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Rivera Gómez AK, Perafán Collazos JF, Prieto JL, Pinzón PV, Ávila González GI, Nino Castaño VE, Dueñas Cuellar RA. Prolonged chronic academic stress and its relationship with cytokine dysregulation in health science students. Stress Health 2024; 40:e3363. [PMID: 38146787 DOI: 10.1002/smi.3363] [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: 05/06/2022] [Revised: 10/20/2023] [Accepted: 12/03/2023] [Indexed: 12/27/2023]
Abstract
Academic stress is a problem that affects students due to a number of factors that are considered stressors. These include academic overload and completion of assignments and exams, exacerbated by such external conditions as family, social and economic problems. Together, these can affect emotional and physical health, which may lead in the long term to developing a number of pathologies, given the alteration of immunological homoeostasis with which they are related. OBJECTIVE To evaluate the effect of academic stress on the production of cytokines IL-6, TNF-α, IL-1β and IL-10 in Morphology students in the Faculty of Health Sciences of the Universidad del Cauca during an academic period. METHODOLOGY A descriptive longitudinal study was carried out with a population of 78 students studying Morphology, among the subjects with the highest academic load in the Physiotherapy, Medicine, Nursing and Phonoaudiology programs in the Faculty. Academic stress was assessed in the students by applying the Academic Stress Questionnaire (ASQ), and through quantification of the IL-6, TNF-α, IL-1β and IL-10 cytokines using the ELISA (Enzyme-linked immunosorbent assay) technique in three "moments" of the academic semester: Moment 1: beginning of the academic semester; Moment 2: week of evaluations of 70% of the semester; Moment 3: week of final exams. RESULTS The students perceived stress as "normal" at Moment 1, while at Moments 2 and 3 it was perceived as "quite a lot", with percentages of 48.7% and 50%, respectively. The predominant stressors were: "methodological deficiencies", "academic overload", and "exams", for the three moments of the study. "Physical exhaustion" was the most prevalent stress response at all three moments, followed by "irascible behaviour" (Moment 2 and 3), and "sleep disturbances" (Moment 3). To cope with the stress, the students resorted mainly to "planning and management of personal resources" in the three moments of the study. A progressive increase in the pro-inflammatory cytokines IL-6 and TNF-α and a decrease in IL-10 were observed at all three moments. A correlation was found between some questions belonging to the "methodological deficiencies", "beliefs about performance", "sleep disturbances", "physical exhaustion" and "irascible behaviour" dimensions with IL-6, IL-1β, TNF-α and IL. -10. CONCLUSION The morphology students suffer increased stress indicators (perceived stress and pro-inflammatory cytokines) throughout the academic period. The "methodological deficiencies", "academic overload" and "exams" stressors, together with "physical exhaustion", "sleep disturbances" and "irascible behaviour", possibly influence the production of the IL-6, TNF-α and IL-10 cytokines.
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Affiliation(s)
- Angie Katherine Rivera Gómez
- Research Group in Immunology and Infectious Diseases, Medicine Program, Department of Pathology, Faculty of Health Sciences, Universidad del Cauca, Popayán, Colombia
| | | | - Jerónimo Londoño Prieto
- Human Body Movement Research Group, Physiotherapy Program, Faculty of Health Sciences, Universidad del Cauca, Popayán, Colombia
| | - Paola Vernaza Pinzón
- Human Body Movement Research Group, Physiotherapy Program, Faculty of Health Sciences, Universidad del Cauca, Popayán, Colombia
| | - Gloria Inés Ávila González
- Research Group in Immunology and Infectious Diseases, Medicine Program, Department of Pathology, Faculty of Health Sciences, Universidad del Cauca, Popayán, Colombia
| | - Victoria Eugenia Nino Castaño
- Research Group in Immunology and Infectious Diseases, Medicine Program, Department of Pathology, Faculty of Health Sciences, Universidad del Cauca, Popayán, Colombia
| | - Rosa Amalia Dueñas Cuellar
- Research Group in Immunology and Infectious Diseases, Medicine Program, Department of Pathology, Faculty of Health Sciences, Universidad del Cauca, Popayán, Colombia
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Ahmed F, Dubey DK, Garg R, Srivastava R. Effects of examination-induced stress on memory and blood pressure. J Family Med Prim Care 2023; 12:2757-2762. [PMID: 38186846 PMCID: PMC10771144 DOI: 10.4103/jfmpc.jfmpc_925_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/08/2023] [Accepted: 07/25/2023] [Indexed: 01/09/2024] Open
Abstract
Stress has been defined in many ways as a state of psychological arousal that results when the external demand is beyond what one can cope with. Stress is caused by various factors called stressors. Medical students are subjected to different kinds of stressors, such as pressure of academics with obligation to succeed, an uncertain future and difficulties of integrating into the system and different teaching protocols, which may affect their learning ability and performance. Stress has a great impact on brain mainly in the form of impaired memory and on cardiovascular function in the form of increased heart rate and blood pressure. The study was planned to assess the effects of examination induced stress on memory and blood pressure. The study was longitudinal in nature conducted at Department of Physiology, Santosh Medical College, Ghaziabad, India. Initially 100 subjects were selected from 17-24 years of age group then all the subjects were divided into two groups of 'slow-learners' and 'fast-learners' based upon their past academic performances. Readings were taken at two stages of academic year, 05 months before pre-prof examination and 03 days before pre-prof examination. Blood Pressure were measured and the memory assessments were done by using 10 subtests of PGI memory scale. We found a significant increase in stress level 3 days before the examination, compared to 5 months before the examination which in turn affected both blood pressure and memory functions. But, slow-learners were affected more compared to fast-learners.
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Affiliation(s)
- Firoz Ahmed
- Department of Physiology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Dinesh K. Dubey
- Department of Physiology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Rinku Garg
- Department of Physiology, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Rani Srivastava
- Department of Psychology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
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Rai R, Nahar M, Jat D, Gupta N, Mishra SK. A systematic assessment of stress insomnia as the high-risk factor for cervical cancer and interplay of cervicovaginal microbiome. Front Cell Infect Microbiol 2022; 12:1042663. [PMID: 36560927 PMCID: PMC9763463 DOI: 10.3389/fcimb.2022.1042663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Cervical cancer is a dreaded form of cancer in women, the fourth most common cancer, with around 0.3 million females suffering from this disease worldwide. Over the past several decades, global researches have focused on the mitigation of cervical lesions and cancers and have explored the impact of physiological and psychological stress and insomnia on cervical pathogenesis. Furthermore, disruption of the cervicovaginal microbiome profiles is identified as an added high-risk factor for the occurrence of cervical cancer. The physiological regulation of stress has an underlying mechanism controlled via hypothalamic pituitary adrenal (HPA) and sympatho-adrenal medullary (SAM) axes. Disruptions in these axes have been identified as the factors responsible for maintaining the homeostasis balance. Recent studies on microbiomes have offered novel ways to combat cervical cancer and cervix infection by exploring the interplay of the cervicovaginal microbiome. Moreover, the integration of various immune cells and microbiome diversity is known to act as an effective strategy to decipher the cervix biological activity. Cytokine profiling and the related immune competence, and physiological stress and insomnia impart to the regulatory networks underlying the mechanism which may be helpful in designing mitigation strategies. This review addressed the current progress in the research on cervical cancer, HPV infection, immune cell interaction, and physiological stress and insomnia with the cervicovaginal microbiome to decipher the disease occurrence and therapeutic management.
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Affiliation(s)
- Ravina Rai
- Department of Zoology, School of Biological Sciences, Dr. Harisingh Gour Central University, Sagar, India
| | - Manisha Nahar
- Department of Zoology, School of Biological Sciences, Dr. Harisingh Gour Central University, Sagar, India
| | - Deepali Jat
- Department of Zoology, School of Biological Sciences, Dr. Harisingh Gour Central University, Sagar, India,*Correspondence: Siddhartha Kumar Mishra, ; Deepali Jat,
| | - Neelima Gupta
- Vice-Chancellor, Dr. Harisinsgh Gour Central University, Sagar, India
| | - Siddhartha Kumar Mishra
- Department of Biochemistry, University of Lucknow, Lucknow, India,*Correspondence: Siddhartha Kumar Mishra, ; Deepali Jat,
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Gellisch M, Wolf OT, Minkley N, Kirchner WH, Brüne M, Brand-Saberi B. Decreased sympathetic cardiovascular influences and hormone-physiological changes in response to Covid-19-related adaptations under different learning environments. ANATOMICAL SCIENCES EDUCATION 2022; 15:811-826. [PMID: 35968688 DOI: 10.1002/ase.2213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/07/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
To examine the implications of the transition from face-to-face to online learning from a psychobiological perspective, this study investigated potential differences in physiological stress parameters of students engaged in online or face-to-face learning and determined whether these can be identified as possible mediators between learning experience and achievement emotions. In a randomized experimental field study, medical students (n = 82) attended either regular face-to-face classes of the microscopic anatomy course or the same practical course online using Zoom videoconferencing platform. The present study investigated Heart Rate Variability (HRV) and salivary cortisol concentration as stress correlates, within the contexts of online and face-to-face learning and compared these parameters with a control group that was measured at rest. Additionally, participants completed a standardized questionnaire about their experienced emotions in relation to task achievement and subjective stress levels. A significant reduction in HRV was found in face-to-face learning, suggesting stronger stress responses in the face-to-face learning environment (η2 = 0.421, P < 0.001). Furthermore, participants engaged in face-to-face learning showed significantly higher cortisol concentrations (η2 = 0.115, P = 0.032). Additionally, increased sympathetic activation correlated with the discrete positive emotion of enjoyment exclusively within the face-to-face condition (r = 0.365, P = 0.043). These results indicate that the transfer of a face-to-face practical course in microscopic anatomy to an online learning environment is associated with decreased sympathetic and enhanced vagal cardiovascular influences, together with lower cortisol concentrations in healthy medical students.
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Affiliation(s)
- Morris Gellisch
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Nina Minkley
- Behavioral Biology and Biology Education, Faculty of Biology and Biotechnology, Ruhr University Bochum, Bochum, Germany
| | - Wolfgang H Kirchner
- Behavioral Biology and Biology Education, Faculty of Biology and Biotechnology, Ruhr University Bochum, Bochum, Germany
| | - Martin Brüne
- Department of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Landschaftsverband Westfalen-Lippe (LWL) University Hospital of Ruhr University Bochum, Bochum, Germany
| | - Beate Brand-Saberi
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany
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Correia AS, Vale N. Tryptophan Metabolism in Depression: A Narrative Review with a Focus on Serotonin and Kynurenine Pathways. Int J Mol Sci 2022; 23:ijms23158493. [PMID: 35955633 PMCID: PMC9369076 DOI: 10.3390/ijms23158493] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023] Open
Abstract
Depression is a common and serious disorder, characterized by symptoms like anhedonia, lack of energy, sad mood, low appetite, and sleep disturbances. This disease is very complex and not totally elucidated, in which diverse molecular and biological mechanisms are involved, such as neuroinflammation. There is a high need for the development of new therapies and gaining new insights into this disease is urgent. One important player in depression is the amino acid tryptophan. This amino acid can be metabolized in two important pathways in the context of depression: the serotonin and kynurenine pathways. These metabolic pathways of tryptophan are crucial in several processes that are linked with depression. Indeed, the maintenance of the balance of serotonin and kynurenine pathways is critical for the human physiological homeostasis. Thus, this narrative review aims to explore tryptophan metabolism (particularly in the serotonin and kynurenine pathways) in depression, starting with a global overview about these topics and ending with the focus on these pathways in neuroinflammation, stress, microbiota, and brain-derived neurotrophic factor regulation in this disease. Taken together, this information aims to clarify the metabolism of tryptophan in depression, particularly the serotonin and kynurenine pathways.
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Affiliation(s)
- Ana Salomé Correia
- OncoPharma Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Nuno Vale
- OncoPharma Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- Correspondence: ; Tel.: +351-220426537
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Al Saedi A, Chow S, Vogrin S, Guillemin GJ, Duque G. Association Between Tryptophan Metabolites, Physical Performance, and Frailty in Older Persons. Int J Tryptophan Res 2022; 15:11786469211069951. [PMID: 35125874 PMCID: PMC8808031 DOI: 10.1177/11786469211069951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/11/2021] [Indexed: 11/22/2022] Open
Abstract
Frailty is defined as a syndrome of physiological decline in late life, characterized by marked vulnerability to adverse health outcomes. A robust biomarker for frailty is still lacking. Tryptophan (TRP) metabolism through the kynurenine pathway (KP) plays essential roles in aging, the musculoskeletal system, and physical performance. In this study, we quantified 7 KP metabolites, including kynurenine (KYN), kynurenine acid (KYNA), quinolinic acid (QUIN), picolinic acid (PIC), 3-hydroxykynurenine (3-HK), 3-hydroxyanthranilic acid (3-HAA), and anthranilic acid (AA) using ultra-high-performance liquid chromatography and gas chromatography-mass spectrometry in the serum of 85 participants (median age 75; 65% female; 28 non-frail, 29 pre-frail, and 28 frail) at the Nepean Osteoporosis and Frailty (NOF) Study. We looked at the association between TRP metabolites and physical performance, sarcopenia, and frailty. After adjusting for age and sex, our results showed that KYN and KYN/TRP were associated with higher interleukin (IL)-6 levels (r = .324 and r = .390, respectively). KYNA and its ratios to other products (mainly KYNA/KYN, KYNA/QUIN, and KYNA/PIC) were associated with a lower likelihood of frailty by Fried’s criteria (OR 0.93 [0.88, 0.98], P = .009) and Rockwood index (r = −.241, P = .028) as well as a lower likelihood of sarcopenia (OR 0.88 [0.78, 1.00], P = .049). QUIN and QUIN/KYN showed an association with increased IL-6 (r = .293 and .204 respectively), higher likelihood of frailty (OR 1.02 [1.00, 1.04], P = .029 and OR 6.43 [2.23, 18.51], P = .001 respectively) and lower physical function (r = −.205 and r = −.292). In conclusion, different TRP metabolites have various associations with physical performance, frailty, and sarcopenia. Defining the underlying mechanisms may permit the development and validation of new biomarkers and therapeutics for frailty and musculoskeletal conditions targeting specific metabolites of the TRP catabolic pathway.
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Affiliation(s)
- Ahmed Al Saedi
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St. Albans, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St. Albans, VIC, Australia
| | - Sharron Chow
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St. Albans, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St. Albans, VIC, Australia
| | - Gilles J Guillemin
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St. Albans, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St. Albans, VIC, Australia
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Zhvania M, Japaridze N, Tizabi Y, Sharikadze I, Pochkhidze N, Cheishvili L. Anxiety and ultrastructural consequences of chronic mild stress in rats. Neurosci Lett 2021; 771:136390. [PMID: 34896437 DOI: 10.1016/j.neulet.2021.136390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/05/2021] [Indexed: 10/19/2022]
Abstract
Detrimental consequences following exposure to severe stress, either acute or chronic are well recognized. Chronic mild stress (CMS) is also a leading cause of emotional distress and neuropsychiatric conditions such as anxiety disorders. However, the neurobiological substrates of the latter, particularly at the ultrastructural levels have not been adequately investigated. In this study, adult male Wistar rats were subjected to 4 h daily mild restraint for 20 days and their behavior in open field and elevated plus maze (EPM) were evaluated 24 h after the last restraint. Anxiety-like behavior was evident in CMS exposed rats by increases in rearing and grooming in the open field and the avoidance of open arms in the EPM. Concomitant ultrastructural alterations such as chromatolysis, agglutination of synaptic vesicles or mitochondrial damage were also observed in the central nucleus of amygdala (CNA), an area intimately involved in emotional and fear response, in CMS exposed rats. These results while confirming detrimental consequences of CMS, also suggest that ultrastructural alterations in CNA may be a basis for CMS-induced anxiety.
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Affiliation(s)
- Mzia Zhvania
- School of Natural Sciences and Medicine, Ilia State University. 3/5 K. Cholokashvili Avenue, Tbilisi 0162, Georgia; Department of Brain Ultrastructure and Nanoarchitecture I. Beritashvili Center of Experimental Biomedicine. 14 Gotua Street, Tbilisi 0160, Georgia.
| | - Nadezhda Japaridze
- Department of Brain Ultrastructure and Nanoarchitecture I. Beritashvili Center of Experimental Biomedicine. 14 Gotua Street, Tbilisi 0160, Georgia; School of Medicine, New Vision University. 1A Evgeni Mikeladze Street, Tbilisi 0159, Georgia
| | - Yousef Tizabi
- Department of Pharmacology, Howard University College of Medicine, Washington, DC, USA
| | - Irina Sharikadze
- School of Natural Sciences and Medicine, Ilia State University. 3/5 K. Cholokashvili Avenue, Tbilisi 0162, Georgia
| | - Nino Pochkhidze
- School of Natural Sciences and Medicine, Ilia State University. 3/5 K. Cholokashvili Avenue, Tbilisi 0162, Georgia; Department of Brain Ultrastructure and Nanoarchitecture I. Beritashvili Center of Experimental Biomedicine. 14 Gotua Street, Tbilisi 0160, Georgia
| | - Levan Cheishvili
- School of Natural Sciences and Medicine, Ilia State University. 3/5 K. Cholokashvili Avenue, Tbilisi 0162, Georgia
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Herhaus B, Joisten N, Wessels I, Zimmer P, Petrowski K. How acute physical and psychological stress differentially influence the kynurenine pathway: A randomized cross-over trial. Psychoneuroendocrinology 2021; 134:105433. [PMID: 34695711 DOI: 10.1016/j.psyneuen.2021.105433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/30/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
Psychological stress is associated with the pathogenesis of several neuropsychiatric disorders. In contrast, physical stress, as provoked by exercise, counteracts symptoms and potentially also disease progression. The kynurenine pathway, which is imbalanced in neuropsychiatric disorders, responds to both psychological and physical stress. Here, we compared the acute effects of psychological versus physical stress on the kynurenine pathway and inflammatory mediators. Thirty-five healthy males (mean age: 24.09±3.39 years) underwent both the Trier Social Stress Test (psychological stressor) and the Wingate-Test (physical stressor). The kinetics of tryptophan and its metabolites as well as cytokines IL-6, IFN-γ, TNF-α, and IL-10 were measured before and after the two stress conditions. After both stressors, there was a significant change over time for the kinetics of tryptophan metabolites and for cytokines. Furthermore, the reactivity of kynurenine pathway metabolite ratios and cytokines was statistically greater after physical stress than after psychological stress. The increased metabolic flux towards kynurenic acid following acute physical stress suggests an exercise-induced neuroprotective mechanism. Despite the paradoxical influence of both stressors on neuropsychiatric diseases, the acute kynurenine pathway reactivity appears to be similar, although effects were more pronounced in response to physical stress.
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Affiliation(s)
- Benedict Herhaus
- Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Niklas Joisten
- Division of Performance and Health (Sports Medicine), Department for Sport and Sport Science, TU Dortmund University, Dortmund, Germany.
| | - Inga Wessels
- Institute of Immunology, Medical Faculty, RWTH Aachen University, Aachen, Nordrhein-Westfalen, Germany
| | - Philipp Zimmer
- Division of Performance and Health (Sports Medicine), Department for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Myint K, Jacobs K, Myint AM, Lam SK, Lim YAL, Boey CCM, Hoe SZ, Guillemin GJ. Psychological Stresses in Children Trigger Cytokine- and Kynurenine Metabolite-Mediated Abdominal Pain and Proinflammatory Changes. Front Immunol 2021; 12:702301. [PMID: 34539633 PMCID: PMC8442661 DOI: 10.3389/fimmu.2021.702301] [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: 04/29/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Recurrent abdominal pain (RAP) is a common medically unexplained symptom among children worldwide. However, the biological mechanisms behind the development of functional and behavioral symptoms and changes in blood markers have not been well explored. This study aimed to assess changes in the concentrations of inflammatory markers, including cytokines and tryptophan catabolites, in the serum of children with RAP compared to those with subclinical infections. Children with RAP but without organic diseases were included, and those with asymptomatic intestinal parasitic infections were used as a subclinical infection cohort. Blood samples were collected and used to measure the cytokine profile using Multiplex Immunoassay and tryptophan catabolites using high performance liquid chromatography. Children with RAP showed significantly higher concentrations of serum tumor necrotic factor-α, p<0.05, but lower concentrations of IL-10, p<0.001, IL-6, p<0.001 and brain-derived neurotrophic factors (BDNF) p<0.01. In addition, a significant increase in the metabolite of the kynurenine pathway, 3-hydroxyanthranilic acid (3-HAA) p<0.01, a significant decrease in the concentrations of anthranilic acid (AA) p<0.001, together with an increased ratio of serum 3-HAA to AA (3-HAA/AA) p<0.001, was found in this cohort. These findings indicate the significant activation of the immune system and presence of inflammation in children with RAP than those with subclinical parasitic infections. Moreover, children with RAP tested with the Strengths and Difficulties Questionnaire (SDQ), displayed high psychological problems though these SDQ scores were not statistically associated with measured cytokines and kynurenine metabolites. We however could hypothesize that the pro-inflammatory state together with concomitant low concentrations of BDNF in those children with RAP could play a role in psychological stress and experiencing medically unexplained symptoms.
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Affiliation(s)
- Kyaimon Myint
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kelly Jacobs
- Neuroinflammation Group, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Aye-Mu Myint
- Psychoneuroimmunology Research Group, European Collaborative Project, Munich, Germany
| | - Sau Kuen Lam
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Malaysia
| | - Yvonne Ai-Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - See Ziau Hoe
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Gilles J Guillemin
- Neuroinflammation Group, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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