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Montero-López E, Peralta-Ramírez MI, Ortego-Centeno N, Sabio JM, Callejas-Rubio JL, Navarrete-Navarrete N, García-Ríos MC, Santos-Ruiz A. Does stress response axis activation differ between patients with autoimmune disease and healthy people? Stress Health 2024; 40:e3392. [PMID: 38454759 DOI: 10.1002/smi.3392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
Many studies have shown that patients with autoimmune disease present a hypoactive hypothalamic-pituitary-adrenal (HPA) axis, but the results are controversial. Our objective was to study differences in stress response axis activity between patients with autoimmune disease and healthy people. The study sample consisted of 97 women divided into four groups: 37 healthy women (HW), 21 with systemic lupus erythematosus (SLE), 21 with Sjögren's syndrome (SS), and 18 with systemic sclerosis (SSc). After being exposed to a stress task, participants' skin conductance and salivary cortisol levels were measured in order to assess their response to psychological stress. Diurnal cortisol concentrations were assessed by measuring salivary cortisol in samples collected five times over one day. In addition, self-administered questionnaires were used to assess psychological variables. A time × group interaction effect was found (p = 0.003) in salivary cortisol secretion in response to stressful challenge. The healthy group presented normal activation, the SS and SLE groups showed no activation, and the SSc group presented a similar activation pattern to the HW group, except at the time of recovery. Total cortisol production (AUCg) was higher in the SSc group than in the HW group (p = 0.001). Differences were also observed in the cortisol AUCg collected over one day between healthy women and patients with SLE (p = 0.004) as well as with SSc (p = 0.001): women with SLE and SSc presented higher total hormone production than healthy women. Patients with autoimmune disease present a different HPA axis response, which may contribute to the harmful effects of stress in these diseases.
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Affiliation(s)
- Eva Montero-López
- Department of Evolutionary Psychology, University of Granada, Granada, Spain
| | - María Isabel Peralta-Ramírez
- Department of Personality, Evaluation, and Psychological Treatment, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
| | - Norberto Ortego-Centeno
- Department of Medicine, University of Granada, Granada, Spain
- Systemic Autoimmune Diseases Unit, San Cecilio Clinical Hospital, Granada, Spain
- Biohealth Research Institute (IBS), Granada, Spain
| | - José Mario Sabio
- Systemic Autoimmune Disease Unit, Internal Medicine Service, Virgen de las Nieves University Hospital, Granada, Spain
| | - José Luis Callejas-Rubio
- Systemic Autoimmune Diseases Unit, San Cecilio Clinical Hospital, Granada, Spain
- Biohealth Research Institute (IBS), Granada, Spain
| | - Nuria Navarrete-Navarrete
- Systemic Autoimmune Disease Unit, Internal Medicine Service, Virgen de las Nieves University Hospital, Granada, Spain
| | - M Carmen García-Ríos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Ana Santos-Ruiz
- Department of Health Psychology, School of Health Sciences, University of Alicante, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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Lee JH, Meyer EJ, Nenke MA, Lightman SL, Torpy DJ. Cortisol, Stress, and Disease-Bidirectional Associations; Role for Corticosteroid-Binding Globulin? J Clin Endocrinol Metab 2024:dgae412. [PMID: 38941154 DOI: 10.1210/clinem/dgae412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Indexed: 06/30/2024]
Abstract
Selye described stress as a unified neurohormonal mechanism maintaining homeostasis. Acute stress system activation is adaptive through neurocognitive, catecholaminergic, and immunomodulation mechanisms, followed by a reset via cortisol. Stress system components, the sympathoadrenomedullary system, hypothalamic-pituitary-adrenal axis, and limbic structures are implicated in many chronic diseases by establishing an altered homeostatic state, allostasis. Consequent "primary stress system disorders" were popularly accepted, with phenotypes based on conditions such as Cushing syndrome, pheochromocytoma, and adrenal insufficiency. Cardiometabolic and major depressive disorders are candidates for hypercortisolemic etiology, contrasting the "hypocortisolemic symptom triad" of stress sensitivity, chronic fatigue, and pain. However, acceptance of chronic stress etiology requires cause-and-effect associations, and practical utility such as therapeutics altering stress system function. Inherent predispositions to stress system perturbations may be relevant. Glucocorticoid receptor (GR) variants have been associated with metabolic/neuropsychological states. The SERPINA6 gene encoding corticosteroid-binding globulin (CBG), was the sole genetic factor in a single-nucleotide variation-genome-wide association study linkage study of morning plasma cortisol, a risk factor for cardiovascular disease, with alterations in tissue-specific GR-related gene expression. Studies showed genetically predicted high cortisol concentrations are associated with hypertension and anxiety, and low CBG concentrations/binding affinity, with the hypocortisolemic triad. Acquired CBG deficiency in septic shock results in 3-fold higher mortality when hydrocortisone administration produces equivocal results, consistent with CBG's role in spatiotemporal cortisol delivery. We propose some stress system disorders result from constitutional stress system variants rather than stressors themselves. Altered CBG:cortisol buffering may influence interstitial cortisol ultradian surges leading to pathological tissue effects, an example of stress system variants contributing to stress-related disorders.
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Affiliation(s)
- Jessica H Lee
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
| | - Emily Jane Meyer
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
- Endocrine and Diabetes Services, The Queen Elizabeth Hospital, Woodville South, SA 5011, Australia
| | - Marni Anne Nenke
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
- Endocrine and Diabetes Services, The Queen Elizabeth Hospital, Woodville South, SA 5011, Australia
| | - Stafford L Lightman
- Systems Neuroendocrinology Research Group, University of Bristol, Bristol, BS1 3NY, UK
| | - David J Torpy
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
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Li C, Hu J, Hu N, Zhao J, Li Q, Han Y, Liu Y, Hu X, Zheng L, Cao Q. Aptamer-aided plasmonic nano-urchins for reporter-free surface-enhanced Raman spectroscopy analysis of cortisol. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024. [PMID: 38683672 DOI: 10.1039/d4ay00401a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Cortisol is a vital glucocorticoid hormone reflecting stress levels and related disease processes. In this study, we report an aptamer-functionalized plasmonic nano-urchin (α-FeOOH@Au-aptamer)-aided cortisol-capturing and surface-enhanced Raman spectroscopy (SERS) analysis approach. The designed α-FeOOH@Au-aptamer exhibits a well-patterned plasma structure, which combines the good SERS enhancement ability of reduced nanogaps between the Au plasma and the hot spot-favored structure of anisotropic tips from α-FeOOH urchins, with the high affinity of the aptamer towards cortisol molecules. The α-FeOOH@Au-aptamer achieved reporter-free SERS quantification for cortisol with good sensitivity (limit of detection <0.28 μmol L-1), robust salt (1.0 mol per L NaCl) and protein (5.0 mg per mL bovine serum protein) tolerance, favorable reproducibility, as well as good reusability. We further demonstrated the good cortisol-capturing ability and SERS efficacy of the α-FeOOH@Au-aptamer profiling in the serum and urine samples. Our approach provides an alternative tool for cortisol analysis and a reference strategy for report-free SERS detection of small molecules.
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Affiliation(s)
- Chengyu Li
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Jing Hu
- Clinical Psychology Department, Zhongshan Third People's Hospital, Zhongshan, Guangdong, 528451, China
| | - Nan Hu
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Jianjun Zhao
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Qianwen Li
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Yanhui Han
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Yanxiong Liu
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Xufang Hu
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Liyan Zheng
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Qiue Cao
- School of Chemical Science and Technology, National Demonstration Center for Experimental Chemistry and Chemical Engineering Education, Yunnan University, Kunming, Yunnan, 650091, China.
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Hsu TW, Bai YM, Tsai SJ, Chen TJ, Chen MH, Liang CS. Risk of autoimmune diseases after post-traumatic stress disorder: a nationwide cohort study. Eur Arch Psychiatry Clin Neurosci 2024; 274:487-495. [PMID: 37322294 DOI: 10.1007/s00406-023-01639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 06/03/2023] [Indexed: 06/17/2023]
Abstract
This longitudinal study aimed to investigate the risk of subsequent autoimmune disease in patients with post-traumatic stress disorder (PTSD) in Asian population. Between 2002 and 2009, we enrolled 5273 patients with PTSD and 1:4 matched controls from the National Health Insurance Database of Taiwan, and followed up the patients until December 31, 2011, or death. The investigated autoimmune diseases included thyroiditis, lupus, rheumatic arthritis, inflammatory bowel disease, Sjogren's syndrome, dermatomyositis, and polymyositis. The Cox regression model was used to estimate the risk of developing autoimmune diseases, with adjustment for demographics and psychiatric and medical comorbidities. Furthermore, we examined the psychiatric clinics utility of patients with PTSD indicating the severity of PTSD in association with autoimmune diseases. After adjusting for confounders, patients with PTSD had a 2.26-fold higher risk of developing any autoimmune diseases (reported as hazard ratios with 95% confidence intervals: 1.82-2.80) than the controls. For specific autoimmune diseases, patients with PTSD had a 2.70-fold higher risk (1.98-3.68) of thyroiditis, a 2.95-fold higher risk (1.20-7.30) of lupus, and a 6.32-fold higher risk (3.44-11.60) of Sjogren's syndrome. Moreover, the PTSD severity was associated with the risk of autoimmune diseases in a dose-dependent manner. The patient with the highest psychiatric clinics utility was associated with an 8.23-fold higher risk (6.21-10.90) of any autoimmune diseases than the controls. Patients with PTSD had an increased risk of autoimmune diseases, and such risk was associated with the severity of PTSD in a dose-dependent manner. However, the present study did not provide a direct effect between PTSD and autoimmune diseases, but rather an association. Further studies are warranted to examine the underlying pathophysiological mechanisms.
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Affiliation(s)
- Tien-Wei Hsu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, No. 60, Xinmin Road, Beitou District, Taipei, 11243, Taiwan.
- Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan.
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Bhatia A, Hanna J, Stuart T, Kasper KA, Clausen DM, Gutruf P. Wireless Battery-free and Fully Implantable Organ Interfaces. Chem Rev 2024; 124:2205-2280. [PMID: 38382030 DOI: 10.1021/acs.chemrev.3c00425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.
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Affiliation(s)
- Aman Bhatia
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Jessica Hanna
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Tucker Stuart
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Kevin Albert Kasper
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - David Marshall Clausen
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Philipp Gutruf
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Department of Electrical and Computer Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Bio5 Institute, The University of Arizona, Tucson, Arizona 85721, United States
- Neuroscience Graduate Interdisciplinary Program (GIDP), The University of Arizona, Tucson, Arizona 85721, United States
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He T, Qian W. Immunologic derangement caused by intestinal dysbiosis and stress is the intrinsic basis of reactive arthritis. Z Rheumatol 2024:10.1007/s00393-024-01480-4. [PMID: 38403666 DOI: 10.1007/s00393-024-01480-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/27/2024]
Abstract
Reactive arthritis (ReA) is defined as arthritis resulting from infections in other body parts, such as the gastrointestinal and urogenital tracts. The primary clinical manifestations involve acute-onset and self-limiting asymmetric large joint inflammation in the lower limbs. Although bacterial or chlamydia infections have long been recognized as playing a pivotal role in its pathogenesis, recent studies suggest that antibiotic treatment may perpetuate rather than eradicate chlamydia within the host, indicating an involvement of other mechanisms in Reactive arthritis. Reactive arthritis is currently believed to be associated with infection, genetic marker (HLA-B27), and immunologic derangement. As an autoimmune disease, increasing attention has been given to understanding the role of the immune system in Reactive arthritis. This review focuses on elucidating how the immune system mediates reactive arthritis and explores the roles of intestinal dysbiosis-induced immune disorders and stress-related factors in autoimmune diseases, providing novel insights into understanding reactive arthritis.
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Affiliation(s)
- Tao He
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Weiqing Qian
- Nanjing City Hospital of Chinese Medicine, 157, Daming Road, Nanjing, Qinhuai District, China.
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Parks CG, Pettinger M, de Roos AJ, Tindle HA, Walitt BT, Howard BV. Life Events, Caregiving, and Risk of Autoimmune Rheumatic Diseases in the Women's Health Initiative Observational Study. Arthritis Care Res (Hoboken) 2023; 75:2519-2528. [PMID: 37230960 PMCID: PMC10798355 DOI: 10.1002/acr.25164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Growing evidence suggests psychosocial stressors may increase risk of developing autoimmune disease. We examined stressful life events and caregiving in relation to incident rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in the Women's Health Initiative Observational Study cohort. METHODS The sample of postmenopausal women included 211 incident RA or SLE cases reported within 3 years after enrollment, confirmed by use of disease-modifying antirheumatic drugs (i.e., probable RA/SLE), and 76,648 noncases. Baseline questionnaires asked about life events in the past year, caregiving, and social support. We used Cox regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CIs), adjusting for age, race/ethnicity, occupational class, education, pack-years of smoking and BMI. RESULTS Incident RA/SLE was associated with reporting 3 or more life events (e.g., age-adjusted HR 1.70 [95% CI 1.14, 2.53]; P for trend = 0.0026). Elevated HRs were noted for physical (HR 2.48 [95% CI 1.02, 6.04]) and verbal (HR 1.34 [0.89, 2.02]) abuse (P for trend = 0.0614), 2 or more interpersonal events (HR 1.23 [95% CI 0.87, 1.73]; P for trend = 0.2403), financial stress (HR 1.22 [95% CI 0.90, 1.64]), and caregiving 3 or more days per week (HR 1.25 [95% CI 0.87, 1.81]; P for trend = 0.2571). Results were similar, excluding women with baseline symptoms of depression or moderate-to-severe joint pain in the absence of diagnosed arthritis. CONCLUSION Our findings support the idea that diverse stressors may increase risk of developing probable RA or SLE in postmenopausal women, supporting the need for further studies in autoimmune rheumatic diseases, including childhood adverse events, life event trajectories, and modifying psychosocial and socioeconomic factors.
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Affiliation(s)
- Christine G. Parks
- National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - Anneclaire J. de Roos
- Department of Environmental & Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, PA
| | - Hilary A. Tindle
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN
| | - Brian T. Walitt
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - Barbara V. Howard
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA; MedStar Health Research Institute, Hyattsville, MD, USA
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Li J, Zhao M, Luo W, Huang J, Zhao B, Zhou Z. B cell metabolism in autoimmune diseases: signaling pathways and interventions. Front Immunol 2023; 14:1232820. [PMID: 37680644 PMCID: PMC10481957 DOI: 10.3389/fimmu.2023.1232820] [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: 06/01/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023] Open
Abstract
Autoimmune diseases are heterogeneous disorders believed to stem from the immune system's inability to distinguish between auto- and foreign- antigens. B lymphocytes serve a crucial role in humoral immunity as they generate antibodies and present antigens. Dysregulation of B cell function induce the onset of autoimmune disorders by generating autoantibodies and pro-inflammatory cytokines, resulting in an imbalance in immune regulation. New research in immunometabolism shows that cellular metabolism plays an essential role in controlling B lymphocytes immune reactions by providing the energy and substrates for B lymphocytes activation, differentiation, and function. However, dysregulated immunometabolism lead to autoimmune diseases by disrupting self-tolerance mechanisms. This review summarizes the latest research on metabolic reprogramming of B lymphocytes in autoimmune diseases, identifying crucial pathways and regulatory factors. Moreover, we consider the potential of metabolic interventions as a promising therapeutic strategy. Understanding the metabolic mechanisms of B cells brings us closer to developing novel therapies for autoimmune disorders.
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Affiliation(s)
- Jingyue Li
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mingjiu Zhao
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wenjun Luo
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jiaqi Huang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Bin Zhao
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Furong Laboratory, Central South University, Changsha, China
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Batóg G, Dołoto A, Bąk E, Piątkowska-Chmiel I, Krawiec P, Pac-Kożuchowska E, Herbet M. The interplay of oxidative stress and immune dysfunction in Hashimoto's thyroiditis and polycystic ovary syndrome: a comprehensive review. Front Immunol 2023; 14:1211231. [PMID: 37588599 PMCID: PMC10426741 DOI: 10.3389/fimmu.2023.1211231] [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: 04/24/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
In recent years, there has been a significant increase in the concomitant incidence of Hashimoto's thyroiditis (HT) and polycystic ovary syndrome (PCOS), both in terms of incidence, etiology, and clinical consequences. PCOS patients suffering from autoimmune thyroid diseases show insulin resistance, impaired glucose tolerance, weight gain, and metabolic and reproductive complications. Studies have shown that chronic stress and its consequence, i.e. oxidative stress, play an important role in the pathomechanism of both disorders. It has also been shown that long-term exposure to stress triggers biological mechanisms, in particular related to the regulation of the inflammatory cascade, which plays a key role in autoimmune diseases. The paper is a review of the literature on the role of chronic stress, oxidative stress, and immune processes in the pathogenesis of HT and PCOS. In addition, the review is a source of knowledge about the treatment of these diseases, and in particular the use of antioxidants in therapeutic management.
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Affiliation(s)
- Gabriela Batóg
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Anna Dołoto
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Ewelina Bąk
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Iwona Piątkowska-Chmiel
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Paulina Krawiec
- Department of Paediatrics and Gastroenterology, Medical University of Lublin, Lublin, Poland
| | | | - Mariola Herbet
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
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10
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Briones-Buixassa L, Montañés-Masias B, Milà-Villaroel R, Arrufat FX, Aragonès JM, Norton S, Bort-Roig J, Moss-Morris R. The bidirectional effect of stress and functionality in multiple sclerosis and the interaction role of anxiety, coping and social support. J Psychosom Res 2023; 170:111375. [PMID: 37196585 DOI: 10.1016/j.jpsychores.2023.111375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/27/2023] [Accepted: 05/10/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE The present study aims to analyse the bidirectional hypothesis between stress and multiple sclerosis with several measures of stress, impairment and functionality, considering also the interaction role of stress-related psychosocial factors such as anxiety, coping and social support. METHODS A one-year follow-up was conducted with 26 people with multiple sclerosis. Participants reported i) at baseline, anxiety (State-Trait Anxiety Inventory), and social support (Multidimensional Scale of Perceived Social Support); ii) daily, Ecological Momentary Assessment through self-reported diaries of stressful events and coping strategies; iii) monthly, the perceived stress (Perceived Stress Scale), iv) trimonthly, the self-reported functionality (Functionality Assessment in multiple sclerosis) and v) at baseline and at the end, neurologist rated impairment (Expanded Disability Status Scale). Mixed-effect regression models were conducted. RESULTS The bidirectional hypothesis was confirmed with perceived stress and self-reported functionality, which were negatively related in both directions. Coping and anxiety showed an interaction effect: active coping increased functionality only with high levels of stress, and high-trait anxiety showed lower functionality whereas low-trait anxiety showed higher functionality but only with low stress levels. CONCLUSION People with multiple sclerosis may benefit from different types of psychological therapies, from gold-standard therapies like Cognitive Behavioural Therapy to third-waves therapies like Dialectical Behaviour Therapy or mindfulness, that focus on dealing with stress and affective symptoms, adjusting to the disease, and to improving their overall quality of life. More research is needed in this field under the biopsychosocial model.
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Affiliation(s)
- Laia Briones-Buixassa
- Department of basic health sciences, Innovation in Mental Health and Social Wellbeing Research Group (ISaMBeS), Centre for Health and Social Care Research (CESS), Universitat de Vic - Universitat Central de Catalunya, C/ Sagrada Familia, 7, Vic 08500 - Spain; Department of Health Sciences, Universitat de Vic-Universitat Central de Catalunya, Vic, Catalonia, Spain.
| | - Brenda Montañés-Masias
- Department of basic health sciences, Innovation in Mental Health and Social Wellbeing Research Group (ISaMBeS), Centre for Health and Social Care Research (CESS), Universitat de Vic - Universitat Central de Catalunya, C/ Sagrada Familia, 7, Vic 08500 - Spain
| | - Raimon Milà-Villaroel
- Global Research on Wellbeing (GRoW), Blanquerna School of Health Sciences-Ramon Llull University, Barcelona, Spain
| | | | - Josep Mª Aragonès
- Neurology Department, Consorci Hospitalari de Vic, Vic, Catalonia, Spain
| | - Sam Norton
- Psychology Department, Health Psychology Section, Institute for Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Judit Bort-Roig
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, Universitat de Vic - Universitat Central de Catalunya, Vic, Catalonia, Spain
| | - Rona Moss-Morris
- Psychology Department, Health Psychology Section, Institute for Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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11
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Gaitán-Cepeda LA, Rivera-Reza DI, Villanueva-Vilchis MDC. Neuroticism and Psychological Stress in Patients Suffering Oral Lichen Planus: Research Evidence of Psycho-Stomatology? Healthcare (Basel) 2023; 11:1738. [PMID: 37372856 DOI: 10.3390/healthcare11121738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Psychosocial factors influence the development, exacerbation, or aggravation of some oral diseases. However, the possible relationship between personality traits, affective disorders, and psychological stress in oral diseases, and their impact on oral health-related quality of life (OHRQoL), has not been fully clarified. The aim of the present study was to determine the association of neuroticism and stress with the presence of oral lichen planus (OLP), and to discover whether or not these factors impact OHRQoL. This is a case-control study matched for age and sex. The case group (OLP group) was composed of 20 patients diagnosed with OLP, while 20 people with a diagnosis of lesions not associated with stress formed the control group. Three instruments were used: the Holmes-Rahe Social Readjustment Scale, the Five Factor Personality Model, and the OHIP-49. Neuroticism obtained a score of 25.5 (±5.4) in the OLP group, which was higher than the control group value (21.7) (±5.1) (p = 0.03). The OLP group showed a worse quality of life (p < 0.05); the most affected dimensions were psychological discomfort and physical disability. It is important to include a psychological profile to establish a comprehensive treatment for these patients. We propose the recognition of a new area of clinical oral medicine: psycho-stomatology.
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Affiliation(s)
- Luis Alberto Gaitán-Cepeda
- Department of Oral and Maxillofacial Medicine and Pathology, Research and Graduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Diana Ivette Rivera-Reza
- Department of Oral and Maxillofacial Medicine and Pathology, Research and Graduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico
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12
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Logel SN, Maru J, Whitehead J, Brady C, Walch A, Lasarev M, Rehm JL, Millington K. Higher Rates of Certain Autoimmune Diseases in Transgender and Gender Diverse Youth. Transgend Health 2023. [DOI: 10.1089/trgh.2022.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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13
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Gauckler P, Kronbichler A. Response to: 'Correspondence on 'What comes after the lockdown? Clustering of ANCA-associated vasculitis: single-centre observation of a spatiotemporal pattern'' by Hakroush and Tampe. Ann Rheum Dis 2023; 82:e64. [PMID: 33408076 DOI: 10.1136/annrheumdis-2020-219696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Philipp Gauckler
- Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria
| | - Andreas Kronbichler
- Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria
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14
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Single-cell RNA sequencing reveals the suppressive effect of PPP1R15A inhibitor Sephin1 in antitumor immunity. iScience 2023; 26:105954. [PMID: 36718369 PMCID: PMC9883195 DOI: 10.1016/j.isci.2023.105954] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/28/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
Protein phosphatase 1 regulatory subunit 15A (PPP1R15A) is an important factor in the integrated stress response (ISR) in mammals and may play a crucial role in tumorigenesis. In our studies, we found an inhibitor of PPP1R15A, Sephin1, plays a protumorigenic role in mouse tumor models. By analyzing the single-cell transcriptome data of the mouse tumor models, we found that in C57BL/6 mice, Sephin1 treatment could lead to higher levels of ISR activity and lower levels of antitumor immune activities. Specifically, Sephin1 treatment caused reductions in antitumor immune cell types and lower expression levels of cytotoxicity-related genes. In addition, T cell receptor (TCR) repertoire analysis demonstrated that the clonal expansion of tumor-specific T cells was inhibited by Sephin1. A special TCR + macrophage subtype in tumor was identified to be significantly depleted upon Sephin1 treatment, implying its key antitumor role. These results suggest that PPP1R15A has the potential to be an effective target for tumor therapy.
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15
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van den Boom L, Kostev K, Kuss O, Rathmann W, Rosenbauer J. Type 1 diabetes incidence in children and adolescents during the COVID-19 pandemic in Germany. Diabetes Res Clin Pract 2022; 193:110146. [PMID: 36347421 PMCID: PMC9637016 DOI: 10.1016/j.diabres.2022.110146] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 11/08/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to analyze the incidence of type 1 diabetes in children and adolescents (<20 years of age) during the COVID-19 pandemic (3/2020 to 12/2021) in Germany. METHODS The present study was based on the IQVIA longitudinal prescription database (LRx), All persons (age ≤ 20 years) with new insulin prescriptions from 2016 to 2021 (index date) were selected and stratified by age group. Weekly (age-specific) data were used to forecast the prescription incidence for the pandemic period based on pre-pandemic data and to explore the relationship between weekly reported age-specific COVID-19 incidences and type 1 diabetes incidence and rate ratios of observed vs. predicted diabetes incidence respectively. RESULTS During the pre-pandemic period, there was a stable higher insulin prescription incidence during the winter period and a lower insulin prescription incidence during summer. During the pandemic period, there was less seasonal variation in incidence related to the finding that the observed incidence during summer in 2002 and 2021 was 44 % and 65 %, higher, respectively, than the expected incidence based on pre-pandemic year. We did not find any cross-correlations between the COVID-19 incidence and the type 1 diabetes incidence for any age group. Likewise, there were no cross-correlations between the COVID-19 incidence and the incidence rate ratios of observed incidences to predicted incidences. CONCLUSIONS/INTERPRETATION During the COVID-19 pandemic, there was less seasonal variation in the incidence of type 1 diabetes (defined by new insulin prescriptions), with higher observed than expected incidences during summer. We found no evidence that the increase in type 1 diabetes incidence during the COVID-19 pandemic relates to direct effects of COVID-19 pandemic.
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Affiliation(s)
- Louisa van den Boom
- Division of Pediatrics, DRK Hospital, Kirchen, Germany; Division of Pediatric Diabetology, Endocrinology, Metabolism and Obesity, Children's Hospital, University of Bonn, Bonn, Germany
| | | | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research, München-Neuherberg, Germany; Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research, München-Neuherberg, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research, München-Neuherberg, Germany
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16
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Molina E, Gould N, Lee K, Krimins R, Hardenbergh D, Timlin H. Stress, mindfulness, and systemic lupus erythematosus: An overview and directions for future research. Lupus 2022; 31:1549-1562. [PMID: 35998903 DOI: 10.1177/09612033221122980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although the pathogenesis of autoimmunity is not fully understood, it is thought to involve genetic, hormonal, immunologic, and environmental factors. Stress has been evaluated as a potential trigger for autoimmunity and disease flares in patients with systemic lupus erythematosus (SLE). The physiologic changes that occur with stress involve numerous catecholamines, hormones, and cytokines that communicate intricately with the immune system. There is some evidence that these systems may be dysregulated in patients with autoimmune disease. Mindfulness-based techniques are practices aimed at mitigating stress response and have been shown to improve quality of life in general population. This review will discuss pathophysiology of chronic stress as it relates to SLE, evidence behind mindfulness-based practices in these patients, and directions for future research.
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Affiliation(s)
- Emily Molina
- Rheumatology Fellowship, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Neda Gould
- Division of Psychiatry and Behavioral Science, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Kristen Lee
- Internal Medicine Residency, 12244Northwestern University Hospitals, Chicago, IL, USA
| | - Rebecca Krimins
- Department of Radiology and Radiological Science, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Dylan Hardenbergh
- Internal Medicine Residency, 21611Columbia and Presbyterian Hospitals, NY, NY, USA
| | - Homa Timlin
- Division of Rheumatology, 1466Johns Hopkins University, Baltimore, MD, USA
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17
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Girardi P, Lupo A, Mastromatteo LY, Scrimin S. Mothers living with contamination of perfluoroalkyl substances: an assessment of the perceived health risk and self-reported diseases. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:60491-60507. [PMID: 35426015 DOI: 10.1007/s11356-022-20085-5] [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] [Received: 02/10/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
Widespread contamination of the superficial, drinking, and groundwater by perfluoroalkyl substances (PFASs) was discovered in the Veneto Region (northeast of Italy) in 2013. Mothers from the contaminated area were concerned about the effects of PFAS on their own and their children's health. We determined the factors that influenced the perceived risk of PFAS and the presence of self-reported diseases by conducting a study with 384 mothers of children aged 1-13 years living in the contaminated area (Red Zone, Veneto, Italy). Information on demography, the sources of exposure, and the health condition of the mothers was collected through an online survey. The serum PFAS concentration was recorded for some of the participants. We determined the factors influencing the perceived risk, risk of health outcomes, and serum PFAS levels through regression analyses. The PFAS perceived risk of the mothers increased with an increase in the trust in scientific institutions and social media, and when many friends were present, trust in politics and full-time employment had a protective effect. The PFAS perceived risk increased the occurrences of self-reported and autoimmune diseases. Longer residence (> 20 years) in the most exposed area (Red Zone A) increased the frequency of some health outcomes. Serum PFAS concentrations decreased with breastfeeding, but increased with tap water consumption, residence in Red Zone A, and residence time. The PFAS perceived risk of the mothers was associated with many factors that influenced reporting of health issues. The association between PFAS exposure and health outcomes needs further investigation.
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Affiliation(s)
- Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, via Torino 155, 30172, Venezia-Mestre, Italy.
| | - Alice Lupo
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | | | - Sara Scrimin
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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18
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Stuart T, Hanna J, Gutruf P. Wearable devices for continuous monitoring of biosignals: Challenges and opportunities. APL Bioeng 2022; 6:021502. [PMID: 35464617 PMCID: PMC9010050 DOI: 10.1063/5.0086935] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/29/2022] [Indexed: 12/17/2022] Open
Abstract
The ability for wearable devices to collect high-fidelity biosignals continuously over weeks and months at a time has become an increasingly sought-after characteristic to provide advanced diagnostic and therapeutic capabilities. Wearable devices for this purpose face a multitude of challenges such as formfactors with long-term user acceptance and power supplies that enable continuous operation without requiring extensive user interaction. This review summarizes design considerations associated with these attributes and summarizes recent advances toward continuous operation with high-fidelity biosignal recording abilities. The review also provides insight into systematic barriers for these device archetypes and outlines most promising technological approaches to expand capabilities. We conclude with a summary of current developments of hardware and approaches for embedded artificial intelligence in this wearable device class, which is pivotal for next generation autonomous diagnostic, therapeutic, and assistive health tools.
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Affiliation(s)
- Tucker Stuart
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Jessica Hanna
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Philipp Gutruf
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
- Department of Electrical and Computer Engineering, University of Arizona, Tucson, Arizona 85721, USA
- Bio5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Neuroscience GIDP, University of Arizona, Tucson, Arizona 85721, USA
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19
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Ponomarev SA, Sadova AA, Rykova MP, Orlova KD, Vlasova DD, Shulgina SM, Antropova EN, Kutko OV, Germanov NS, Galina VS, Shmarov VA. The impact of short-term confinement on human innate immunity. Sci Rep 2022; 12:8372. [PMID: 35589846 PMCID: PMC9120181 DOI: 10.1038/s41598-022-12380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/28/2022] [Indexed: 11/09/2022] Open
Abstract
During space missions cosmonauts are exposed to a myriad of distinct stressors such as radiation, overloads, weightlessness, radiation, isolation in artificial environmental conditions, which causes changes in immune system. During space flights it is very difficult to determine the particular factor associated with the observed immunological responses. This makes ground-based experiments examining the effect of each space flight associated factor along of particular value. Determining mechanisms causing alterations in cosmonauts' immunity can lead to potential targets for different countermeasures. In the current article we present the study of the early period of adaptation of human innate immunity of 6 healthy test-subjects, 4 males and 2 females aged 25 through 40, to isolation factors (hypodynamia, psychological stress, artificial environment). We measured multiple parameters characterizing innate immunity status in blood samples at chosen time points before, during and after the mission. In the experiment, highly enhanced cytokine responses were observed upon ex vivo antigen stimulations in comparison to baseline values. For cellular parameters we found multidirectional dynamics with a persistent prevalence of increasing TLRs+ monocytes as well as TLRs expression. Our study provides evidence that even a short-term confinement leads to immune changes in healthy humans that may trigger aberrant immune response.
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Affiliation(s)
- S A Ponomarev
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation.
| | - A A Sadova
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation.,Pirigov Russian National Research Medical University (Pirogov Medical University), Moscow, 117997, Russian Federation
| | - M P Rykova
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation
| | - K D Orlova
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation
| | - D D Vlasova
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation
| | - S M Shulgina
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation
| | - E N Antropova
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation
| | - O V Kutko
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation
| | - N S Germanov
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation.,Pirigov Russian National Research Medical University (Pirogov Medical University), Moscow, 117997, Russian Federation
| | - V S Galina
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation.,Pirigov Russian National Research Medical University (Pirogov Medical University), Moscow, 117997, Russian Federation
| | - V A Shmarov
- Laboratory of Immune System Physiology, SSC RF-IBMP RAS, Moscow, 123007, Russian Federation
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20
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Borisova A, Veltishchev D, Lisitsyna T, Reshetnyak T, Seravina O, Kovalevskaya O, Cheldieva F, Abramkin A. Anxiety-depressive disorders and stress factors in patients with systemic lupus erythematosus and antiphospholipid syndrome. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:65-71. [DOI: 10.17116/jnevro202212203165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Agorastos A, Chrousos GP. The neuroendocrinology of stress: the stress-related continuum of chronic disease development. Mol Psychiatry 2022; 27:502-513. [PMID: 34290370 DOI: 10.1038/s41380-021-01224-9] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/24/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
Stress is defined as a state of threatened homeodynamic balance by a wide range of intrinsic or extrinsic, real or perceived challenges or stimuli, defined as stressors. To preserve this optimal homeodynamic state within a physiologic range, organisms have developed a highly sophisticated system, the stress system, which serves self-regulation and adaptability of the organism by energy redirection according to the current needs. Repeated, ephemeral, and motivating stress states lead to adaptive responses and response habituations, being fairly beneficial; in contrast, inadequate, aversive, excessive, or prolonged stress may surpass the regulatory capacity and adjustive resources of the organism and produce maladaptive responses and a chronically altered homeodynamic state associated with compromised mental and physical health and life expectancy. Neuroendocrine responses to stress depend on developmental timing, duration, time of day and nature of stressors leading to a vulnerable phenotype with disrupted stress reactivity (i.e., hyper- or hypoactivation of the stress system), impaired glucocorticoid signaling, and accumulated cacostatic load with cumulatively elevated long-term risk of mental and physical morbidity. This article offers a brief overview on the organization and physiology of the human stress system and its (re)activity, refreshes the plethora of somatic effects of acute and chronic stress and discusses a conceptual model of acute and chronic stress pathophysiology as a continuum in chronic disease development.
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Affiliation(s)
- Agorastos Agorastos
- II. Department of Psychiatry, Division of Neurosciences, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece. .,VA Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA, USA.
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Medical School, Aghia Sophia Children's Hospital, Athens, Greece
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22
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Molina E, Petri M, Manno R, Williamson L, Williamson L, Timlin H. A prescription for exercise in systemic lupus erythematosus. Lupus 2021; 30:2183-2190. [PMID: 34903093 DOI: 10.1177/09612033211061060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with systemic lupus erythematosus (SLE) have increased cardiovascular risk, and fatigue is a major subjective complaint. Sedentary lifestyle has been shown to have negative health impacts in cardiovascular and rheumatic disease, though exercise has not traditionally been incorporated into routine therapy recommendations. Regular exercise in SLE may improve difficult to treat Type 2 symptoms, such as fatigue, depression, stress, and quality of life. Insufficient counseling on exercise by physicians is a notable barrier for SLE patients to engage in physical activity. Aerobic exercise regimens are more commonly studied, and have been shown to improve cardiovascular health in SLE. Exercise may improve some inflammatory markers, though does not definitively affect SLE clinical disease activity. Physical activity should be recommended to improve quality of life and cardiovascular health in patients with SLE. Developing clearer guidelines for exercise regimens in a patient-centered manner is warranted, especially given diverse phenotypes of SLE patients and varying degrees of physical limitations.
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Affiliation(s)
- Emily Molina
- Department of Internal Medicine, 1501Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle Petri
- Department of Internal Medicine, 1501Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rebecca Manno
- Department of Rheumatology, 249252Comprehensive Orthopaedic Global, Saint Thomas, VI, USA
| | - Luke Williamson
- Department of Rheumatology, 8539Westmead Hospital, Westmead, NSW, USA
| | - Lyn Williamson
- Department of Rheumatology, 8539Great Western Hospital Wiltshire, Swindon, UK
| | - Homa Timlin
- Division of Rheumatology, 1501Johns Hopkins University School of Medicine, Baltimore, MD, USA
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23
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Marks BE, Khilnani A, Meyers A, Flokas ME, Gai J, Monaghan M, Streisand R, Estrada E. Increase in the Diagnosis and Severity of Presentation of Pediatric Type 1 and Type 2 Diabetes during the COVID-19 Pandemic. Horm Res Paediatr 2021; 94:275-284. [PMID: 34564073 PMCID: PMC8805060 DOI: 10.1159/000519797] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The impact of the COVID-19 pandemic on the incidence of pediatric type 1 (T1D) and type 2 diabetes (T2D) and severity of presentation at diagnosis is unclear. METHODS A retrospective comparison of 737 youth diagnosed with T1D and T2D during the initial 12 months of the COVID-19 pandemic and in the preceding 2 years was conducted at a pediatric tertiary care center. RESULTS Incident cases of T1D rose from 152 to 158 in the 2 years before the pandemic (3.9% increase) to 182 cases during the pandemic (15.2% increase). The prevalence of diabetic ketoacidosis (DKA) at T1D diagnosis increased over 3 years (41.4%, 51.9%, and 57.7%, p = 0.003); severe DKA increased during the pandemic as compared to the 2 years before (16.8% vs. 28%, p = 0.004). Although there was no difference in the mean hemoglobin A1c (HbA1c) between racial and ethnic groups at T1D diagnosis in the 2-years pre-pandemic (p = 0.31), during the pandemic HbA1c at T1D diagnosis was higher in non-Hispanic Black (NHB) youth (11.3 ± 1.4%, non-Hispanic White 10.5 ± 1.6%, Latinx 10.8 ± 1.5%, p = 0.01). Incident cases of T2D decreased from 54 to 50 cases (7.4% decrease) over the 2-years pre-pandemic and increased 182% during the pandemic (n = 141, 1.45 cases/month, p < 0.001). As compared to the 2-years pre-pandemic, cases increased most among NHB youth (56.7% vs. 76.6%, p = 0.001) and males (40.4% vs. 58.9%, p = 0.005). Cases of DKA (5.8% vs. 23.4%, p < 0.001) and hyperosmolar DKA (0 vs. 9.2%, p = 0.001) increased among youth with T2D during the pandemic. CONCLUSIONS During the pandemic, the incidence and severity of presentation of T1D increased modestly, while incident cases of T2D increased 182%, with a nearly 6-fold increase in DKA and nearly a 10% incidence of hyperosmolar DKA. NHB youth were disproportionately impacted, raising concern about worsening of pre-existing health disparities during and after the pandemic.
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Affiliation(s)
- Brynn E. Marks
- Division of Endocrinology, Children's National Hospital, Washington, District of Columbia, USA,George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA,*Brynn E. Marks,
| | - Aneka Khilnani
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Abby Meyers
- Division of Endocrinology, Children's National Hospital, Washington, District of Columbia, USA,George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Myrto E. Flokas
- Division of Endocrinology, Children's National Hospital, Washington, District of Columbia, USA
| | - Jiaxiang Gai
- Division of Biostatistics, Children's National Hospital, Washington, District of Columbia, USA
| | - Maureen Monaghan
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA,Division of Psychology and Behavioral Health, Children's National Hospital, Washington, District of Columbia, USA
| | - Randi Streisand
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA,Division of Psychology and Behavioral Health, Children's National Hospital, Washington, District of Columbia, USA
| | - Elizabeth Estrada
- Division of Endocrinology, Children's National Hospital, Washington, District of Columbia, USA,George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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24
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Campanati A, Martina E, Diotallevi F, Radi G, Marani A, Sartini D, Emanuelli M, Kontochristopoulos G, Rigopoulos D, Gregoriou S, Offidani A. Saliva Proteomics as Fluid Signature of Inflammatory and Immune-Mediated Skin Diseases. Int J Mol Sci 2021; 22:ijms22137018. [PMID: 34209865 PMCID: PMC8267971 DOI: 10.3390/ijms22137018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/11/2022] Open
Abstract
Saliva is easy to access, non-invasive and a useful source of information useful for the diagnosis of serval inflammatory and immune-mediated diseases. Following the advent of genomic technologies and -omic research, studies based on saliva testing have rapidly increased and human salivary proteome has been partially characterized. As a proteomic protocol to analyze the whole saliva proteome is not currently available, the most common aim of the proteomic analysis is to discriminate between physiological and pathological conditions. The salivary proteome has been initially investigated in several diseases: oral squamous cell carcinoma and oral leukoplakia, chronic graft-versus-host disease, and Sjögren's syndrome. Otherwise, salivary proteomics studies in the dermatological field are still in the initial phase, thus the aim of this review is to collect the best research evidence on the role of saliva proteomics analysis in immune-mediated skin diseases to understand the direction of research in this field. The results of PRISMA analysis reported herein suggest that human saliva analysis could provide significant data for the diagnosis and prognosis of several immune-mediated and inflammatory skin diseases in the next future.
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Affiliation(s)
- Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
- Correspondence:
| | - Emanuela Martina
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Federico Diotallevi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Giulia Radi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Andrea Marani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Davide Sartini
- Biochemistry, Department of Clinical Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (D.S.); (M.E.)
| | - Monica Emanuelli
- Biochemistry, Department of Clinical Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (D.S.); (M.E.)
| | - George Kontochristopoulos
- Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 124 62 Athens, Greece; (G.K.); (D.R.); (S.G.)
| | - Dimitris Rigopoulos
- Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 124 62 Athens, Greece; (G.K.); (D.R.); (S.G.)
| | - Stamatis Gregoriou
- Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 124 62 Athens, Greece; (G.K.); (D.R.); (S.G.)
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
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Karmacharya P, Chakradhar R, Ogdie A. The epidemiology of psoriatic arthritis: A literature review. Best Pract Res Clin Rheumatol 2021; 35:101692. [DOI: 10.1016/j.berh.2021.101692] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Son C, Park YK, Park JW. Long-term evaluation of temporomandibular disorders in association with cytokine and autoantibody status in young women. Cytokine 2021; 144:155551. [PMID: 33941445 DOI: 10.1016/j.cyto.2021.155551] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022]
Abstract
Temporomandibular disorders (TMD) is a chronic pain disease affecting 4-60% of general population. Its suggested etiology includes mechanical overloading to related structures, psychosocial factors, and genetic vulnerability. However, its pathogenesis is yet to be fully understood, especially in cases with a higher level of pain and more associated comorbidities. Recently chronic systemic inflammation and possible autoimmunity has been indicated in several pain conditions as the underlying mechanism of chronicity but this aspect has not been rigorously investigated in TMD. This article focuses on analyzing the levels of cytokines, chemokines, autoantibodies and nonspecific inflammatory markers and comparing their levels according to pain severity and duration in 66 female TMD patients in their 20 s and investigating their association with clinical indices of TMD and comorbidities. The high pain disability group showed decreased range of jaw function and more pain on palpation of capsule areas compared to the low pain disability group. Comorbidities such as anxiety and sleep disturbance were also significantly more prevalent. The level of IL-8 and IgG were significantly higher in the high pain disability group. IL-2, -8, -13, IFN- γ, RANTES, PGE2, and thrombopoietin levels showed a significant effect on indices reflecting jaw function, generalized pain intensity, and health related quality of life. Such results imply that longer pain duration and higher pain intensity is associated with higher levels of systemic inflammation suggesting the possible role of immunologic disturbance as an underlying factor of chronic TMD pain and warranting further investigation for its consideration in diagnosis and treatment.
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Affiliation(s)
- Chunghwan Son
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101 Yunkeun-Dong, Chongro-Ku, Seoul 03080, Republic of Korea.
| | - Yoon Kyung Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101 Yunkeun-Dong, Chongro-Ku, Seoul 03080, Republic of Korea.
| | - Ji Woon Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101 Yunkeun-Dong, Chongro-Ku, Seoul 03080, Republic of Korea.
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Alsharie AM, Rafiee F, Rezaeimanesh N, Moghadasi AN, Sahraian MA, Eskandarieh S. Stressful life events and the risk of primary progressive multiple sclerosis: A population-based case-control study. Mult Scler Relat Disord 2021; 51:102937. [PMID: 33857898 DOI: 10.1016/j.msard.2021.102937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/17/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The onset and presentation of primary progressive multiple sclerosis (PPMS) like any other autoimmune diseases can be triggered by unexpected lifetime stressful events, which require to be assessed in order to minimize our exposure to such events as much as possible. OBJECTIVE The aim of the present study was to determine the possible role of socioeconomic status (SES) and stressful events in PPMS development METHODS: The present population-based case-control study recruited PPMS cases and healthy controls from the general population during 2019-2020 in Tehran, Iran. Clinical diagnosis of cases was based on the 2017 McDonald criteria and confirmed by a neurologist. The selection of sex-matched controls from the same source population of cases was performed using the standard method of Random Digit Dialing (RDD). The study questionnaire was filled out over telephone interviews. Matched logistic regression was administered to estimate the adjusted and unadjusted odds ratio (OR) at 95% confidence intervals (CIs) adjusted for sex, age, and marital status using SPSS 23. RESULTS This study examined 146 PPMS cases and 294 controls. Mean ages (SD) for cases and controls were 46.97 (9.4) and 37.67 (6.12), respectively (P < 0.001). No stressful events over five years prior to the disease onset were associated with an increased risk of PPMS. Marriage (OR: 0.04; 95% CI (0.01- 0.37), P = 0.004), close family members' serious disease (OR: 0.10; 95% CI (0.02-0.60), P = 0.01), and being in debt (OR: 0.03; 95% CI (0-0.37), P = 0.006) were found to have a negative association with the risk of disease occurrence. Death of a loved one, family disruption, jail term, homelessness period, Conquer(national university entrance exam), death of spouse, getting fired from a job, joblessness, divorce, migration, close family members' suicide, and retirement were not associated with the risk of PPMS (P > 0.05). History of depression before the PPMS presentation was considerably associated with the incidence of PPMS (P < 0.001). Self-rated health status was scored noticeably lower by cases as compared with controls (P < 0.001). Participants with the paternal educational degree of guidance school showed a higher risk of PPMS by 2.83 time (OR: 2.83; 95% CI (1.02 - 7.80), P = 0.04) than participants with university educated fathers. In total, SES during adolescence did not indicate any association with the risk of PPMS (with the exception of levels 2 (P = 0.02) and 7 (P = 0.05)). CONCLUSION No stressful life events were identified as possible increasing risk factors for PPMS. Marriage, close family members' serious disease, and being in debt had a negative association with the disease risk. The history of depression may elevate the risk of PPMS. While the highest and lowest SES levels in adolescence were not remarkable determiners for PPMS, levels 2 and 7 had a positive association with the risk of PPMS. The maternal educational level was not an important factor; however, the paternal educational degree of guidance school as compared to university degree made individuals more susceptible to PPMS. Self-rated health status score was higher in controls.
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Affiliation(s)
| | - Farnaz Rafiee
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Rezaeimanesh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Posttraumatic Stress Disorder and the Associated Risk of Autoimmune Skin Diseases: A Nationwide Population-Based Cohort Study. Psychosom Med 2021; 83:212-217. [PMID: 33587564 DOI: 10.1097/psy.0000000000000920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is known as a risk factor for various immune-related disorders; however, the association between PTSD and related autoimmune skin diseases (ASDs) remains unclear. This study aimed to investigate the association of PTSD with the risk of related ASDs. METHODS Participants were recruited from the National Health Insurance Research Database in Taiwan. We included 9801 patients with PTSD and 39,204 matched controls to assess the risk of developing ASDs. Cox regression model was used for analyses. RESULTS After adjusting for confounders, we found an increased risk of ASDs among the patients with PTSD (adjusted hazard ratio [aHR] = 3.00, 95% confidence interval [CI] = 2.21-4.07) compared with that among matched controls. Statistically significant associations were found between PTSD and five individual ASDs, including psoriasis (aHR = 3.81, 95% CI = 1.90-7.67), lichen planus (aHR = 31.63, 95% CI = 4.00-249.91), alopecia areata (aHR = 4.77, 95% CI = 2.47-9.20), autoimmune bullous diseases (aHR = 9.55, 95% CI = 1.98-45.99), and vitiligo (aHR = 16.06, 95% CI = 4.48-57.54). CONCLUSIONS Patients with PTSD had an increased risk of developing ASDs compared with the matched controls. Further studies are needed for better understanding of the underlying mechanisms.
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Sterkens A, Lambert J, Bervoets A. Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options. Clin Exp Med 2021; 21:215-230. [PMID: 33386567 DOI: 10.1007/s10238-020-00673-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023]
Abstract
Patients suffering from alopecia areata (AA) can lose hair in focal regions, the complete scalp, including eyelashes and eyebrows, or even the entire body. The exact pathology is not yet known, but the most described theory is a collapse of the immune privilege system, which can be found in some specific regions of the body. Different treatment options, local and systemic, are available, but none of them have been proven to be effective in the long term as well for every treatment there should be considered for the possible side effects. In many cases, treated or non-treated, relapse often occurs. The prognosis is uncertain and is negatively influenced by the subtypes alopecia totalis and alopecia universalis and characteristics such as associated nail lesions, hair loss for more than 10 years and a positive familial history. The unpredictable course of the disease also makes it a mental struggle and AA patients are more often associated with depression and anxiety compared to the healthy population. Research into immunology and genetics, more particularly in the field of dendritic cells (DC), is recommended for AA as there is evidence of the possible role of DC in the treatment of other autoimmune diseases such as multiple Sclerosis and cancer. Promising therapies for the future treatment of AA are JAK-STAT inhibitors and PRP.
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Affiliation(s)
- A Sterkens
- Department of Dermatology, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium.
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - A Bervoets
- Department of Dermatology, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium
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DiMeglio LA, Albanese-O'Neill A, Muñoz CE, Maahs DM. COVID-19 and Children With Diabetes-Updates, Unknowns, and Next Steps: First, Do No Extrapolation. Diabetes Care 2020; 43:2631-2634. [PMID: 32887703 DOI: 10.2337/dci20-0044] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Linda A DiMeglio
- Division of Pediatric Endocrinology and Diabetology and Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Anastasia Albanese-O'Neill
- Division of Endocrinology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL
| | - Cynthia E Muñoz
- University of Southern California Keck School of Medicine, Children's Hospital Los Angeles Center for Endocrinology, Diabetes, and Metabolism, and Children's Hospital Los Angeles University Center for Excellence in Developmental Disabilities, Los Angeles, CA
| | - David M Maahs
- Division of Pediatric Endocrinology, Stanford Diabetes Research Center, and Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA
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Cañas-González B, Fernández-Nistal A, Ramírez JM, Martínez-Fernández V. Influence of Stress and Depression on the Immune System in Patients Evaluated in an Anti-aging Unit. Front Psychol 2020; 11:1844. [PMID: 32849086 PMCID: PMC7417678 DOI: 10.3389/fpsyg.2020.01844] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/06/2020] [Indexed: 12/26/2022] Open
Abstract
Background There is compelling evidence pointing out that stress and depression produce a dramatic impact on human well-being mainly through impairing the regular function of the immune system and producing a low-chronic inflammation status that favors the occurrence of infections, metabolic diseases, and even cancer. The present work aims to evaluate the stress/depression levels of some patients treated in an antiaging unit and detect any potential relationship with their immune system status prior of the implementation of a physical/psychological program designed to prevent health deterioration. Methods We evaluated 48 patients (16 men and 32 women with a mean age of 55.11 ± 10.71 years) from middle-upper class from psychological and immunological points of view. In particular, we analyzed neutrophil chemotaxis and phagocytosis; lymphocyte chemotaxis and proliferation, and natural killer (NK) cell activity. Results Women showed more depressive symptoms than men. Chemotaxis levels of lymphocytes and neutrophils in women showed a significant reduction compared with those in men. We also found a strong negative correlation between depression and NK cell function. This correlation was also significant independently of gender. Conclusion We conclude that NK activity is affected at least by depression state, and we propose that a combined treatment consisting of cognitive behavioral therapy and physical activity programs might improve patient health deterioration.
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Affiliation(s)
- Beatriz Cañas-González
- Department of Psychobiology, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Alonso Fernández-Nistal
- Department of Pharmacology and Toxicology, Facultad de Farmacia y Nutrición, University of Navarra, Pamplona, Spain
| | - Juan M Ramírez
- Department of Morphological Sciences, School of Medicine, University of Córdoba, Córdoba, Spain
| | - Vicente Martínez-Fernández
- Department of Pharmacology and Toxicology, Facultad de Farmacia y Nutrición, University of Navarra, Pamplona, Spain
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Ku M, Kim J, Won JE, Kang W, Park YG, Park J, Lee JH, Cheon J, Lee HH, Park JU. Smart, soft contact lens for wireless immunosensing of cortisol. SCIENCE ADVANCES 2020; 6:eabb2891. [PMID: 32923592 PMCID: PMC7455488 DOI: 10.1126/sciadv.abb2891] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/26/2020] [Indexed: 05/04/2023]
Abstract
Despite various approaches to immunoassay and chromatography for monitoring cortisol concentrations, conventional methods require bulky external equipment, which limits their use as mobile health care systems. Here, we describe a human pilot trial of a soft, smart contact lens for real-time detection of the cortisol concentration in tears using a smartphone. A cortisol sensor formed using a graphene field-effect transistor can measure cortisol concentration with a detection limit of 10 pg/ml, which is low enough to detect the cortisol concentration in human tears. In addition, this soft contact lens only requires the integration of this cortisol sensor with transparent antennas and wireless communication circuits to make a smartphone the only device needed to operate the lens remotely without obstructing the wearer's view. Furthermore, in vivo tests using live rabbits and the human pilot experiment confirmed the good biocompatibility and reliability of this lens as a noninvasive, mobile health care solution.
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Affiliation(s)
- Minjae Ku
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
| | - Joohee Kim
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
| | - Jong-Eun Won
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
| | - Wonkyu Kang
- Department of Chemical Engineering, Myongji University, Yongin 17058, Republic of Korea
| | - Young-Geun Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- School of Materials Science and Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Jihun Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- School of Materials Science and Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Jae-Hyun Lee
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- Advanced Science Institute, Yonsei University, Seoul 03722, Republic of Korea
| | - Jinwoo Cheon
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- Advanced Science Institute, Yonsei University, Seoul 03722, Republic of Korea
- Department of Chemistry, Yonsei University, Seoul 03722, Republic of Korea
| | - Hyun Ho Lee
- Department of Chemical Engineering, Myongji University, Yongin 17058, Republic of Korea
| | - Jang-Ung Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- Advanced Science Institute, Yonsei University, Seoul 03722, Republic of Korea
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Bogdan A, Barnett C, Ali A, AlQwaifly M, Abraham A, Mannan S, Ng E, Bril V. Prospective study of stress, depression and personality in myasthenia gravis relapses. BMC Neurol 2020; 20:261. [PMID: 32600271 PMCID: PMC7322879 DOI: 10.1186/s12883-020-01802-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/21/2020] [Indexed: 11/25/2022] Open
Abstract
Background Psychopathology and personality traits may influence the course of autoimmune disorders. With this prospective longitudinal cohort study, we aimed to assess personality, stress and depression in myasthenia patients who relapse and those who remain stable or improve (non-relapsers). Method We collected data from 155 consecutive adult patients with confirmed MG attending the Neuromuscular Clinic, Toronto General Hospital, between March 2017 and July 2018, for this study. Patients were assessed at baseline and 6 months, or at the time of MG relapse. At both visits, the patients were assessed clinically and were asked to complete self-administered questionnaires for disease severity, chronic stress and depression. Personality type was assessed at baseline only. Relapsing patients were defined as those patients with MGII score increasing by more than 5.5 points from visit 1 to visit 2. Results Relapsers had higher baseline scores for depression (p = 0.01) and the change in disease severity correlated with the change in depression score (r = 0.2534, p = 0.0015, 95% CI: 0.098 0.3961). Higher levels of stress at baseline and neuroticism predicted higher relapse rates (p = 0.01 and p < .0001, respectively). In the linear regression model, with change of the MGII score as the dependent variable, change in depression scores (p = 0.0004) and age (p = 0.03) predicted change in disease severity. Conclusions Since emotional factors and personality type may influence MG, attention to these factors might improve care in MG patients.
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Affiliation(s)
- Anca Bogdan
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, 5EC, Room 309 200 Elizabeth St, Toronto, ON, M5G 2G4, Canada
| | - Carolina Barnett
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, 5EC, Room 309 200 Elizabeth St, Toronto, ON, M5G 2G4, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Abdulrahman Ali
- National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Alon Abraham
- Neuromuscular Diseases Unit of the Department of Neurology, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shabber Mannan
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, 5EC, Room 309 200 Elizabeth St, Toronto, ON, M5G 2G4, Canada
| | - Eduardo Ng
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, 5EC, Room 309 200 Elizabeth St, Toronto, ON, M5G 2G4, Canada
| | - Vera Bril
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, 5EC, Room 309 200 Elizabeth St, Toronto, ON, M5G 2G4, Canada. .,Institute for Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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Hunter EA, Spears EC, Martz CD, Chung K, Fuller-Rowell TE, Lim SS, Drenkard C, Chae DH. Racism-related stress and psychological distress: Black Women's Experiences Living with Lupus study. J Health Psychol 2020; 26:2374-2389. [PMID: 32228184 DOI: 10.1177/1359105320913085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Disparate health consequences in African American women with systemic lupus erythematosus include greater severity of physical and psychological distress. Racism-related stress is also related to psychological distress correlates in this population. This study examined the relationships between racism-related experiences, psychological distress, and systemic lupus erythematosus activity in 430 African American women from the Black Women's Experiences Living with Lupus study. The structural equation model suggests that psychological distress mediates the relationship between racism-related stress and systemic lupus erythematosus disease activity. The impact of racism-related stress on systemic lupus erythematosus disease activity may occur primarily through their impact on psychological health variables. Implications for clinical care and future directions are explored.
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Logel SN, Bekx MT, Rehm JL. Potential association between type 1 diabetes mellitus and gender dysphoria. Pediatr Diabetes 2020; 21:266-270. [PMID: 31747094 PMCID: PMC7978411 DOI: 10.1111/pedi.12947] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/25/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND/OBJECTIVE Multiple factors have been proposed to explain the increasing prevalence of type 1 diabetes mellitus (T1DM), including psychological stress. The prevalence of gender dysphoria (GD) in youth is also growing. Identifying environmental triggers, such as psychological minority stress experienced by youth with GD, that may influence the pathogenesis and management of T1DM could have important clinical implications. The objective of this study was to determine the prevalence of concurrent diagnosis of T1DM and GD in adolescents evaluated at a university-based children's hospital. METHODS An electronic data extraction was conducted at the University of Wisconsin Hospital and Clinics from 1 November 2007 to 1 November 2017. Inclusion criteria included age 10 to 21 years and diagnosis of T1DM and/or GD. Prevalence rates were calculated for T1DM and GD. For adolescents with T1DM and GD, information related to diagnosis, treatment, and psychiatric history was collected. RESULTS The prevalence for T1DM was 2.69 per 1000; the prevalence for GD was 0.42 per 1000. Eight adolescents had T1DM and GD. In adolescents with GD, the prevalence of T1DM was 9.4-fold higher than the prevalence of T1DM alone (24.77 vs 2.68 per 1000). Five adolescents were seen in GD clinic and their glycemic control initially improved after the first GD clinic visit. CONCLUSIONS There was an increased prevalence of a concurrent diagnosis of T1DM in those with GD compared to the general population. Glycemic control improved after the first GD clinic visit in adolescents with T1DM and GD, which may be secondary to stress reduction.
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Affiliation(s)
- Santhi N. Logel
- Division of Pediatric Endocrinology and Diabetes, University of Wisconsin-Madison School of Medicine and Public Health
| | - M. Tracy Bekx
- Division of Pediatric Endocrinology and Diabetes, University of Wisconsin-Madison School of Medicine and Public Health
| | - Jennifer L. Rehm
- Division of Pediatric Endocrinology and Diabetes, University of Wisconsin-Madison School of Medicine and Public Health
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Indirect impact of violent events on emergency department utilization and disease patterns. BMC Emerg Med 2020; 20:10. [PMID: 32054436 PMCID: PMC7020587 DOI: 10.1186/s12873-020-0307-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 02/04/2020] [Indexed: 12/02/2022] Open
Abstract
Background The health effects of war and armed conflict on casualties and mental health of those directly exposed has been well described, but few studies have explored the indirect health effects of violent events. This paper assesses the indirect health impact of several violent events that took place in Beirut in 2013–2014 on ED visit utilization and disease patterns. Methods As tracked by media reports, there were 9 violent events in Beirut during 2013–2014. We compared visits to the Emergency Department of a major medical center during weeks when violent events happened and weeks without such events (the preceding week and the same week in preceding years). After re-coding de-identified data from the medical records of 23,067 patients, we assessed differences in the volume of visits, severity index, and discharge diagnoses. Individual control charts were used to analyze ED visit trends post-event. Results Comparisons of weeks with violent events and weeks without such events indicate that the socio-demographic characteristics of patients who visited the Emergency Department were similar. Patients seen during violent weeks were significantly more likely to be admitted to the hospital, and less likely to present with low acuity complaints, indicating greater complexity of their conditions. The discharge diagnoses that were significantly higher during violent event weeks included anxiety disorders, sprains, and gastritis. Daily ED visits dropped post events by 14.111%, p < 0.0001. Conclusions The results indicate that violent events such as bombs, explosions, and terrorist attacks reverberate through the population, impact patterns of ED utilization immediately post-event and are associated with adverse health outcomes, even among those who are not directly affected by the events.
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Martina E, Campanati A, Diotallevi F, Offidani A. Saliva and Oral Diseases. J Clin Med 2020; 9:E466. [PMID: 32046271 PMCID: PMC7074457 DOI: 10.3390/jcm9020466] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 02/06/2023] Open
Abstract
Saliva is a fascinating biological fluid which has all the features of a perfect diagnostic tool. In fact, its collection is rapid, simple, and noninvasive. Thanks to several transport mechanisms and its intimate contact with crevicular fluid, saliva contains hundreds of proteins deriving from plasma. Advances in analytical techniques have opened a new era-called "salivaomics"-that investigates the salivary proteome, transcriptome, microRNAs, metabolome, and microbiome. In recent years, researchers have tried to find salivary biomarkers for oral and systemic diseases with various protocols and technologies. The review aspires to provide an overall perspective of salivary biomarkers concerning oral diseases such as lichen planus, oral cancer, blistering diseases, and psoriasis. Saliva has proved to be a promising substrate for the early detection of oral diseases and the evaluation of therapeutic response. However, the wide variation in sampling, processing, and measuring of salivary elements still represents a limit for the application in clinical practice.
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Bookwalter DB, Roenfeldt KA, LeardMann CA, Kong SY, Riddle MS, Rull RP. Posttraumatic stress disorder and risk of selected autoimmune diseases among US military personnel. BMC Psychiatry 2020; 20:23. [PMID: 31941473 PMCID: PMC6964079 DOI: 10.1186/s12888-020-2432-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 01/07/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Increasing evidence suggests a link between posttraumatic stress disorder (PTSD) and physical health. Stress disorders may lead to impairment of the immune system and subsequent autoimmune disease. This study investigated the association between PTSD and risk of selected autoimmune diseases (i.e. rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel diseases, and multiple sclerosis) among US active duty service members. METHODS Using data from the Millennium Cohort Study, incident autoimmune cases between study initiation and September 2015 were identified from medical encounter records in the Military Health System Data Repository (MDR). Participants were classified as having a history of PTSD if they self-reported receiving a health care provider's diagnosis of PTSD or if they screened positive using the PTSD Checklist-Civilian Version. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression models adjusted for demographics and history of another mental health condition. RESULTS Among 120,572 participants followed for a mean of 5.2 years, risk of any of the selected autoimmune diseases was 58% higher for those with a history of PTSD (HR = 1.58, 95% CI: 1.25, 2.01) compared with no history of PTSD. Further adjustment for BMI, smoking status, and alcohol use had little impact on the effect estimates, and results were not appreciably different according to combat experience and history of physical or sexual trauma. CONCLUSIONS Active duty military personnel with PTSD may have an elevated risk of a range of autoimmune diseases, regardless of combat experience or prior trauma. Future research is needed to understand potential mechanisms which may inform future mitigative strategies in reducing extra-neuropsychiatric health problems among those with PTSD.
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Affiliation(s)
- Deborah Boggs Bookwalter
- 0000 0004 0587 8664grid.415913.bDeployment Health Research Department, Naval Health Research Center, 140 Sylvester Rd., San Diego, CA 92106 USA ,0000 0000 9270 6633grid.280561.8Westat, 1009 Slater Rd. Suite 110, Durham, North Carolina 27703 USA
| | - Kimberly A. Roenfeldt
- 0000 0004 0587 8664grid.415913.bDeployment Health Research Department, Naval Health Research Center, 140 Sylvester Rd., San Diego, CA 92106 USA ,0000 0004 4665 8158grid.419407.fLeidos, 11951 Freedom Dr., Reston, Virginia 20190 USA
| | - Cynthia A. LeardMann
- 0000 0004 0587 8664grid.415913.bDeployment Health Research Department, Naval Health Research Center, 140 Sylvester Rd., San Diego, CA 92106 USA ,0000 0004 4665 8158grid.419407.fLeidos, 11951 Freedom Dr., Reston, Virginia 20190 USA
| | - So Yeon Kong
- 0000 0004 0587 8664grid.415913.bDeployment Health Research Department, Naval Health Research Center, 140 Sylvester Rd., San Diego, CA 92106 USA
| | - Mark S. Riddle
- 0000 0004 1936 914Xgrid.266818.3School of Medicine, University of Nevada, Reno, 1664 North Virginia Street, Reno, NV 89557 USA
| | - Rudolph P. Rull
- 0000 0004 0587 8664grid.415913.bDeployment Health Research Department, Naval Health Research Center, 140 Sylvester Rd., San Diego, CA 92106 USA
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Hung HM, Chen MF, Chen CH. The clinically crucial predictors of depression in women with systemic autoimmune diseases. Health Care Women Int 2019; 41:293-307. [PMID: 31246540 DOI: 10.1080/07399332.2019.1623796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The researchers' aim of this study was to identify and quantify the useful, clinically crucial predictors of depression in Taiwanese women with systemic autoimmune diseases (SADs). We used a cross-sectional method. A total of 241 Taiwanese women with SADs between 21 and 85 years of age participated in the study. Analysis revealed that the strongest predictors of depression in participants were: perceived stress, fatigue, mental health, physical health, chronic-disease-related comorbidities, self-perceived SAD severity, and social support. The model used in the present study explained 70.9% of the variance in the depression.
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Affiliation(s)
- Hsuan-Man Hung
- Department of Nursing, Fooyin University, Kaohsiung City, Taiwan
| | - Ming-Fu Chen
- Internal Medical Department, St. Joseph Hospital, Kaohsiung, Taiwan
| | - Chung-Hey Chen
- Department of Nursing, Hungkuang University, Taichung, Taiwan.,Department of Nursing, Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
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Lopez-Jornet P, Zavattaro E, Mozaffari HR, Ramezani M, Sadeghi M. Evaluation of the Salivary Level of Cortisol in Patients with Oral Lichen Planus: A Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E213. [PMID: 31137861 PMCID: PMC6571959 DOI: 10.3390/medicina55050213] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/05/2019] [Accepted: 05/21/2019] [Indexed: 12/29/2022]
Abstract
Background and objective: Cortisol, as the main human glucocorticoid, is considered to be a biological marker of stress and anxiety. Since it is known that oral lichen planus (OLP) can appear and worsen during stressful events, cortisol levels have been previously studied in OLP patients. The present meta-analysis aims to assess the salivary concentration of cortisol in OLP patients compared to healthy controls. Materials and methods: Web of Science, PubMed, Cochrane Library, and Scopus databases were searched up to October 2018. The RevMan 5.3 software was used with the mean difference (MD) and 95% confidence intervals (CIs). The CMA 2.0 Software was used to evaluate the publication bias, sensitivity analysis, and meta-regression as possible sources of heterogeneity. Results: 10 studies were analyzed and a total of 269 OLP patients and 268 controls were included. The pooled MD of the salivary levels of cortisol in OLP patients compared with controls was 4.27 ng/mL (95% CI: 2.33, 6.21; P < 0.0001), thus, the salivary level of cortisol in OLP patients was significantly higher than in controls. In Indian-based population studies, a significant difference in the salivary cortisol levels in OLP patients compared with controls was detected (MD = 5.62 ng/mL; 95% CI: 2.67, 8.56; P = 0.0002). In addition, a significant difference in the salivary cortisol levels in the OLP patients compared with the controls was obtained in studies performed with enzyme-linked immunosorbent assay (ELISA) method (MD = 5.33 ng/mL; 95% CI: 2.72, 7.93; P < 0.0001). Conclusion: We suggest that supportive psychological treatment together with the conventional therapy could increase patients' capability to prevent stress, anxiety, and depression.
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Affiliation(s)
- Pia Lopez-Jornet
- Facultad de Medicina y Odontologia Universidad de Murcia, Hospital Morales Meseguer, Clinica Odontologic Adv Marques Velez s/n, 30008 Murcia, Spain.
| | - Elisa Zavattaro
- Dermatology Unit, Department of Translational Medicine, University of Eastern Piedmont "Amedeo Avogadro", 28100 Novara, Italy.
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran.
| | - Mazaher Ramezani
- Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah 6714415153, Iran.
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran.
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran.
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Pathological cardiac hypertrophy: the synergy of adenylyl cyclases inhibition in cardiac and immune cells during chronic catecholamine stress. J Mol Med (Berl) 2019; 97:897-907. [PMID: 31062036 DOI: 10.1007/s00109-019-01790-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/18/2019] [Accepted: 04/26/2019] [Indexed: 12/21/2022]
Abstract
Response to stressors in our environment and daily lives is an adaptation conserved through evolution as it is beneficial in enhancing the survival and continuity of humans. Although stressors have evolved, the drastic physiological response they elicit still remains unchanged. The chronic secretion and circulation of catecholamines to produce physical responses when they are not required may result in pathological consequences which affect cardiac function drastically. This review seeks to point out the probable implication of chronic stress in inducing an inflammation disorder in the heart. We discussed the likely synergy of a G protein-independent stimuli signaling via β2-adrenergic receptors in both cardiomyocytes and immune cells during chronic catecholamine stress. To explain this synergy, we hypothesized the possibility of adenylyl cyclases having a regulatory effect on G protein-coupled receptor kinases. This was based on the negative correlations they exhibit during normal cardiac function and heart failures. As such, the downregulation of adenylyl cyclases in cardiomyocytes and immune cells during chronic catecholamine stress enhances the expressions of G protein-coupled receptor kinases. In addition, we explain the maladaptive roles played by G protein-coupled receptor kinase and extracellular signal-regulated kinase in the synergistic cascade that pathologically remodels the heart. Finally, we highlighted the therapeutic potentials of an adenylyl cyclases stimulator to attenuate pathological cardiac hypertrophy (PCH) and improve cardiac function in patients developing cardiac disorders due to chronic catecholamine stress.
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Preventing psoriatic arthritis: focusing on patients with psoriasis at increased risk of transition. Nat Rev Rheumatol 2019; 15:153-166. [DOI: 10.1038/s41584-019-0175-0] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Sharif K, Watad A, Coplan L, Amital H, Shoenfeld Y, Afek A. Psychological stress and type 1 diabetes mellitus: what is the link? Expert Rev Clin Immunol 2018; 14:1081-1088. [PMID: 30336709 DOI: 10.1080/1744666x.2018.1538787] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Type 1 diabetes mellitus (T1DM) is a chronic disease characterized by the destruction of insulin-producing β-cells of the pancreas. The current paradigm in this disease's etiopathogenesis points toward the interplay of genetic and environmental factors. Among the environmental variables, dietary factors, intestinal microbiota, toxins, and psychological stress have been implicated in disease onset. Areas covered: This review aims to investigate the relationship between psychological stress and T1DM by presenting evidence from epidemiological studies, animal models, and to provide the mechanism involved in this association. The literature search was conducted through PubMed to identify studies that investigate the connection between stress and T1DM. Experimental designs, such as case-control, and retrospective and prospective cohorts studies, were included. Expert commentary: A wide array of evidence, ranging from epidemiological to animal models, points toward the role of psychological stressors in T1DM pathogenesis. Various mechanisms have been proposed, including the hypothalamic-pituitary-adrenal (HPA) axis, influence of the nervous system on immune cells, and insulin resistance. Further research could investigate the gene-stress interactions to evaluate the risk of T1DM development.
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Affiliation(s)
- Kassem Sharif
- a Department of Medicine 'B' , Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center , Tel-Hashomer , Israel.,b Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel
| | - Abdulla Watad
- a Department of Medicine 'B' , Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center , Tel-Hashomer , Israel.,b Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel
| | - Louis Coplan
- b Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel
| | - Howard Amital
- a Department of Medicine 'B' , Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center , Tel-Hashomer , Israel.,b Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel
| | - Yehuda Shoenfeld
- b Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel.,c Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center , Tel-Hashomer , Israel.,d Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases , Tel-Aviv University , Tel-Aviv , Israel.,e Head of The Mosaic of Autoimmunity Project , Saint Petersburg State University , Saint Petersburg , Russia
| | - Arnon Afek
- b Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel.,c Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center , Tel-Hashomer , Israel
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Azzawi S, Penzi LR, Senna MM. Immune Privilege Collapse and Alopecia Development: Is Stress a Factor. Skin Appendage Disord 2018; 4:236-244. [PMID: 30410890 PMCID: PMC6219219 DOI: 10.1159/000485080] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/07/2017] [Indexed: 01/05/2023] Open
Abstract
Hair is a defining mammalian feature that serves as a hallmark of human communication. Given the critical significance of hair in social, religious, and political contexts, it is important to understand factors that play a role in hair loss disorders. The hair follicle is an immune privileged site, and mounting evidence suggests that the collapse of immune privilege contributes to the pathogenesis of autoimmune hair loss disorders, including alopecia areata and lichen planopilaris. This review comprehensively appraises the current literature to shed light on mechanisms for immune privilege collapse, and examines the role of neurogenic stress in triggering this process.
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Affiliation(s)
| | - Lauren R. Penzi
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Maryanne M. Senna
- Harvard Medical School, Boston, MA, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
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Unravelling the Roles of Susceptibility Loci for Autoimmune Diseases in the Post-GWAS Era. Genes (Basel) 2018; 9:genes9080377. [PMID: 30060490 PMCID: PMC6115971 DOI: 10.3390/genes9080377] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/06/2018] [Accepted: 07/23/2018] [Indexed: 12/18/2022] Open
Abstract
Although genome-wide association studies (GWAS) have identified several hundred loci associated with autoimmune diseases, their mechanistic insights are still poorly understood. The human genome is more complex than single nucleotide polymorphisms (SNPs) that are interrogated by GWAS arrays. Apart from SNPs, it also comprises genetic variations such as insertions-deletions, copy number variations, and somatic mosaicism. Although previous studies suggest that common copy number variations do not play a major role in autoimmune disease risk, it is possible that certain rare genetic variations with large effect sizes are relevant to autoimmunity. In addition, other layers of regulations such as gene-gene interactions, epigenetic-determinants, gene and environmental interactions also contribute to the heritability of autoimmune diseases. This review focuses on discussing why studying these elements may allow us to gain a more comprehensive understanding of the aetiology of complex autoimmune traits.
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Borde A, Åstrand A. Alopecia areata and the gut-the link opens up for novel therapeutic interventions. Expert Opin Ther Targets 2018; 22:503-511. [PMID: 29808708 DOI: 10.1080/14728222.2018.1481504] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION This review aims to raise the potential of the modern society's impact on gut integrity often leading to increased intestinal permeability, as a cause or driver of Alopecia Areata (AA) in genetically susceptible people. With the increasing rate of T cell-driven autoimmunity, we hypothesize that there is a common root cause of these diseases that originates from chronic inflammation, and that the gut is the most commonly exposed area with our modern lifestyle. Areas covered: We will discuss the complexity in the induction of AA and its potential link to increased intestinal permeability. Our main focus will be on the gut microbiome and mechanisms involved in the interplay with the immune system that may lead to local and/or peripheral inflammation and finally, tissue destruction. Expert opinion: We have seen a link between AA and a dysfunctional gastrointestinal system which raised the hypothesis that an underlying intestinal inflammation drives the priming and dysregulation of immune cells that lead to hair follicle destruction. While it is still important to resolve local inflammation and restore the IP around the hair follicles, we believe that the root cause needs to be eradicated by long-term interventions to extinguish the fire driving the disease.
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Affiliation(s)
- Annika Borde
- a Respiratory, Inflammation and Autoimmunity IMED Biotech Unit , AstraZeneca , Gothenburg , Sweden
| | - Annika Åstrand
- a Respiratory, Inflammation and Autoimmunity IMED Biotech Unit , AstraZeneca , Gothenburg , Sweden
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Bellinger DL, Lorton D. Sympathetic Nerve Hyperactivity in the Spleen: Causal for Nonpathogenic-Driven Chronic Immune-Mediated Inflammatory Diseases (IMIDs)? Int J Mol Sci 2018; 19:ijms19041188. [PMID: 29652832 PMCID: PMC5979464 DOI: 10.3390/ijms19041188] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 04/05/2018] [Accepted: 04/05/2018] [Indexed: 12/21/2022] Open
Abstract
Immune-Mediated Inflammatory Diseases (IMIDs) is a descriptive term coined for an eclectic group of diseases or conditions that share common inflammatory pathways, and for which there is no definitive etiology. IMIDs affect the elderly most severely, with many older individuals having two or more IMIDs. These diseases include, but are not limited to, type-1 diabetes, obesity, hypertension, chronic pulmonary disease, coronary heart disease, inflammatory bowel disease, and autoimmunity, such as rheumatoid arthritis (RA), Sjőgren's syndrome, systemic lupus erythematosus, psoriasis, psoriatic arthritis, and multiple sclerosis. These diseases are ostensibly unrelated mechanistically, but increase in frequency with age and share chronic systemic inflammation, implicating major roles for the spleen. Chronic systemic and regional inflammation underlies the disease manifestations of IMIDs. Regional inflammation and immune dysfunction promotes targeted end organ tissue damage, whereas systemic inflammation increases morbidity and mortality by affecting multiple organ systems. Chronic inflammation and skewed dysregulated cell-mediated immune responses drive many of these age-related medical disorders. IMIDs are commonly autoimmune-mediated or suspected to be autoimmune diseases. Another shared feature is dysregulation of the autonomic nervous system and hypothalamic pituitary adrenal (HPA) axis. Here, we focus on dysautonomia. In many IMIDs, dysautonomia manifests as an imbalance in activity/reactivity of the sympathetic and parasympathetic divisions of the autonomic nervous system (ANS). These major autonomic pathways are essential for allostasis of the immune system, and regulating inflammatory processes and innate and adaptive immunity. Pathology in ANS is a hallmark and causal feature of all IMIDs. Chronic systemic inflammation comorbid with stress pathway dysregulation implicate neural-immune cross-talk in the etiology and pathophysiology of IMIDs. Using a rodent model of inflammatory arthritis as an IMID model, we report disease-specific maladaptive changes in β₂-adrenergic receptor (AR) signaling from protein kinase A (PKA) to mitogen activated protein kinase (MAPK) pathways in the spleen. Beta₂-AR signal "shutdown" in the spleen and switching from PKA to G-coupled protein receptor kinase (GRK) pathways in lymph node cells drives inflammation and disease advancement. Based on these findings and the existing literature in other IMIDs, we present and discuss relevant literature that support the hypothesis that unresolvable immune stimulation from chronic inflammation leads to a maladaptive disease-inducing and perpetuating sympathetic response in an attempt to maintain allostasis. Since the role of sympathetic dysfunction in IMIDs is best studied in RA and rodent models of RA, this IMID is the primary one used to evaluate data relevant to our hypothesis. Here, we review the relevant literature and discuss sympathetic dysfunction as a significant contributor to the pathophysiology of IMIDs, and then discuss a novel target for treatment. Based on our findings in inflammatory arthritis and our understanding of common inflammatory process that are used by the immune system across all IMIDs, novel strategies to restore SNS homeostasis are expected to provide safe, cost-effective approaches to treat IMIDs, lower comorbidities, and increase longevity.
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Affiliation(s)
- Denise L Bellinger
- Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA.
| | - Dianne Lorton
- College of Arts and Sciences, Kent State University, Kent, OH 44304, USA.
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Edwards M, Dai R, Ahmed SA. Our Environment Shapes Us: The Importance of Environment and Sex Differences in Regulation of Autoantibody Production. Front Immunol 2018; 9:478. [PMID: 29662485 PMCID: PMC5890161 DOI: 10.3389/fimmu.2018.00478] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/22/2018] [Indexed: 01/17/2023] Open
Abstract
Consequential differences exist between the male and female immune systems’ ability to respond to pathogens, environmental insults or self-antigens, and subsequent effects on immunoregulation. In general, females when compared with their male counterparts, respond to pathogenic stimuli and vaccines more robustly, with heightened production of antibodies, pro-inflammatory cytokines, and chemokines. While the precise reasons for sex differences in immune response to different stimuli are not yet well understood, females are more resistant to infectious diseases and much more likely to develop autoimmune diseases. Intrinsic (i.e., sex hormones, sex chromosomes, etc.) and extrinsic (microbiome composition, external triggers, and immune modulators) factors appear to impact the overall outcome of immune responses between sexes. Evidence suggests that interactions between environmental contaminants [e.g., endocrine disrupting chemicals (EDCs)] and host leukocytes affect the ability of the immune system to mount a response to exogenous and endogenous insults, and/or return to normal activity following clearance of the threat. Inherently, males and females have differential immune response to external triggers. In this review, we describe how environmental chemicals, including EDCs, may have sex differential influence on the outcome of immune responses through alterations in epigenetic status (such as modulation of microRNA expression, gene methylation, or histone modification status), direct and indirect activation of the estrogen receptors to drive hormonal effects, and differential modulation of microbial sensing and composition of host microbiota. Taken together, an intriguing question develops as to how an individual’s environment directly and indirectly contributes to an altered immune response, dysregulation of autoantibody production, and influence autoimmune disease development. Few studies exist utilizing well-controlled cohorts of both sexes to explore the sex differences in response to EDC exposure and the effects on autoimmune disease development. Translational studies incorporating multiple environmental factors in animal models of autoimmune disease are necessary to determine the interrelationships that occur between potential etiopathological factors. The presence or absence of autoantibodies is not a reliable predictor of disease. Therefore, future studies should incorporate all the susceptibility/influencing factors, coupled with individual genomics, epigenomics, and proteomics, to develop a model that better predicts, diagnoses, and treats autoimmune diseases in a personalized-medicine fashion.
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Affiliation(s)
- Michael Edwards
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Rujuan Dai
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - S Ansar Ahmed
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
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Goldberg A, Ebraheem Z, Freiberg C, Ferarro R, Chai S, Gottfried OD. Sweet and Sensitive: Sensory Processing Sensitivity and Type 1 Diabetes. J Pediatr Nurs 2018; 38:e35-e38. [PMID: 29100650 DOI: 10.1016/j.pedn.2017.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 10/28/2017] [Accepted: 10/28/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Sensory processing sensitivity (SPS) is a recently proposed construct that refers to a genetically influenced tendency to more strongly and deeply process a variety of information. The aim of the study was to examine whether SPS is associated with an autoimmune disease such as type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS Participants were 128 adolescents (62 with T1D and 66 comparisons [without autoimmune disease]) and their parents who completed the Highly Sensitive Person Scale (HSPS) questionnaire, assessing SPS level. RESULTS Higher levels of SPS were found in the T1D group than in the comparison group. Furthermore, the frequency of SPS trait was significantly higher in the T1D group than in the comparison group. CONCLUSIONS T1D is associated with higher levels of SPS. Hence, there is a need to develop interventions, treatments, and care focused on the needs of T1D patients with SPS temperament, aimed at better treatment adherence. Furthermore, longitudinal research is needed to evaluate whether SPS is a risk factor in the development of T1D.
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Affiliation(s)
- Alon Goldberg
- Tel-Hai College, Department of Education, Upper Galilee, Israel.
| | - Zaheera Ebraheem
- The Center for Juvenile Diabetes and Pediatric Endocrinology and Pediatric Outpatient Clinics, Ziv Hospital, Zefat, Israel
| | - Cynthia Freiberg
- School of Medicine, Bar Ilan University, affiliated to Ziv Hospital, Zefat, Israel
| | - Rachel Ferarro
- The Center for Juvenile Diabetes and Pediatric Endocrinology and Pediatric Outpatient Clinics, Ziv Hospital, Zefat, Israel
| | - Sharon Chai
- Department of Field Practice, Tel-Hai College, Upper Galilee, Israel
| | - Orna Dally Gottfried
- Diabetes Service Manager, The Center for Juvenile Diabetes and Pediatric Endocrinology and Pediatric Outpatient Clinics, Ziv Hospital, affiliated to The School of Medicine, Bar Ilan University, Zefat, Israel
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50
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Roberts AL, Malspeis S, Kubzansky LD, Feldman CH, Chang SC, Koenen KC, Costenbader KH. Association of Trauma and Posttraumatic Stress Disorder With Incident Systemic Lupus Erythematosus in a Longitudinal Cohort of Women. Arthritis Rheumatol 2017; 69:2162-2169. [PMID: 28929625 DOI: 10.1002/art.40222] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/20/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To conduct the first longitudinal study examining whether trauma exposure and posttraumatic stress disorder (PTSD) are associated with increased risk of incident systemic lupus erythematosus (SLE) in a civilian cohort. METHODS We examined the association of trauma exposure and PTSD symptoms with SLE incidence over 24 years of follow-up in a US longitudinal cohort of women (n = 54,763). Incident SLE in women meeting ≥4 American College of Rheumatology criteria was ascertained by self-report and confirmed by medical record review. PTSD and trauma exposure were assessed with the Short Screening Scale for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PTSD and the Brief Trauma Questionnaire, respectively. Women were categorized as having no trauma, trauma and no PTSD symptoms, subclinical PTSD (1-3 symptoms), or probable PTSD (4-7 symptoms). We examined whether longitudinally assessed health risk factors (e.g., smoking, body mass index [BMI], oral contraceptive use) accounted for increased SLE risk among women with trauma exposure and PTSD versus those without. RESULTS During follow-up, 73 cases of SLE occurred. Compared to women with no trauma, probable PTSD was associated with increased SLE risk (for 4-7 symptoms, hazard ratio [HR] 2.94 [95% confidence interval {95% CI} 1.19-7.26], P < 0.05). Subclinical PTSD was associated with increased SLE risk, although this did not reach statistical significance (for 1-3 symptoms, HR 1.83 [95% CI 0.74-4.56], P = 0.19). Smoking, BMI, and oral contraceptive use slightly attenuated the associations (e.g., for 4-7 symptoms, adjusted HR 2.62 [95% CI 1.09-6.48], P < 0.05). Trauma exposure, regardless of PTSD symptoms, was strongly associated with incident SLE (HR 2.83 [95% CI 1.29-6.21], P < 0.01). CONCLUSION This study contributes to growing evidence that psychosocial trauma and associated stress responses may lead to autoimmune disease.
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Affiliation(s)
- Andrea L Roberts
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Susan Malspeis
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Candace H Feldman
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Karestan C Koenen
- Harvard T. H. Chan School of Public Health and Massachusetts General Hospital, Boston, Massachusetts
| | - Karen H Costenbader
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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