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Marsland AL, Walsh C, Lockwood K, John-Henderson NA. The effects of acute psychological stress on circulating and stimulated inflammatory markers: A systematic review and meta-analysis. Brain Behav Immun 2017; 64:208-219. [PMID: 28089638 PMCID: PMC5553449 DOI: 10.1016/j.bbi.2017.01.011] [Citation(s) in RCA: 377] [Impact Index Per Article: 53.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 12/23/2016] [Accepted: 01/10/2017] [Indexed: 12/21/2022] Open
Abstract
Inflammatory reactivity to acute laboratory stress is thought to reflect individual differences in responsivity to environmental stressors and may confer future health risk. To characterize this response, we conducted a meta-analysis of 34 studies that measured circulating inflammatory markers and 15 studies that measured stimulated production of inflammatory markers before and after exposure to laboratory challenge. Results showed significant stress-related increases in circulating interleukin (IL)-1β (d=0.66, p<0.001), IL-6 (d=0.35, p<0.001), IL-10 (d=0.69, p<0.001), and tumor necrosis factor(TNF)-α (d=0.28, p<0.001), but not IL-1ra, IL-2, interferon-γ, or C-reactive protein. There were sufficient data to assess the time course of IL-6, IL-1β, and TNF-α reactivity. IL-6 increased from baseline to measures taken 40-50, 60-75, 90, and 120min following stress, with the largest effect at 90min post-stress (d=0.70, p<0.001). IL-1β increased from baseline to 20-30, 40-50, and 60-70min following stress, with the largest effect between 40 and 50min post-stress (d=0.73, p=0.02). For TNF-α, there was a significant increase from baseline to 31-50min post stress (d=0.44, p=0.01), but not at later times. There was no difference in magnitude of IL-6 reactivity as a function of type of stress (social-evaluative versus other). For stimulated inflammatory markers, results showed stress-related increases in IL-1β when measured 20-120min post-stress (d=1.09, p<0.001), and in IL-4 and interferon-γ when measured 0-10min post stressor (d=-0.42, p<0.001 and d=0.47, p<0.001). These results extend findings from a prior meta-analysis (Steptoe et al., 2007) to show reliable increases in circulating IL-6, IL-1β, IL-10 and TNF-α and stimulated IL-1β, IL-4 and interferon-γ in response to acute stress. It is possible that these responses contribute to associations between exposure to life challenges and vulnerability to inflammatory disease.
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Affiliation(s)
- Anna L Marsland
- Department of Psychology, University of Pittsburgh, United States.
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Fleshner M, Frank M, Maier SF. Danger Signals and Inflammasomes: Stress-Evoked Sterile Inflammation in Mood Disorders. Neuropsychopharmacology 2017; 42:36-45. [PMID: 27412959 PMCID: PMC5143484 DOI: 10.1038/npp.2016.125] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/23/2016] [Accepted: 07/06/2016] [Indexed: 02/08/2023]
Abstract
Major depressive disorder (MDD) and other mood disorders remain difficult to effectively treat, and innovative interventions and therapeutic targets are needed. Psychological stressors and inappropriate inflammation increase the risk and severity of mood disorders; however, only recently have the importance of sterile inflammatory processes in this effect been revealed. This review will introduce the reader to pathogen vs sterile inflammation, inflammatory receptor-ligand interactions, microbial-associated molecular patterns (MAMPs), pathogen-associated molecular patterns (PAMPs), danger-associated molecular patterns (DAMPs), and the more recent discovery of the role of the inflammasome in peripheral and central nervous system cytokine/chemokine inflammatory responses. The review will focus on current preclinical and clinical evidence that sterile inflammation and inflammasome-dependent signaling may contribute to mood disorders. By understanding these inflammatory signaling processes, new approaches for quieting chronic or inappropriate inflammatory states may be revealed and this could serve as novel pharmacological targets for the treatment of mood disorders.
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Affiliation(s)
- Monika Fleshner
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, CO, USA
- Center for Neuroscience, University of Colorado at Boulder, Boulder, CO, USA
| | - Matthew Frank
- Center for Neuroscience, University of Colorado at Boulder, Boulder, CO, USA
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO, USA
| | - Steven F Maier
- Center for Neuroscience, University of Colorado at Boulder, Boulder, CO, USA
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO, USA
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Eisenberger NI, Moieni M, Inagaki TK, Muscatell KA, Irwin MR. In Sickness and in Health: The Co-Regulation of Inflammation and Social Behavior. Neuropsychopharmacology 2017; 42:242-253. [PMID: 27480575 PMCID: PMC5143485 DOI: 10.1038/npp.2016.141] [Citation(s) in RCA: 220] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/16/2016] [Accepted: 07/18/2016] [Indexed: 01/18/2023]
Abstract
Although it has commonly been assumed that the immune system and the processes that govern social behavior are separate, non-communicating entities, research over the past several decades suggests otherwise. Considerable evidence now shows that inflammatory processes and social behavior are actually powerful regulators of one another. This review first summarizes evidence that inflammatory processes regulate social behavior, leading to characteristic changes that may help an individual navigate the social environment during times of sickness. Specifically, this review shows that inflammation: (1) increases threat-related neural sensitivity to negative social experiences (eg, rejection, negative social feedback), presumably to enhance sensitivity to threats to well-being or safety in order to avoid them and (2) enhances reward-related neural sensitivity to positive social experiences (eg, viewing close others and receiving positive social feedback), presumably to increase approach-related motivation towards others who might provide support and care during sickness. Next, this review summarizes evidence showing that social behavior also regulates aspects of inflammatory activity, preparing the body for situations in which wounding and infection may be more likely (social isolation). Here, we review research showing: (1) that exposure to social stressors increases proinflammatory activity, (2) that individuals who are more socially isolated (ie, lonely) show increased proinflammatory activity, and (3) that individuals who are more socially isolated show increased proinflammatory activity in response to an inflammatory challenge or social stressor. The implications of the co-regulation of inflammation and social behavior are discussed.
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Affiliation(s)
- Naomi I Eisenberger
- Department of Psychology, University of California, Los Angeles, CA, USA,Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA, Tel: +1 310 267 5196, Fax: +1 310 206 5895, E-mail:
| | - Mona Moieni
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Tristen K Inagaki
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Keely A Muscatell
- Department of Psychology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences and Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, USA
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Pathogen-Host Defense in the Evolution of Depression: Insights into Epidemiology, Genetics, Bioregional Differences and Female Preponderance. Neuropsychopharmacology 2017; 42:5-27. [PMID: 27629366 PMCID: PMC5143499 DOI: 10.1038/npp.2016.194] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/28/2016] [Accepted: 09/08/2016] [Indexed: 12/25/2022]
Abstract
Significant attention has been paid to the potential adaptive value of depression as it relates to interactions with people in the social world. However, in this review, we outline the rationale of why certain features of depression including its environmental and genetic risk factors, its association with the acute phase response and its age of onset and female preponderance appear to have evolved from human interactions with pathogens in the microbial world. Approaching the relationship between inflammation and depression from this evolutionary perspective yields a number of insights that may reveal important clues regarding the origin and epidemiology of the disorder as well as the persistence of its risk alleles in the modern human genome.
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Duarte J, Pinto-Gouveia J. Correlates of psychological inflexibility mediate the relation between alexithymic traits and positive emotions. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2016.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The purpose of this study was to investigate the stress-reactivity of the anti-inflammatory cytokine, IL-10, in saliva and to determine how salivary IL-10 levels change in relation to those of IL-1β, a pro-inflammatory cytokine, following stress. Healthy young adults were randomly assigned to retrieve a negative emotional memory (n = 46) or complete a modified version of the Trier Social Stress Test (n = 45). Saliva samples were taken 10 min before (baseline) and 50 min after (post-stressor) onset of a 10-min stressor, and were assayed using a high sensitivity multiplex assay for cytokines. Measurable IL-10 levels (above the minimum detectable concentration) were found in 96% of the baseline samples, and 98% of the post-stressor samples. Flow rate-adjusted salivary IL-10 levels as well as IL-1β/IL-10 ratios showed moderate but statistically significant increases in response to stress. Measurement of salivary IL-10 and pro-/anti-inflammatory cytokine ratios may be useful, noninvasive tools, in stress research.
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Affiliation(s)
- Yvette Z Szabo
- a Department of Psychological and Brain Sciences , University of Louisville , Louisville , KY , USA
| | - Tamara L Newton
- a Department of Psychological and Brain Sciences , University of Louisville , Louisville , KY , USA
| | - James J Miller
- b Department of Pathology and Laboratory Medicine , University of Louisville , Louisville , KY , USA
| | - Keith B Lyle
- a Department of Psychological and Brain Sciences , University of Louisville , Louisville , KY , USA
| | - Rafael Fernandez-Botran
- b Department of Pathology and Laboratory Medicine , University of Louisville , Louisville , KY , USA
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Complicated Grief Treatment: An Evidence-Based Approach to Grief Therapy. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2016. [DOI: 10.1007/s10942-016-0242-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nat Rev Immunol 2016; 16:22-34. [PMID: 26711676 DOI: 10.1038/nri.2015.5] [Citation(s) in RCA: 2037] [Impact Index Per Article: 254.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Crosstalk between inflammatory pathways and neurocircuits in the brain can lead to behavioural responses, such as avoidance and alarm, that are likely to have provided early humans with an evolutionary advantage in their interactions with pathogens and predators. However, in modern times, such interactions between inflammation and the brain appear to drive the development of depression and may contribute to non-responsiveness to current antidepressant therapies. Recent data have elucidated the mechanisms by which the innate and adaptive immune systems interact with neurotransmitters and neurocircuits to influence the risk for depression. Here, we detail our current understanding of these pathways and discuss the therapeutic potential of targeting the immune system to treat depression.
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Affiliation(s)
- Andrew H Miller
- Emory University School of Medicine, Winship Cancer Institute, Atlanta, 30322 Georgia, USA
| | - Charles L Raison
- School of Human Ecology, University of Wisconsin-Madison, Madison, 53706 Wisconsin, USA
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Aschbacher K, Derakhshandeh R, Flores AJ, Narayan S, Mendes WB, Springer ML. Circulating angiogenic cell function is inhibited by cortisol in vitro and associated with psychological stress and cortisol in vivo. Psychoneuroendocrinology 2016; 67:216-23. [PMID: 26925833 PMCID: PMC4808379 DOI: 10.1016/j.psyneuen.2016.02.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 02/17/2016] [Accepted: 02/18/2016] [Indexed: 02/07/2023]
Abstract
Psychological stress and glucocorticoids are associated with heightened cardiovascular disease risk. We investigated whether stress or cortisol would be associated with reduced circulating angiogenic cell (CAC) function, an index of impaired vascular repair. We hypothesized that minority-race individuals who experience threat in interracial interactions would exhibit reduced CAC function, and that this link might be explained by cortisol. To test this experimentally, we recruited 106 African American participants for a laboratory interracial interaction task, in which they received socially evaluative feedback from Caucasian confederates. On a separate day, a subset of 32 participants (mean age=26years, 47% female) enrolled in a separate biological substudy and provided blood samples for CAC isolation and salivary samples to quantify the morning peak in cortisol (the cortisol awakening response, CAR). CAC function was quantified using cell culture assays of migration to vascular endothelial growth factor (VEGF) and secretion of VEGF into the culture medium. Heightened threat in response to an interracial interaction and trait anxiety in vivo were both associated with poorer CAC migratory function in vitro. Further, threat and poorer sustained attention during the interracial interaction were associated with a higher CAR, which in turn, was related to lower CAC sensitivity to glucocorticoids. In vitro, higher doses of cortisol impaired CAC migratory function and VEGF protein secretion. The glucocorticoid receptor antagonist RU486 reversed this functional impairment. These data identify a novel, neuroendocrine pathway by which psychological stress may reduce CAC function, with potential implications for cardiovascular health.
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Affiliation(s)
- Kirstin Aschbacher
- Department of Psychiatry, University of California, 3333 California Street, San Francisco, CA 94143, United States; The Institute for Integrative Health, 1407 Fleet Street, Baltimore, MD 21231, United States.
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Hassett AL, Finan PH. The Role of Resilience in the Clinical Management of Chronic Pain. Curr Pain Headache Rep 2016; 20:39. [DOI: 10.1007/s11916-016-0567-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Association of peripheral inflammation with body mass index and depressive relapse in bipolar disorder. Psychoneuroendocrinology 2016; 65:76-83. [PMID: 26731572 DOI: 10.1016/j.psyneuen.2015.12.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 01/21/2023]
Abstract
Bipolar I disorder (BD) is associated with increased inflammation, which is believed to be central to disease etiology and progression. However, BD patients also have high rates of obesity, itself an inflammatory condition, and the relative contributions of mood illness and obesity to inflammation are unknown. Moreover, the impact of inflammation on clinical illness course has not been well studied. The objectives of this analysis were therefore: (1) to determine if inflammation in BD is mood illness-related or secondary to elevated body mass index (BMI), and (2) to investigate the impact of inflammation on prospectively-ascertained relapse into depression and mania. We measured the serum levels of 7 inflammatory cytokines (TNF-α, γ-interferon, monocyte chemoattractant protein-1 [MCP-1], IL-1α, IL-2, IL-6, and IL-8) and 2 anti-inflammatory cytokines (IL-4 and IL-10) in 52 early-stage BD patients and 22 healthy subjects. In patients, a multivariate multiple regression model that controlled for psychotropic medications found that higher BMI, but not recent (past-6-month) mood episodes, predicted greater inflammatory cytokines (p=.05). Healthy subjects also had a BMI-related increase in inflammatory cytokines (p<.01), but it was counter-balanced by a compensatory increase in anti-inflammatory cytokines (p=.02), reducing their total inflammatory burden from higher BMI. In patients, linear regression showed that two inflammatory cytokines predicted depressive relapse in the 12 months after cytokine measurement: IL-1α (p<.01) and MCP-1 (p<.01). These results suggest that elevated BMI is a significant contributor to inflammation in BD, more so even than recent mood illness severity. They also point to inflammation as an important predictor of illness course, particularly depressive relapse.
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Hygiene and other early childhood influences on the subsequent function of the immune system. Brain Res 2015; 1617:47-62. [DOI: 10.1016/j.brainres.2014.04.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/17/2014] [Accepted: 04/05/2014] [Indexed: 02/08/2023]
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Sin NL, Graham-Engeland JE, Ong AD, Almeida DM. Affective reactivity to daily stressors is associated with elevated inflammation. Health Psychol 2015; 34:1154-65. [PMID: 26030309 DOI: 10.1037/hea0000240] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Inflammation increases the risk of chronic diseases, but the links between emotional responses to daily events and inflammation are unknown. We examined individual differences in affective reactivity to daily stressors (i.e., changes in positive and negative affect in response to stressors) as predictors of inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP). METHODS A cross-sectional sample of 872 adults from the National Study of Daily Experiences (substudy of Midlife in the United States II) reported daily stressors and affect during telephone interviews for 8 days. Blood samples were obtained at a separate clinic visit and assayed for inflammatory markers. Multilevel models estimated trait affective reactivity slopes for each participant, which were inputted into regression models to predict inflammation. RESULTS People who experienced greater decreases in positive affect on days when stressors occurred (i.e., positive affect reactivity) had elevated log IL-6, independent of demographic, physical, psychological, and behavioral factors (B = 1.12, SE = 0.45, p = .01). Heightened negative affect reactivity was associated with higher log CRP among women (p = .03) but not men (p = .57); health behaviors accounted for this association in women. CONCLUSIONS Adults who fail to maintain positive affect when faced with minor stressors in everyday life appear to have elevated levels of IL-6, a marker of inflammation. Women who experience increased negative affect when faced with minor stressors may be at particular risk of elevated inflammation. These findings add to growing evidence regarding the health implications of affective reactivity to daily stressors.
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Sin NL, Graham-Engeland JE, Almeida DM. Daily positive events and inflammation: findings from the National Study of Daily Experiences. Brain Behav Immun 2015; 43:130-8. [PMID: 25102453 PMCID: PMC4258510 DOI: 10.1016/j.bbi.2014.07.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/15/2014] [Accepted: 07/28/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Inflammation is implicated in the development of chronic diseases and increases the risk of mortality. People who experience more daily stressors than others have higher levels of inflammation, but it is unknown whether daily positive events are linked to inflammation. OBJECTIVE To examine the association of daily positive events with 3 inflammatory markers, interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen. METHOD A cross-sectional sample of 969 adults aged 35-86 from the Midlife in the United States Study completed telephone interviews for 8 consecutive evenings. Participants reported positive experiences that occurred over the past 24h. Blood samples were obtained at a separate clinic visit and later assayed for inflammatory markers. Regression analyses evaluated the frequency of daily positive events (defined as the percent of study days with at least 1 positive event) as a predictor of each inflammatory marker. Covariates included information on demographics, physical health, depressive symptoms, dispositional and behavioral factors, and daily positive and negative affect. RESULTS On average, participants experienced positive events on 73% of days (SD=27%). The frequency of daily positive events was associated with lower IL-6 (p<0.001) and CRP (p=0.02) in the overall sample, and lower fibrinogen among women (p=0.01). The association remained for IL-6 in the fully adjusted model, but was no longer significant for CRP and fibrinogen after controlling for household income and race. Effects were more pronounced for participants in the lowest quartile of positive event frequency than for those in the top 3 quartiles, suggesting that lack of positivity in daily life may be particularly consequential for inflammation. Furthermore, interpersonal positive events were more predictive of lower IL-6 overall and lower fibrinogen in women than non-interpersonal positive events. CONCLUSION Daily positive events may serve a protective role against inflammation.
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Affiliation(s)
- Nancy L Sin
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA.
| | | | - David M Almeida
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA; Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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Aschbacher K, Kornfeld S, Picard M, Puterman E, Havel P, Stanhope K, Lustig RH, Epel E. Chronic stress increases vulnerability to diet-related abdominal fat, oxidative stress, and metabolic risk. Psychoneuroendocrinology 2014; 46:14-22. [PMID: 24882154 PMCID: PMC4104274 DOI: 10.1016/j.psyneuen.2014.04.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 03/05/2014] [Accepted: 04/02/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND In preclinical studies, the combination of chronic stress and a high sugar/fat diet is a more potent driver of visceral adiposity than diet alone, a process mediated by peripheral neuropeptide Y (NPY). METHODS In a human model of chronic stress, we investigated whether the synergistic combination of highly palatable foods (HPF; high sugar/fat) and stress was associated with elevated metabolic risk. Using a case-control design, we compared 33 post-menopausal caregivers (the chronic stress group) to 28 age-matched low-stress control women on reported HPF consumption (modified Block Food Frequency Questionnaire), waistline circumference, truncal fat ultrasound, and insulin sensitivity using a 3-h oral glucose tolerance test. A fasting blood draw was assayed for plasma NPY and oxidative stress markers (8-hydroxyguanosine and F2-Isoprostanes). RESULTS Among chronically stressed women only, greater HPF consumption was associated with greater abdominal adiposity, oxidative stress, and insulin resistance at baseline (all p's≤.01). Furthermore, plasma NPY was significantly elevated in chronically stressed women (p<.01), and the association of HPF with abdominal adiposity was stronger among women with high versus low NPY. There were no significant predictions of change over 1-year, likely due to high stability (little change) in the primary outcomes over this period. DISCUSSION Chronic stress is associated with enhanced vulnerability to diet-related metabolic risk (abdominal adiposity, insulin resistance, and oxidative stress). Stress-induced peripheral NPY may play a mechanistic role.
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Affiliation(s)
- Kirstin Aschbacher
- Department of Psychiatry, University of California, San Francisco, CA, United States; The Institute for Integrative Health, Baltimore, MD, United States.
| | - Sarah Kornfeld
- California School of Professional Psychology, Alliant International University, San Francisco, CA, United States
| | - Martin Picard
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, United States
| | - Eli Puterman
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Peter Havel
- Department of Molecular Biosciences and Nutrition, University of California Davis, CA, United States
| | - Kimber Stanhope
- Department of Molecular Biosciences and Nutrition, University of California Davis, CA, United States
| | - Robert H. Lustig
- Department of Pediatrics, University of California, San Francisco, CA, United States,Institute for Health Policy Studies, University of California, San Francisco, CA, United States
| | - Elissa Epel
- Department of Psychiatry, University of California, San Francisco, CA, United States.
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66
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Dhabhar FS. Effects of stress on immune function: the good, the bad, and the beautiful. Immunol Res 2014; 58:193-210. [DOI: 10.1007/s12026-014-8517-0] [Citation(s) in RCA: 452] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Fang CY, Egleston BL, Manzur AM, Townsend RR, Stanczyk FZ, Spiegel D, Dorgan JF. Psychological reactivity to laboratory stress is associated with hormonal responses in postmenopausal women. J Int Med Res 2014; 42:444-56. [PMID: 24595153 DOI: 10.1177/0300060513504696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The present study examined associations between psychological reactivity and hormonal responses to a standardized laboratory stressor (Trier Social Stress Test, TSST) in postmenopausal women. METHODS Postmenopausal women aged 50-74 years undertook anxiety and mood assessments prior to and following the TSST. Blood samples were drawn at multiple timepoints for assessment of cortisol, adrenocorticotrophic hormone (ACTH) and dehydroepiandrosterone (DHEA). RESULTS Forty postmenopausal women completed the assessments. As expected, significant increases in anxiety and negative affect and decreases in positive affect were observed after the TSST; however, the magnitude of change in anxiety and mood varied considerably across individuals. Analyses indicated that greater increases in anxiety and negative affect after the TSST were associated with higher levels of cortisol, ACTH and DHEA after controlling for race, age, body mass index and smoking status. Changes in positive affect were not associated with cortisol, ACTH or DHEA. CONCLUSIONS These findings suggest that enhanced reactivity to stress is associated with higher hormone levels among postmenopausal women, which could have potential implications for health.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
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Puterman E, Haritatos J, Adler NE, Sidney S, Schwartz JE, Epel ES. Indirect effect of financial strain on daily cortisol output through daily negative to positive affect index in the Coronary Artery Risk Development in Young Adults Study. Psychoneuroendocrinology 2013; 38:2883-9. [PMID: 23969421 PMCID: PMC3844074 DOI: 10.1016/j.psyneuen.2013.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 07/11/2013] [Accepted: 07/23/2013] [Indexed: 12/25/2022]
Abstract
Daily affect is important to health and has been linked to cortisol. The combination of high negative affect and low positive affect may have a bigger impact on increasing HPA axis activity than either positive or negative affect alone. Financial strain may both dampen positive affect as well as increase negative affect, and thus provides an excellent context for understanding the associations between daily affect and cortisol. Using random effects mixed modeling with maximum likelihood estimation, we examined the relationship between self-reported financial strain and estimated mean daily cortisol level (latent cortisol variable), based on six salivary cortisol assessments throughout the day, and whether this relationship was mediated by greater daily negative to positive affect index measured concurrently in a sample of 776 Coronary Artery Risk Development in Young Adults (CARDIA) Study participants. The analysis revealed that while no total direct effect existed for financial strain on cortisol, there was a significant indirect effect of high negative affect to low positive affect, linking financial strain to elevated cortisol. In this sample, the effects of financial strain on cortisol through either positive affect or negative affect alone were not significant. A combined affect index may be a more sensitive and powerful measure than either negative or positive affect alone, tapping the burden of chronic financial strain, and its effects on biology.
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Affiliation(s)
- Eli Puterman
- Department of Psychiatry, University of California, San Francisco, United States.
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Hoge EA, Bui E, Marques L, Metcalf CA, Morris LK, Robinaugh DJ, Worthington JJ, Pollack MH, Simon NM. Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. J Clin Psychiatry 2013; 74:786-92. [PMID: 23541163 PMCID: PMC3772979 DOI: 10.4088/jcp.12m08083] [Citation(s) in RCA: 239] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 02/11/2013] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Mindfulness meditation has met increasing interest as a therapeutic strategy for anxiety disorders, but prior studies have been limited by methodological concerns, including a lack of an active comparison group. This is the first randomized, controlled trial comparing the manualized Mindfulness-Based Stress Reduction (MBSR) program with an active control for generalized anxiety disorder (GAD), a disorder characterized by chronic worry and physiologic hyperarousal symptoms. METHOD Ninety-three individuals with DSM-IV-diagnosed GAD were randomly assigned to an 8-week group intervention with MBSR or to an attention control, Stress Management Education (SME), between 2009 and 2011. Anxiety symptoms were measured with the Hamilton Anxiety Rating Scale (HAMA; primary outcome measure), the Clinical Global Impressions-Severity of Illness and -Improvement scales (CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress reactivity was assessed by comparing anxiety and distress during pretreatment and posttreatment administration of the Trier Social Stress Test (TSST). RESULTS A modified intent-to-treat analysis including participants who completed at least 1 session of MBSR (n = 48) or SME (n = 41) showed that both interventions led to significant (P < .0001) reductions in HAMA scores at endpoint, but did not significantly differ. MBSR, however, was associated with a significantly greater reduction in anxiety as measured by the CGI-S, the CGI-I, and the BAI (all P values < .05). MBSR was also associated with greater reductions than SME in anxiety and distress ratings in response to the TSST stress challenge (P < .05) and a greater increase in positive self-statements (P = .004). CONCLUSIONS These results suggest that MBSR may have a beneficial effect on anxiety symptoms in GAD and may also improve stress reactivity and coping as measured in a laboratory stress challenge. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01033851.
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Affiliation(s)
- Elizabeth A. Hoge
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Luana Marques
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | | | - Laura K. Morris
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | | | | | | | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
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Rook GAW, Lowry CA, Raison CL. Microbial 'Old Friends', immunoregulation and stress resilience. EVOLUTION MEDICINE AND PUBLIC HEALTH 2013; 2013:46-64. [PMID: 24481186 PMCID: PMC3868387 DOI: 10.1093/emph/eot004] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Chronic inflammatory diseases (autoimmunity, allergy and inflammatory bowel diseases) are increasing in prevalence in urban communities in high-income countries. One important factor is reduced exposure to immunoregulation-inducing macro- and microorganisms and microbiota that accompanied mammalian evolution (the hygiene hypothesis or 'Old Friends' mechanism). Reduced exposure to these organisms predisposes to poor regulation of inflammation. But inflammation is equally relevant to psychiatric disorders. Inflammatory mediators modulate brain development, cognition and mood, and accompany low socioeconomic status and some cases of depression in developed countries. The risk of all these conditions (chronic inflammatory and psychiatric) is increased in urban versus rural communities, and increased in immigrants, particularly if they move from a low- to a high-income country during infancy, and often the prevalence increases further in second generation immigrants, suggesting that critical exposures modulating disease risk occur during pregnancy and infancy. Diminished exposure to immunoregulation-inducing Old Friends in the perinatal period may enhance the consequences of psychosocial stressors, which induce increased levels of inflammatory mediators, modulate the microbiota and increase the risk for developing all known psychiatric conditions. In later life, the detrimental effects of psychosocial stressors may be exaggerated when the stress occurs against a background of reduced immunoregulation, so that more inflammation (and therefore more psychiatric symptoms) result from any given level of psychosocial stress. This interaction between immunoregulatory deficits and psychosocial stressors may lead to reduced stress resilience in modern urban communities. This concept suggests novel interpretations of recent epidemiology, and novel approaches to the increasing burden of psychiatric disease.
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Affiliation(s)
- Graham A W Rook
- Centre for Clinical Microbiology, Department of Infection, University College London (UCL), London, UK; Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA and Department of Psychiatry, College of Medicine and Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, USA
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Poitras VJ, Pyke KE. The impact of acute mental stress on vascular endothelial function: evidence, mechanisms and importance. Int J Psychophysiol 2013; 88:124-35. [PMID: 23562766 DOI: 10.1016/j.ijpsycho.2013.03.019] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 03/21/2013] [Accepted: 03/26/2013] [Indexed: 01/23/2023]
Abstract
Cardiovascular disease is a principle cause of morbidity and mortality worldwide, and it has a complex etiology that involves lifestyle factors such as psychosocial stress. Recent evidence suggests that temporary impairments in vascular endothelial cell function may contribute to the relationship between stress and cardiovascular disease. Indeed, impaired endothelial function has been observed to occur transiently (lasting up to 1.5h) following mental stress, and such periods of impairment could accumulate to become clinically relevant over the long term. The finding of acute stress induced endothelial dysfunction is not universal however, and both physiological (e.g. sympathetic nervous system and hypothalamic-pituitary-adrenal axis reactivity), and methodological factors contribute to the conflicting results. A clear understanding of the interaction between stress response activation and endothelial function is critical to elucidating the complexities of the relationship between psychosocial stress and cardiovascular disease. Therefore, the purpose of this review is: 1) to briefly describe the importance of vascular endothelial function and how it is assessed, 2) to review the literature investigating the impact of acute mental stress on endothelial function in humans, identifying factors that may explain contradictory results, and 3) to summarize our current understanding of the mechanisms that may mediate an acute mental stress-endothelial function interaction.
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Affiliation(s)
- Veronica J Poitras
- Queen's University School of Kinesiology and Health Studies, 28 Division St. Kingston, Ontario, Canada
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Abstract
Although we generally experience our bodies as being biologically stable across time and situations, an emerging field of research is demonstrating that external social conditions, especially our subjective perceptions of those conditions, can influence our most basic internal biological processes-namely, the expression of our genes. This research on human social genomics has begun to identify the types of genes that are subject to social-environmental regulation, the neural and molecular mechanisms that mediate the effects of social processes on gene expression, and the genetic polymorphisms that moderate individual differences in genomic sensitivity to social context. The molecular models resulting from this research provide new opportunities for understanding how social and genetic factors interact to shape complex behavioral phenotypes and susceptibility to disease. This research also sheds new light on the evolution of the human genome and challenges the fundamental belief that our molecular makeup is relatively stable and impermeable to social-environmental influence.
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Affiliation(s)
- George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Bogdan R, Nikolova YS, Pizzagalli DA. Neurogenetics of depression: a focus on reward processing and stress sensitivity. Neurobiol Dis 2012; 52:12-23. [PMID: 22659304 DOI: 10.1016/j.nbd.2012.05.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 04/30/2012] [Accepted: 05/24/2012] [Indexed: 11/27/2022] Open
Abstract
Major depressive disorder (MDD) is etiologically complex and has a heterogeneous presentation. This heterogeneity hinders the ability of molecular genetic research to reliably detect the small effects conferred by common genetic variation. As a result, significant research efforts have been directed at investigating more homogenous intermediate phenotypes believed to be more proximal to gene function and lie between genes and/or environmental effects and disease processes. In the current review we survey and integrate research on two promising intermediate phenotypes linked to depression: reward processing and stress sensitivity. A synthesis of this burgeoning literature indicates that a molecular genetic approach focused on intermediate phenotypes holds significant promise to fundamentally improve our understanding of the pathophysiology and etiology of depression, which will be required for improved diagnostic definitions and the development of novel and more efficacious treatment and prevention strategies. We conclude by highlighting challenges facing intermediate phenotype research and future development that will be required to propel this pivotal research into new directions.
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Affiliation(s)
- Ryan Bogdan
- BRAIN Laboratory, Department of Psychology, Washington University in St. Louis, Box 1125, One Brookings Drive, St. Louis, MO 63130, USA.
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