1
|
Junger N, Hirsch O. Ethics of Nudging in the COVID-19 Crisis and the Necessary Return to the Principles of Shared Decision Making: A Critical Review. Cureus 2024; 16:e57960. [PMID: 38601812 PMCID: PMC11005480 DOI: 10.7759/cureus.57960] [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: 04/09/2024] [Indexed: 04/12/2024] Open
Abstract
Nudging, a controversial technique for modifying people's behavior in a predictable way, is claimed to preserve freedom of choice while simultaneously influencing it. Nudging had been largely confined to situations such as promoting healthy eating choices but has been employed in the coronavirus disease 2019 (COVID-19) crisis in a shift towards measures that involve significantly less choice, such as shoves and behavioral prods. Shared decision making (SDM), a method for direct involvement and autonomy, is an alternative approach to communicate risk. Predominantly peer-reviewed scientific publications from standard literature databases like PubMed, PsycInfo, and Psyndex were evaluated in a narrative review. The so-called fear nudges, as well as the dissemination of strongly emotionalizing or moralizing messages can lead to intense psycho-physical stress. The use of these nudges by specialized units during the COVID-19 pandemic generated a societal atmosphere of fear that precipitated a deterioration of the mental and physical health of the population. Major recommendations of the German COVID-19 Snapshot Monitoring (COSMO) study, which are based on elements of nudging and coercive measures, do not comply with ethical principles, basic psychological principles, or evidence-based data. SDM was misused in the COVID-19 crisis, which helped to achieve one-sided goals of governments. The emphasis on utilitarian thinking is criticized and the unethical behavior of decision makers is explained by both using the concept of moral disengagement and the maturity level of coping strategies. There should be a return to an open-ended, democratic, and pluralistic scientific debate without using nudges. It is therefore necessary to return to the origins of SDM.
Collapse
Affiliation(s)
- Nancy Junger
- Psychology, Independent Researcher, Tübingen, DEU
| | - Oliver Hirsch
- Psychology, FOM University of Applied Sciences, Siegen, DEU
| |
Collapse
|
2
|
The long-term impact of early adverse experience on adaptive functioning: a pilot study integrating measures of mental status, nonverbal communication, and heart rate variability. Eur J Psychotraumatol 2023; 14:2181766. [PMID: 37052107 PMCID: PMC9980016 DOI: 10.1080/20008066.2023.2181766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Background: Childhood maltreatment (CM) can disrupt the development of behavioural and physiological systems, increasing the risk of physical and psychological adverse outcomes across the lifespan. CM may cause interpersonal dysfunctions that impair social communication and lead to dysfunctional activation of the autonomic nervous system. The present exploratory study analyzed the long-term impact of CM from an integrated perspective through the simultaneous assessment of psychological symptoms, social and behavioural communication, and physiological regulation. Methods: Participants were 55 healthy university students (9 males and 46 females; mean age ± SD = 25.26 ± 2.83 years), who filled out a battery of questionnaires to assess the presence of CM (Childhood Trauma Questionnaire) and psychopathological symptoms (Symptom Check-List-90 Item Revised). Participants were then subjected to a videotaped interview for the assessment of non-verbal behaviour (Ethological Coding System for Interviews) and measurement of tonic heart rate variability (HRV), a measure of physiological adaptability to the environment. We performed Pearson's correlation analysis to evaluate the associations between non-verbal behaviour, HRV, and CM variables. Multiple regression analysis was used to evaluate the independent associations between CM variables on HRV and nonverbal behaviour. Results: We found an association between more severe CM, increased symptoms-related distress (ps < .001), less submissive behaviour (ps < .018), and decreased tonic HRV (ps < .028). As a result of multiple regression analysis, participants with a history of emotional abuse (R² = .18, p = .002) and neglect (R² = .10, p = .03) were more likely to display decreased submissive behaviour during the dyadic interview. Moreover, early experience of emotional (R² = .21, p = .005) and sexual abuse (R² = .14, p = .04) was associated with decreased tonic HRV. Conclusion: Our preliminary findings show the utility of analyzing the long-term effects of adverse early experiences at different levels of ‘adaptive functioning’ (the capabilities needed to respond effectively to environmental demands). Substantial traumatic experiences during childhood, such as emotional abuse, emotional neglect, and sexual abuse were associated with lower heart rate variability levels in a sample of young adults. Young adults with a history of emotional abuse and neglect were more likely to display decreased submissive behaviour (ethological behaviour) during the dyadic interview. Severe childhood maltreatment was associated with increased symptoms-related distress, less submissive behaviour (ethological behaviour), and decreased tonic heart rate variability in young adults.
Collapse
|
3
|
Connor A, Starnino L, Busque L, Tardif JC, Bourgoin V, Dubé MP, Busseuil D, D'Antono B. Childhood maltreatment and leukocyte telomere length in men and women with chronic illness: an evaluation of moderating and mediating influences. Psychol Med 2023; 53:6242-6252. [PMID: 36943406 PMCID: PMC10522448 DOI: 10.1017/s0033291722003543] [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: 05/10/2022] [Revised: 09/08/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Childhood maltreatment can result in lifelong psychological and physical sequelae, including coronary artery disease (CAD). Mechanisms leading to increased risk of illness may involve emotional dysregulation and shortened leukocyte telomere length (LTL). METHODS To evaluate whether (1) childhood maltreatment is associated with shorter LTL among older adults with CAD or other chronic illnesses; (2) sex and/or CAD status influence these results; and (3) symptoms of anxiety, depression, and stress moderate or mediate the association between childhood maltreatment and LTL, men and women (N = 1247; aged 65 ± 7.2 years) with and without CAD completed validated questionnaires on childhood maltreatment, symptoms of depression, anxiety, and perceived stress. LTL was measured using quantitative polymerase chain reaction. Analyses included bivariate correlations, hierarchical regressions, and moderation/mediation analyses, controlling for sociodemographic and lifestyle variables. RESULTS Childhood maltreatment was associated with significantly shorter LTL (r = -0.059, p = 0.038, b = -0.016, p = 0.005). This relation was not moderated by depression, anxiety, nor perceived stress, though there was mitigated evidence for absence of a maltreatment-LTL relation in men with CAD. Stress perception (but not anxiety or depression) partially mediated the relation between childhood maltreatment and LTL [Indirect effect, b = -0.0041, s.e. = 0.002, 95% CI (-0.0085 to -0.0002)]. CONCLUSIONS Childhood maltreatment was associated with accelerated biological aging independently of patient characteristics. Emotional dysregulation resulting in chronic stress may contribute to this process. Whether stress management or other interventions may help prevent or slow premature aging in those who have suffered maltreatment requires study.
Collapse
Affiliation(s)
- Alexandra Connor
- Research Centre, Montreal Heart Institute, Montreal, Canada
- Psychology Department, Université de Montréal, Montreal, Canada
| | - Louisia Starnino
- Research Centre, Montreal Heart Institute, Montreal, Canada
- Psychology Department, Université du Québec à Montréal, Montreal, Canada
| | - Lambert Busque
- Hematology Division, Research Center, Hôpital Maisonneuve-Rosemont; Université de Montréal, Montreal, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Vincent Bourgoin
- Hematology Division, Research Center, Hôpital Maisonneuve-Rosemont; Université de Montréal, Montreal, Canada
| | - Marie-Pierre Dubé
- Research Centre, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - David Busseuil
- Research Centre, Montreal Heart Institute, Montreal, Canada
| | - Bianca D'Antono
- Research Centre, Montreal Heart Institute, Montreal, Canada
- Psychology Department, Université de Montréal, Montreal, Canada
| |
Collapse
|
4
|
Zhang H, Yuan X, Mohd Zain NB, Gao Y. Analysis of therapeutic effect of subliminal cognition combined with hypnotherapy on anxiety disorder via neural network. Biotechnol Genet Eng Rev 2023:1-18. [PMID: 37129528 DOI: 10.1080/02648725.2023.2204604] [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: 05/03/2023]
Abstract
Hypnotherapy combined with cognitive therapy is an effective way to intervene anxiety problems, which also responds to the call that using hypnotherapy to treat somatic disorders should become a trend in the future. This paper constructs an evaluation index of the intervention effect of cognitive hypnotherapy on anxiety patients, and then uses neural network to evaluate its effect. At last, we have completed the following work: 1) This paper constructs the theoretical basis related to this topic after searching and sorting out the related literature on anxiety disorders and hypnotherapy at home and abroad. 2) This paper constructs the evaluation index system of the intervention effect of cognitive hypnotherapy on anxiety patients, and then introduces the basic principle and structure of DBN model. 3) Experiments are used to determine the best values for the DBN model's parameters. To accomplish this, you will need to input the experimental data into the trained model and compare the evaluation results from experts with the model's predictions. The experimental findings of this study demonstrate the great accuracy of the DBN model presented in this work for assessing the effectiveness of cognitive combination hypnotherapy for anxiety disorders.
Collapse
Affiliation(s)
- Hanyue Zhang
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
| | - Xuejiao Yuan
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
| | | | - Ying Gao
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
| |
Collapse
|
5
|
Is the Technology Era Aging You? A Review of the Physiologic and Psychologic Toll of Technology Use. Dermatol Surg 2022; 48:978-988. [PMID: 35862680 DOI: 10.1097/dss.0000000000003535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Technology use is at an all-time high and its potential impact on psychological and physiologic health should be explored. OBJECTIVE The objective of this narrative review was to identify the role of technology use on health and well-being. MATERIALS AND METHODS Authors performed a review of PubMed and publications of the World Health Organization, Department of Defense, and Centers for Disease Control and Prevention to determine the impact of technology regarding electromagnetic radiation (EM), posture and mobility, sleep disturbance, and psychological stress and well-being. RESULTS Studies on the impact of EM were conflicting, with about 45% reporting negative consequences and 55% reporting no effect. Radiofrequency EM (RF-EM) may more significantly affect fibroblasts and immature cells. Device use was implicated in worsening cognitive focus, imbalance, and sleep. Social media use affects self-esteem and mental health and is associated with up to 33% presence of addiction. Effects seem to be dose related and more pronounced in younger ages. CONCLUSION Technology use significantly affects sleep, mental health, and cognitive function. Seeking psychological help, limiting social media use, and reducing use before sleep may partially mitigate these effects. The impact of EM is undetermined, but the WHO lists RF-EM as a potential carcinogen.
Collapse
|
6
|
Hu L, Bai Y, Hu G, Zhang Y, Han X, Li J. Association of Dietary Magnesium Intake With Leukocyte Telomere Length in United States Middle-Aged and Elderly Adults. Front Nutr 2022; 9:840804. [PMID: 35662923 PMCID: PMC9161353 DOI: 10.3389/fnut.2022.840804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
AimMagnesium supplementation may extend the life span; however, the biological mechanism is still unknown. Leukocyte telomere length (LTL) is a marker of cell aging and biological health in humans. Data concerning whether magnesium supplementation can maintain telomere length, thus prolonging life are limited. We aimed to investigate the association between dietary magnesium intake and LTL in United States middle-aged and elderly adults.MethodsA total of 4,039 United States adults aged ≥ 45 years from National Health and Nutrition Examination Survey (1999–2002). Dietary magnesium intake was collected by a trained interviewer using 24-h dietary recall method and LTL was obtained using the quantitative polymerase chain reaction method. Multiple linear regression analysis was performed to evaluate the crude and adjusted association of dietary magnesium intake with LTL.ResultsThe overall mean (SD) of LTL was 5.6 (0.6) kp. After adjusting potential confounders, every 1 mg increase in log-transformed dietary magnesium intake was associated with 0.20 kp (95% confidence intervals: 0.05–0.34) longer LTL. Participants with the highest tertile (≥299 mg) of dietary magnesium intake had statistically significant longer LTL (β = 0.07, P = 0.038) compared with the lowest tertile (<198 mg), with significant linear trends across tertiles. Moreover, the association between dietary magnesium intake and LTL was significantly stronger in participants with higher levels of education (≥high school compared with < high school, P for interaction = 0.002). E-value analysis suggested robustness to unmeasured confounding.ConclusionOur findings showed that increased dietary magnesium intake was associated with longer LTL, which suggested that magnesium was conducive to a longer life expectancy.
Collapse
Affiliation(s)
- Lihua Hu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yi Bai
- Department of Epidemiology and Bio-Statistics, School of Public Health, Peking University, Beijing, China
| | - Guiping Hu
- School of Engineering Medicine, Beihang University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
- *Correspondence: Guiping Hu,
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiaoning Han
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Jianping Li,
| |
Collapse
|
7
|
Méndez-Chacón E. Gender Differences in Perceived Stress and Its Relationship to Telomere Length in Costa Rican Adults. Front Psychol 2022; 13:712660. [PMID: 35282254 PMCID: PMC8915848 DOI: 10.3389/fpsyg.2022.712660] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Stress is associated with disease and reduced leukocyte telomere length (LTL). The objective of this research is to determine if self-perceived stress is associated with telomere length in Costa Rican adults and the gender differences in this association. Findings may help explain how some populations in apparent socioeconomic disadvantage and with limited access to specialized medical services have a remarkably high life expectancy. Methodology Data come from the pre-retirement cohort of the Costa Rican Longevity and Healthy Aging Study (CRELES), a population based survey conducted in the households to 2,327 adults aged 53 to 66 years. The DNA to measure LTL was extracted from blood cells in laboratories of the University of Costa Rica whereas the Blackburn laboratory at the University of California performed the telomere length measurement applying the quantitative polymerase chain reaction (Q-PCR). The relationship between telomere length and perceived stress was measured using least-squares multiple regression. Perceived stress was measured by a set of questions about family, job, finances and, health reasons to be stressed. Models included the control variables: (1) age and sex of the participant, (2) whether he or she resides in the Nicoya area, a “blue zone” known for its high longevity, and (3) the aforementioned sociodemographic, health and lifestyles characteristics. Results Stress perception and LTL are significantly different by sex. Women perceived higher stress levels than men in almost all aspects studied, except work. Women have significantly longer telomeres. Shorter telomeres are significantly associated with caregiving stress in men and with parental health concerns in women. Counter-intuitive telomere lengthenings were observed among women who feel stressed about caring for family members; and among men who feel stressed due to their family relationships as well as concerns about their own health. Discussion Results confirm that people with self-perceived stress due to caregiving or health issues have shorter telomeres. The relationship between stress and telomere length differs between men and women. Gender relations exert a strong modifier effect on the relationship between stress and LTL: gender is related to perceived stress, telomere length, and apparently also to the way stress and LTL are related.
Collapse
|
8
|
Ridout KK, Syed SA, Kao HT, Porton B, Rozenboym AV, Tang J, Fulton S, Perera T, Jackowski AP, Kral JG, Tyrka AR, Coplan J. Relationships Between Telomere Length, Plasma Glucagon-like Peptide 1, and Insulin in Early-Life Stress–Exposed Nonhuman Primates. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 2:54-60. [DOI: 10.1016/j.bpsgos.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022] Open
|
9
|
Lin A, Mertens AN, Arnold BF, Tan S, Lin J, Stewart CP, Hubbard AE, Ali S, Benjamin-Chung J, Shoab AK, Rahman MZ, Famida SL, Hossen MS, Mutsuddi P, Akther S, Rahman M, Unicomb L, Naved RT, Mamun MMA, Parvin K, Dhabhar FS, Kariger P, Fernald LC, Luby SP, Colford JM. Telomere length is associated with growth in children in rural Bangladesh. eLife 2021; 10:60389. [PMID: 34494545 PMCID: PMC8494482 DOI: 10.7554/elife.60389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Previously, we demonstrated that a water, sanitation, handwashing, and nutritional intervention improved linear growth and was unexpectedly associated with shortened childhood telomere length (TL) (Lin et al., 2017). Here, we assessed the association between TL and growth. Methods: We measured relative TL in whole blood from 713 children. We reported differences between the 10th percentile and 90th percentile of TL or change in TL distribution using generalized additive models, adjusted for potential confounders. Results: In cross-sectional analyses, long TL was associated with a higher length-for-age Z score at age 1 year (0.23 SD adjusted difference in length-for-age Z score [95% CI 0.05, 0.42; FDR-corrected p-value = 0.01]). TL was not associated with other outcomes. Conclusions: Consistent with the metabolic telomere attrition hypothesis, our previous trial findings support an adaptive role for telomere attrition, whereby active TL regulation is employed as a strategy to address ‘emergency states’ with increased energy requirements such as rapid growth during the first year of life. Although short periods of active telomere attrition may be essential to promote growth, this study suggests that a longer overall initial TL setting in the first 2 years of life could signal increased resilience against future telomere erosion events and healthy growth trajectories. Funding: Funded by the Bill and Melinda Gates Foundation. Clinical trial number: NCT01590095
Collapse
Affiliation(s)
- Audrie Lin
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Andrew N Mertens
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Benjamin F Arnold
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, United States
| | - Sophia Tan
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, United States
| | - Christine P Stewart
- Department of Nutrition, University of California, Davis, Davis, United States
| | - Alan E Hubbard
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Shahjahan Ali
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jade Benjamin-Chung
- Department of Epidemiology & Population Health, Stanford University, Stanford, United States
| | - Abul K Shoab
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ziaur Rahman
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Syeda L Famida
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Saheen Hossen
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Palash Mutsuddi
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Salma Akther
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mahbubur Rahman
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Leanne Unicomb
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ruchira Tabassum Naved
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Mahfuz Al Mamun
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Kausar Parvin
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Firdaus S Dhabhar
- Department of Psychiatry & Behavioral Sciences, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, United States
| | - Patricia Kariger
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Lia Ch Fernald
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Stephen P Luby
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, United States
| | - John M Colford
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, United States
| |
Collapse
|
10
|
Ogłuszka M, te Pas MFW, Poławska E, Nawrocka A, Stepanow K, Pierzchała M. Omega-3 Alpha-Linolenic Fatty Acid Affects the Level of Telomere Binding Protein TRF1 in Porcine Skeletal Muscle. Animals (Basel) 2020; 10:ani10061090. [PMID: 32599751 PMCID: PMC7341232 DOI: 10.3390/ani10061090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 01/17/2023] Open
Abstract
Omega-3 fatty acids are health-promoting nutrients that contribute to the amelioration of age-related diseases. Recent studies have reported the role of these fatty acids in the aging process, explicitly impacting telomere biology. The shelterin protein complex, located at the extremities of chromosomes, ensures telomere protection and length regulation. Here, we analyzed the impact of dietary omega-3 alpha-linolenic fatty acid from linseed oil on skeletal muscle telomere biology using an animal model of female pigs. Fifteen animals were supplemented with linseed oil for nine weeks and an equal number of individuals were fed with a control diet. Linseed-oil-supplemented animals showed an increased level of alpha-linolenic acid in skeletal muscles compared to control animals. There was no difference between groups in the telomere length measured in leukocytes and muscles. However, muscles of the linseed-oil-supplemented pigs showed lower levels of the shelterin TRF1 protein compared to the control group. Our results suggest that omega-3 linolenic acid counteracts the elevation of TRF1 levels, which increase with age and due to the presence of reactive oxygen species in muscle. The observed effect may be due to attenuation of oxidative stress.
Collapse
Affiliation(s)
- Magdalena Ogłuszka
- Department of Genomics and Biodiversity, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, 05-552 Jastrzębiec, Poland; (E.P.); (A.N.); (K.S.); (M.P.)
- Correspondence:
| | - Marinus F. W. te Pas
- Animal Breeding and Genomics, Wageningen UR Livestock Research, 6700AH Wageningen, The Netherlands;
| | - Ewa Poławska
- Department of Genomics and Biodiversity, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, 05-552 Jastrzębiec, Poland; (E.P.); (A.N.); (K.S.); (M.P.)
| | - Agata Nawrocka
- Department of Genomics and Biodiversity, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, 05-552 Jastrzębiec, Poland; (E.P.); (A.N.); (K.S.); (M.P.)
| | - Kamila Stepanow
- Department of Genomics and Biodiversity, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, 05-552 Jastrzębiec, Poland; (E.P.); (A.N.); (K.S.); (M.P.)
| | - Mariusz Pierzchała
- Department of Genomics and Biodiversity, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, 05-552 Jastrzębiec, Poland; (E.P.); (A.N.); (K.S.); (M.P.)
| |
Collapse
|
11
|
Biological embedding of maternal postpartum depressive symptoms: The potential role of cortisol and telomere length. Biol Psychol 2019; 150:107809. [PMID: 31734351 DOI: 10.1016/j.biopsycho.2019.107809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/15/2019] [Accepted: 11/04/2019] [Indexed: 12/29/2022]
Abstract
Although maternal postpartum depressive symptoms (PDS) are associated with child behavior problems, the underlying biological mechanisms are poorly understood. Thus, the current study focused on 193 healthy mother-child dyads and investigated child cortisol and telomere length as potential mediating factors. At 3 and 6 months postpartum, mothers reported on PDS. At age 6, children provided saliva and buccal swab samples. At age 10, mothers and children reported on child behavior problems. Structural equation modelling revealed (a) no association between PDS and child behavior problems and thus no possibility of mediation, but that (b) lower cortisol forecast more child-reported internalizing problems, and (c) shorter telomere length predicted more child-reported internalizing and externalizing problems. These findings raise mediational questions about the determinants of these biomarkers.
Collapse
|
12
|
Ridout KK, Ridout SJ, Guille C, Mata DA, Akil H, Sen S. Physician-Training Stress and Accelerated Cellular Aging. Biol Psychiatry 2019; 86:725-730. [PMID: 31230727 PMCID: PMC6788968 DOI: 10.1016/j.biopsych.2019.04.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Stress is a key precipitant for many common diseases, but established biological markers to track stress and guide investigations into mechanisms linking stress and disease are lacking. Cross-sectional studies have identified correlations between stress and telomere attrition, but no large, longitudinal studies examining the impacts of chronic stress on telomere length exist. Residency training for physicians is a well-established stressful experience and can be used as a prospective stress model. METHODS In a longitudinal cohort study of 250 interns (first-year residents) at 55 United States hospital systems serving during the 2015-2016 academic year, we examined associations between measures of the residency experience and saliva-measured telomere attrition. RESULTS Telomere length shortened significantly over the course of internship year, from mean ± SD of 6465.1 ± 876.8 base pairs before internship to 6321.5 ± 630.6 base pairs at the end of internship (t246 = 2.69; p = .008). Stressful early family environments and neuroticism were significantly associated with shorter preinternship telomere length. Longer work hours were associated with greater telomere intern telomere loss over the year (p = .002). Of note, the mean telomere attrition during internship year was six times greater than the typical annual attrition rate identified in a recent meta-analysis. CONCLUSIONS This work implicates telomere attrition as a biologically measurable consequence of physician training, with the magnitude of attrition associated with workload. Identification of an objective, biological sequela of residency stress may help to facilitate the development of effective interventions. Further, the findings implicate telomere attrition as an objective biomarker to follow the pathologic effects of stress, in general.
Collapse
Affiliation(s)
- Kathryn K. Ridout
- Department of Psychiatry, Kaiser Permanente, San Jose, CA,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | | | - Constance Guille
- Brain Research and Integrative Neuropsychopharmacology Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Douglas A. Mata
- Department of Pathology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA,Brigham Education Institute, Boston, MA
| | - Huda Akil
- Molecular and Behavioral Neuroscience Institute and Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
| |
Collapse
|
13
|
Ridout KK, Parade SH, Kao HT, Magnan S, Seifer R, Porton B, Price LH, Tyrka AR. Childhood maltreatment, behavioral adjustment, and molecular markers of cellular aging in preschool-aged children: A cohort study. Psychoneuroendocrinology 2019; 107:261-269. [PMID: 31174164 PMCID: PMC7839663 DOI: 10.1016/j.psyneuen.2019.05.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 05/04/2019] [Accepted: 05/14/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Childhood maltreatment is a major risk factor for the development of behavioral problems and poor physical and mental health. Accelerated cellular aging, through reduced telomere length and mitochondrial dysfunction, may be a mechanism underlying these associations. METHODS Families with (n = 133) and without (n = 123) child welfare documentation of moderate-severe maltreatment in the past six months participated in this study. Children ranged in age from 3 to 5 years, were racially and ethnically diverse, and 91% qualified for public assistance. Structured record review and interviews were used to assess a history of maltreatment and other adversities. Telomere length and mitochondrial DNA copy number (mtDNAcn) were measured from saliva DNA using real-time PCR. Measures were repeated at a six-month follow-up assessment. Repeated measures general linear models were used to examine the effects of maltreatment and other adversities on telomere length and mtDNAcn over time. RESULTS Maltreatment and other adverse experiences were significant positive predictors of both telomere length and mtDNAcn over time. Internalizing and externalizing behavior problems were also both significantly associated with telomere length, but only internalizing symptoms were associated with mtDNAcn. CONCLUSIONS This is the first study to show that mtDNAcn is altered in children with stress and trauma, and the findings are consistent with recent studies of adults. Surprisingly, children who experienced moderate-severe levels of maltreatment in the prior six months had longer telomeres, possibly reflecting compensatory changes in response to recent trauma. Telomere length and mtDNAcn were also associated with behavioral problems, suggesting that these measures of cellular aging may be causally implicated in the pathophysiology of stress-related conditions.
Collapse
Affiliation(s)
- Kathryn K. Ridout
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Stephanie H. Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA,Bradley/Hasbro Children’s Research Center, E. P. Bradley Hospital, East Providence, RI, USA
| | - Hung-Teh Kao
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Stevie Magnan
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA,Bradley/Hasbro Children’s Research Center, E. P. Bradley Hospital, East Providence, RI, USA
| | - Barbara Porton
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Lawrence H. Price
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Audrey R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA,Address Correspondence to: Audrey R. Tyrka, M.D., Ph.D., Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906. TEL: (401) 455-6520. FAX: (401) 455-6534.
| |
Collapse
|
14
|
Kalungi A, Womersley JS, Kinyanda E, Joloba ML, Ssembajjwe W, Nsubuga RN, Levin J, Kaleebu P, Kidd M, Seedat S, Hemmings SMJ. Internalizing Mental Disorders and Accelerated Cellular Aging Among Perinatally HIV-Infected Youth in Uganda. Front Genet 2019; 10:705. [PMID: 31428136 PMCID: PMC6688656 DOI: 10.3389/fgene.2019.00705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 07/03/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction: Internalizing mental disorders (IMDs) in HIV+ children and adolescents are associated with impaired quality of life and non-adherence to anti-retroviral treatment. Telomere length is a biomarker of cellular aging, and shorter telomere length has been associated with IMDs. However, the nature of this association has yet to be elucidated. Objective: We determined the longitudinal association between IMDs and relative telomere length (rTL) and the influence of chronic stress among Ugandan perinatally HIV-infected youth (PHIY). Methods: IMDs (depressive disorders, anxiety disorders, and post-traumatic stress disorder) and IMDs were assessed using the locally adapted Child and Adolescent Symptom Inventory-5. In 368 PHIY with any IMD and 368 age- and sex-matched PHIY controls without any psychiatric disorder, rTL was assessed using quantitative polymerase chain reaction. Hierarchical cluster analysis was used to generate the three chronic stress classes (mild, moderate, and severe). t-tests were used to assess the difference between baseline and 12 month rTL and the mean difference in rTL between cases and controls both at baseline and at 12 months. Linear regression analysis was used to model the effects of chronic stress on the association between IMDs and rTL, controlling for age and sex. Results: We observed longer rTL among cases of IMDs compared with controls (p < 0.001). We also observed a statistically significant reduction in rTL between baseline and 12 months in the combined sample of cases and controls (p < 0.001). The same statistical difference was observed when cases and controls were individually analyzed (p < 0.001). We found no significant difference in rTL between cases and controls at 12 months (p = 0.117). We found no significant influence of chronic stress on the association between IMDs and rTL at both baseline and 12 months. Conclusion: rTL is longer among cases of IMDs compared with age- and sex-matched controls. We observed a significant attrition in rTL over 12 months, which seems to be driven by the presence of any IMDs. There is a need for future longitudinal and experimental studies to understand the mechanisms driving our findings.
Collapse
Affiliation(s)
- Allan Kalungi
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.,Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Medical Microbiology, Makerere University, Kampala, Uganda
| | | | - Eugene Kinyanda
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses L Joloba
- Department of Medical Microbiology, Makerere University, Kampala, Uganda.,School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Wilber Ssembajjwe
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Rebecca N Nsubuga
- Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Jonathan Levin
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | | | - Martin Kidd
- Centre for Statistical Consultation, Department of Statistics and Actuarial Sciences University of Stellenbosch, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
15
|
Heim CM, Entringer S, Buss C. Translating basic research knowledge on the biological embedding of early-life stress into novel approaches for the developmental programming of lifelong health. Psychoneuroendocrinology 2019; 105:123-137. [PMID: 30578047 PMCID: PMC6561839 DOI: 10.1016/j.psyneuen.2018.12.011] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/22/2018] [Accepted: 12/11/2018] [Indexed: 12/12/2022]
Abstract
This review integrates scientific knowledge obtained over the past few decades on the biological mechanisms that contribute to the profound association between exposure to early adversity, including childhood trauma and prenatal stress, and the lifelong elevated risk to develop a broad range of diseases. We further discuss insights into gene-environment interactions moderating the association between early adversity and disease manifestation and we discuss the role of epigenetic and other molecular processes in the biological embedding of early adversity. Based on these findings, we propose potential mechanisms that may contribute to the intergenerational transmission of risk related to early adversity from the mother to the fetus. Finally, we argue that basic research knowledge on the biological embedding of early adversity must now be translated into novel intervention strategies that are mechanism-driven and sensitive to developmental timing. Indeed, to date, there are no diagnostic biomarkers of risk or mechanism-informed interventions that we can offer to victims of early adversity in order to efficiently prevent or reverse adverse health outcomes. Such translational efforts can be expected to have significant impact on both clinical practice and the public health system, and will promote precision medicine in pediatrics and across the lifespan.
Collapse
Affiliation(s)
- Christine M. Heim
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany,Department of Biobehavioral Health, College of Health & Human Development, The Pennsylvania State University, University Park, PA, USA,Corresponding authors at: Institute of Medical Psychology, Charité Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany., (C.M. Heim), (S. Entringer), (C. Buss)
| | - Sonja Entringer
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany; Development, Health, and Disease Research Program, University of California Irvine, Orange, CA, USA.
| | - Claudia Buss
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany; Development, Health, and Disease Research Program, University of California Irvine, Orange, CA, USA.
| |
Collapse
|
16
|
Bürgin D, O'Donovan A, d'Huart D, di Gallo A, Eckert A, Fegert J, Schmeck K, Schmid M, Boonmann C. Adverse Childhood Experiences and Telomere Length a Look Into the Heterogeneity of Findings-A Narrative Review. Front Neurosci 2019; 13:490. [PMID: 31191214 PMCID: PMC6541108 DOI: 10.3389/fnins.2019.00490] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/29/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Adverse childhood experiences (ACEs) have been associated with poor mental and somatic health. Accumulating evidence indicates that accelerated biological aging-indexed by altered telomere-related markers-may contribute to associations between ACEs and negative long-term health outcomes. Telomeres are repeated, non-coding deoxyribonucleic acid (DNA) sequences at the end of chromosomes. Telomeres shorten during repeated cell divisions over time and are being used as a marker of biological aging. Objectives: The aim of the current paper is to review the literature on the relationship between ACEs and telomere length (TL), with a specific focus on how the heterogeneity of sample and ACEs characteristics lead to varying associations between ACEs and TL. Methods: Multiple databases were searched for relevant English peer-reviewed articles. Thirty-eight papers were found to be eligible for inclusion in the current review. Results: Overall, the studies indicated a negative association between ACEs and TL, although many papers presented mixed findings and about a quarter of eligible studies found no association. Studies with smaller sample sizes more often reported significant associations than studies with larger samples. Also, studies reporting on non-clinical and younger samples more often found associations between ACEs and TL compared to studies with clinical and older samples. Reviewing the included studies based on the "Stressor Exposure Characteristics" recently proposed by Epel et al. (2018) revealed a lack of detailed information regarding ACEs characteristics in many studies. Conclusion: Overall, it is difficult to achieve firm conclusions about associations of ACEs with TL due to the heterogeneity of study and ACE characteristics and the heterogeneity in reported findings. The field would benefit from more detailed descriptions of study samples and measurement of ACEs.
Collapse
Affiliation(s)
- David Bürgin
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Aoife O'Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Delfine d'Huart
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Alain di Gallo
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Anne Eckert
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Jörg Fegert
- Child and Adolescent Psychiatry/Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Marc Schmid
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Cyril Boonmann
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| |
Collapse
|
17
|
Young-Wolff KC, Sarovar V, Sterling SA, Leibowitz A, McCaw B, Hare CB, Silverberg MJ, Satre DD. Adverse childhood experiences, mental health, substance use, and HIV-related outcomes among persons with HIV. AIDS Care 2019; 31:1241-1249. [PMID: 30887831 DOI: 10.1080/09540121.2019.1587372] [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] [Indexed: 01/01/2023]
Abstract
While persons with HIV (PWH) have benefited from significant advances in treatment and resulting longevity, mental health problems remain elevated in this population. Adverse childhood experiences (ACEs) are common among PWH and may negatively affect mental health and HIV-related outcomes. We examined the association between ACEs, depression and anxiety symptoms, substance use, antiretroviral therapy (ART) adherence, and HIV-clinical indicators in a sample of 584 PWH at risk for unhealthy alcohol use enrolled in a primary care-based alcohol intervention study. The sample was 96.9% male, 63.0% non-Hispanic white, with an average age of 49.0 years. ACEs were highly prevalent: 82.5% reported ≥1 ACE, including 34.2% reporting 1-2 ACEs, 25.0% reporting 3-4 ACEs, and 23.3% reporting ≥5 ACEs. Adjusting for demographics, having 1-2, 3-4 or ≥5 ACEs was significantly associated with anxiety (ORs (95%CI): 3.41 (1.13-10.33), 4.36 (1.42-3.36), and 3.96 (1.28-12.19), respectively) and poorer mental health quality of life (Betas (SE): -3.21 (1.40), -6.23 (1.51), and -7.09 (1.54), respectively), but not with other outcomes. Trauma-informed interventions to reduce anxiety and improve mental health quality of life in PWH may reduce the negative health sequelae of ACEs.
Collapse
Affiliation(s)
- Kelly C Young-Wolff
- a Division of Research, Kaiser Permanente , Oakland , CA , USA.,b Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California , San Francisco , CA , USA
| | - Varada Sarovar
- a Division of Research, Kaiser Permanente , Oakland , CA , USA
| | | | - Amy Leibowitz
- a Division of Research, Kaiser Permanente , Oakland , CA , USA
| | - Brigid McCaw
- c Family Violence Prevention Program, Kaiser Permanente , Oakland , CA , USA
| | - Charles B Hare
- d Department of Adult and Family Medicine, Kaiser Permanente San Francisco Medical Center , San Francisco , CA , USA
| | | | - Derek D Satre
- a Division of Research, Kaiser Permanente , Oakland , CA , USA.,b Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California , San Francisco , CA , USA
| |
Collapse
|
18
|
Christian LM. At the forefront of psychoneuroimmunology in pregnancy: Implications for racial disparities in birth outcomes: PART 2: Biological mechanisms. Neurosci Biobehav Rev 2019; 117:327-333. [PMID: 30885813 DOI: 10.1016/j.neubiorev.2019.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/26/2019] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
As reviewed in Part 1 of this two part review, birth prior to full term is a substantial public health issue. In the US, ˜400,000 babies per year are born preterm (< 37 weeks), while>1 million are early term (37-386/7 weeks) and remarkable racial disparities in shortened gestation are observed among African Americans as compared to Whites. Biomechanisms linking stressor exposures with birth outcomes are increasingly being explicated. The current paper reviews the mechanistic role of maternal biological functioning in the link between behavioral exposures and birth outcomes. These include the inter-related roles of neuroendocrine function, inflammatory regulation, biological aging, and the microbiome. An integrative approach which addresses both behavioral and biological factors within the same study, carefully considers the role of race/ethnicity, and rigorously defines birth outcomes (e.g., spontaneous versus medically-indicated and inclusive of early term birth) is needed to move research in this field toward better mechanistic understanding and clinical application.
Collapse
Affiliation(s)
- Lisa M Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA.
| |
Collapse
|
19
|
Depression caused by long-term stress regulates premature aging and is possibly associated with disruption of circadian rhythms in mice. Physiol Behav 2019; 199:100-110. [DOI: 10.1016/j.physbeh.2018.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/09/2018] [Accepted: 11/10/2018] [Indexed: 12/21/2022]
|
20
|
Xavier G, Spindola LM, Ota VK, Carvalho CM, Maurya PK, Tempaku PF, Moretti PN, Mazotti DR, Sato JR, Brietzke E, Miguel EC, Grassi-Oliveira R, Mari J, Bressan RA, Gadelha A, Pan PM, Belangero SI. Effect of male-specific childhood trauma on telomere length. J Psychiatr Res 2018; 107:104-109. [PMID: 30384090 DOI: 10.1016/j.jpsychires.2018.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/10/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022]
Abstract
Child maltreatment (CM) is a global issue with serious lifelong consequences. In fact, maltreatment during childhood might be an important risk factor for the development of psychiatric disorders. Furthermore, previous studies showed a strong relationship between telomere length (TL) and early life stress. Considering that only a few studies have evaluated this relationship in children and that even fewer considered the sex as a possible moderator, we investigated whether TL in the blood of both children and adolescents was associated with psychopathology and with a history of CM, and whether these associations were moderated by the sex. In this cross-sectional study, 561 individuals (ranging between 6 and 14 years of age) from a large prospective community school-based study, i.e., the Brazilian High-Risk Cohort (HRC), were evaluated. The Child Behavior Checklist (CBCL) score was used to assess psychopathology, whereas a latent variable encompassing some questions about history of adverse environment and trauma was employed to determine the CM history. TL was measured in blood cells using a multiplex quantitative polymerase chain reaction. Additionally, TL was inserted in two moderation models, in which the CBCL score/CM, TL and sex were the independent variables, the outcome, and the moderator variable, respectively. Although an association between psychiatric symptoms and TL was not observed, a relation between CM and TL moderated by the sex was seen, indicating that males with higher CM scores presented with shorter telomeres than did females. Our results suggest that child maltreatment could influence telomere length in both children and adolescents and that this effect is mediated by the sex.
Collapse
Affiliation(s)
- Gabriela Xavier
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil
| | - Letícia M Spindola
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Vanessa K Ota
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil
| | - Carolina M Carvalho
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Pawan Kumar Maurya
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Biochemistry, Central University of Haryana, Mahendergarh, Haryana, India
| | | | - Patricia N Moretti
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Genetics and Morphology, Universidade de Brasília (UNB) Brasília, Brazil
| | - Diego R Mazotti
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, United States
| | - João Ricardo Sato
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Brazil
| | | | | | - Rodrigo Grassi-Oliveira
- Post-Graduation Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil; Developmental Cognitive Neuroscience Lab, PUCRS, Brazil
| | - Jair Mari
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Rodrigo A Bressan
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Ary Gadelha
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Pedro M Pan
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Sintia Iole Belangero
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil.
| |
Collapse
|
21
|
Young-Wolff KC, Alabaster A, McCaw B, Stoller N, Watson C, Sterling S, Ridout KK, Flanagan T. Adverse Childhood Experiences and Mental and Behavioral Health Conditions During Pregnancy: The Role of Resilience. J Womens Health (Larchmt) 2018; 28:452-461. [PMID: 30183473 DOI: 10.1089/jwh.2018.7108] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Little is known about how exposure to adverse childhood experiences (ACEs) and protective factors, such as resilience, influence prenatal mental and behavioral health. This study examined associations between exposure to ACEs and mental and behavioral health during pregnancy overall and among women with high versus low levels of resilience. MATERIALS AND METHODS Women in two Kaiser Permanente Northern California medical centers were screened for ACEs and resilience during prenatal care (∼14-23 weeks of gestation; N = 355). Multivariable logistic regression analyses examined associations between ACEs and prenatal mental and behavioral health conditions overall and for women with low (≤32) versus high (>32) resilience on the 10-item Connor-Davidson Resilience Scale. RESULTS Overall, 54% of women reported 0 ACEs, 28% 1-2 ACEs, and 18% 3+ ACEs. Relative to women with 0 ACEs, those with 1-2 ACEs had higher odds of an anxiety or depressive disorder and intimate partner violence (IPV) (odds ratios [ORs] 2.42-3.12, p < 0.05), and those with 3+ ACEs had higher odds of an anxiety or depressive disorder, depression symptoms, and IPV (ORs 3.08-4.71, p < 0.05). In stratified analyses by high (56%) and low (44%) resilience, having one or more ACEs (vs. 0 ACEs) was only associated with worse mental and behavioral health in women with low resilience. CONCLUSIONS ACEs predicted mental and behavioral health conditions among pregnant women, and associations were the strongest among women with low levels of current resilience. Longitudinal research is needed to understand the causal mechanisms underlying these associations.
Collapse
Affiliation(s)
- Kelly C Young-Wolff
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Amy Alabaster
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Brigid McCaw
- 2 Family Violence Prevention Program, Kaiser Permanente Northern California, Oakland, California
| | - Nicole Stoller
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Carey Watson
- 3 Obstetrics and Gynecology, Kaiser Antioch Medical Center, Antioch, California
| | - Stacy Sterling
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Kathryn K Ridout
- 4 Department of Psychiatry, Kaiser Permanente San Jose, San Jose, California
| | - Tracy Flanagan
- 5 The Permanente Medical Group, Regional Offices, Kaiser Permanente Northern California, Oakland, California
| |
Collapse
|
22
|
Crawford B, Craig Z, Mansell G, White I, Smith A, Spaull S, Imm J, Hannon E, Wood A, Yaghootkar H, Ji Y, Mullins N, Lewis CM, Mill J, Murphy TM. DNA methylation and inflammation marker profiles associated with a history of depression. Hum Mol Genet 2018; 27:2840-2850. [PMID: 29790996 PMCID: PMC6680088 DOI: 10.1093/hmg/ddy199] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/30/2018] [Accepted: 05/16/2018] [Indexed: 11/13/2022] Open
Abstract
Depression is a common and disabling disorder, representing a major social and economic health issue. Moreover, depression is associated with the progression of diseases with an inflammatory etiology including many inflammatory-related disorders. At the molecular level, the mechanisms by which depression might promote the onset of these diseases and associated immune-dysfunction are not well understood. In this study we assessed genome-wide patterns of DNA methylation in whole blood-derived DNA obtained from individuals with a self-reported history of depression (n = 100) and individuals without a history of depression (n = 100) using the Illumina 450K microarray. Our analysis identified six significant (Šidák corrected P < 0.05) depression-associated differentially methylated regions (DMRs); the top-ranked DMR was located in exon 1 of the LTB4R2 gene (Šidák corrected P = 1.27 × 10-14). Polygenic risk scores (PRS) for depression were generated and known biological markers of inflammation, telomere length (TL) and IL-6, were measured in DNA and serum samples, respectively. Next, we employed a systems-level approach to identify networks of co-methylated loci associated with a history of depression, in addition to depression PRS, TL and IL-6 levels. Our analysis identified one depression-associated co-methylation module (P = 0.04). Interestingly, the depression-associated module was highly enriched for pathways related to immune function and was also associated with TL and IL-6 cytokine levels. In summary, our genome-wide DNA methylation analysis of individuals with and without a self-reported history of depression identified several candidate DMRs of potential relevance to the pathogenesis of depression and its associated immune-dysfunction phenotype.
Collapse
Affiliation(s)
- Bethany Crawford
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Zoe Craig
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK
| | - Georgina Mansell
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Isobel White
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Adam Smith
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Steve Spaull
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK
| | - Jennifer Imm
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Eilis Hannon
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Andrew Wood
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Hanieh Yaghootkar
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Yingjie Ji
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | | | - Niamh Mullins
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
- Division of Genetics and Molecular Medicine, King’s College London, London SE1 9RT, UK
| | - Jonathan Mill
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| | - Therese M Murphy
- University of Exeter Medical School, University of Exeter, EX2 5DW Exeter, UK
| |
Collapse
|
23
|
Ridout KK, Khan M, Ridout SJ. Adverse Childhood Experiences Run Deep: Toxic Early Life Stress, Telomeres, and Mitochondrial DNA Copy Number, the Biological Markers of Cumulative Stress. Bioessays 2018; 40:e1800077. [DOI: 10.1002/bies.201800077] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/20/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Kathryn K. Ridout
- Department of Psychiatry; Kaiser Permanente; San Jose CA 95123 USA
- Department of Psychiatry and Human Behavior; Alpert Medical School of Brown University; Providence RI 02906 USA
| | - Mariam Khan
- Oncology Clinical Trials Department; Kaiser Permanente; San Jose CA 95123 USA
| | - Samuel J. Ridout
- Department of Psychiatry; Kaiser Permanente; San Jose CA 95123 USA
| |
Collapse
|
24
|
Ridout KK, Levandowski M, Ridout SJ, Gantz L, Goonan K, Palermo D, Price LH, Tyrka AR. Early life adversity and telomere length: a meta-analysis. Mol Psychiatry 2018; 23:858-871. [PMID: 28322278 PMCID: PMC5608639 DOI: 10.1038/mp.2017.26] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/25/2016] [Accepted: 01/09/2017] [Indexed: 02/06/2023]
Abstract
Early adversity, in the form of abuse, neglect, socioeconomic status and other adverse experiences, is associated with poor physical and mental health outcomes. To understand the biologic mechanisms underlying these associations, studies have evaluated the relationship between early adversity and telomere length, a marker of cellular senescence. Such results have varied in regard to the size and significance of this relationship. Using meta-analytic techniques, we aimed to clarify the relationship between early adversity and telomere length while exploring factors affecting the association, including adversity type, timing and study design. A comprehensive search in July 2016 of PubMed/MEDLINE, PsycINFO and Web of Science identified 2462 studies. Multiple reviewers appraised studies for inclusion or exclusion using a priori criteria; 3.9% met inclusion criteria. Data were extracted into a structured form; the Newcastle-Ottawa Scale assessed study quality, validity and bias. Forty-one studies (N=30 773) met inclusion criteria. Early adversity and telomere length were significantly associated (Cohen's d effect size=-0.35; 95% CI, -0.46 to -0.24; P<0.0001). Sensitivity analyses revealed no outlier effects. Adversity type and timing significantly impacted the association with telomere length (P<0.0001 and P=0.0025, respectively). Subgroup and meta-regression analyses revealed that medication use, medical or psychiatric conditions, case-control vs longitudinal study design, methodological factors, age and smoking significantly affected the relationship. Comprehensive evaluations of adversity demonstrated more extensive telomere length changes. These results suggest that early adversity may have long-lasting physiological consequences contributing to disease risk and biological aging.
Collapse
Affiliation(s)
- Kathryn K. Ridout
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI, USA,Address Correspondence to: Kathryn K. Ridout, M.D.,
Ph.D., Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906. TEL: (401)
455-6270. FAX: (401) 455-6252.
| | - Mateus Levandowski
- Developmental Cognitive Neuroscience Lab, Pontifical Catholic
University of Rio Grande do Sul (PUCRS), Brazil
| | - Samuel J. Ridout
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI, USA
| | - Lindsay Gantz
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Kelly Goonan
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Daniella Palermo
- Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI, USA
| | - Lawrence H. Price
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI, USA
| | - Audrey R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI, USA
| |
Collapse
|
25
|
Khan RJ, Gebreab SY, Crespo PR, Xu R, Gaye A, Davis SK. Race-specific associations between health-related quality of life and cellular aging among adults in the United States: evidence from the National Health and Nutrition Examination Survey. Qual Life Res 2017; 26:2659-2669. [PMID: 28597109 PMCID: PMC5597687 DOI: 10.1007/s11136-017-1610-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE Poor health-related quality of life (HRQOL) could lead to higher morbidity and mortality through telomere attrition or accelerated cellular aging. We conducted a cross-sectional analysis to examine the relationship between four dimensions of HRQOL and leukocyte telomere length (LTL) among a nationally representative sample of 3547 US adults (≥20 years) using the data from the 2001-2002 National Health and Nutrition Examination Survey. METHOD We used HRQOL survey information collected on individuals' self-rated general health, recent physical health, recent mental health, and recent activity limitation. Telomere length was assessed using quantitative polymerase chain reaction. Multiple linear regressions were used to estimate the relationship between each dimension of HRQOL and log-transformed values of LTL with adjustment for sample weights and design effects. RESULTS HRQOL-race interactions were significant, and the results were stratified by race. After controlling for demographic factors, disease conditions, and lifestyle variables, worse general health was significantly associated with shorter LTL for Blacks (coefficient, β: -0.022, 95% Confidence Interval, 95% CI: -0.03 to -0.01), but not for Whites or Mexican Americans. Unwell physical health was associated with shorter telomere length for Whites (β: -0.005, 95% CI: -0.01 to -0.001) only. Unwell mental health showed no significant association with LTL in any race. CONCLUSIONS Although longitudinal studies are needed to prove causality, our findings suggest that HRQOL could be associated with LTL shortening. We also found a possible racial difference in this association and recommend additional multiethnic studies to confirm this and to understand the reasons and consequences of this difference.
Collapse
Affiliation(s)
- Rumana J Khan
- Genomics of Metabolic, Cardiovascular and Inflammatory Disease Branch, Social Epidemiology Research Unit, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316, MSC 1644, Bethesda, MD, 20892, USA.
| | - Samson Y Gebreab
- Genomics of Metabolic, Cardiovascular and Inflammatory Disease Branch, Social Epidemiology Research Unit, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316, MSC 1644, Bethesda, MD, 20892, USA
| | - Pia R Crespo
- Genomics of Metabolic, Cardiovascular and Inflammatory Disease Branch, Social Epidemiology Research Unit, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316, MSC 1644, Bethesda, MD, 20892, USA
| | - Ruihua Xu
- Genomics of Metabolic, Cardiovascular and Inflammatory Disease Branch, Social Epidemiology Research Unit, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316, MSC 1644, Bethesda, MD, 20892, USA
| | - Amadou Gaye
- Genomics of Metabolic, Cardiovascular and Inflammatory Disease Branch, Social Epidemiology Research Unit, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316, MSC 1644, Bethesda, MD, 20892, USA
| | - Sharon K Davis
- Genomics of Metabolic, Cardiovascular and Inflammatory Disease Branch, Social Epidemiology Research Unit, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316, MSC 1644, Bethesda, MD, 20892, USA
| |
Collapse
|
26
|
Kronenberg G, Schöner J, Nolte C, Heinz A, Endres M, Gertz K. Charting the perfect storm: emerging biological interfaces between stress and stroke. Eur Arch Psychiatry Clin Neurosci 2017; 267:487-494. [PMID: 28393267 PMCID: PMC5561158 DOI: 10.1007/s00406-017-0794-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/25/2017] [Indexed: 12/20/2022]
Abstract
A growing body of evidence demonstrates that psychosocial stress is an important and often underestimated risk factor for cardiovascular disease such as myocardial infarction and stroke. In this article, we map out major biological interfaces between stress, stress-related psychiatric disorders, and stroke, placing special emphasis on the fact that stress and psychiatric disorders may be both cause and consequence of cardiovascular disease. Apart from high-risk lifestyle habits such as smoking and lack of exercise, neuroendocrine dysregulation, alterations of the hemostatic system, increased oxidative stress, and inflammatory changes have been implicated in stress-related endothelial dysfunction. Heart rate provides another useful and easily available measure that reflects the complex interplay of vascular morbidity and psychological distress. Importantly, heart rate is emerging as a valuable predictor of stroke outcome and, possibly, even a target for therapeutic intervention. Furthermore, we review recent findings highlighting the role of FK506-binding protein 51 (FKBP5), a co-chaperone of the glucocorticoid receptor, and of perturbations in telomere maintenance, as potential mediators between stress and vascular morbidity. Finally, psychiatric sequelae of cardiovascular events such as post-stroke depression or posttraumatic stress disorder are highly prevalent and may, in turn, exert far-reaching effects on recovery and outcome, quality of life, recurrent ischemic events, medication adherence, and mortality.
Collapse
Affiliation(s)
- G. Kronenberg
- 0000 0000 9737 0454grid.413108.fKlinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock, Rostock, Germany ,0000 0001 2218 4662grid.6363.0Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany ,0000 0001 2218 4662grid.6363.0Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J. Schöner
- 0000 0001 2218 4662grid.6363.0Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany ,0000 0001 2218 4662grid.6363.0Klinik und Poliklinik für Neurologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany ,0000 0001 2218 4662grid.6363.0Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - C. Nolte
- 0000 0001 2218 4662grid.6363.0Klinik und Poliklinik für Neurologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany ,0000 0001 2218 4662grid.6363.0Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A. Heinz
- 0000 0001 2218 4662grid.6363.0Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - M. Endres
- 0000 0001 2218 4662grid.6363.0Klinik und Poliklinik für Neurologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany ,0000 0001 2218 4662grid.6363.0Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany ,0000 0004 0438 0426grid.424247.3German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ,grid.452396.fGerman Center for Cardiovascular Research (DZHK), Berlin, Germany
| | - Karen Gertz
- Klinik und Poliklinik für Neurologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. .,Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany.
| |
Collapse
|
27
|
Hammadah M, Al Mheid I, Wilmot K, Ramadan R, Abdelhadi N, Alkhoder A, Obideen M, Pimple PM, Levantsevych O, Kelli HM, Shah A, Sun YV, Pearce B, Kutner M, Long Q, Ward L, Ko YA, Hosny Mohammed K, Lin J, Zhao J, Bremner JD, Kim J, Waller EK, Raggi P, Sheps D, Quyyumi AA, Vaccarino V. Telomere Shortening, Regenerative Capacity, and Cardiovascular Outcomes. Circ Res 2016; 120:1130-1138. [PMID: 27956416 PMCID: PMC5376244 DOI: 10.1161/circresaha.116.309421] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/22/2016] [Accepted: 12/12/2016] [Indexed: 01/04/2023]
Abstract
RATIONALE Leukocyte telomere length (LTL) is a biological marker of aging, and shorter LTL is associated with adverse cardiovascular outcomes. Reduced regenerative capacity has been proposed as a mechanism. Bone marrow-derived circulating progenitor cells are involved in tissue repair and regeneration. OBJECTIVE Main objective of this study was to examine the relationship between LTL and progenitor cells and their impact on adverse cardiovascular outcomes. METHODS AND RESULTS We measured LTL by quantitative polymerase chain reaction in 566 outpatients (age: 63±9 years; 76% men) with coronary artery disease. Circulating progenitor cells were enumerated by flow cytometry. After adjustment for age, sex, race, body mass index, smoking status, and previous myocardial infarction, a shorter LTL was associated with a lower CD34+ cell count: for each 10% shorter LTL, CD34+ levels were 5.2% lower (P<0.001). After adjustment for the aforementioned factors, both short LTL (<Q1) and low CD34+ levels (<Q1) predicted adverse cardiovascular outcomes (death, myocardial infarction, coronary revascularization, or cerebrovascular events) independently of each other, with a hazard ratio of 1.8 and 95% confidence interval of 1.1 to 2.0, and a hazard ratio of 2.1 and 95% confidence interval of 1.3 to 3.0, respectively, comparing Q1 to Q2-4. Patients who had both short LTL (<Q1) and low CD34+ cell count (<Q1) had the greatest risk of adverse outcomes (hazard ratio =3.5; 95% confidence interval, 1.7-7.1). CONCLUSIONS Although shorter LTL is associated with decreased regenerative capacity, both LTL and circulating progenitor cell levels are independent and additive predictors of adverse cardiovascular outcomes in coronary artery disease patients. Our results suggest that both biological aging and reduced regenerative capacity contribute to cardiovascular events, independent of conventional risk factors.
Collapse
Affiliation(s)
- Muhammad Hammadah
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Ibhar Al Mheid
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Kobina Wilmot
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Ronnie Ramadan
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Naser Abdelhadi
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Ayman Alkhoder
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Malik Obideen
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Pratik M Pimple
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Oleksiy Levantsevych
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Heval M Kelli
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Amit Shah
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Yan V Sun
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Brad Pearce
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Michael Kutner
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Qi Long
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Laura Ward
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Yi-An Ko
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Kareem Hosny Mohammed
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Jue Lin
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Jinying Zhao
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - J Douglas Bremner
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Jinhee Kim
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Edmund K Waller
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Paolo Raggi
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - David Sheps
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Arshed A Quyyumi
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Viola Vaccarino
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.).
| |
Collapse
|
28
|
Levandowski ML, Tractenberg SG, de Azeredo LA, De Nardi T, Rovaris DL, Bau CHD, Rizzo LB, Maurya PK, Brietzke E, Tyrka AR, Grassi-Oliveira R. Crack cocaine addiction, early life stress and accelerated cellular aging among women. Prog Neuropsychopharmacol Biol Psychiatry 2016; 71:83-9. [PMID: 27346744 DOI: 10.1016/j.pnpbp.2016.06.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/19/2016] [Accepted: 06/19/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Early life stress (ELS) and addiction are related to age-related diseases and telomere shortening. However, the role of telomere length (TL) in crack cocaine addiction remains unknown. The purpose of this study was to investigate the TL in a sample of crack cocaine dependent-women who reported an ELS history and in a community-based sample of elderly women as a reference group for senescence. METHODS This study included treatment seeking crack cocaine dependents women (n=127) and elderly women without a psychiatric diagnosis (ELD, n=49). The crack cocaine sample was divided in two groups according to their Childhood Trauma Questionnaire (CTQ) scores: presence of history of childhood abuse and neglect (CRACK-ELS) and absence of ELS history (CRACK). TL was assessed by T/S ratio obtained from peripheral blood DNA using quantitative PCR assay. RESULTS CRACK and CRACK-ELS subjects exhibited shortened TL in comparison to the ELD group, despite their younger age. Among crack cocaine sample, CRACK-ELS group had significantly shorter telomeres than the CRACK group. Correlation analysis within crack cocaine group indicated that TL was negatively correlated with emotional abuse scores. CONCLUSIONS These results support previous findings associating telomere shortening with both ELS and drug addiction. This study suggests new evidence of a distinct biological phenotype for drug-dependent women with ELS. The results support the biological senescence hypothesis underpinning ELS experience.
Collapse
Affiliation(s)
- Mateus Luz Levandowski
- Developmental Cognitive Neuroscience Lab (DCNL), Biomedical Research Institute (IPB), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil
| | - Saulo Gantes Tractenberg
- Developmental Cognitive Neuroscience Lab (DCNL), Biomedical Research Institute (IPB), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil
| | - Lucas Araújo de Azeredo
- Developmental Cognitive Neuroscience Lab (DCNL), Biomedical Research Institute (IPB), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil
| | - Tatiana De Nardi
- Developmental Cognitive Neuroscience Lab (DCNL), Biomedical Research Institute (IPB), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil
| | - Diego L Rovaris
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Lucas B Rizzo
- Research Group in Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Pawan Kumar Maurya
- Research Group in Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Elisa Brietzke
- Research Group in Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Audrey R Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Department of Psychiatry and Human Behavior, Brown University, USA
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab (DCNL), Biomedical Research Institute (IPB), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil
| |
Collapse
|
29
|
Childhood adversity and epigenetic regulation of glucocorticoid signaling genes: Associations in children and adults. Dev Psychopathol 2016; 28:1319-1331. [PMID: 27691985 DOI: 10.1017/s0954579416000870] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Early childhood experiences have lasting effects on development, including the risk for psychiatric disorders. Research examining the biologic underpinnings of these associations has revealed the impact of childhood maltreatment on the physiologic stress response and activity of the hypothalamus-pituitary-adrenal axis. A growing body of literature supports the hypothesis that environmental exposures mediate their biological effects via epigenetic mechanisms. Methylation, which is thought to be the most stable form of epigenetic change, is a likely mechanism by which early life exposures have lasting effects. We present recent evidence related to epigenetic regulation of genes involved in hypothalamus-pituitary-adrenal axis regulation, namely, the glucocorticoid receptor gene (nuclear receptor subfamily 3, group C, member 1 [NR3C1]) and FK506 binding protein 51 gene (FKBP5), after childhood adversity and associations with risk for psychiatric disorders. Implications for the development of interventions and future research are discussed.
Collapse
|
30
|
Abstract
A growing body of evidence suggests that alterations of the stress response system may be a mechanism by which childhood maltreatment alters risk for psychopathology. FK506 binding protein 51 (FKBP5) binds to the glucocorticoid receptor and alters its ability to respond to stress signaling. The aim of the present study was to examine methylation of the FKBP5 gene (FKBP5), and the role of an FKBP5 genetic variant, in relation to childhood maltreatment in a sample of impoverished preschool-aged children. One hundred seventy-four families participated in this study, including 69 with child welfare documentation of moderate to severe maltreatment in the past 6 months. The children, who ranged in age from 3 to 5 years, were racially and ethnically diverse. Structured record review and interviews in the home were used to assess a history of maltreatment, other traumas, and contextual life stressors; and a composite variable assessed the number exposures to these adversities. Methylation of two sites in intron 7 of FKBP5 was measured via sodium bisulfite pyrosequencing. Maltreated children had significantly lower levels of methylation at both CpG sites (p < .05). Lifetime contextual stress exposure showed a trend for lower levels of methylation at one of the sites, and a trend for an interaction with the FKBP5 polymorphism. A composite adversity variable was associated with lower levels of methylation at one of the sites as well (p < .05). FKBP5 alters glucocorticoid receptor responsiveness, and FKBP5 gene methylation may be a mechanism of the biobehavioral effects of adverse exposures in young children.
Collapse
|
31
|
Ridout KK, Ridout SJ, Price LH, Sen S, Tyrka AR. Depression and telomere length: A meta-analysis. J Affect Disord 2016; 191:237-47. [PMID: 26688493 PMCID: PMC4760624 DOI: 10.1016/j.jad.2015.11.052] [Citation(s) in RCA: 168] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/06/2015] [Accepted: 11/30/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND Several recent studies have investigated the relationship between telomere length and depression with inconsistent results. This meta-analysis examined whether telomere length and depression are associated and explored factors that might affect this association. METHODS Studies measuring telomere length in subjects with clinically significant unipolar depression were included. A comprehensive search strategy identified studies in PubMed, MEDLINE, PsycINFO, Global Health, The Cochrane Library, and Web of Science. A structured data abstraction form was used and studies were appraised for inclusion or exclusion using a priori conditions. Analyses were conducted using standardized mean differences in a continuous random effects model. RESULTS Thirty-eight studies (N=34,347) met the inclusion criteria. The association between depression and telomere length was significant, with a Cohen's d effect size of -0.205 (p<0.0001, I(2)=42%). Depression severity significantly associated with telomere length (p=0.03). Trim and fill analysis indicated the presence of publication bias (p=0.003), but that the association remained highly significant after accounting for the bias. Subgroup analysis revealed depression assessment tools, telomere measurement techniques, source tissue and comorbid medical conditions significantly affected the relationship. LIMITATIONS Other potentially important sub-groups, including antidepressant use, have not been investigated in sufficient detail or number yet and thus were not addressed in this meta-analysis. CONCLUSIONS There is a negative association between depression and telomere length. Further studies are needed to clarify potential causality underlying this association and to elucidate the biology linking depression and this cellular marker of stress exposure and aging.
Collapse
Affiliation(s)
- Kathryn K. Ridout
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI,Address Correspondence to: Kathryn K. Ridout, M.D.,
Ph.D., Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906. TEL: (401)
455-6270. FAX: (401) 455-6252.
| | - Samuel J. Ridout
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI
| | - Lawrence H. Price
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute and Department of
Psychiatry, University of Michigan, Ann Arbor, MI
| | - Audrey R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and
Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School
of Brown University, Providence, RI
| |
Collapse
|
32
|
Montalvo-Ortiz JL, Gelernter J, Hudziak J, Kaufman J. RDoC and translational perspectives on the genetics of trauma-related psychiatric disorders. Am J Med Genet B Neuropsychiatr Genet 2016; 171B:81-91. [PMID: 26592203 PMCID: PMC4754782 DOI: 10.1002/ajmg.b.32395] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/09/2015] [Indexed: 01/01/2023]
Abstract
Individuals with a history of child abuse are at high risk for depression, anxiety disorders, aggressive behavior, and substance use problems. The goal of this paper is to review studies of the genetics of these stress-related psychiatric disorders. An informative subset of studies that examined candidate gene by environment (GxE) predictors of these psychiatric problems in individuals maltreated as children is reviewed, together with extant genome wide association studies (GWAS). Emerging findings on epigenetic changes associated with adverse early experiences are also reviewed. Meta-analytic support and replicated findings are evident for several genetic risk factors; however, extant research suggests the effects are pleiotropic. Genetic factors are not associated with distinct psychiatric disorders, but rather diverse clinical phenotypes. Research also suggests adverse early life experiences are associated with changes in gene expression of multiple known candidate genes, genes involved in DNA transcription and translation, and genes necessary for brain circuitry development, with changes in gene expression reported in key brain structures implicated in the pathophysiology of psychiatric and substance use disorders. The finding of pleiotropy highlights the value of using the Research Domain Criteria (RDoC) framework in future studies of the genetics of stress-related psychiatric disorders, and not trying simply to link genes to multifaceted clinical syndromes, but to more limited phenotypes that map onto distinct neural circuits. Emerging work in the field of epigenetics also suggests that translational studies that integrate numerous unbiased genome-wide approaches will help to further unravel the genetics of stress-related psychiatric disorders.
Collapse
Affiliation(s)
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut,Veteran's Administration Connecticut Health Care Center, Newington, Connecticut
| | - James Hudziak
- Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, Vermont
| | - Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, Maryland,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland,Correspondence to: Joan Kaufman, Ph.D., Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1750 East Fairmont Street, Baltimore, MD 21231.
| |
Collapse
|
33
|
|