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Santamarina AB, de Freitas JA, Franco LAM, Nehmi-Filho V, Fonseca JV, Martins RC, Turri JA, da Silva BFRB, Fugi BEI, da Fonseca SS, Gusmão AF, Olivieri EHR, de Souza E, Costa S, Sabino EC, Otoch JP, Pessoa AFM. Nutraceutical blends predict enhanced health via microbiota reshaping improving cytokines and life quality: a Brazilian double-blind randomized trial. Sci Rep 2024; 14:11127. [PMID: 38750102 PMCID: PMC11096337 DOI: 10.1038/s41598-024-61909-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/10/2024] [Indexed: 05/18/2024] Open
Abstract
Nutraceutical interventions supporting microbiota and eliciting clinical improvements in metabolic diseases have grown significantly. Chronic stress, gut dysbiosis, and metainflammation have emerged as key factors intertwined with sleep disorders, consequently exacerbating the decline in quality of life. This study aimed to assess the effects of two nutraceutical formulations containing prebiotics (fructooligosaccharides (FOS), galactooligosaccharides (GOS), yeast β-glucans), minerals (Mg, Se, Zn), and the herbal medicine Silybum marianum L. Gaertn., Asteraceae (Milk thistle or Silymarin). These formulations, namely NSupple (without silymarin) and NSupple_Silybum (with silymarin) were tested over 180 days in overweight/obese volunteers from Brazil's southeastern region. We accessed fecal gut microbiota by partial 16S rRNA sequences; cytokines expression by CBA; anthropometrics, quality of life and sleep, as well as metabolic and hormonal parameters, at baseline (T0) and 180 days (T180) post-supplementation. Results demonstrated gut microbiota reshaping at phyla, genera, and species level post-supplementation. The Bacteroidetes phylum, Bacteroides, and Prevotella genera were positively modulated especially in the NSupple_Silybum group. Gut microbiota modulation was associated with improved sleep patterns, quality-of-life perception, cytokines expression, and anthropometric parameters post-supplementation. Our findings suggest that the nutraceutical blends positively enhance cardiometabolic and inflammatory markers. Particularly, NSupple_Silybum modulated microbiota composition, underscoring its potential significance in ameliorating metabolic dysregulation. Clinical trial registry number: NCT04810572. 23/03/2021.
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Affiliation(s)
- Aline Boveto Santamarina
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil
- Pesquisa e Desenvolvimento Efeom Nutrição S/A, São Paulo, SP, 03317000, Brazil
| | - Jéssica Alves de Freitas
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil
- Pesquisa e Desenvolvimento Efeom Nutrição S/A, São Paulo, SP, 03317000, Brazil
| | - Lucas Augusto Moyses Franco
- Laboratório de Parasitologia Médica (LIM-46), Departamento de Doenças Infecciosas e Parasitárias, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, SP, 05403-000, Brazil
| | - Victor Nehmi-Filho
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil
- Pesquisa e Desenvolvimento Efeom Nutrição S/A, São Paulo, SP, 03317000, Brazil
| | - Joyce Vanessa Fonseca
- Laboratório de Investigação Médica em Protozoologia, Bacteriologia e Resistência Antimicrobiana (LIM-49)Departamento de Doenças Infecciosas e Parasitárias, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, SP, 05403-000, Brazil
| | - Roberta Cristina Martins
- Laboratório de Parasitologia Médica (LIM-46), Departamento de Doenças Infecciosas e Parasitárias, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, SP, 05403-000, Brazil
| | - José Antônio Turri
- Grupo de Pesquisa em Economia da Saúde, Departamento de Ginecologia e Obstetrícia, Universidade de São Paulo Faculdade de Medicina, São Paulo, SP, 01246903, Brazil
| | - Bruna Fernanda Rio Branco da Silva
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil
- Laboratório Interdisciplinar em Fisiologia e Exercício, Universidade Federal de São Paulo (UNIFESP), Santos, SP, 11015-020, Brazil
| | - Beatriz Emi Itikawa Fugi
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil
- Graduação em Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, 01246904, Brazil
| | - Sumaia Sobral da Fonseca
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil
- Graduação em Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, 01246904, Brazil
| | - Arianne Fagotti Gusmão
- International Research Center, A.C. Camargo Cancer Center, São Paulo, SP, 01508-010, Brazil
| | | | - Erica de Souza
- Ambulatório Monte Azul, São Paulo, SP, 05801-110, Brazil
| | - Silvia Costa
- Laboratório de Investigação Médica em Protozoologia, Bacteriologia e Resistência Antimicrobiana (LIM-49)Departamento de Doenças Infecciosas e Parasitárias, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, SP, 05403-000, Brazil
| | - Ester Cerdeira Sabino
- Laboratório de Parasitologia Médica (LIM-46), Departamento de Doenças Infecciosas e Parasitárias, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, SP, 05403-000, Brazil
| | - José Pinhata Otoch
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil
- Pesquisa e Desenvolvimento Efeom Nutrição S/A, São Paulo, SP, 03317000, Brazil
- Faculdade de Medicina da, Universidade de São Paulo, Hospital Universitário da Universidade de São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Ana Flávia Marçal Pessoa
- Laboratório de Produtos e Derivados Naturais, Laboratório de Investigação Médica-26 (LIM-26), Departamento de Cirurgia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 01246903, Brazil.
- Pesquisa e Desenvolvimento Efeom Nutrição S/A, São Paulo, SP, 03317000, Brazil.
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Dornowski M, Wilczyńska D, Lachowicz M, Sokolowska I, Szot T, Urbański R, Maznychenko A, Szwarc A, Gotner K, Duda D, Sawicki P, Hinca J. The effect of EEG neurofeedback on lowering the stress reaction level depending on various stressors on the biochemical, muscular and psychomotor sphere: A preliminary randomized study. Medicine (Baltimore) 2024; 103:e37042. [PMID: 38306574 PMCID: PMC10843594 DOI: 10.1097/md.0000000000037042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/03/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND The human body is exposed to stressors on a daily basis. Short-term exposure to a particular stressor can cause the release of inflammatory markers - including c-reactive protein (CRP). EEG neurofeedback is a noninvasive form of therapy that aims to improve brain function. Neurofeedback is a type of feedback based on brain activity. METHODS The research process was performed by a group of 80 men who were divided into 2 research groups and 2 control groups. In the first research group and the first control group, the stressor of high temperature was applied, while in the second research group and the second control group, the stressor was physical exertion to refusal. Meanwhile, blood samples were taken to visualize inflammatory markers. These were taken before and after the stressor, as well as before and after the application of EEG neurofeedback. RESULTS In research group after EEG neurofeedback intervention, the level of CRP significantly dropped in the measurement after stressor implementation. Analysis of the SMK test revealed a significant influence of both factors (time F = 13.525, P = .035; state F = 10.658, P = .047) and their interaction (F = 16.709, P = .026). Same statically significant decrease was observed in the level of rect. abdom. EMG was after physical work after neurofeedback. In all tests, a decrease in the EMG amplitude of upper trap. was observed after physical work before neurofeedback with its further increase after neurofeedback. After neurofeedback training, the results of the 3 tested parameters of the sensorimotor coordination test performed after the second heat stressor improved statistically insignificantly compared to the values obtained before. CONCLUSION This article shows the effect of EGG neurofeedback on reducing the negative effects of stress exposure in humans. The study showed that the level and a pattern of EEG neurofeedback influence and significance is different depending on the applied stressor. Furthermore, the level of EEG neurofeedback influence and significance in decreasing the stressor effect is different depending on the examined sphere.
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Affiliation(s)
- Marcin Dornowski
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | | | - Milena Lachowicz
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Inna Sokolowska
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Tomasz Szot
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Robert Urbański
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | | | - Andrzej Szwarc
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Kacper Gotner
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Dominik Duda
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Piotr Sawicki
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Jakub Hinca
- Gdansk University of Physical Education and Sport, Gdansk, Poland
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Křenek P, Hořínková J, Bartečků E. Peripheral Inflammatory Markers in Subtypes and Core Features of Depression: A Systematized Review. Psychopathology 2023; 56:403-416. [PMID: 36812905 PMCID: PMC10568602 DOI: 10.1159/000528907] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023]
Abstract
INTRODUCTION The aim of this work was to summarize relationships between two subtypes of major depressive disorder (melancholic and atypical) and four core features of depression that reflect the domains identified consistently in previous studies of major depressive disorder endophenotypes (exaggerated reactivity to negative information, altered reward processing, cognitive control deficits, and somatic symptoms) on the one hand and selected peripheral inflammatory markers (C-reactive protein [CRP], cytokines, and adipokines) on the other. METHODS A systematized review was conducted. The database used for searching articles was PubMed (MEDLINE). RESULTS According to our search, most peripheral immunological markers associated with major depressive disorder are not specific to a single depressive symptom group. The most evident examples are CRP, IL-6, and TNF-α. The strongest evidence supports the connection of peripheral inflammatory markers with somatic symptoms; weaker evidence indicates a role of immune changes in altered reward processing. The least amount of evidence was found for the role of peripheral inflammatory markers in exaggerated reactivity to negative information and cognitive control deficits. Regarding the depression subtypes, a tendency for higher CRP and adipokines was observed in atypical depression; increased IL-6 was found in melancholic depression. CONCLUSION Somatic symptoms of depression could be a manifestation of a specific immunological endophenotype of depressive disorder. Melancholic and atypical depression may be characterized by different profiles of immunological markers.
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Affiliation(s)
- Pavel Křenek
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia,
| | - Jana Hořínková
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Elis Bartečků
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
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Bendezú JJ, Handley ED, Manly JT, Toth SL, Cicchetti D. Psychobiological foundations of coping and emotion regulation: Links to maltreatment and depression in a racially diverse, economically disadvantaged sample of adolescent girls. Psychoneuroendocrinology 2022; 143:105826. [PMID: 35700563 PMCID: PMC9357119 DOI: 10.1016/j.psyneuen.2022.105826] [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: 02/10/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Abstract
Adolescent risk for depression and passive or active suicidal ideation (PASI) involves disturbance across multiple systems (e.g., arousal regulatory, affective valence, neurocognitive). Exposure to maltreatment while growing up as a child or teenager may potentiate this risk by noxiously impacting these systems. However, research exploring how coordinated disturbance across these systems (i.e., profiles) might be uniquely linked to depressogenic function, and how past maltreatment contributes to such disturbance, is lacking. Utilizing a racially diverse, economically disadvantaged sample of adolescent girls, this person-centered study identified psychobiological profiles and linked them to maltreatment histories, as well as current depressive symptoms and PASI. Girls (N = 237, Mage=13.98, SD=0.85) who were non-depressed/non-maltreated (15.1%), depressed/non-maltreated (40.5%), or depressed/maltreated (44.4%) provided morning saliva samples, completed questionnaires, a clinical interview, and a neurocognitive battery. Latent profile analysis of girls' morning cortisol:C-reactive protein ratio, positive and negative affect levels, and attentional set-shifting ability revealed four profiles. Relative to Normative (66.6%), girls exhibiting a Pro-inflammatory Affective Disturbance (13.1%), Severe Affective Disturbance (10.1%), or Hypercortisol Affective Neurocognitive Disturbance (n = 24, 10.1%) profile reported exposure to a greater number of maltreatment subtypes while growing up. Girls exhibiting these dysregulated profiles were also more likely (relative to Normative) to report current depressive symptoms (all three profiles) and PASI (only Pro-inflammatory Affective Disturbance and Hypercortisol Affective Neurocognitive Disturbance). Of note, girls' cognitive reappraisal utilization moderated profile membership-depression linkages (depressive symptoms, but not PASI). A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.
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Affiliation(s)
- Jason José Bendezú
- The Institute of Child Development, University of Minnesota, USA; Department of Psychology, University of Minnesota, USA.
| | | | - Jody T Manly
- Mt. Hope Family Center, University of Rochester, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, USA
| | - Dante Cicchetti
- The Institute of Child Development, University of Minnesota, USA
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Fong TCT, Ho RTH, Yau JCY. Longitudinal associations between salivary cortisol to C-reactive protein ratios and psychological well-being in Chinese adults. Psychoneuroendocrinology 2022; 143:105824. [PMID: 35689984 DOI: 10.1016/j.psyneuen.2022.105824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Salivary C-reactive protein (CRP) could be a viable biomarker of inflammation and has been associated with stress outcomes. The hypothalamic-pituitary-adrenal axis can modulate stress-related inflammation. This study aimed to evaluate the interaction effects of immune-endocrine markers on psychological outcomes. METHODS The study participants were 52 healthy Chinese adults who collected 10 saliva samples over 2 consecutive days at baseline. The participants completed validated measures on anxiety, depression, positive affect, and sleep disturbance at baseline and 1 month later. The stability and diurnal patterns of salivary cortisol and CRP were investigated via paired t-tests and repeated-measures analyses of variance. Regression analysis was used to examine the longitudinal associations between immune-endocrine markers and their interactions (cortisol [Cort]: morning CRP [CRPmorn] and Cort:CRPeven) and psychological measures. RESULTS Salivary cortisol and CRP displayed satisfactory stability over 2 consecutive days and diurnal patterns of abrupt and gradual decline during the day, respectively. Controlling for baseline psychological measures and confounding variables, Cortmorn and diurnal cortisol slope was significantly and negatively associated with anxiety symptoms and positive affect 1 month later, respectively. Cort:CRPeven and Cort:CRPmorn was significantly and positively associated with depressive symptoms and sleep disturbance 1 month later, respectively. CONCLUSION These findings offer initial support for the prognostic utility of salivary cortisol and CRP and their balance as determinants of psychological health in healthy adults.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Rainbow T H Ho
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Dept of Social Work & Social Administration, The University of Hong Kong, Hong Kong.
| | - Joshua C Y Yau
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong
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Choshen-Hillel S, Gileles-Hillel A. A wake-up call: Time to raise physicians' awareness of the consequences of fatigue. MEDICAL EDUCATION 2021; 55:1342-1344. [PMID: 34472652 DOI: 10.1111/medu.14655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Shoham Choshen-Hillel
- School of Business Administration, & The Federmann Center for the Study of Rationality, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alex Gileles-Hillel
- Pediatric Pulmonology and Sleep Unit, Hadassah Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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The ratio of morning cortisol to CRP prospectively predicts first-onset depression in at-risk adolescents. Soc Sci Med 2021; 281:114098. [PMID: 34126291 DOI: 10.1016/j.socscimed.2021.114098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/25/2021] [Accepted: 05/31/2021] [Indexed: 12/22/2022]
Abstract
RATIONALE Early-onset adolescent depression is related to poor prognosis and a range of psychiatric and medical comorbidities later in life, making the identification of a priori risk factors for depression highly important. Increasingly, dysregulated levels of immune and neuroendocrine markers, such as C-reactive protein (CRP) and cortisol, have been demonstrated as both precursors to and consequences of depression. However, longitudinal research with adolescent populations is limited and demonstrates mixed immuno-endocrine-depression links. OBJECTIVE This study explored the putative bidirectional relationship between salivary measures of cortisol (Cort) and CRP, including the novel Cort:CRP ratio and depression. METHODS Participants from the randomized control trial 'Sleep and Education: learning New Skills Early' (SENSE) Study were 122 adolescents at risk for depression (73 females) aged 12-16 years (M = 12.71 years, SD = 1.01 years) assessed at baseline (T1), post-intervention (T2), and a two-year follow-up (T3). RESULTS Logistic regression results demonstrated that adolescents with higher T1 Cort:CRPmorn ratio levels were two-fold more likely to develop a first-onset depressive disorder from T2 to T3 as compared to adolescents with lower Cort:CRPmorn ratio levels, β = 0.73, t (36) = 2.15, p = .04, OR = 2.08. This effect was not moderated by treatment condition (β = -1.38, t (13) = -1.33, p = .20) and did not change when controlling for known risk factors for depression, including sex, age, body-mass index, socio-economic status, T1 anxiety disorder, nor T1 sleep disturbance, anxiety, or depressive symptoms (β = 0.91, t (31) = 2.14, p = .04). CONCLUSION Results highlight potential immuno-endocrine dysregulation as an underlying risk factor for adolescent first-onset depression, and may inform the development of targeted, preventative biobehavioral treatment strategies for youth depression.
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Ferreira AI, Pérez-Nebra AR, Ellen Costa E, Aguiar MLA, Zambonato A, Costa CG, Modesto JG, Ferreira PDC. Presenteeism and Productivity: The Role of Biomarkers and Hormones. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095014. [PMID: 34068466 PMCID: PMC8126032 DOI: 10.3390/ijerph18095014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 12/17/2022]
Abstract
Purpose. This study aimed to assess whether self-reported productivity despite presenteeism may be affected by biomarkers and hormones and how these physiological indicators can interact with each other to explain the presenteeism dimensions. Methods. This pilot study included 180 healthy participants with a mean age of 41.22 years (SD = 13.58), 76.11% of whom were female. The dependent variable included a self-reported measure of productivity loss due to presenteeism: the Stanford Presenteeism Scale 6. This study also includes physiological indicators such as biomarkers (C-reactive protein (CRP) and blood glucose) and hormones (cortisol and TSH thyroid hormone). Results. Multiple linear regression analyses revealed that CRP moderated the relationship between cortisol levels and productivity despite presenteeism. Moreover, the increase of TSH moderated the relationship between cortisol, glycemia, and employees’ capacity to complete work tasks while sick. Conclusions. The results highlight TSH’s moderating role in decreasing employees’ capacity to fulfill tasks when these individuals have high levels of glycemia and cortisol in their blood. These findings have practical and theoretical implications based on a fuller understanding of how biomarkers and hormones explain productivity despite presenteeism.
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Affiliation(s)
- Aristides I. Ferreira
- ISCTE—Instituto Universitário de Lisboa (ISCTE-IUL), Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
- Correspondence: ; Tel.: +351-21-790-3415
| | - Amalia R. Pérez-Nebra
- UnB—Universidade de Brasília, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil;
- Department of Psychology, Universidad Internacional de Valencia, Calle Pintor Sorolla, 21, 46002 Valencia, Spain
| | - Eva Ellen Costa
- ISCSP—Instituto Superior de Ciências Sociais e Politicas da Universidade de Lisboa, R. Almerindo Lessa, 1300-666 Lisboa, Portugal;
| | - Maria Luisa A. Aguiar
- UniCEUB—Centro Universitário de Brasília, SEPN 707/907, Campus do UniCEUB, Bloco 9, Asa Norte, Brasília, DF 70910-900, Brazil; (M.L.A.A.); (A.Z.); (J.G.M.)
| | - Adriane Zambonato
- UniCEUB—Centro Universitário de Brasília, SEPN 707/907, Campus do UniCEUB, Bloco 9, Asa Norte, Brasília, DF 70910-900, Brazil; (M.L.A.A.); (A.Z.); (J.G.M.)
| | - Carla G. Costa
- ISMAT—Instituto Superior Manuel Teixeira Gomes, R. Dr. Estevão de Vasconcelos 33 A, 8500-656 Portimão, Portugal;
| | - João G. Modesto
- UniCEUB—Centro Universitário de Brasília, SEPN 707/907, Campus do UniCEUB, Bloco 9, Asa Norte, Brasília, DF 70910-900, Brazil; (M.L.A.A.); (A.Z.); (J.G.M.)
- UEG—Universidade Estadual de Goiás, Av. Universitária, S/N—Nordeste, Formosa, GO 73807-250, Brazil
| | - Paula da Costa Ferreira
- CICPSI (UIDB/04527/2020; UIDP/04527/2020)—Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal;
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Choshen-Hillel S, Ishqer A, Mahameed F, Reiter J, Gozal D, Gileles-Hillel A, Berger I. Acute and chronic sleep deprivation in residents: Cognition and stress biomarkers. MEDICAL EDUCATION 2021; 55:174-184. [PMID: 32697336 PMCID: PMC7854866 DOI: 10.1111/medu.14296] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/29/2020] [Accepted: 07/16/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Insufficient sleep affects circadian hormonal profiles and inflammatory markers and may modulate attention, executive functioning and decision-making. Medical professionals and specifically resident physicians, who are involved in long-term nightshift schedules during their post-graduate training, are prone to acute and chronic sleep deprivation and disruption, putting them at risk for making medical errors. The aim of the study was to evaluate the impact of chronic and acute-on-chronic sleep deprivation and disruption among residents on selected physiological and cognitive measures. METHODS Thirty-three medical and surgical residents were evaluated twice - at baseline and after a 26-hour shift. Eighteen young attending physicians who did not engage in nightshift schedules served as controls and were evaluated once. Measures included morning cortisol and high-sensitivity C-reactive protein (hs-CRP), computerised tests of attention and behaviour, the Behaviour Rating Inventory of Executive Function, a risk-taking questionnaire and the Pittsburgh Sleep Quality Index. RESULTS Residents, but not attendings, reported chronic sleep disruption and deprivation. Residents at baseline exhibited reduced morning cortisol levels and elevated hs-CRP levels, compared to attendings. Residents at baseline had impaired global executive function compared to attendings. A nightshift with acute sleep deprivation further reduced residents' executive function. Residents at baseline and after a nightshift demonstrated increased impulsivity and slower processing time than attendings. Residents and attendings did not differ in risk-taking tendencies which were assessed in a separate cohort. CONCLUSIONS In a real-life setting, resident physicians exhibit increased low-grade systemic inflammation (hs-CRP) and impaired HPA-axis function. Their chronic sleep curtailment is associated with greater impulsivity, slower cognitive processing, and impaired executive function. Future research is warranted to understand how improving working schedule by increasing sleep duration may minimise the short-term and potential long-term risks to physicians in training.
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Affiliation(s)
- Shoham Choshen-Hillel
- School of Business Administration and the Federmann Center for the Study of Rationality, Hebrew University of Jerusalem
| | - Ahmad Ishqer
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
| | - Fadi Mahameed
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
| | - Joel Reiter
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
| | - David Gozal
- Department of Child Health, MU Women’s and Children’s Hospital, University of Missouri School of Medicine
| | - Alex Gileles-Hillel
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
- The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center
| | - Itai Berger
- Pediatric Neurology; Department of Pediatrics, Assuta-Ashdod University Medical Center
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
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Wood BL, Woods SB, Sengupta S, Nair T. The Biobehavioral Family Model: An Evidence-Based Approach to Biopsychosocial Research, Residency Training, and Patient Care. Front Psychiatry 2021; 12:725045. [PMID: 34675826 PMCID: PMC8523802 DOI: 10.3389/fpsyt.2021.725045] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022] Open
Abstract
Engel's biopsychosocial model, based in systems theory, assumes the reciprocal influence of biological, psychological, and social factors on one another and on mental and physical health. However, the model's application to scientific study is limited by its lack of specificity, thus constraining its implementation in training and healthcare environments. The Biobehavioral Family Model (BBFM) is one model that can facilitate specification and integration of biopsychosocial conceptualization and treatment of illness. The model identifies specific pathways by which family relationships (i.e., family emotional climate) impact disease activity, through psychobiological mechanisms (i.e., biobehavioral reactivity). Furthermore, it is capable of identifying positive and negative effects of family process in the same model, and can be applied across cultural contexts. The BBFM has been applied to the study of child health outcomes, including pediatric asthma, and adult health, including for underserved primary care patients, minoritized samples, and persons with chronic pain, for example. The BBFM also serves as a guide for training and clinical practice; two such applications are presented, including the use of the BBFM in family medicine residency and child and adolescent psychiatry fellowship programs. Specific teaching and clinical approaches derived from the BBFM are described in both contexts, including the use of didactic lecture, patient interview guides, assessment protocol, and family-oriented care. Future directions for the application of the BBFM include incorporating temporal dynamics and developmental trajectories in the model, extending testable theory of family and individual resilience, examining causes of health disparities, and developing family-based prevention and intervention efforts to ameliorate contributing factors to disease. Ultimately, research and successful applications of the BBFM could inform policy to improve the lives of families, and provide additional support for the value of a biopsychosocial approach to medicine.
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Affiliation(s)
- Beatrice L Wood
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Sarah B Woods
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sourav Sengupta
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Turya Nair
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
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11
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Bitsika V, Sharpley CF, McMillan ME, Jesulola E, Agnew LL. Effects of Subtypes of Child Maltreatment on CRP in Adulthood. Front Psychiatry 2021; 12:533722. [PMID: 34867491 PMCID: PMC8637154 DOI: 10.3389/fpsyt.2021.533722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/28/2021] [Indexed: 11/26/2022] Open
Abstract
In order to evaluate the effects of specific forms of childhood maltreatment (CM) upon adult C-reactive protein (CRP) concentrations, and to further describe the potentially confounding role that recent life stress and depression hold in that relationship, 221 participants from rural Australia (M age = 44yr, SD = 17.8yr) completed self-report questionnaires and provided a blood sample. There were no sex differences in any variables across the 91 males and 130 females, but depression status did confound the association between global CM and CRP. The specific aspect of CM was identified as physical and mental health abuse, and this was significantly associated with CRP level in participants with depressive symptoms and those without. There was no significant confound from recent life stressors. Results hold implications for the diagnosis of CM-related CRP elevation and (potentially) depression.
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Affiliation(s)
- Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| | | | - Mary E McMillan
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| | | | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
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12
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Does the cortisol: CRP ratio inform the measurement of individual burden of illness for depression in community samples? JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2020.100058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Zhu YL, Li SL, Zhu CY, Wang W, Zuo WF, Qiu XJ. Metabolomics analysis of the antidepressant prescription Danzhi Xiaoyao Powder in a rat model of Chronic Unpredictable Mild Stress (CUMS). JOURNAL OF ETHNOPHARMACOLOGY 2020; 260:112832. [PMID: 32387465 DOI: 10.1016/j.jep.2020.112832] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/24/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Danzhi Xiaoyao Powder (DZXY) is a classical prescription, that has been extensively used in traditional Chinese medicine (TMC) to treat depression for many years. However, the mechanism of DZXY is still unclear. AIM OF THE STUDY The aim was to investigate the mechanism of the antidepressant effect of DZXY on a rat model of chronic unpredictable mild stress (CUMS). MATERIALS AND METHODS Forty male SD (Sprague-Dawley) rats with similar open field test (OFT) results were randomLy divided into a control group (n = 10) and an experimental group (n = 30). A depression model was established in the experimental group using the CUMS method. After the CUMS model was established successfully, the rats were randomLy divided into a depression model group and a DZXY group. The DZXY group was fed DZXY, while the depression model group and control group were given an equal amount of 0.5% sodium carboxymethyl cellulose suspension. Intragastric administration was performed once daily for 14 consecutive days. Animal weight, the sugar preference test, the open field test and the forced swimming test were used to evaluate the modeling effect and the antidepressant effect of DZXY. After the experiment, the plasma of rats was collected and the changes in plasma metabolites were analyzed by UPLC/Q-TOF-MS. The UPLC/Q-TOF-MS spectra data were evaluated by pattern recognition analysis to determine the changes in endogenous metabolites in the rat plasma samples. RESULTS The results of the behavioral investigation showed that the rat model of depression was successfully replicated and that DZXY had an antidepressant effect. Using the UPLC-MS/MS metabolomics platform, partial least squares (PLS) and orthogonal partial least squares (OPLS), metabolic profile models (R2 and Q2 ≥ 0.5) of rat plasma were successfully constructed. The model could distinguish among the control group, the depression model group and the DZXY group. Finally, 38 differential metabolites were identified in the plasma. According to KEGG (http://www.kegg.jp) pathway analysis, amino acid metabolism, lipid metabolism, purine metabolism, the prolactin signaling pathway and bile secretion were enriched and represented the main metabolic pathways influenced in the plasma. CONCLUSIONS This study successfully established a CUMS depression model. A total of 38 differential metabolites associated with depression were identified in the plasma of rats, 24 of which were modulated by DZXY. These results suggest that DZXY can improve excitability and play an antidepressant role by regulating phenylalanine metabolism, arachidonic acid metabolism, porphyrin metabolism, D-arginine and D-ornithine metabolism, steroid hormone biosynthesis, unsaturated fatty acid biosynthesis and steroid biosynthesis.
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MESH Headings
- Animals
- Antidepressive Agents/pharmacology
- Behavior, Animal/drug effects
- Biomarkers/blood
- Chromatography, High Pressure Liquid
- Depression/blood
- Depression/drug therapy
- Depression/psychology
- Disease Models, Animal
- Drugs, Chinese Herbal/pharmacology
- Energy Metabolism/drug effects
- Exploratory Behavior/drug effects
- Food Preferences/drug effects
- Male
- Metabolomics
- Motor Activity/drug effects
- Powders
- Rats, Sprague-Dawley
- Spectrometry, Mass, Electrospray Ionization
- Stress, Psychological/blood
- Stress, Psychological/drug therapy
- Stress, Psychological/psychology
- Tandem Mass Spectrometry
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Affiliation(s)
- Yong-Liang Zhu
- Medical College of Henan University of Science and Technology, Luoyang, 471023, PR China.
| | - Shuang-Long Li
- Medical College of Henan University of Science and Technology, Luoyang, 471023, PR China.
| | - Chun-Yang Zhu
- Medical College of Henan University of Science and Technology, Luoyang, 471023, PR China.
| | - Wan Wang
- Medical College of Henan University of Science and Technology, Luoyang, 471023, PR China.
| | - Wen-Fei Zuo
- Medical College of Henan University of Science and Technology, Luoyang, 471023, PR China.
| | - Xiang-Jun Qiu
- Medical College of Henan University of Science and Technology, Luoyang, 471023, PR China.
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14
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Negative affect reactivity to stress and internalizing symptoms over the transition to college for Latinx adolescents: Buffering role of family support. Dev Psychopathol 2020; 33:1322-1337. [PMID: 32611477 DOI: 10.1017/s095457942000053x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Affect reactivity to stress may play a role in the development of internalizing symptoms during the college transition, a critical developmental juncture for Latinx adolescents, the largest ethnic minority group on college campuses. This study examined whether affect reactivity during high school is associated with internalizing symptoms in college and explored two potential protective factors, perceived family and peer support. Participants were 209 Latinx adolescents (Mage = 18.10; 64.4% female) who completed standard surveys and four diary assessments per day over 7 days (N > 4,500 momentary observations). First, to measure affect reactivity, we assessed whether perceived stress was associated with negative affect at the momentary level during high school (senior year). Second, we tested whether affect reactivity predicted internalizing symptoms during the first year of college. Third, we tested whether perceived family or peer support buffered the negative consequences of affect reactivity. Results indicated statistically significant within- and between-person associations between stress and negative affect. Moreover, affect reactivity significantly predicted depressive, but not anxiety, symptoms. Buffering was found for family, but not peer, support. Findings extend previous research by detecting associations between momentary affect reactivity and internalizing symptoms during a sociocultural shift in Latinx adolescents' lives and have implications for culturally appropriate programs to prevent depressive symptoms.
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15
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McFarland DC, Breitbart W, Miller AH, Nelson C. Depression and Inflammation in Patients With Lung Cancer: A Comparative Analysis of Acute Phase Reactant Inflammatory Markers. PSYCHOSOMATICS 2020; 61:527-537. [PMID: 32331769 DOI: 10.1016/j.psym.2020.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Depression and inflammation are intertwined, which is particularly relevant for patients with lung cancer who have an abundance of inflammation and experience depression. Acute phase reactants (APRs), albumin and C-reactive protein (CRP), are easily interpretable indirect markers of inflammation that have never been concomitantly compared with depression. Inflammation increases CRP (positive APR) and decreases albumin (negative APR). We hypothesize that albumin will be similarly associated with depression, thereby helping to inform the diagnosis of inflammatory depression. OBJECTIVE Compares the relationship between depression and representative positive and negative acute phase reactants in patients with metastatic lung cancer. METHODS Patients (n = 109) with metastatic lung cancer were evaluated for depression using the Hospital Anxiety and Depression Scale. Inflammation as measured by positive (CRP) and negative (albumin) APRs along with demographic and treatment variables were analyzed for associations with depression. RESULTS Depression was associated with lower albumin (r = -0.35, P < 0.001), higher CRP (r = 0.47, P < 0.001), and the CRP/albumin ratio (r = 0.45, P < 0.001). Hierarchical linear regression modeling found that albumin was associated with depression when controlling for demographics, disease, and treatment types (β = -0.28, P = 0.01). When both APRs were in the model, only CRP predicted depression (β = 0.31, P = 0.01), and albumin did not moderate CRP and depression. CRP/albumin ratio did not add to understanding depression variability, but patients with both low albumin and high CRP had particularly severe depression. CONCLUSION Albumin is associated with depression but not to a greater extent than CRP. The coupling of lower albumin and higher CRP describes more severe depression. Positive and negative APRs may form a distinct biologic signature to help identify patients with inflammatory depression in the lung cancer setting.
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Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
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16
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Sharpley CF, Bitsika V, McMillan ME, Jesulola E, Agnew LL. Dyadic coping and the cortisol:CRP ratio: How marital stress influences physiological state. Physiol Behav 2019; 211:112669. [PMID: 31479683 DOI: 10.1016/j.physbeh.2019.112669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 11/26/2022]
Abstract
Although previous data indicate that dyadic coping is associated with Hypothalamic-Pituitary-Adrenal (HPA-axis and C-reactive protein (CRP) separately, no study has reported on the ratio between these two systems and dyadic coping, despite this index of physiological homeostasis being associated with physical health and depression. Forty-eight community volunteers who were either married (n = 36) or cohabiting (n = 12) provided saliva and serum samples, and also completed a dyadic coping inventory. There was a significant inverse correlation between cortisol:CRP ratio and dyadic coping, but only for married participants. One of the six dyadic coping items, related to being able to calmly discuss something within a dyad, was the key factor in the association between dyadic coping and cortisol:CRP ratio. These findings provide some initial support for the influence of the way that spouses interact to solve problems and the balance between their HPA and immune systems.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale 2351, NSW, Australia.
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale 2351, NSW, Australia
| | - Mary E McMillan
- Brain-Behaviour Research Group, University of New England, Armidale 2351, NSW, Australia
| | - Emmanuel Jesulola
- Emergency Department, Bathurst Base Hospital, Bathurst, 2795, NSW, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale 2351, NSW, Australia
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17
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Sharpley CF, Bitsika V, McMillan ME, Jesulola E, Agnew LL. The association between cortisol:C-reactive protein ratio and depressive fatigue is a function of CRP rather than cortisol. Neuropsychiatr Dis Treat 2019; 15:2467-2475. [PMID: 31695383 PMCID: PMC6717724 DOI: 10.2147/ndt.s213839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Hormonal and inflammatory factors have been suggested as potentially influencing depressive state and depressive symptoms, but rarely compared for their relative contribution to these states and to specific depressive symptoms. This study examined cortisol:C-reactive protein (CRP) ratio, plus cortisol and CRP separately, as correlates of global depression and fatigue-related depression. PATIENTS AND METHODS One hundred and twenty-six community volunteers from rural Australia provided saliva and serum samples, and also completed a depression inventory. RESULTS There was a significant correlation between cortisol:CRP ratio and depression-related fatigue, and this resolved to the effects of CRP rather than cortisol. Most of the variance in this association came from patients who were "depressed", and there were no significant gender associations. CONCLUSION Inflammation, rather than HPA-axis activity, was associated with depression-related fatigue, supporting a model that places inflammation as a contributor to one of the major symptoms and predictors of depression. Individualization of therapy for depression-related fatigue in chronically stressed or physically ill patients might benefit from future research into cytokine therapy.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
| | - Mary E McMillan
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
| | - Emmanuel Jesulola
- Emergency Department, Bathurst Base Hospital, Bathurst, NSW 2795, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
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