled for bacterial composition by 16S rRNA gene amplicon sequencing and metabolites quantified by targeted liquid-chromatography mass spectrometry. Sixty-six percent of the participants were classified as having molecular-BV, with the rest being either dominated by L. crispatus (10%) or L. iners (24%). High levels of lifetime trauma were associated with higher odds of having molecular-BV (adjusted Odds Ratio (aOR): 2.5, 95% Credible Interval (CrI): 1.1-5.3). Measures of psychosocial stress, including historic loss and historic loss associated symptoms, were significantly associated with lifestyle and behavioral practices. Higher scores of lifetime trauma were associated with increased concentrations of spermine (aFC: 3.3, 95% CrI: 1.2-9.2). Historic loss associated symptoms and biogenic amines were the major correlates of molecular-BV. Historical loss associated symptoms and lifetime trauma are potentially important underlying factors associated with BV.
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Affiliation(s)
- Joanna-Lynn C. Borgogna
- Department of Microbiology and Immunology, Montana State University, Bozeman, Montana, United States of America
- Department of Animal and Range Sciences, Montana State University, Bozeman, Montana, United States of America
| | - Michael Anastario
- Department of Health Promotion and Disease Prevention, Florida International University, Miami, Florida, United States of America
| | - Paula Firemoon
- Fort Peck Community College, Poplar, Montana, United States of America
| | - Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, Montana, United States of America
| | - Adriann Ricker
- School of Public Health–Center for American Indian Health and School of Nursing, John Hopkins University, Baltimore, Maryland, United States of America
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Rebecca M. Brotman
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Carl J. Yeoman
- Department of Microbiology and Immunology, Montana State University, Bozeman, Montana, United States of America
- Department of Animal and Range Sciences, Montana State University, Bozeman, Montana, United States of America
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Bourassa KJ, Rasmussen LJH, Danese A, Eugen-Olsen J, Harrington H, Houts R, Poulton R, Ramrakha S, Sugden K, Williams B, Moffitt TE, Caspi A. Linking stressful life events and chronic inflammation using suPAR (soluble urokinase plasminogen activator receptor). Brain Behav Immun 2021; 97:79-88. [PMID: 34224821 PMCID: PMC8453112 DOI: 10.1016/j.bbi.2021.06.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022] Open
Abstract
Stressful life events have been linked to declining health, and inflammation has been proposed as a physiological mechanism that might explain this association. Using 828 participants from the Dunedin Longitudinal Study, we tested whether people who experienced more stressful life events during adulthood would show elevated systemic inflammation when followed up in midlife, at age 45. We studied three inflammatory biomarkers: C-reactive protein (CRP), interleukin-6 (IL-6), and a newer biomarker, soluble urokinase plasminogen activator receptor (suPAR), which is thought to index systemic chronic inflammation. Stressful life events were not associated with CRP or IL-6. However, people who experienced more stressful life events from age 38 to 44 had elevated suPAR at age 45, and had significantly greater increases in suPAR from baseline to follow-up across the same period. When examining stressful life events across the lifespan, both adverse childhood experiences (ACEs) and adult stressful life events were independently associated with suPAR at age 45. ACEs moderated the association of adult stressful life events and suPAR at age 45-children with more ACEs showed higher suPAR levels after experiencing stressful life events as adults. The results suggest systemic chronic inflammation is one physiological mechanism that could link stressful life events and health, and support the use of suPAR as a useful biomarker for such research.
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Affiliation(s)
- Kyle J. Bourassa
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC,Department of Psychology & Neuroscience, Duke University, Durham, NC
| | - Line J. H. Rasmussen
- Department of Psychology & Neuroscience, Duke University, Durham, NC,Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Andrea Danese
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, United Kingdom,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom,National and Specialist Child and Adolescent Mental Health Services Trauma, Anxiety, and Depression Clinic, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Jesper Eugen-Olsen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | | | - Renate Houts
- Department of Psychology & Neuroscience, Duke University, Durham, NC
| | - Richie Poulton
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Sandhya Ramrakha
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Karen Sugden
- Department of Psychology & Neuroscience, Duke University, Durham, NC
| | - Ben Williams
- Department of Psychology & Neuroscience, Duke University, Durham, NC
| | - Terrie E. Moffitt
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC,Department of Psychology & Neuroscience, Duke University, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC,Center for Genomic and Computational Biology, Duke University, Durham, NC
| | - Avshalom Caspi
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC,Department of Psychology & Neuroscience, Duke University, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC,Center for Genomic and Computational Biology, Duke University, Durham, NC
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8
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Barroso I, Cabral M, Ramos E, Guimarães JT. Parental education associated with immune function in adolescence. Eur J Public Health 2021; 30:444-448. [PMID: 31872259 DOI: 10.1093/eurpub/ckz229] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The immune system is affected and shaped by several internal and external factors. Among the external variables, the socioeconomic status is known to influence the immune system since the early years of life and throughout life. METHODS In this study, we assessed the relationship between parental education with the white blood cells and its subtypes in 1213 adolescents from the EPITeen cohort, assessed at the age of 13. Beta coefficients (β) and 95% confidence intervals (CI) were fitted using linear regression models to quantify the association and were adjusted for sex, body mass index and chronic disease. RESULTS After adjustment, parental education presented a negative association with white blood cells, which was significant among those with higher high-sensitivity C-reactive protein (hs-CRP) median levels [-0.05 mg/l (95% CI -0.08, -0.01)]. On the contrary, a positive association with lymphocytes was observed, which was, significant among those with lower hs-CRP [0.17 mg/l (95% CI 0.02, 0.32)]. A neutrophil-to-lymphocyte ratio significant decrease was also observed with the increment of parental education (P<0.001). CONCLUSION We found that parental education was positively associated with a higher proportion of lymphocytes and a lower proportion of neutrophils, suggesting that parental education is associated with offsprinǵs innate immune system regulation. These results may contribute to clarify the relationships between childhood socioeconomic status and increased risk of adverse cardiovascular outcomes and other immune-related diseases.
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Affiliation(s)
- Isaac Barroso
- Department of Clinical Pathology, São João Hospital Centre, EPE, Porto, Portugal.,EPIUnit, Instituto de Saúde Pública, University of Porto, Porto, Portugal
| | - Maria Cabral
- EPIUnit, Instituto de Saúde Pública, University of Porto, Porto, Portugal
| | - Elisabete Ramos
- EPIUnit, Instituto de Saúde Pública, University of Porto, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - João T Guimarães
- Department of Clinical Pathology, São João Hospital Centre, EPE, Porto, Portugal.,EPIUnit, Instituto de Saúde Pública, University of Porto, Porto, Portugal.,Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
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9
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Spitsin S, Pappa V, Kinder A, Evans DL, Rappaport J, Douglas SD. Effect of aprepitant on kynurenine to tryptophan ratio in cART treated and cART naïve adults living with HIV. Medicine (Baltimore) 2021; 100:e25313. [PMID: 34114978 PMCID: PMC8202663 DOI: 10.1097/md.0000000000025313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/03/2021] [Indexed: 01/04/2023] Open
Abstract
Changes in tryptophan metabolism affect human physiology including the immune system, mood, and sleep and are associated with human immunodeficiency virus (HIV) pathogenesis. This study investigates whether the treatment of HIV-infected individuals with the neurokinin-1 receptor antagonist, aprepitant, alters tryptophan metabolism.This study utilized archival samples from 3 phase 1B clinical trials "Anti-HIV Neuroimmunomodulatory Therapy with Neurokinin-1 Antagonist Aprepitant"-2 double-blinded, placebo-controlled, and 1 open-label study. We tested samples from a total of 57 individuals: 26 combination antiretroviral therapy (cART) naïve individuals receiving aprepitant, 19 cART naïve individuals receiving placebo, and 12 individuals on a ritonavir-containing cART regimen receiving aprepitant. We evaluated the effect of aprepitant on tryptophan metabolism by measuring levels of kynurenine and tryptophan in archival plasma samples and calculating the kynurenine to tryptophan ratio.Aprepitant treatment affected tryptophan metabolism in both cART treated and cART naïve individuals with more profound effects in patients receiving cART. While aprepitant treatment affected tryptophan metabolism in all HIV-infected patients, it only significantly decreased kynurenine to tryptophan ratio in cART treated individuals. Aprepitant treatment offers an opportunity to target inflammation and mood disorders frequently co-existing in chronic HIV infection.
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Affiliation(s)
| | | | | | - Dwight L. Evans
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jay Rappaport
- Tulane National Primate Research Center, Covington, LA, USA
| | - Steven D. Douglas
- Children's Hospital of Philadelphia Research Institute
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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10
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Abstract
OBJECTIVE The Great Recession in 2008 was a period of severe economic upheaval and myriad financial stressors. Financial stress is associated with poorer health, but for whom is this stress the most health-relevant? The current study examined the association between financial stressors and mortality, as well as whether this association varied based on people's financial status. METHODS Participants from the Midlife in the United States study (n = 2760) were assessed before (2004-2005) and after (2013-2014) the Great Recession (2008). Mortality status was then tracked from 2013 to 2017. RESULTS People who experienced more financial stressors during the Great Recession were at greater risk of early mortality over the 4-year follow-up (hazard ratio [HR] = 1.14 [1.00-1.29], p = .046). This association was moderated by the importance of financial security (B = 0.34 [0.08-0.59], p = .009). Financial stressors were more strongly associated with mortality among people who reported that financial security was important to their well-being (HR = 1.29 [1.08-1.54], p = .006) compared with people who reported it was not (HR = 1.02 [0.82-1.26], p = .89). Household income and subjective financial status did not moderate the association between financial stressors and mortality. CONCLUSIONS Experiencing financial stressors during the Great Recession was associated with increased mortality over the 4-year follow-up period, particularly for people who reported financial security was important to their well-being. Interventions designed to reduce financial stress to improve health may benefit from targeting people for whom such stressors are particularly important.
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Affiliation(s)
- Kyle J Bourassa
- From the Center for the Study of Aging and Human Development, Duke University Medical Center, and Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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11
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Liu Q, Song H, Andersson TML, Magnusson PKE, Zhu J, Smedby KE, Fang F. Psychiatric Disorders Are Associated with Increased Risk of Sepsis Following a Cancer Diagnosis. Cancer Res 2020; 80:3436-3442. [PMID: 32532824 DOI: 10.1158/0008-5472.can-20-0502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/08/2020] [Accepted: 06/09/2020] [Indexed: 02/05/2023]
Abstract
Psychiatric disorders and infections are both common comorbidities among patients with cancer. However, little is known about the role of precancer psychiatric disorders on the subsequent risk of sepsis as a complication of infections among patients with cancer. We conducted a cohort study of 362,500 patients with newly diagnosed cancer during 2006-2014 in Sweden. We used flexible parametric models to calculate the HRs of sepsis after cancer diagnosis in relation to precancer psychiatric disorders and the analyses were performed in two models. In model 1, analyses were adjusted for sex, age at cancer diagnosis, calendar period, region of residence, and type of cancer. In model 2, further adjustments were made for marital status, educational level, cancer stage, infection history, and Charlson Comorbidity Index score. During a median follow-up of 2.6 years, we identified 872 cases of sepsis among patients with cancer with precancer psychiatric disorders (incidence rate, IR, 14.8 per 1,000 person-years) and 12,133 cases among patients with cancer without such disorders (IR, 11.6 per 1000 person-years), leading to a statistically significant association between precancer psychiatric disorders and sepsis in both the simplified (HR, 1.31; 95% CI, 1.22-1.40) and full (HR, 1.26; 95% CI, 1.18-1.35) models. The positive association was consistently noted among patients with different demographic factors or cancer characteristics, for most cancer types, and during the entire follow-up after cancer diagnosis. Collectively, preexisting psychiatric disorders were associated with an increased risk of sepsis after cancer diagnosis, suggesting a need of heightened clinical awareness in this patient group. SIGNIFICANCE: These results call for extended prevention and surveillance of sepsis among patients with cancer with psychiatric comorbidities.
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Affiliation(s)
- Qianwei Liu
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- West China Biomedical Big Data Centre, West China Hospital, Sichuan University, Chengdu, China.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jianwei Zhu
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Karin E Smedby
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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12
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Waehrer GM, Miller TR, Silverio Marques SC, Oh DL, Burke Harris N. Disease burden of adverse childhood experiences across 14 states. PLoS One 2020; 15:e0226134. [PMID: 31990910 PMCID: PMC6986706 DOI: 10.1371/journal.pone.0226134] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 11/20/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To examine whether the relationship between Adverse Childhood Experiences (ACEs) and health outcomes is similar across states and persists net of ACEs associations with smoking, heavy drinking, and obesity. METHODS We use data from the Behavioral Risk Factor Surveillance System for 14 states. Logistic regressions yield estimates of the direct associations of ACEs exposure with health outcomes net of health risk factors, and indirect ACEs-health associations via health risk factors. Models were estimated for California (N = 22,475) and pooled data from 13 states (N = 110,076), and also separately by state. RESULTS Exposure to ACEs is associated with significantly higher odds of smoking, heavy drinking, and obesity. Net of these health risk factors, there was a significant and graded relationship in California and the pooled 13-state data between greater ACEs exposure and odds of depression, asthma, COPD, arthritis, and cardiovascular disease. Four or more ACEs were less consistently associated across states with cancer and diabetes and a dose-response relationship was also not present. There was a wide range across individual states in the percentage change in health outcomes predicted for exposure to 4+ ACEs. ACEs-related smoking, heavy drinking, and obesity explain a large and significant proportion of 4+ ACEs associations with COPD and cardiovascular disease, however some effect, absent of risk behavior, remained. CONCLUSIONS ACE's associations with most of the health conditions persist independent of behavioral pathways but only asthma, arthritis, COPD, cardiovascular disease, and depression consistently exhibit a dose-response relationship. Our results suggest that attention to child maltreatment and household dysfunction, mental health treatment, substance abuse prevention and promotion of physical activity and healthy weight outcomes might mitigate some adverse health consequences of ACEs. Differences across states in the pattern of ACEs-health associations may also indicate fruitful areas for prevention.
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Affiliation(s)
- Geetha M. Waehrer
- Pacific Institute for Research and Evaluation, Calverton, Maryland, United States of America
| | - Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland, United States of America
- School of Public Health, Curtin University, Perth, Australia
| | | | - Debora L. Oh
- Center for Youth Wellness, San Francisco, California, United States of America
| | - Nadine Burke Harris
- Center for Youth Wellness, San Francisco, California, United States of America
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13
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Miller TR, Waehrer GM, Oh DL, Purewal Boparai S, Ohlsson Walker S, Silverio Marques S, Burke Harris N. Adult health burden and costs in California during 2013 associated with prior adverse childhood experiences. PLoS One 2020; 15:e0228019. [PMID: 31990957 PMCID: PMC6986705 DOI: 10.1371/journal.pone.0228019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/06/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To estimate the adult health burden and costs in California during 2013 associated with adults' prior Adverse Childhood Experiences (ACEs). METHODS We analyzed five ACEs-linked conditions (asthma, arthritis, COPD, depression, and cardiovascular disease) and three health risk factors (lifetime smoking, heavy drinking, and obesity). We estimated ACEs-associated fractions of disease risk for people aged 18+ for these conditions by ACEs exposure using inputs from a companion study of California Behavioral Risk Factor Surveillance System data for 2008-2009, 2011, and 2013. We combined these estimates with published estimates of personal healthcare spending and Disability-Adjusted-Life-Years (DALYs) in the United States by condition during 2013. DALYs captured both the years of healthy life lost to disability and the years of life lost to deaths during 2013. We applied a published estimate of cost per DALY. RESULTS Among adults in California, 61% reported ACEs. Those ACEs were associated with $10.5 billion in excess personal healthcare spending during 2013, and 434,000 DALYs valued at approximately $102 billion dollars. During 2013, the estimated health burden per exposed adult included $589 in personal healthcare expenses and 0.0224 DALYs valued at $5,769. CONCLUSIONS Estimates of the costs of childhood adversity are far greater than previously understood and provide a fiscal rationale for prevention efforts.
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Affiliation(s)
- Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland, United States of America
- School of Public Health, Curtin University, Perth, Australia
| | - Geetha M. Waehrer
- Pacific Institute for Research and Evaluation, Calverton, Maryland, United States of America
| | - Debora L. Oh
- University of California, San Francisco, California, United States of America
| | | | - Sheila Ohlsson Walker
- Children’s National Medical Center, George Washington University, Washington, DC, United States of America
| | | | - Nadine Burke Harris
- Center for Youth Wellness, San Francisco, California, United States of America
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14
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Using street view data and machine learning to assess how perception of neighborhood safety influences urban residents' mental health. Health Place 2019; 59:102186. [PMID: 31400645 DOI: 10.1016/j.healthplace.2019.102186] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 12/15/2022]
Abstract
Previous studies have shown that perceptions of neighborhood safety are associated with various mental health outcomes. However, scant attention has been paid to the mediating pathways by which perception of neighborhood safety affects mental health. In addition, most previous studies have evaluated perception of neighborhood safety with questionnaires or field audits, both of which are labor-intensive and time-consuming. This study is the first attempt to measure perception of neighborhood safety using street view data and a machine learning approach. Four potential mediating pathways linking perception of neighborhood safety to mental health were explored for 1029 participants from 35 neighborhoods of Guangzhou, China. The results of multilevel regression models confirm that perception of neighborhood safety is positively associated with mental health. More importantly, physical activity, social cohesion, stress and life satisfaction mediate this relationship. The results of a moderation analysis suggest that the beneficial effects of physical activity and social cohesion on mental health are strengthened by a perception of neighborhood safety. Our findings suggest the need to increase residents' perception of neighborhood safety to maintain mental health in urban areas of China.
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15
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Dhabhar FS. The short-term stress response - Mother nature's mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity. Front Neuroendocrinol 2018; 49:175-192. [PMID: 29596867 PMCID: PMC5964013 DOI: 10.1016/j.yfrne.2018.03.004] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 02/07/2023]
Abstract
Our group has proposed that in contrast to chronic stress that can have harmful effects, the short-term (fight-or-flight) stress response (lasting for minutes to hours) is nature's fundamental survival mechanism that enhances protection and performance under conditions involving threat/challenge/opportunity. Short-term stress enhances innate/primary, adaptive/secondary, vaccine-induced, and anti-tumor immune responses, and post-surgical recovery. Mechanisms and mediators include stress hormones, dendritic cell, neutrophil, macrophage, and lymphocyte trafficking/function and local/systemic chemokine and cytokine production. Short-term stress may also enhance mental/cognitive and physical performance through effects on brain, musculo-skeletal, and cardiovascular function, reappraisal of threat/anxiety, and training-induced stress-optimization. Therefore, short-term stress psychology/physiology could be harnessed to enhance immuno-protection, as well as mental and physical performance. This review aims to provide a conceptual framework and targets for further investigation of mechanisms and conditions under which the protective/adaptive aspects of short-term stress/exercise can be optimized/harnessed, and for developing pharmacological/biobehavioral interventions to enhance health/healing, and mental/cognitive/physical performance.
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Affiliation(s)
- Firdaus S Dhabhar
- Department of Psychiatry & Behavioral Sciences, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Mail Stop M877, 1550 NW 10th Avenue, Miami, FL 33136-1000, United States.
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16
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Zhu J, Sjölander A, Fall K, Valdimarsdottir U, Fang F. Mental disorders around cancer diagnosis and increased hospital admission rate - a nationwide cohort study of Swedish cancer patients. BMC Cancer 2018; 18:322. [PMID: 29580232 PMCID: PMC5870174 DOI: 10.1186/s12885-018-4270-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 03/20/2018] [Indexed: 12/19/2022] Open
Abstract
Background Whether the emotional distress around cancer diagnosis is associated with the long-term outcomes and care utilization is unknown. We aimed to examine the association of mental disorders around cancer diagnosis with the hospital admission rates of cancer patients thereafter. Methods We conducted a nationwide cohort study including 218,508 cancer patients diagnosed in Sweden during 2004–2009 and followed them from 90 days after cancer through 2010. We used a clinical diagnosis of stress-related mental disorders from 90 days before to 90 days after cancer diagnosis as the exposure. We studied first all hospital admissions and then separately three common admissions, including external injuries, infections, and cardiovascular diseases. The Cox model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Results Four thousand one hundred five patients received a diagnosis of stress-related mental disorders around the cancer diagnosis, and experienced a 35% increased rate of any hospital admission during follow-up (HR: 1.35, 95%CI: 1.28–1.41) as well as hospital admissions for external injuries (HR: 1.89, 95%CI: 1.67–2.14), infections (HR: 1.28, 95%CI: 1.08–1.52), and cardiovascular diseases (HR: 1.16, 95%CI: 1.03–1.30). Similar association was noted for most common cancer types. Conclusions These data suggest that cancer patients diagnosed with a stress-related mental disorder immediately before or after cancer diagnosis are subsequently at increased risk of hospital admissions for major comorbidities of cancer. Electronic supplementary material The online version of this article (10.1186/s12885-018-4270-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jianwei Zhu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Stockholm, Sweden.
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Stockholm, Sweden
| | - Katja Fall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Stockholm, Sweden.,Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, SE-701 82, Örebro, Sweden
| | - Unnur Valdimarsdottir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Stockholm, Sweden.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA.,Faculty of Medicine, Center of Public Health Sciences, School of Health Sciences, University of Iceland, Sæmundargata 2, Reykjavík, Iceland
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Stockholm, Sweden
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17
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Jonker I, Rosmalen JGM, Schoevers RA. Childhood life events, immune activation and the development of mood and anxiety disorders: the TRAILS study. Transl Psychiatry 2017; 7:e1112. [PMID: 28463238 PMCID: PMC5534944 DOI: 10.1038/tp.2017.62] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/09/2016] [Accepted: 02/10/2017] [Indexed: 12/11/2022] Open
Abstract
The experience of childhood life events is associated with higher vulnerability to develop psychiatric disorders. One of the pathways suggested to lead to this vulnerability is activation of the immune system. The aim of this study is to find out whether the association between childhood life events and the development of mood and anxiety disorders is predicted by the activation of the immune system. This study was performed in TRAILS, a large prospective population cohort, from which a subgroup was selected (N=1084, 54.3% female, mean age 19.0 (s.d., 0.6)). Childhood life events before age 16 were assessed using questionnaires at age 12, 14, 16 and 19. Immune activation was assessed at age 16 by elevated high-sensitive C-reactive protein (hsCRP) and by levels of immunoglobulin G antibodies against the herpes viruses herpes simplex virus 1, cytomegalovirus and Epstein-Barr virus. At age 19, the presence of mood and anxiety disorders was determined using the World Health Organization Composite International Diagnostic Interview Version 3.0. Regression analyses were used to study the association between life events, the inflammatory markers and mental health. We found that childhood life events score was associated with risk of mood disorders (B=0.269, P<0.001) and anxiety disorders (B=0.129, P<0.001). Childhood life events score was marginally associated with elevated hsCRP (B=0.076, P=0.006), but not with the antibody levels. This was especially due to separation trauma (P=0.015) and sexual abuse (P=0.019). Associations lost significance after correcting for lifestyle factors such as body mass index and substance abuse (P=0.042). None of the inflammatory markers were associated with development of anxiety disorders or mood disorders. In conclusion, the life event scores predicted the development of anxiety disorders and mood disorders at age 19. Life event scores were associated with elevated hsCRP, which was partly explained by lifestyle factors. Elevated hsCRP was not associated with the development of psychiatric disorders at age 19.
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Affiliation(s)
- I Jonker
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands,Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), Hanzeplein 1, Postbus 30.001, Groningen 9700 RB, The Netherlands. E-mail:
| | - J G M Rosmalen
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands,Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R A Schoevers
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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18
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Personality modulates proportions of CD4 + regulatory and effector T cells in response to socially induced stress in a rodent of wild origin. Physiol Behav 2016; 167:255-264. [DOI: 10.1016/j.physbeh.2016.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/02/2016] [Accepted: 09/15/2016] [Indexed: 12/20/2022]
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19
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Ray A, Gulati K, Rai N. Stress, Anxiety, and Immunomodulation: A Pharmacological Analysis. VITAMINS AND HORMONES 2016; 103:1-25. [PMID: 28061967 DOI: 10.1016/bs.vh.2016.09.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Stress and stressful events are common occurrences in our daily lives and such aversive situations bring about complex changes in the biological system. Such stress responses influence the brain and behavior, neuroendocrine and immune systems, and these responses orchestrate to increase or decrease the ability of the organism to cope with such stressors. The brain via expression of complex behavioral paradigms controls peripheral responses to stress and a bidirectional link exists in the modulation of stress effects. Anxiety is a common neurobehavioral correlate of a variety of stressors, and both acute and chronic stress exposure could precipitate anxiety disorders. Psychoneuroimmunology involves interactions between the brain and the immune system, and it is now being increasingly recognized that the immune system could contribute to the neurobehavioral responses to stress. Studies have shown that the brain and its complex neurotransmitter networks could influence immune function, and there could be a possible link between anxiogenesis and immunomodulation during stress. Physiological and pharmacological data have highlighted this concept, and the present review gives an overview of the relationship between stress, anxiety, and immune responsiveness.
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Affiliation(s)
- A Ray
- Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
| | - K Gulati
- Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - N Rai
- Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
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20
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Biswas UN. Promoting Health and Well-being in Lives of People Living with HIV and AIDS. PSYCHOLOGY AND DEVELOPING SOCIETIES 2016. [DOI: 10.1177/097133360701900205] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The highly effective pharmaceutical polytherapies for the treatment of HIV (Human immunodeficiency virus) and AIDS (Acquired immune deficiency syndrome) have practically reduced HIV and AIDS to a chronic condition like any other chronic illness. People living with HIV and AIDS can now have an almost normal life expectancy; the challenge for them is to live a physically and mentally healthy life. These challenges involve avoiding and managing opportunistic infections physically on one hand and taking care of their mental health needs and promoting and sustaining psycho-social well-being on the other hand. Although a torrent of research has studied the psychosocial correlates of slower disease progression and psycho-social well-being among people living with HIV and AIDS, very few sustained approaches have been made to understand and isolate the contribution of different psycho-bio-behavioural parameters for the psycho-immuno-enhancement in people living with HIV and AIDS. Systematic search in different electronic databases as well as different relevant psychological and AIDS care journals have been done to assimilate and review the research studying the effect of different psycho-social, bio-behavioural interventions through randomised control trials on the health promotion, well-being and disease progression parameters in people living with HIV and AIDS. The article makes an attempt to synchronise and consolidate these research efforts, discussing the role of cognitive behavioural stress management, exercise, spiritual practices, hypnosis, relaxation and guided imagery, social support for the psycho-immuno-enhancement in lives of people living with HIV and AIDS, and suggests a comprehensive three-tier intervention model, consisting of intervention at individual, dyadic and community levels, for psychological and immunological improvement in lives of people living with HIV and AIDS.
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Affiliation(s)
- Urmi Nanda Biswas
- Urmi Nanda Biswas is based at the Department of Psychology, The M.S. University, Gujarat, India. This paper was prepared during the author's placement at the Clinical and Health Psychology Research Centre, Roehampton University, London, as a Commonwealth Fellow. The author acknowledges the support of the University resources to prepare the paper
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21
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Affiliation(s)
- Monica Bucci
- Center for Youth Wellness, 3450 3rd Street, Building 2, Suite 201, San Francisco, CA 94124, USA
| | - Sara Silvério Marques
- Center for Youth Wellness, 3450 3rd Street, Building 2, Suite 201, San Francisco, CA 94124, USA.
| | - Debora Oh
- Center for Youth Wellness, 3450 3rd Street, Building 2, Suite 201, San Francisco, CA 94124, USA
| | - Nadine Burke Harris
- Center for Youth Wellness, 3450 3rd Street, Building 2, Suite 201, San Francisco, CA 94124, USA
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22
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Temoshok LR. Connecting the Dots Linking Mind, Behavior, and Disease: The Biological Concomitants of Coping Patterns: Commentary on “Attachment and Cancer: A Conceptual Integration”. Integr Cancer Ther 2016; 1:387-91. [PMID: 14664732 DOI: 10.1177/1534735402238189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lydia R Temoshok
- Institute of Human Virology, University of Maryland at Baltimore, 21201, USA.
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23
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Hulett JM, Armer JM. A Systematic Review of Spiritually Based Interventions and Psychoneuroimmunological Outcomes in Breast Cancer Survivorship. Integr Cancer Ther 2016; 15:405-423. [PMID: 27151592 PMCID: PMC5125023 DOI: 10.1177/1534735416636222] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 11/17/2022] Open
Abstract
Objective This is a review of spiritually based interventions (eg, mindfulness-based stress reduction) that utilized psychoneuroimmunological (PNI) outcome measures in breast cancer survivors. Specifically, this review sought to examine the evidence regarding relationships between spiritually based interventions, psychosocial-spiritual outcomes, and biomarker outcomes in breast cancer survivors. Methods A systematic search of 9 online databases was conducted for articles of original research, peer-reviewed, randomized and nonrandomized control trials from 2005-2015. Data were extracted in order to answer selected questions regarding relationships between psychosocial-spiritual and physiological measures utilized in spiritually based interventions. Implications for future spiritually based interventions in breast cancer survivorship are discussed. Results Twenty-two articles were reviewed. Cortisol was the most common PNI biomarker outcome studied. Compared with control groups, intervention groups demonstrated positive mental health outcomes and improved or stable neuroendocrine-immune profiles, although limitations exist. Design methods have improved with regard to increased use of comparison groups compared with previous reviews. There are few spiritually based interventions that specifically measure religious or spiritual constructs. Similarly, there are few existing studies that utilize standardized religious or spiritual measures with PNI outcome measures. Findings suggest that a body of knowledge now exists in support of interventions with mindfulness-breathing-stretching components; furthermore, these interventions appear to offer potential improvement or stabilization of neuroendocrine-immune activity in breast cancer survivors compared to control groups. Conclusion From a PNI perspective, future spiritually based interventions should include standardized measures of religiousness and spirituality in order to understand relationships between and among religiousness, spirituality, and neuroendocrine-immune outcomes. Future research should now focus on determining the minimum dose and duration needed to improve or stabilize neuroendocrine-immune function, as well as diverse setting needs, including home-based practice for survivors who are too ill to travel to group sessions or lack economic resources.
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24
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Theron G, Peter J, Zijenah L, Chanda D, Mangu C, Clowes P, Rachow A, Lesosky M, Hoelscher M, Pym A, Mwaba P, Mason P, Naidoo P, Pooran A, Sohn H, Pai M, Stein DJ, Dheda K. Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study. BMC Infect Dis 2015; 15:253. [PMID: 26126655 PMCID: PMC4487582 DOI: 10.1186/s12879-015-0964-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 05/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The successful cure of tuberculosis (TB) is dependent on adherence to treatment. Various factors influence adherence, however, few are easily modifiable. There are limited data regarding correlates of psychological distress and their association with non-adherence to anti-TB treatment. METHODS In a trial of a new TB test, we measured psychological distress (K-10 score), TB-related health literacy, and morbidity (TBscore), prior to diagnosis in 1502 patients with symptoms of pulmonary TB recruited from clinics in Cape Town (n = 419), Harare (n = 400), Lusaka (n = 400), Durban (n = 200), and Mbeya (n = 83). Socioeconomic, demographic, and alcohol usage-related data were captured. Patients initiated on treatment had their DOTS cards reviewed at two-and six-months. RESULTS 22 %(95 % CI: 20 %, 25 %) of patients had severe psychological distress (K-10 ≥ 30). In a multivariable linear regression model, increased K-10 score was independently associated with previous TB [estimate (95 % CI) 0.98(0.09-1.87); p = 0.0304], increased TBscore [1(0.80, 1.20); p <0.0001], and heavy alcohol use [3.08(1.26, 4.91); p = 0.0010], whereas male gender was protective [-1.47(-2.28, -0.62); p = 0.0007]. 26 % (95 % CI: 21 %, 32 %) of 261 patients with culture-confirmed TB were non-adherent. In a multivariable logistic regression model for non-adherence, reduced TBscore [OR (95 % CI) 0.639 (0.497, 0.797); p = 0.0001], health literacy score [0.798(0.696, 0.906); p = 0.0008], and increased K-10 [1.082(1.033, 1.137); p = 0.0012], and heavy alcohol usage [14.83(2.083, 122.9); p = 0.0002], were independently associated. Culture-positive patients with a K-10 score ≥ 30 were more-likely to be non-adherent (OR = 2.290(1.033-5.126); p = 0.0416]. CONCLUSION Severe psychological distress is frequent amongst TB patients in Southern Africa. Targeted interventions to alleviate psychological distress, alcohol use, and improve health literacy in newly-diagnosed TB patients could reduce non-adherence to treatment.
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Affiliation(s)
- Grant Theron
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, H47 Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.
| | - Jonny Peter
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, H47 Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.
| | - Lynn Zijenah
- Department of Immunology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
| | - Duncan Chanda
- University Teaching Hospital, Lusaka, Zambia. .,Institute for Medical Research & Training, Lusaka, Zambia.
| | - Chacha Mangu
- National Institute of Medical Research, Mbeya Medical Research Centre, Mbeya, Tanzania.
| | - Petra Clowes
- National Institute of Medical Research, Mbeya Medical Research Centre, Mbeya, Tanzania. .,Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), Munich, Germany.
| | - Andrea Rachow
- National Institute of Medical Research, Mbeya Medical Research Centre, Mbeya, Tanzania. .,Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), Munich, Germany.
| | - Maia Lesosky
- Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), Munich, Germany. .,German Centre for Infection Research (DZIF), Munich, Germany.
| | - Alex Pym
- South African Medical Research Council, Durban, South Africa. .,KwaZulu Research Institute for Tuberculosis and HIV (K-RITH), Durban, South Africa.
| | - Peter Mwaba
- University Teaching Hospital, Lusaka, Zambia. .,Institute for Medical Research & Training, Lusaka, Zambia.
| | - Peter Mason
- Biomedical Research & Training Institute, Harare, Zimbabwe.
| | - Pamela Naidoo
- Population Health, Health Systems and Innovation (PHHSI)/HIV/STIs and TB (HAST) Research Programmes, Human Sciences Research Council, Cape Town, South Africa.
| | - Anil Pooran
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, H47 Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.
| | - Hojoon Sohn
- McGill International TB Centre & Department of Epidemiology & Biostatistics, McGill University, Montreal, Canada.
| | - Madhukar Pai
- McGill International TB Centre & Department of Epidemiology & Biostatistics, McGill University, Montreal, Canada.
| | - Dan J Stein
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Keertan Dheda
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, H47 Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.
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McIntosh RC, Hurwitz BE, Antoni M, Gonzalez A, Seay J, Schneiderman N. The ABCs of Trait Anger, Psychological Distress, and Disease Severity in HIV. Ann Behav Med 2015; 49:420-33. [PMID: 25385204 PMCID: PMC4623323 DOI: 10.1007/s12160-014-9667-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Trait anger consists of affective, behavioral, and cognitive (ABC) dimensions and may increase vulnerability for interpersonal conflict, diminished social support, and greater psychological distress. The concurrent influence of anger and psychosocial dysfunction on Human Immunodeficiency Virus (HIV) disease severity is unknown. PURPOSE The purpose of this study was to examine plausible psychosocial avenues (e.g., coping, social support, psychological distress), whereby trait anger may indirectly influence HIV disease status. METHODS Three hundred seventy-seven HIV seropositive adults, aged 18-55 years (58% AIDS-defined), completed a battery of psychosocial surveys and provided a fasting blood sample for HIV-1 viral load and T lymphocyte count assay. RESULTS A second-order factor model confirmed higher levels of the multidimensional anger trait, which was directly associated with elevated psychological distress and avoidant coping (p<.001) and indirectly associated with greater HIV disease severity (p<.01) (comparative fit index (CFI)=0.90, root-mean-square error of approximation (RMSEA)=0.06, standardized root-mean-square residual (SRMR)=0.06). CONCLUSION The model supports a role for the ABC components of anger, which may negatively influence immune function through various psychosocial mechanisms; however, longitudinal study is needed to elucidate these effects.
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Affiliation(s)
- Roger C McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL, 33124, USA,
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Cytomegalovirus Antibody Elevation in Bipolar Disorder: Relation to Elevated Mood States. Neural Plast 2015; 2015:939780. [PMID: 26075105 PMCID: PMC4444593 DOI: 10.1155/2015/939780] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 10/23/2014] [Indexed: 11/18/2022] Open
Abstract
The neurobiology of mood states is complicated by exposure to everyday stressors (e.g., psychosocial, ubiquitous environmental infections like CMV), each fluctuating between latency and reactivation. CMV reactivation induces proinflammatory cytokines (e.g., TNF-α) associated with induction of neurotoxic metabolites and the presence of mood states in bipolar disorder (BD). Whether CMV reactivation is associated with bipolar diagnoses (trait) or specific mood states is unclear. We investigated 139 BD type I and 99 healthy controls to determine if concentrations of IgG antibodies to Herpesviridae (e.g., CMV, HSV-1, and HSV-2) were associated with BD-I diagnosis and specific mood states. We found higher CMV antibody concentration in BD-I than in healthy controls (T234 = 3.1, Puncorr = 0.002; Pcorr = 0.006) but no difference in HSV-1 (P > 0.10) or HSV-2 (P > 0.10). Compared to euthymic BD-I volunteers, CMV IgG was higher in BD-I volunteers with elevated moods (P < 0.03) but not different in depressed moods (P > 0.10). While relationships presented between BD-I diagnosis, mood states, and CMV antibodies are encouraging, they are limited by the study's cross sectional nature. Nevertheless, further testing is warranted to replicate findings and determine whether reactivation of CMV infection exacerbates elevated mood states in BD-I.
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Abstract
OBJECTIVE To characterize the relationship between stress and future risk of sepsis. We also evaluated the role of depression in this relationship. METHODS We used population-based data on 30,183 participants in the Reasons for Geographic and Racial Differences in Stroke cohort, characterizing stress using the Perceived Stress Scale (PSS) and depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). We identified incident sepsis events as hospitalizations for a serious infection with the presence of at least two systemic inflammatory response syndrome criteria. We assessed associations between PSS and incidence of sepsis for 1 and 10 years of follow-up, adjusting for demographics and chronic medical conditions and assessing the role of health behaviors and CES-D in these relationships. RESULTS In 2003 to 2012, 1500 participants experienced an episode of sepsis. Mean PSS and CES-D scores were 3.2 (2.9) and 1.2 (2.1). PSS was associated with increased 1-year adjusted incidence of sepsis (hazard ratio [HR] = 1.21 per PSS standard deviation, 95% confidence interval = 1.06-1.38); multivariable adjustment for health behaviors and CES-D did not change this association (1.20, 1.03-1.39). PSS was also associated with increased 10-year adjusted incidence of sepsis (HR = 1.07 per PSS standard deviation; 95% confidence interval = 1.02-1.13). Multivariable adjustment showed that health behaviors did not affect this long-term association, whereas the addition of CES-D reduced the association between PSS and sepsis during 10-year follow-up (HR = 1.04, 0.98-1.11). CONCLUSIONS Increased stress was associated with higher 1-year adjusted incidence of sepsis, even after accounting for depressive symptoms. The association between stress and 10-year adjusted incidence of sepsis was also significant, but this association was reduced when adjusting for depressive symptoms. Reduction of stress may limit short-term sepsis risk.
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Wainstock T, Shoham-Vardi I, Glasser S, Anteby E, Lerner-Geva L. Fetal sex modifies effects of prenatal stress exposure and adverse birth outcomes. Stress 2015; 18:49-56. [PMID: 25319674 DOI: 10.3109/10253890.2014.974153] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Prenatal maternal stress is associated with pregnancy complications, poor fetal development and poor birth outcomes. Fetal sex has also been shown to affect the course of pregnancy and its outcomes. The aim of this study was to evaluate whether fetal sex modifies the association between continuous exposure to life-threatening rocket attack alarms and adverse pregnancy outcomes. A retrospective cohort study was conducted in which the exposed group was comprised of 1846 women exposed to rocket-attack alarms before and during pregnancy. The unexposed group, with similar sociodemographic characteristics, delivered during the same period of time at the same medical center, but resided out of rocket-attack range. Multivariable models for each gender separately, controlling for possible confounders, evaluated the risk associated with exposure for preterm births (PTB), low birthweight (LBW), small for gestational age and small head circumference (HC). In both univariable and multivariable analyses exposure status was a significant risk factor in female fetuses only: PTB (adj. OR = 1.43; 1.04-1.96), LBW (adj. OR = 1.41; 1.02-1.95) and HC < 31 cm (adj. OR = 1.78; 1.11-2.88). In addition, regarding all adverse outcomes, the male-to-female ratio was higher in the exposed group than in the unexposed group. The findings support the hypothesis that male and female fetuses respond differentially to chronic maternal stress.
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Affiliation(s)
- Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel
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Carlsson E, Frostell A, Ludvigsson J, Faresjö M. Psychological stress in children may alter the immune response. THE JOURNAL OF IMMUNOLOGY 2014; 192:2071-81. [PMID: 24501202 DOI: 10.4049/jimmunol.1301713] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Psychological stress is a public health issue even in children and has been associated with a number of immunological diseases. The aim of this study was to examine the relationship between psychological stress and immune response in healthy children, with special focus on autoimmunity. In this study, psychological stress was based on a composite measure of stress in the family across the domains: 1) serious life events, 2) parenting stress, 3) lack of social support, and 4) parental worries. PBMCs, collected from 5-y-old high-stressed children (n = 26) and from 5-y-old children without high stress within the family (n = 52), from the All Babies In Southeast Sweden cohort, were stimulated with Ags (tetanus toxoid and β-lactoglobulin) and diabetes-related autoantigens (glutamic acid decarboxylase 65, insulin, heat shock protein 60, and tyrosine phosphatase). Immune markers (cytokines and chemokines), clinical parameters (C-peptide, proinsulin, glucose), and cortisol, as an indicator of stress, were analyzed. Children from families with high psychological stress showed a low spontaneous immune activity (IL-5, IL-10, IL-13, IL-17, CCL2, CCL3, and CXCL10; p < 0.01) but an increased immune response to tetanus toxoid, β-lactoglobulin, and the autoantigens glutamic acid decarboxylase 65, heat shock protein 60, and tyrosine phosphatase (IL-5, IL-6, IL-10, IL-13, IL-17, IFN-γ, TNF-α, CCL2, CCL3, and CXCL10; p < 0.05). Children within the high-stress group showed high level of cortisol, but low level of C-peptide, compared with the control group (p < 0.05). This supports the hypothesis that psychological stress may contribute to an imbalance in the immune response but also to a pathological effect on the insulin-producing β cells.
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Affiliation(s)
- Emma Carlsson
- School of Health Sciences, Department of Natural Science and Biomedicine, The Biomedical Platform, Jönköping University, SE-551 11 Jönköping, Sweden
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Kim WJ, Son WS, Ahn DH, Im H, Ahn HC, Lee BJ. Solution structure of Rv0569, potent hypoxic signal transduction protein, from Mycobacterium tuberculosis. Tuberculosis (Edinb) 2013; 94:43-50. [PMID: 24275361 DOI: 10.1016/j.tube.2013.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 08/29/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
Abstract
The latent infection is unique characteristic of Mycobacterium tuberculosis to overcome human immune response for its survival. The M. tb develops adaptation to extreme stress conditions to increase the viability, thus easily acquires drug resistance than any other bacteria and maintains a long-term infection status without any symptoms. Rv0569 is a conserved hypothetical protein that overexpresses under dormant state induced by hypoxia, starvation, and medication. To study function and structure in detail, we determined the solution structure of Rv0569 by NMR. NOE and RDC restraints were used to calculate the structure, which was further refined with AMBER. Rv0569 is composed of five antiparallel β-sheets and one α-helix. Rv0569 shows structural similarity with its homolog Rv2302, yet there is a big difference in the orientation of C-terminal α-helix between Rv0569 and Rv2302. According to previous studies, Rv0569 might comprise a hypoxia induced operon with the Rv0570 which is located 29 bp downstream of the Rv0569 and Rv0570 plays an important role in the latent infection. From our structure and bioinformatics research, we suggest that Rv0569 contributes to signaling transduction in hypoxic condition by binding with DNA for upregulation of Rv0570 or supporting Rv0570 for binding ATP during dormancy of tuberculosis.
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Affiliation(s)
- Won-Je Kim
- College of Pharmacy, Seoul National University, Gwanak-Gu, Seoul 151-742, Republic of Korea
| | - Woo Sung Son
- College of Pharmacy, CHA University, 120 Haeryong-ro, Pocheon-si, Gyeonggi-do 487-010, Republic of Korea
| | - Do-Hwan Ahn
- College of Pharmacy, Seoul National University, Gwanak-Gu, Seoul 151-742, Republic of Korea
| | - Hookang Im
- College of Pharmacy, Seoul National University, Gwanak-Gu, Seoul 151-742, Republic of Korea
| | - Hee-Chul Ahn
- College of Pharmacy, Dongguk University, 32 Dongguk-ro, Ilsandong-gu, Goyang-si 410-820, Republic of Korea
| | - Bong-Jin Lee
- College of Pharmacy, Seoul National University, Gwanak-Gu, Seoul 151-742, Republic of Korea.
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Wong SYS, Wong CK, Chan FWK, Chan PKS, Ngai K, Mercer S, Woo J. Chronic psychosocial stress: does it modulate immunity to the influenza vaccine in Hong Kong Chinese elderly caregivers? AGE (DORDRECHT, NETHERLANDS) 2013; 35:1479-93. [PMID: 22772580 PMCID: PMC3705094 DOI: 10.1007/s11357-012-9449-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 06/20/2012] [Indexed: 05/08/2023]
Abstract
Previous studies evaluated the effects of psychosocial stress on influenza vaccine responses. However, there were methodological limitations. This study aims to determine whether chronic stress is associated with poorer influenza-specific immune responses to influenza vaccines in Hong Kong Chinese elderly people. This is a prospective study with a 12-week follow-up. Subjects were recruited from government general out-patient clinics, non-government organizations, and public housing estates in Hong Kong. Participants include 55 caregivers of spouses with chronic conditions that impaired their activities of daily living and 61 age- and sex-matched non-caregivers. A single-dose trivalent influenza vaccine was given to all subjects by intramuscular ingestion. Blood samples were collected before vaccination, at 6 weeks, and at 12 weeks after vaccination. Influenza vaccine strain-specific antibody titers were measured by the hemagglutination inhibition method. Lymphocyte subsets were analyzed for ratios and absolute counts, and cytokine concentration were measured by flow cytometry. Validated scales were used to assess psychological (depressive symptoms, perceived stress, and caregiver strain), social (multidimensional social support scale), and lifestyle factors (physical exercise, cigarette smoking, and alcohol consumption) at baseline prior to vaccination. Demographic and socioeconomic variables were also collected. Albumin levels were measured as an indicator for nutritional status in subjects. Caregivers had statistically significant (p < 0.05) lower cell-mediated immune responses to influenza vaccination at 12 weeks when compared with those of the controls. No differences in humoral immune response to vaccination were observed between caregivers and controls. Hong Kong Chinese elderly who experience chronic stress have a significantly lower cell-mediated immune response to influenza vaccination when compared with non-caregivers.
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Affiliation(s)
- Samuel Yeung Shan Wong
- The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Vlajinac H, Sipetic S, Marinkovic J, Ratkov I, Maksimovic J, Dzoljic E, Kostic V. The stressful life events and Parkinson's disease: a case-control study. Stress Health 2013; 29:50-5. [PMID: 22396022 DOI: 10.1002/smi.2424] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 09/09/2011] [Accepted: 01/04/2012] [Indexed: 12/17/2022]
Abstract
A case-control study was conducted in order to investigate the possible link between stressful life events and Parkinson's disease (PD). A group of 110 consecutive newly diagnosed PD cases treated at the Institute of Neurology, Faculty of Medicine, Belgrade University, was compared with a control group comprising 220 subjects with degenerative joint disease and some diseases of the digestive tract. The case and control subjects were matched by sex, age (±2 years) and place of residence (urban/rural). According to conditional multivariate logistic regression analysis, PD was found to be significantly related to retirement (odds ratio--OR 18.73, 95% confidence interval--95%CI 1.9-175.4), birth of own child (OR 66.22, 95%CI 8.3-526.3) and air raids (OR 5.66, 95%CI 2.4-13.5). The risk of PD significantly increased with the number of stressful events. The results of the present study support the hypothesis that stress may play a role in the development of PD.
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Affiliation(s)
- Hristina Vlajinac
- Institute of Epidemiology, Faculty of Medicine, Belgrade University, Belgrade, Serbia.
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Hall MD, Vettiger A, Ebert D. Interactions between environmental stressors: the influence of salinity on host-parasite interactions between Daphnia magna and Pasteuria ramosa. Oecologia 2012; 171:789-96. [PMID: 23001624 DOI: 10.1007/s00442-012-2452-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 08/24/2012] [Indexed: 11/26/2022]
Abstract
Interactions between environmental stressors play an important role in shaping the health of an organism. This is particularly true in terms of the prevalence and severity of infectious disease, as stressors in combination will not always act to simply decrease the immune function of a host, but may instead interact to compound or even oppose the influence of parasitism on the health of an organism. Here, we explore the impact of environmental stress on host-parasite interactions using the water flea Daphnia magna and it is obligate parasite Pasteuria ramosa. Utilising an ecologically relevant stressor, we focus on the combined effect of salinity and P. ramosa on the fecundity and survival of the host, as well as on patterns of infectivity and the proliferation of the parasite. We show that in the absence of the parasite, host fecundity and survival was highest in the low salinity treatments. Once a parasite was introduced into the environment, however, salinity and parasitism acted antagonistically to influence both host survival and fecundity, and these patterns of disease were unrelated to infection rates or parasite spore loads. By summarising the form of interactions found in the broader Daphnia literature, we highlight how the combined effect of stress and parasitism will vary with the type of stressor, the trait used to describe the health of Daphnia and the host-parasite combination under observation. Our results highlight how the context-dependent nature of interactions between stress and parasitism inevitably complicates the link between environmental factors and the prevalence and severity of disease.
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Affiliation(s)
- Matthew D Hall
- Zoologisches Institut, Evolutionsbiologie, University of Basel, Basel, Switzerland.
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Danese A, McEwen BS. Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol Behav 2012; 106:29-39. [PMID: 21888923 DOI: 10.1016/j.physbeh.2011.08.019] [Citation(s) in RCA: 1157] [Impact Index Per Article: 96.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 08/16/2011] [Accepted: 08/17/2011] [Indexed: 12/15/2022]
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Salim S, Chugh G, Asghar M. Inflammation in Anxiety. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY VOLUME 88 2012; 88:1-25. [DOI: 10.1016/b978-0-12-398314-5.00001-5] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Abstract
Stress is a constant factor in today's fastpaced life that can jeopardize our health if left unchecked. It is only in the last half century that the role of stress in every ailment from the common cold to AIDS has been emphasized, and the mechanisms involved in this process have been studied. Stress influences the immune response presumably through the activation of the hypothalamic-pituitary adrenal axis, hypothalamic pituitary-gonadal axis, and the sympathetic-adrenal-medullary system. Various neurotransmitters, neuropeptides, hormones, and cytokines mediate these complex bidirectional interactions between the central nervous system (CNS) and the immune system. The effects of stress on the immune responses result in alterations in the number of immune cells and cytokine dysregulation. Various stress management strategies such as meditation, yoga, hypnosis, and muscle relaxation have been shown to reduce the psychological and physiological effects of stress in cancers and HIV infection. This review aims to discuss the effect of stress on the immune system and examine how relaxation techniques such as Yoga and meditation could regulate the cytokine levels and hence, the immune responses during stress.
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Yang TC, Jensen L, Haran M. Social Capital and Human Mortality: Explaining the Rural Paradox with County-Level Mortality Data. RURAL SOCIOLOGY 2011; 76:347-374. [PMID: 25392565 PMCID: PMC4225697 DOI: 10.1111/j.1549-0831.2011.00055.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The "rural paradox" refers to standardized mortality rates in rural areas that are unexpectedly low in view of well-known economic and infrastructural disadvantages there. We explore this paradox by incorporating social capital, a promising explanatory factor that has seldom been incorporated into residential mortality research. We do so while being attentive to spatial dependence, a statistical problem often ignored in mortality research. Analyzing data for counties in the contiguous United States, we find that: (1) the rural paradox is confirmed with both metro/non-metro and rural-urban continuum codes, (2) social capital significantly reduces the impacts of residence on mortality after controlling for race/ethnicity and socioeconomic covariates, (3) this attenuation is greater when a spatial perspective is imposed on the analysis, (4) social capital is negatively associated with mortality at the county level, and (5) spatial dependence is strongly in evidence. A spatial approach is necessary in county-level analyses such as ours to yield unbiased estimates and optimal model fit.
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Affiliation(s)
- Tse-Chuan Yang
- The Social Science Research Institute, The Population Research Institute, The Pennsylvania State University, Address: 803 Oswald Tower, University Park, PA 16801, USA, Telephone: 1-814-865-5553
| | - Leif Jensen
- Department of Agricultural Economics and Rural Sociology, The Population Research Institute, The Pennsylvania State University
| | - Murali Haran
- Department of Statistics The Pennsylvania State University
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Kim HC, Park SG, Leem JH, Jung DY, Hwang SH. Depressive symptoms as a risk factor for the common cold among employees: a 4-month follow-up study. J Psychosom Res 2011; 71:194-6. [PMID: 21843756 DOI: 10.1016/j.jpsychores.2011.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 12/28/2010] [Accepted: 01/13/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the correlation between symptoms of depression in workers and the common cold. METHODS A follow-up survey of workers at 44 small- to medium-sized companies was conducted; 1350 questionnaires were used in the final analysis. The first survey requested information regarding personal information, work characteristics and symptoms of depression (Center for Epidemiologic Studies Depression Scale); the second survey queried participants who answered the first survey about manifestations of the common cold during the previous four months. Odds ratios (ORs) were calculated using a logistic regression model, which was adjusted for potential confounders. All analyses were stratified according to gender separately. RESULTS The ORs for reporting symptoms of the common cold were 1.36 (95% confidence interval [CI]: 1.01-1.83) and 2.27 (95% CI: 1.49-3.45) in males and females, respectively. When adjusted for age, marital status, educational level, smoking habits, alcohol consumption, exercise, sleep duration and job type, the ORs remained significant for both genders (male: 1.38; 95% CI: 1.01-1.89; female: 2.08; 95% CI: 1.32-3.23). CONCLUSIONS The risk of self-reported manifestations of the common cold was higher in workers who reported symptoms of depression.
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Affiliation(s)
- Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University, Nam-Gu, Incheon, Republic of Korea
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Robles TF, Carroll JE. Restorative biological processes and health. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2011; 5:518-537. [PMID: 21927619 DOI: 10.1111/j.1751-9004.2011.00368.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Research on psychological influences on physiology primarily focuses on biological responses during stressful challenges, and how those responses can become dysregulated with prolonged or repeated exposure to stressful circumstances. At the same time, humans spend considerable time recovering from those challenges, and a host of biological processes involved in restoration and repair take place during normal, non-stressed activities. We review restorative biological processes and evidence for links between psychosocial factors and several restorative processes including sleep, wound healing, antioxidant production, DNA repair, and telomerase function. Across these biological processes, a growing body of evidence suggests that experiencing negative emotional states, including acute and chronic stress, depressive symptoms, and individual differences in negative affectivity and hostility, can influence these restorative processes. This review calls attention to restorative processes as fruitful mechanisms and outcomes for future biobehavioral research.
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Suhrcke M, Stuckler D, Suk JE, Desai M, Senek M, McKee M, Tsolova S, Basu S, Abubakar I, Hunter P, Rechel B, Semenza JC. The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence. PLoS One 2011; 6:e20724. [PMID: 21695209 PMCID: PMC3112201 DOI: 10.1371/journal.pone.0020724] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 05/11/2011] [Indexed: 11/19/2022] Open
Abstract
There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.
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Affiliation(s)
- Marc Suhrcke
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - David Stuckler
- Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Jonathan E. Suk
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Monica Desai
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michaela Senek
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Svetla Tsolova
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Sanjay Basu
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Ibrahim Abubakar
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Paul Hunter
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Boika Rechel
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Jan C. Semenza
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Dickinson KL, Randell HF, Kramer RA, Shayo EH. Socio-economic status and malaria-related outcomes in Mvomero District, Tanzania. Glob Public Health 2011; 7:384-99. [PMID: 21271419 DOI: 10.1080/17441692.2010.539573] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
While policies often target malaria prevention and treatment - proximal causes of malaria and related health outcomes - too little attention has been given to the role of household- and individual-level socio-economic status (SES) as a fundamental cause of disease risk in developing countries. This paper presents a conceptual model outlining ways in which SES may influence malaria-related outcomes. Building on this conceptual model, we use household data from rural Mvomero, Tanzania, to examine empirical relationships among multiple measures of household and individual SES and demographics, on the one hand, and malaria prevention, illness, and diagnosis and treatment behaviours, on the other. We find that access to prevention and treatment is significantly associated with indicators of households' wealth; education-based disparities do not emerge in this context. Meanwhile, reported malaria illness shows a stronger association with demographic variables than with SES (controlling for prevention). Greater understanding of the mechanisms through which SES and malaria policies interact to influence disease risk can help to reduce health disparities and reduce the malaria burden in an equitable manner.
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Enhanced psychosocial well-being following participation in a mindfulness-based stress reduction program is associated with increased natural killer cell activity. J Altern Complement Med 2011; 16:531-8. [PMID: 20455784 DOI: 10.1089/acm.2009.0018] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mindfulness-based stress reduction (MBSR) programs have consistently been shown to enhance the psychosocial well-being of participants. Given the well-established association between psychosocial factors and immunologic functioning, it has been hypothesized that enhanced psychosocial well-being among MBSR participants would be associated with corresponding changes in markers of immune activity. OBJECTIVES The objectives of this study were to examine changes in psychosocial and immunologic measures in a heterogeneous patient sample following participation in a MBSR program. DESIGN A single-group, pretest/post-test design was utilized. SETTING The intervention was conducted at an academic health center. SUBJECTS This pilot study involved 24 participants (aged 28-72 years). Inclusion criteria were as follows: > or =18 years of age, English-speaking, and no known autoimmune disorder. INTERVENTION The intervention was an 8-week MBSR program. OUTCOME MEASURES Distress and quality of life (QOL) measures included the Brief Symptom Inventory-18 and the Medical Outcomes Survey Short-Form Health Survey, respectively. Immunologic measures included natural killer (NK) cell cytolytic activity and C-reactive protein (CRP). RESULTS Patients completed psychosocial assessments and provided a blood sample at baseline (pre-MBSR) and within 2 weeks post-MBSR. Significant improvements in anxiety and overall distress as well as across multiple domains of QOL were observed from baseline to post-MBSR. Reductions in anxiety and overall distress were associated with reductions in CRP. Patients who reported improvement in overall mental well-being also showed increased NK cytolytic activity from pre- to post-MBSR, whereas patients who reported no improvement in mental well-being showed no change in NK cytolytic activity. CONCLUSIONS Positive improvement in psychologic well-being following MBSR was associated with increased NK cytolytic activity and decreased levels of CRP.
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Abstract
OBJECTIVE To test the hypothesis that the selective serotonin reuptake inhibitor (SSRI) citalopram would down-regulate human immunodeficiency virus (HIV) infectivity and that the greatest effects would be seen in people with depression. Depression is a risk factor for morbidity and mortality in HIV/acquired immune deficiency syndrome. Serotonin (5-HT) neurotransmission has been implicated in the pathobiology of depression, and pharmacologic therapies for depression target this system. The 5-HT transporter and 5-HT receptors are widely distributed throughout the central nervous and immune systems. Depression has been associated with suppression of natural killer cells and CD8(+) lymphocytes, key regulators of HIV infection. METHODS Ex vivo models for acute and chronic HIV infection were used to study the effects of citalopram on HIV viral infection and replication in 48 depressed and nondepressed women. For both the acute and chronic infection models, HIV reverse transcriptase activity was measured in the citalopram treatment condition and the control condition. RESULTS The SSRI significantly down-regulated the reverse transcriptase response in both the acute and chronic infection models. Specifically, citalopram significantly decreased the acute HIV infectivity of macrophages. Citalopram also significantly decreased HIV viral replication in the latently infected T-cell line and in the latently infected macrophage cell line. There was no difference in down-regulation by depression status. CONCLUSIONS These studies suggest that an SSRI enhances natural killer/CD8 noncytolytic HIV suppression in HIV/acquired immune deficiency syndrome and decreases HIV viral infectivity of macrophages, ex vivo, suggesting the need for in vivo studies to determine a potential role for agents targeting serotonin in the host defense against HIV.
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Solano L, Costa M, Temoshok L, Salvati S, Coda R, Aiuti F, Di Sora F, D'Offizi G, Figa-Talamanca L, Mezzaroma I, Montella F, Bertini M. An Emotionally Inexpressive (Type C) Coping Style Influences HIV Disease Progression at Six and Twelve Month Follow-ups. Psychol Health 2010. [DOI: 10.1080/08870440290025830] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Park SG, Kim HC, Min JY, Hwang SH, Park YS, Min KB. A prospective study of work stressors and the common cold. Occup Med (Lond) 2010; 61:53-6. [DOI: 10.1093/occmed/kqq141] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Oxytocin or Social Housing Alleviates Local Burn Injury in Rats. J Surg Res 2010; 162:122-31. [DOI: 10.1016/j.jss.2009.02.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 02/04/2009] [Accepted: 02/13/2009] [Indexed: 11/23/2022]
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Culhane JF, Rauh VA, Goldenberg RL. Stress, bacterial vaginosis, and the role of immune processes. Curr Infect Dis Rep 2010; 8:459-64. [PMID: 17064639 DOI: 10.1007/s11908-006-0020-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Bacterial vaginosis (BV), the most common lower genital tract infection in women of reproductive age, is associated with adverse gynecologic and reproductive health outcomes. Women at highest risk for BV are young, unmarried, low income, undereducated, and African American. Behaviors such as vaginal douching, numerous sexual partners, frequent sexual intercourse, receptive oral sex, and substance use may contribute to risk, but they account for only a modest proportion of the observed race/ethnicity variance in BV. These subpopulations are also exposed to more social disadvantages or "stressors" such as poverty, poor housing, crime-infested neighborhoods, and discrimination than other groups. Growing physiologic evidence links psychosocial stress to the development of disease. Evidence supports a statistically significant, independent effect of stress on the risk and observed racial/ethnic disparity in the rate of BV. This paper reviews such evidence.
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Affiliation(s)
- Jennifer F Culhane
- Drexel University College of Medicine, Department of Obstetrics/Gynecology, 245 N. 15th Street, MS #495, 17th Floor, Room 17113, Philadelphia, PA 19102, USA.
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Ghebremichael M, Paintsil E, Ickovics JR, Vlahov D, Schuman P, Boland R, Schoenbaum E, Moore J, Zhang H. Longitudinal association of alcohol use with HIV disease progression and psychological health of women with HIV. AIDS Care 2010; 21:834-41. [PMID: 20024739 DOI: 10.1080/09540120802537864] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We evaluated the association of alcohol consumption and depression, and their effects on HIV disease progression among women with HIV. The study included 871 women with HIV who were recruited from 1993-1995 in four US cities. The participants had physical examination, medical record extraction, and venipuncture, CD4+T-cell counts determination, measurement of depression symptoms (using the self-report Center for Epidemiological Studies-Depression Scale), and alcohol use assessment at enrollment, and semiannually until March 2000. Multilevel random coefficient ordinal models as well as multilevel models with joint responses were used in the analysis. There was no significant association between level of alcohol use and CD4+ T-cell counts. When participants were stratified by antiretroviral therapy (ART) use, the association between alcohol and CD4+ T-cell did not reach statistical significance. The association between alcohol consumption and depression was significant (p<0.001). Depression had a significant negative effect on CD4+ T-cell counts over time regardless of ART use. Our findings suggest that alcohol consumption has a direct association with depression. Moreover, depression is associated with HIV disease progression. Our findings have implications for the provision of alcohol use interventions and psychological resources to improve the health of women with HIV.
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Affiliation(s)
- Musie Ghebremichael
- Department of Biostatistics, Harvard University & Dana-Farber Cancer Center, Boston, MA, USA.
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