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Witoszyńska-Sobkowiak J, Sikorska D, Rutkowski R, Niklas K, Żychowska I, Samborski W. Treatment of ankylosing spondylitis with TNFα inhibitors does not affect serum levels of tryptophan metabolites. Inflammopharmacology 2023; 31:2393-2400. [PMID: 37646896 PMCID: PMC10518270 DOI: 10.1007/s10787-023-01317-7] [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: 06/27/2023] [Accepted: 08/04/2023] [Indexed: 09/01/2023]
Abstract
The imbalance between the kynurenine and serotonin pathways can have serious consequences, e.g., depression. One of the factors leading to the imbalance between the pathways of tryptophan metabolism is inflammation. The aim of our study was to assess the impact of treatment with tumor necrosis factor-alpha (TNFα)-inhibitors on tryptophan metabolism in patients with ankylosing spondylitis (AS). Forty patients with AS (twenty-eight males, twelve females; mean age 40 ± 11 years), qualified to receive anti-TNF-α treatment, were prospectively assessed. As a control group, 20 healthy volunteers (7 males and 13 females, mean age 38 ± 5 years) were recruited from the general population. Patients underwent full clinical and biochemical assessment before and after 6 months of therapy. Disease activity was assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The presence of depressive disorders was assessed with Beck's Depression Inventory (BDI) scale. Serum concentrations of tryptophan, serotonin, kynurenine, and quinolinic acid were measured. The predominance of the kynurenine pathway in AS patients (compared to the control group) was demonstrated (p < 0.001). Surprisingly, no significant changes in serum levels of tryptophan and its metabolites in AS patients after treatment were found, despite clinical improvement. Moreover, the components of tryptophan metabolism did not correlate significantly with the clinical activity of AS, depression nor laboratory inflammatory markers. Probably some other factors influence the pathways of tryptophan metabolism in patients with ankylosing spondylitis.
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Affiliation(s)
- Joanna Witoszyńska-Sobkowiak
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 28 Czerwca 1956 Roku 135/147, 61-545, Poznan, Poland.
| | - Dorota Sikorska
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 28 Czerwca 1956 Roku 135/147, 61-545, Poznan, Poland
| | - Rafał Rutkowski
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Karolina Niklas
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 28 Czerwca 1956 Roku 135/147, 61-545, Poznan, Poland
| | - Iwona Żychowska
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 28 Czerwca 1956 Roku 135/147, 61-545, Poznan, Poland
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 28 Czerwca 1956 Roku 135/147, 61-545, Poznan, Poland
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Knight EL, Engeland CG, Yocum AK, Abu-Mohammad A, Bertram H, Vest E, McInnis MG, Saunders EF. Heightened inflammation in bipolar disorder occurs independent of symptom severity and is explained by body mass index. Brain Behav Immun Health 2023; 29:100613. [PMID: 37025250 PMCID: PMC10070374 DOI: 10.1016/j.bbih.2023.100613] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/02/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023] Open
Abstract
Inflammation is hypothesized to be a key component of bipolar disorder (BP) development and progression. However, findings linking BP prevalence and symptomology to immune functioning have been mixed, with some work suggesting that obesity may play an important role in BP-relevant inflammation. Here we investigate differences in biomarkers of inflammation [C-reactive protein (CRP), interleukin (IL)-1β, IL-6, IL-8, IL-10] between healthy controls (HC) and individuals with BP or other mental illness (MI). Adults with BP, MI, or HC (n = 545, 70% BP, 21% HC, 9% MI) self-reported depressive and manic symptoms close to a blood draw and physical exam that included measurement of height and weight. A composite score was calculated from the four cytokines measured in plasma; follow-up analyses explored a pro-inflammatory composite and IL-10, individually. BP individuals had elevated cytokine concentrations compared to HC (B = 0.197, [0.062, 0.333], t (542) = 2.855, p = .004); this difference was also evident for the pro-inflammatory composite and for IL-10. Cytokine concentrations were not associated with BP mood states. Body mass index (BMI), an indicator of obesity, was significantly higher in BP compared to HC (B = 3.780, [2.118, 5.443], t (479) = 4.457, p < .001) and differences in cytokines between the two groups was no longer significant after controlling for BMI. No differences in CRP were evident between BP and HC. These results suggest that cytokine concentrations are elevated in BP and this difference from HC is associated with obesity. Interventions targeting immune modulators in BP must carefully consider the complex relationships within the BP-inflammation-obesity triangle.
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Association between Fecal Microbiota, SCFA, Gut Integrity Markers and Depressive Symptoms in Patients Treated in the Past with Bariatric Surgery-The Cross-Sectional Study. Nutrients 2022; 14:nu14245372. [PMID: 36558532 PMCID: PMC9781380 DOI: 10.3390/nu14245372] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: Depressive symptoms often appear after surgical treatment. (2) Methods: We involved 41 adults who underwent bariatric surgery a minimum of 6 months before the study and had the Beck scale ≥12. We analysed patients' mental state, gut barrier markers, faecal short chain fatty acids, and microbiota. (3) Results: Gut microbiota composition differed significantly among patients undergoing two different types of surgery (F = 1.64, p = 0.00002). Additionally, we discovered an association between short chain fatty acids and the Beck scale (F = 1.22, p = 0.058). The rearrangement of bacterial metabolites may be due to the patients' use of increased dietary protein, with insufficient intake of products containing vegetable fiber (Diet Quality Index (DQI-I )adequacy 22.55 (±3.46) points). (4) Conclusions: Bariatric surgery affects the gut microbiota, which may play an important role in the development of depressive and gastrointestinal symptoms in patients after bariatric surgery. Low fiber consumption and increased levels of faecal isobutyric acid may lead to intestinal inflammation. There is a need for further research on this topic including a larger sample size.
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Intestinal Permeability and Depression in Patients with Inflammatory Bowel Disease. J Clin Med 2022; 11:jcm11175121. [PMID: 36079050 PMCID: PMC9457405 DOI: 10.3390/jcm11175121] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/16/2022] [Accepted: 08/26/2022] [Indexed: 12/01/2022] Open
Abstract
Depression is a global health problem that requires an early and accurate diagnosis to ensure quick access to appropriate treatment. Among multiple psychopathological paths, recent attention has focused on analysing the brain–gut–microbiota axis. The intestinal barrier plays a key role, and dysfunctions occurring at this level have implications for mental health. The aim of the present study was to investigate the role of intestinal permeability biomarkers, i.e., calprotectin, zonulin, lipopolysaccharide-binding protein (LBP) and intestinal fatty acid-binding protein (I-FAB), in relation to depression in patients with inflammatory bowel disease (IBD). This is the first study of this kind taking place in Romania, Eastern Europe, with an emphasis on patients with Crohn’s disease and ulcerative colitis. The correlations identified between depression and calprotectin and depression and LBP have the potential to shed light on the process of rapid diagnosis of depression with the help of biomarkers. Since depression is correlated with a decrease in the quality of life in patients with IBD, the need for access to appropriate treatments must be urgent.
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Lindsay EK, Creswell JD, Stern HJ, Greco CM, Walko TD, Dutcher JM, Wright AGC, Brown KW, Marsland AL. Mindfulness-based stress reduction increases stimulated IL-6 production among lonely older adults: A randomized controlled trial. Brain Behav Immun 2022; 104:6-15. [PMID: 35550854 PMCID: PMC9646928 DOI: 10.1016/j.bbi.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/15/2022] [Accepted: 05/06/2022] [Indexed: 12/13/2022] Open
Abstract
Loneliness is a potent psychosocial stressor that predicts poor health and mortality among older adults, possibly in part by accelerating age-related declines in immunocompetence. Mindfulness interventions have shown promise for reducing loneliness and improving markers of physical health. In a sample of lonely older adults, this two-arm parallel trial tested whether mindfulness training enhances stimulated interleukin-6 (IL-6) production, a measure of innate immune responsivity. Lonely older adults (65-85 years; N = 190) were randomized to an 8-week Mindfulness-Based Stress Reduction (MBSR) or control Health Enhancement Program (HEP) intervention. Lipopolysaccharide (LPS)-stimulated production of IL-6 was measured in vitro by blinded outcome assessors at pre-intervention, post-intervention, and 3-month follow-up. Mixed-effects linear models tested time (pre, post, follow-up) by condition (MBSR vs. HEP) effects. As predicted, a significant time × condition effect on stimulated IL-6 production was observed across pre, post, and follow-up timepoints. Significant MBSR vs. HEP differences emerged from pre- to post-intervention (p =.009, d = 0.38) and from pre-intervention to 3-month follow-up (p =.017, d = 0.35), with larger increases in IL-6 production following MBSR compared to HEP. No study-related adverse events were reported. Results show that mindfulness training may be effective for boosting innate immunocompetence among lonely older adults. Given that immunocompetence tends to decline with age, mindfulness training may help to counteract the effects of aging and psychosocial stress on infection risk and recovery from injury.
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Song S, DeMeo NN, Almeida DM, Majd M, Engeland CG, Graham-Engeland JE. The longitudinal connection between depressive symptoms and inflammation: Mediation by sleep quality. PLoS One 2022; 17:e0269033. [PMID: 35617264 PMCID: PMC9135207 DOI: 10.1371/journal.pone.0269033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/12/2022] [Indexed: 11/19/2022] Open
Abstract
Although there is a strong association between depressive symptoms and markers of inflammation, it remains unclear whether depressive symptoms at one point in life may predict inflammation later in life. Moreover, despite extant literature linking sleep with both depressive symptoms and inflammation, there is little research investigating poor sleep as a mechanism linking depressive symptoms with later inflammation. The links between depression and physical health can also vary by gender. In longitudinal analyses with data from the Midlife in the United States (MIDUS) study, we examined whether depressive symptoms were associated with inflammatory markers 11 years later and whether these associations were mediated by sleep disturbances or moderated by gender. Participants reported depressive symptoms and demographic information at baseline. At 11-year follow-up, the same participants (n = 968) reported depressive symptoms, sleep quality and duration using validated scale items, and provided a blood sample from which inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) were quantified. Actigraphy assessment of sleep was obtained in a subsample (n = 276). After adjusting for concurrent depressive symptoms and other relevant covariates, baseline depressive symptoms were associated with CRP 11 years later in the full sample, and with IL-6 among women. Subjective sleep quality mediated the association between depressive symptoms and CRP. Results suggest that depressive symptoms may be longitudinally associated with inflammation; however, directionality issues cannot be determined from the present work, particularly as inflammation markers (which might have been associated with baseline depressive symptoms) were not available at baseline. Findings further suggest that longitudinal associations between depressive symptoms and inflammation may potentially be explained by sleep and may reflect gender specific patterns.
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Affiliation(s)
- Sunmi Song
- Department of Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
| | - Natasha N. DeMeo
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States of America
| | - Marzieh Majd
- Department of Psychological Sciences, Rice University, Houston, TX, United States of America
| | - Christopher G. Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
- The College of Nursing, The Pennsylvania State University, University Park, PA, United States of America
| | - Jennifer E. Graham-Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
- * E-mail:
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7
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Van Bogart K, Engeland CG, Sliwinski MJ, Harrington KD, Knight EL, Zhaoyang R, Scott SB, Graham-Engeland JE. The Association Between Loneliness and Inflammation: Findings From an Older Adult Sample. Front Behav Neurosci 2022; 15:801746. [PMID: 35087386 PMCID: PMC8787084 DOI: 10.3389/fnbeh.2021.801746] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/17/2021] [Indexed: 11/20/2022] Open
Abstract
Loneliness has been linked to poor mental and physical health outcomes. Past research suggests that inflammation is a potential pathway linking loneliness and health, but little is known about how loneliness assessed in daily life links with inflammation, or about linkages between loneliness and inflammation among older adults specifically. As part of a larger investigation, we examined the cross-sectional associations between loneliness and a panel of both basal and LPS-stimulated inflammatory markers. Participants were 222 socioeconomically and racially diverse older adults (aged 70-90 years; 38% Black; 13% Hispanic) systematically recruited from the Bronx, NY. Loneliness was measured in two ways, with a retrospective trait measure (the UCLA Three Item Loneliness Scale) and an aggregated momentary measure assessed via ecological momentary assessment (EMA) across 14 days. Inflammatory markers included both basal levels of C-reactive protein (CRP) and cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-α) and LPS-stimulated levels of the same cytokines. Multiple regression analyses controlled for age, body-mass index, race, and depressive symptoms. Moderation by gender and race were also explored. Both higher trait loneliness and aggregated momentary measures of loneliness were associated with higher levels of CRP (β = 0.16, p = 0.02; β = 0.15, p = 0.03, respectively). There were no significant associations between loneliness and basal or stimulated cytokines and neither gender nor race were significant moderators. Results extend prior research linking loneliness with systemic inflammation in several ways, including by examining this connection among a sample of older adults and using a measure of aggregated momentary loneliness.
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Affiliation(s)
- Karina Van Bogart
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
| | - Christopher G. Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, United States
| | - Martin J. Sliwinski
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - Karra D. Harrington
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - Erik L. Knight
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Ruixue Zhaoyang
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - Stacey B. Scott
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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Rasmusson AJ, Gallwitz M, Soltanabadi B, Ciuculete DM, Mengel-From J, Christensen K, Nygaard M, Soerensen M, Boström AE, Fredriksson R, Freyhult E, Mwinyi J, Czamara D, Binder EB, Schiöth HB, Cunningham JL. Toll-like receptor 4 methylation grade is linked to depressive symptom severity. Transl Psychiatry 2021; 11:371. [PMID: 34226490 PMCID: PMC8257733 DOI: 10.1038/s41398-021-01481-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 04/27/2021] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
This study explores potential associations between the methylation of promoter-associated CpG sites of the toll-like receptor (TLR)-family, plasma levels of pro-inflammatory proteins and depressive symptoms in young female psychiatric patients. Ratings of depressive symptoms and blood samples were obtained from 92 young women seeking psychiatric care. Methylation of 32 promoter-associated CpG sites in TLR1 to TLR10 was analysed using the Illumina Infinium Methylation EPIC BeadChip. Expression levels of 91 inflammatory proteins were determined by proximity extension assay. Statistical correlations between depressive state, TLR1-10 methylation and inflammatory proteins were investigated. Four additional cohorts were studied to evaluate the generalizability of the findings. In the discovery cohort, methylation grade of cg05429895 (TLR4) in blood was inversely correlated with depressive symptoms score in young adults. After correction for multiple testing, plasma levels of macrophage inflammatory protein 1β (MIP-1β/CCL4) were associated with both TLR4 methylation and depressive symptom severity. A similar inverse association between TLR4 methylation in blood and affective symptoms score was also found in a cohort of 148 both males and females (<40 years of age) from the Danish Twin Registry. These findings were not, however, replicated in three other external cohorts; which differed from the first two cohorts by a higher age and mixed ethnicities, thus limiting the generalizability of our findings. However, TLR4 methylation inversely correlated with TLR4 mRNA expression in the Danish Twin Study indicating a functional significance of methylation at this particular CpG. Higher depression scores in young Scandinavian adults was associated with decreased methylation of TLR4 in blood.
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Affiliation(s)
- Annica J Rasmusson
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
| | - Maike Gallwitz
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
| | - Bardia Soltanabadi
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
| | - Diana M Ciuculete
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Jonas Mengel-From
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Kaare Christensen
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Marianne Nygaard
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Mette Soerensen
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Adrian E Boström
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Robert Fredriksson
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology, Uppsala University, 75124, Uppsala, Sweden
| | - Eva Freyhult
- Department of Medical Sciences, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jessica Mwinyi
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Darina Czamara
- Department Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Elisabeth B Binder
- Department Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Helgi B Schiöth
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
- Institute of Translational Medicine and Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Janet L Cunningham
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden.
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Knight EL, Jiang Y, Rodriguez-Stanley J, Almeida DM, Engeland CG, Zilioli S. Perceived stress is linked to heightened biomarkers of inflammation via diurnal cortisol in a national sample of adults. Brain Behav Immun 2021; 93:206-213. [PMID: 33515741 PMCID: PMC8274563 DOI: 10.1016/j.bbi.2021.01.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 12/21/2022] Open
Abstract
Exposure to and perceptions of stress have been associated with altered systemic inflammation, but the intermediate processes by which stress links to inflammation are not fully understood. Diurnal cortisol slopes were examined as a pathway by which self-reported psychosocial stress is associated with inflammation [i.e., C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, E-Selectin, and Intercellular Adhesion Molecule-1 (ICAM-1)] in a large sample of adults (the Midlife in the US study; N = 914; 55.9% female; aged 34-84 years). Structural equation modeling indicated that perceived psychological stress was associated with flattened diurnal cortisol slopes and flatter diurnal cortisol slopes were, in turn, associated with heightened inflammation in these cross-sectional analyses (index of indirect pathway, ω = 0.003, 95% CI [0.001, 0.004], ωSTD = 0.027; with covariates, ω = 0.001, [0.0002, 0.002], ωSTD = 0.011). A similar indirect effect was evident for self-reported traumatic life events (ω = 0.007, [0.004, 0.012], ωSTD = 0.030); however, inclusion of covariates (i.e., age, gender, race, ethnicity, body mass index, and other factors associated with physical health) accounted for this finding (ω = 0.001, [-0.001, 0.004], ωSTD = 0.005). These results support an allostatic load model of psychosomatic health, in which cortisol (along with other stress-responsive signaling molecules) is a necessary component for understanding links between stress exposure, perceived stress, and immune functioning.
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Affiliation(s)
- Erik L Knight
- Center for Healthy Aging, Pennsylvania State University, University Park, United States; Department of Psychology and Neuroscience, University of Colorado, Boulder, United States.
| | - Yanping Jiang
- Department of Psychology, Wayne State University, United States
| | | | - David M Almeida
- Center for Healthy Aging, Pennsylvania State University, University Park, United States; Department of Human Development and Family Studies, Pennsylvania State University, University Park, United States
| | - Christopher G Engeland
- Center for Healthy Aging, Pennsylvania State University, University Park, United States; Department of Biobehavioral Health, Pennsylvania State University, University Park, United States; College of Nursing, Pennsylvania State University, University Park, United States
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, United States; Department of Family Medicine and Public Health Sciences, Wayne State University, United States.
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