The human stress response

The silent pandemic of stress: impact on menstrual cycle and ovulation

In the current age of technological advancement, stress has emerged as a silent pandemic affecting individuals, especially young generations, globally. Factors such as increased competition, social pressures fueled by social media and smartphones, and a sense of diminished control in the face of modern challenges contribute to rising stress levels. In addition to the negative implications on mental well-being, stress affects physiological processes such as the menstrual cycle. Functional hypogonadotropic hypogonadism is a spectrum ranging ranging from regular menstrual cycles with short or insufficient luteal phases to irregular cycles, oligomenorrhea, anovulation, and complete amenorrhea, depending on how stress variably disrupts gonadotropic-releasing hormone (GnRH) drive. Functional hypothalamic amenorrhea (FHA), the most severe manifestation, is a complex global neuroendocrinopathy with several serious health consequences in addition to amenorrhea and infertility. Concomitant health consequences include bone loss, endothelial dysfunction, and cardiovascular risks. The collective health burden underscores the need for clinical awareness and comprehensive treatment strategies addressing behavioral and biopsychosocial stressors that lead to chronic hypothalamic-pituitary-adrenal (HPA) axis activation. Despite its prevalence and numerous adverse health consequences, research on this condition remains limited, revealing a significant gap in understanding and addressing this condition. Larger and long-term follow-up studies are important to accurately assess FHA prevalence, its health consequences, intervention efficacy, and recovery outcomes.

Time- and concentration-dependent metabolic responses reveal adaptation failure in cadmium-exposed Haliotis diversicolor

This study elucidated the time- and concentration-dependent effects of Cd exposure on adult Haliotis diversicolor through an integrated analysis of survival, physiological indices, and metabolomic profiles. Abalones were subjected to varying Cd concentrations for one and two months. While one-month exposure yielded no significant mortality, prolonged exposure to high Cd concentrations for two months substantially elevated mortality risk (hazard ratio = 3.359). Integrated biomarker response values exhibited progressive elevation with both concentration and exposure duration, indicating cumulative perturbation of antioxidant defense and metabolic enzyme systems. Metabolomic analysis revealed distinct temporal and concentration-dependent responses. After one month of exposure, medium concentrations predominantly affected energy and amino acid metabolism with a shift toward anaerobic pathways, while high concentrations activated additional detoxification and stress response mechanisms; after two months of exposure, divergent metabolic strategies emerged, where low concentrations induced lipid remodeling, medium concentrations maintained basic metabolic adjustments, while high concentrations precipitated comprehensive cellular dysfunction. Notably, the observed metabolic focusing at two months represented a forced trade-off under allostatic overload rather than successful adaptation, particularly in high-concentration groups. Combined analysis demonstrated fundamental reorganization of cellular metabolism under prolonged exposure. These findings emphasize the importance of long-term, multi-parameter assessments in evaluating marine ecotoxicological impacts of metal pollution.

Psychological mechanisms underpinning change in intolerance of uncertainty across anxiety-related disorders: New insights for translational research

Intolerance of uncertainty (IU), the tendency to find uncertainty negative, is a fundamental transdiagnostic dimension across anxiety-related disorders. Over the past two decades, there has been an increase in both clinical and experimental research on the role of IU in the maintenance and treatment of anxiety-related disorders. However, there has been a lack of integration of research findings from a mechanistic perspective, which has slowed progress in translational research. This review seeks to fill this gap by synthesising the clinical (e.g. randomised controlled trials) and experimental (e.g. lab-based) literature on the psychological mechanisms that drive change in IU across anxiety-related disorders. The review highlighted that: (1) cognitive restructuring, supported by mechanisms such as cognitive appraisal, modify IU-related cognitions, (2) behavioural exposures, supported by mechanisms such as inhibitory learning, alter IU-related cognitions and physiological arousal, and (3) mindfulness techniques underpinned by mechanisms such as attentional monitoring, decentering, and acceptance, change IU-related cognitions. Across the different therapeutic techniques reviewed, there was a lack of evidence for how different mechanisms change IU-related emotions and behaviours. Directions for further research include directly comparing the effectiveness of different mechanisms that produce change in IU across anxiety disorders and other mental health disorders, and examining the specificity of change in IU over other anxious traits. Overall, the findings provide a foundation for future translational research efforts to build upon maximising existing treatment interventions and/or to develop novel treatment interventions to target dispositional IU and situational uncertainty-related distress in anxiety-related disorders and beyond.

Advanced cortisol detection: A cMWCNTs-enhanced MB@Zr-MOF ratiometric electrochemical aptasensor

A ratiometric electrochemical aptasensor was developed for ultra-sensitive detection of cortisol using aptamer (Apt) as recognition element, methylene blue (MB) as signal probe, and zirconium metal-organic framework (Zr-MOF) as carrier loaded with abundant MB for signal amplification. The carboxylated multi-walled carbon nanotubes (cMWCNTs)-modified Au electrode showed excellent electrochemical performance to immobilize complementary DNA (cDNA) for hybridizing with MB@Zr-MOF-Apt via amide bonds. In the presence of cortisol, it would compete with cDNA for binding the Apt, resulting in the detachment of MB@Zr-MOF-Apt complex from the electrode surface, and the electrochemical signal of MB was decreased, while that of [Fe(CN)6]3-/4- was basically unchanged. The ratio of the electrochemical signals of [Fe(CN)6]3-/4- to MB was proportional to the cortisol concentration. Due to the greatly enhanced conductivity of the cMWCNTs-decorated Au electrode and the largely improved EC signals of Zr-MOF encapsulated MB probes, this ratiometric electrochemical aptasensor offered high sensitivity with an ultra-low detection limit of 0.0046 nM and a wide linearity of 0.01-1000 nM, as well as satisfactory accuracy with recoveries of 93.79-106.76 % in artificial sweat samples, providing a potential strategy for the detection of more trace hormones in different clinical samples by simply replacing the corresponding aptamers.

Height-dependent variation in corticospinal excitability modulation after active but not sham intermittent theta burst stimulation

Poor reproducibility and high inter-individual variability in responses to intermittent theta burst stimulation (iTBS) of the human motor cortex (M1) are matters of concern. Here we recruited 17 healthy young adults in a randomized, sham-controlled, crossover study. Transcranial magnetic stimulation (TMS)-elicited motor evoked potentials (MEPs) were measured pre-iTBS (T0) and post-iTBS at 4-7 (T1), 9-12 (T2), 17-20 (T3), and 27-30 minutes (T4) from the right first dorsal interosseous muscle. MEP grand average (MEPGA) was defined as the mean of the normalized-to-baseline MEPs at all timepoints post-iTBS. As secondary objectives, we measured blood pressure, heart rate, and capillary blood glucose pre-iTBS, and at 0 and 30 minutes post-iTBS. The TMSens_Q structured questionnaire was filled out at the end of each session. Two-way repeated ANOVA did not show a significant TIME×INTERVENTION interaction effect on MEP amplitude, MEP latency, blood pressure, heart rate, and blood glucose (p > 0.05). Sleepiness was the most reported TMSens_Q sensation (82.3 %) in both groups. Surprisingly, the subjects' height negatively correlated with the normalized MEP amplitudes at T3 (r = -0.65, p = 0.005), T4 (r = -0.66, p = 0.004), and MEPGA (r = -0.68, p = 0.003), with a trend correlation at T1 (r = -0.46, p = 0.062) and T2 (r = -0.46, p = 0.065) in the active but not sham group. In view of this, we urge future studies to delve deeper into the influence of height on neuroplasticity induction of the M1 representation of peripheral muscles. In the end, we highlight unique methodological considerations in our study protocol and future recommendations for M1-iTBS studies.

Microneedle-integrated distance-based paper device for simultaneous transdermal detection of cortisol and dopamine

Accurate measurement of stress marker cortisol and neurotransmitter dopamine is essential for understanding the physiological effects of chronic stress, enabling early therapeutic interventions to prevent adverse health consequences. Herein, we introduce the first fully integrated wearable device comprising a microneedle (MN) patch and distance-based paper analytical device (dPAD) for minimally invasive dermal interstitial fluid (ISF) sampling and simultaneous cortisol and dopamine sensing. The MN patch employs a swellable hydrogel matrix for efficient ISF extraction, whereas the simple dPAD sensor can simultaneously detect cortisol and dopamine through colorimetric reactions. Quantitative analysis was achieved through simple measurement of the colored distance proportional to the analyte concentration using a ruler. The device demonstrates high sensitivity, with detection limits of 0.25 μg mL-1 for cortisol and 1.0 ng mL-1 for dopamine, along with excellent selectivity for both analytes. It also exhibited high accuracy and precision, with recovery rates of 98.5-100.7% for cortisol and 98.8-102.2% for dopamine. These results show that the developed sensor device is user-friendly, simplifies the analysis process, reduces costs, and eliminates the need for complex instrumentation, making it a promising tool for point-of-care (POC) testing for stress and its relative disorders, with potential applications in diagnosing other biomarkers.

Activation of Centromedial Amygdala GABAergic Neurons Produces Hypotension in Mice

The central amygdala (CeA) is a crucial modulator of emotional, behavioral, and autonomic functions, including cardiovascular responses. Despite its importance, the specific circuit by which the CeA modulates blood pressure remains insufficiently explored. Our investigations demonstrate that photostimulation of GABAergic neurons in the centromedial amygdala (CeMGABA), as opposed to those in the centrolateral amygdala (CeL), produces a depressor response in both anesthetized and freely-moving mice. In addition, activation of CeMGABA axonal terminals projecting to the nucleus tractus solitarius (NTS) significantly reduces blood pressure. These CeMGABA neurons form synaptic connections with NTS neurons, allowing for the modulation of cardiovascular responses by influencing the caudal or rostral ventrolateral medulla. Furthermore, CeMGABA neurons targeting the NTS receive dense inputs from the CeL. Consequently, stimulation of CeMGABA neurons elicits hypotension through the CeM-NTS circuit, offering deeper insights into the cardiovascular responses associated with emotions and behaviors.

Elevated activity of plasma dipeptidyl peptidase 4 upon stress can be targeted to reverse tumor immunosuppression

The interplay between stress-induced metabolic reprogramming and perturbations in the cancer-immune dialogue is a challenging research topic with huge knowledge gaps to fill. In a repeated social defeat model, we discovered that circulating corticosterone, blood glucose, and plasma DPP4 activity were increased in stressed mice. Consistently, three independent cohort studies showed that plasma DPP4 activity was positively correlated with the severity of psychological distress of newly diagnosed cancer patients. Stress-induced surge of glucocorticoid can boost DPP4 activity via glucocorticoid receptor signaling without influencing Dpp4 transcription or the abundance of soluble DPP4. Albeit catalytic inhibition of DPP4 upon stress can't normalize the behavioral pattern and glucocorticoid secretion, it managed to reverse the expansion of circulating neutrophils and monocytes, restored the efficacy of prophylactic tumor vaccine, and augmented the priming of tumor-antigen specific T cells. DPP4 blockade in the context of stress largely enhanced the intratumoral accumulation of CD8+T cells and DCs, cytokine production by CD8+T and NK cells in situ, and tumor antigen presentation in vitro. Proteome profiling of mouse plasma revealed stress-related DPP4-sensitive changes that can be linked to immunological alterations and disturbed protease network. Altogether, elevated DPP4 activity may be targeted in cancer patients with psychiatric comorbidities to boost anti-tumor immunity.

Rapid analysis in small-volume urine: Optimizing LC-MS/MS for free glucocorticoids

Glucocorticoids, regulators of energy metabolism and immune responses, are known biomarkers of stress response and disease. Downscaling the required sample volumes facilitates large-scale studies and accelerates the generation of valid results. To meet this expectation, we modified our LC-MS/MS method using 100 μL of urine to that using 20 μL, following the same steps as in the original protocol with the addition of cortisone-d8 as an internal standard. Calibration was performed as in the original protocol but using 1/5 diluted standards, resulting in a good linearity of 2-200 ng/mL in the log-log plot, indicating a lower limit of quantitation (LLOQ) of <2 ng/mL from the residue. The coefficients of variation of the matrix factors of the 15 urine samples and water were within 15 % for 10 and 300 ng/mL cortisol and cortisone. The matrix factor of the downscaled method was larger than that of the original method, especially for urine extracts with high specific gravity (up to 2.1-fold), indicating the advantage of the downscaled method; although the theoretical LLOQ is 5-fold with the 1/5 downscaling, the effect on the practical LLOQ may be reduced by the suppressed matrix effect. The current method showed good recovery, accuracy, reproducibility, and agreement with the original method (regression coefficient close to 1.0). After sample freezing, cortisol and cortisone were detected at higher and lower levels, respectively, within 25 %. The downscaled method of urine-free cortisol and cortisone may contribute to the advancement of related research.

Vagal pathway activation links chronic stress to decline in intestinal stem cell function

Chronic stress adversely affects intestinal health, but the specific neural pathways linking the brain to intestinal tissue are not fully understood. Here, we show that chronic stress-induced activation of the central amygdala-dorsal motor nucleus of the vagus (CeA-DMV) pathway accelerates premature aging and impairs the stemness of intestinal stem cells (ISCs). This pathway influences ISC function independently of the microbiota, the hypothalamic-pituitary-adrenal (HPA) axis, the immune response, and the sympathetic nervous system (SNS). Under chronic stress, DMV-mediated vagal activation prompts cholinergic enteric neurons to release acetylcholine (ACh), which engages ISCs via the M3 muscarinic acetylcholine receptor (CHRM3). This interaction activates the p38 mitogen-activated protein kinase (MAPK) pathway, triggering growth arrest and mitochondrial fragmentation, thereby accelerating an aging-like decline in ISCs. Together, our findings provide insights into an alternative neural mechanism that links stress to intestinal dysfunction. Strategies targeting the DMV-associated vagal pathway represent potential therapeutic approaches for stress-induced intestinal diseases.

Smart Bioelectronics for Real-Time Diagnosis and Therapy of Body Organ Functions

Noncommunicable diseases (NCDs) associated with cardiovascular, neurological, and gastrointestinal disorders remain a leading cause of global mortality, sounding the alarm for the urgent need for better diagnostic and therapeutic solutions. Wearable and implantable biointegrated electronics offer a groundbreaking solution, combining real-time, high-resolution monitoring with innovative treatment capabilities tailored to specific organ functions. In this comprehensive review, we focus on the diseases affecting the brain, heart, gastrointestinal organs, bladder, and adrenal gland, along with their associated physiological parameters. Additionally, we provide an overview of the characteristics of these parameters and explore the potential of bioelectronic devices for in situ sensing and therapeutic applications and highlight the recent advancements in their deployment across specific organs. Finally, we analyze the current challenges and prospects of implementing closed-loop feedback control systems in integrated sensor-therapy applications. By emphasizing organ-specific applications and advocating for closed-loop systems, this review highlights the potential of future bioelectronics to address physiological needs and serves as a guide for researchers navigating the interdisciplinary fields of diagnostics, therapeutics, and personalized medicine.

Salivary biomarkers of tactical athlete readiness: A systematic review

Tactical athletes must maintain high levels of physical and cognitive readiness to handle the rigorous demands of their roles. They frequently encounter acute stressors like sleep deprivation, muscle fatigue, dehydration, and harsh environmental conditions, which can impair their readiness and increase the risk of mission failure. Given the challenging conditions these athletes face, there is a vital need for non-invasive, rapidly deployable point-of-care assessments to effectively measure the impact of these stressors on their operational readiness. Salivary biomarkers are promising in this regard, as they reflect physiological changes due to stress. This systematic review aims to investigate salivary markers as potential indicators for readiness, specifically focusing on their sensitivity to acute stressors like sleep deprivation, dehydration, environmental factors, and muscle fatigue. A search was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines (PROSPERO; registration #: CRD42022370388). The primary inclusion criteria were the use of a quantitative analysis to assess salivary biomarkers changes in response to acute stressors. Risk of bias and methodological quality were evaluated with the modified Downs and Black checklist. Hormonal salivary biomarkers were the most commonly studied biomarkers. Muscle damage and fatigue were the most frequently studied acute stressors, followed by sleep deprivation, multiple stressors, dehydration, and environmental. Biomarkers such as creatine kinase, aspartate aminotransferase, uric acid, cortisol, testosterone, and the testosterone to cortisol ratio were indicative of muscle damage. Dehydration influenced osmolality, total protein, flow rate, and chloride ion concentrations. Sleep deprivation affected proteins, peptides, and alpha-amylase levels. Environmental stressors, such as hypoxia and cold temperatures, altered cortisol, pH, dehydroepiandrosterone-sulfate (DHEA-s), and salivary IgA levels. The current body of research highlights that various salivary biomarkers react to acute stressors, and proteomic panels appear promising for predicting physical and cognitive outcomes relevant to the operational readiness of tactical athletes.

IUPHAR Review: Microbiota-Gut-Brain Axis and its role in Neuropsychiatric Disorders

The human gut microbiome, composed of a vast array of microorganisms that have co-evolved with humans, is crucial for the development and function of brain systems. Research has consistently shown bidirectional communication between the gut and the brain through neuronal, endocrine, and immunological, and chemical pathways. Recent neuroscience studies have linked changes in the microbiome and microbial metabolites to various neuropsychiatric disorders such as autism, depression, anxiety, schizophrenia, eating disorders, and neurocognitive disorders. Novel metagenome-wide association studies have confirmed these microbiome variations in large samples and expanded our understanding of the interactions between human genes and the gut microbiome. The causal relationship between gut microbiota and neuropsychiatric disorders is being elucidated through the establishment of large cohort studies incorporating microbiome data and advanced statistical techniques. Ongoing animal and human studies focused on the microbiota-gut-brain axis are promising for developing new prevention and treatment strategies for neuropsychiatric conditions. The scope of these studies has broadened from microbiome-modulating therapies including prebiotics, probiotics, synbiotics and postbiotics to more extensive approaches such as fecal microbiota transplantation. Recent systematic reviews and meta-analyses have strengthened the evidence base for these innovative treatments. Despite extensive research over the past decade, many intriguing aspects still need to be elucidated regarding the role and therapeutic interventions of the microbiota-gut-brain axis in neuropsychiatric disorders.

Mitigating fatigue in long COVID patients with MYPplus: a clinical observation

PURPOSE

The COVID-19 pandemic has led to the emergence of a secondary public health crisis known as Long COVID. It is estimated that approximately 10% of individuals who contact COVID-19 develop Long COVID, with fatigue and brain fog being among the most commonly reported and debilitating symptoms. However, no standardized or effective treatments are currently available. This observational study aimed to evaluate the efficacy of MYPplus, an herbal formulation composed of Astragali Radix, Salviae Radix, and Aquilariae Lignum, in alleviating fatigue and brain fog in patients with Long COVID.

METHODS

Subjects with a score of 60 or higher on the Modified Korean version of the Chalder Fatigue scale (mKCFQ11) or a brain fog rating of 5 or higher on the visual analogue scale (VAS) took two capsules of MYPplus (500 mg per capsule) twice daily for 4 weeks. Changes in symptoms were assessed using the mKCFQ11, Multidimensional Fatigue Inventory (MFI-20), Fatigue VAS, Brain fog VAS, and overall quality of life using the Short-Form Health Survey (SF-12). Additionally, levels of three cytokines (TNF-α, TGF-β, IFN- γ) and cortisol were measured.

RESULTS

Fifty participants successfully completed the 4-week administration with MYPplus. At baseline, fatigue severity was 75.3 ± 10.9 in mKCFQ11, 70.9 ± 11.2 in MFI-20, 7.5 ± 1.2 in Fatigue VAS, 8.4 ± 1.1 in Brain fog VAS, and 45.3 ± 17.8 in SF-12. All parameters significantly improved (p < 0.01), with a decrease of 46% in mKCFQ11, 26% in MFI-20, 49% in Fatigue VAS, and 52% in Brain fog VAS, and an increase of 59% in SF-12, respectively. Unlikely others, the plasma level of TGF-β showed a declining pattern after MYPplus administration (from 765.0 ± 1759.7 to 243.9 ± 708.1 pg/mL, p = 0.07). No safety concerns were observed.

CONCLUSION

This pilot observational study suggests the clinical potential of MYPplus for managing patients with Long COVID, focusing on fatigue-related symptoms and quality of life. Further studies are required to confirm its efficacy and safety using large-scale randomized placebo-controlled trials in the future.

PROTOCOL REGISTRATION

This study has been retrospectively registered with the identifier number KCT0008948 on https://cris.nih.go.kr , as of 27/10/23.

The ACTH test fails to diagnose adrenal insufficiency and augments cytokine production in sepsis

The adrenocorticotropic hormone (ACTH) test diagnoses relative adrenal insufficiency (RAI) or critical illness-related corticosteroid insufficiency (CIRCI). Initially, guidelines recommended corticosteroid/glucocorticoid (GC) therapy for septic patients with RAI, but later trials did not show a survival benefit, leading to updated guidelines that abandon targeting RAI or CIRCI. Recent studies with an RAI mouse model showed a clear survival benefit from GC therapy in mice with RAI, suggesting that inconclusive GC clinical trials might be due to issues with the ACTH test rather than targeting RAI. To investigate, we performed the ACTH test in septic mice. Interestingly, the ACTH test identified most mice as having adrenal insufficiency in early and middle stages of sepsis, even those with a normal adrenal stress response. Surprisingly, the ACTH test increased inflammatory cytokines to lethal levels, moderately increasing mortality in septic mice. This study revealed significant flaws in the ACTH test for diagnosing RAI/CIRCI. It not only fails to correctly identify these conditions, leading to misguided use of GCs, but also induces a lethal inflammatory response in sepsis. These findings suggest that inconclusive GC therapy trials may be due to the problematic nature of the ACTH test rather than ineffectiveness of targeting RAI/CIRCI.

Short sleep duration and daytime outdoor activities effects on adolescents mental health: A stress susceptibility-recovery model analysis

BACKGROUND

Mental health disorders are a growing public health challenge globally. This study aimed to utilize the Stress Susceptibility-Recovery Model to identify the relationship between sleep duration, daytime outdoor activities, and major mental health outcomes among adolescents.

METHODS

Data from the Yunnan Students' Common Disease Survey was analyzed. Multi-factorial logistic regression assessed the impact of each variable on mental health, while subgroup analyses and interaction tests examined the stability of the association between sleep duration, daytime outdoor activity, and mental health. Mendelian Randomization analysis assessed causal effects.

RESULTS

The analysis included 204,158 participants aged 12-18 from 953 surveillance schools. After adjusting for covariates, the prevalence of depressive mood increased from 18.81 % (12-13 years) to 24.89 % (16-18 years); Females had a higher prevalence than males (1:1.36). Senior high school students (26.04 %) had a significantly higher rate than junior high school (21.41 %), and vocational high school students (18.42 %). Students with <2 h of daytime outdoor activity had a higher prevalence of depressive mood (24.40 %) compared to those with 2 or more hours of daytime outdoor activity (19.96 % for 2 h and 19.70 % for 3 or more hours). Short sleep duration mediated the association between reduced daytime outdoor activity and increased depressive mood or affective disorders risk, supporting the Stress Susceptibility-recovery Model.

CONCLUSIONS

Sleep duration and daytime outdoor activity were key determinants of emotional well-being, considering aging and gender disparities.

LIMITATIONS

Potential sampling bias due to differences in baseline characteristics between participants with and without missing data.

Enzymatic digestion of hair increases extraction yields of cortisol: a novel two-dimensional liquid chromatography-tandem mass spectrometry method for hair cortisol analysis

Hair cortisol concentration is a retrospective, long-term measure of cortisol secretion, often used as a biomarker for chronic stress or suspected cyclic Cushing's syndrome. Various methods for hair cortisol extraction, typically involving intact, minced, or milled hair incubated with methanol or extraction buffers, may not achieve complete extraction. Incomplete extraction can bias results, particularly when comparing hair samples of differing thickness and texture. Additionally, sample-to-sample variation might be caused by inconsistent cutting or grinding of the hair by different technicians. We aimed to achieve complete cortisol extraction through the enzymatic digestion of hair. After digestion and sample clean-up, we analyzed the final extracts using two-dimensional liquid chromatography-mass spectrometry. Complete digestion was observed with an overnight enzymatic reaction. This method demonstrated high reproducibility, with an intra-day precision of 3.6%, and inter-day precision of 6.5% in a homogenized pool. Moreover, duplicate CV% of intact hairlocks ranged from 0.1% to 8.9%. Our protocol does not influence the cortisol concentration. It is less labor-intensive and more consistent than mincing or milling hair. Our extraction yield was higher compared to the commonly used methanol extraction method. Samples extracted with methanol showed, on average, 19% lower cortisol concentrations than those measured in digested aliquots. We have developed and validated a new, superior method for extracting cortisol from hair utilizing enzymatic digestion. This strategy provides a more thorough extraction, greater consistency, and requires less labor than traditional methods.

Mediation on the association between HPA axis hyperactivity and cognitive impairment by abnormal hippocampal function in people who lost their only child

BACKGROUND

People who have lost their only child (PLOCs) in China exhibit chronic hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and a range of abnormal symptoms. The hippocampus may serve as a potential mediator between HPA axis dysregulation and the symptoms. However, the mechanisms underlying these developments remain unclear.

METHODS

Functional magnetic resonance imaging data were collected from 51 PLOCs and 29 healthy individuals. A linear regression model was utilized to explore the interrelationships between blood cortisol levels, hippocampal structure and function, and abnormal symptoms. Additionally, a mediation effect model was employed to examine the influence of the hippocampus on the relationship between blood cortisol levels and abnormal symptoms.

RESULTS

Compared with the healthy controls, the PLOCs had significantly reduced gray matter volume in the hippocampus, and increased degree centrality (DC) values in the right hippocampus. Additionally, the PLOCs exhibited more severe cognitive impairment and poorer immediate memory ability, which were significantly negatively correlated with blood cortisol levels. The mediation effect model revealed specific effects of DC values in the right hippocampus on the association between blood cortisol levels and MMSE scores and immediate memory scores.

LIMITATIONS

Cross-sectional design of this study could not demonstrate the causality.

CONCLUSION

The alterations in DC in the right hippocampus substantially mediated the relationship between HPA axis dysregulation and cognitive impairment in the sampled Chinese PLOCs. High blood cortisol levels led to cognitive impairment by causing changes in right hippocampal function.

Does heart rate variability predict and improve performance in pediatric CPR?-a simulation study

INTRODUCTION

Out-of-hospital pediatric resuscitation is a severe medical condition with a low survival rate. Providing pediatric resuscitation is a significant stressor for medical teams that may impair performance. The vagal nerve is a crucial moderator of stress responses, and its activation (indexed by heart rate variability, HRV) has been shown to predict and improve performance in various settings. However, there is limited data about vagal activation and performance in medical settings.

METHODS

In a randomized simulation Study, paramedic students and medics were assigned to 3 min of slow-paced breathing or watching an educational 3-minute video. The participant received a scenario describing an unconscious baby without a pulse and with no breathing. The participants then performed CPR (cardiopulmonary resuscitation) on a manikin. During the scenario, every 2 min, the participant was asked a question that tested the recall of information from the scenario, and CPR performance was continuously monitored. HRV and subjective stress were taken 3 times.

RESULTS

Higher baseline HRV predicted better CPR performance. No difference in CPR performance between the groups was found, and explanations for these results will be discussed.

CONCLUSION

HRV may be used to predict CPR performance. Short-term slow-paced breathing does not improve CPR performance. Future studies should investigate the effect of long-term stress reduction interventions on CPR performance.

Sleep Quality and Evening Salivary Cortisol Levels in Association with the Psychological Resources of Parents of Children with Developmental Disorders and Type 1 Diabetes

BACKGROUND

Sleep deprivation can decrease parental well-being and degrade mental and physical health in parents of children with chronic illness. The aim of this study was to explore the associations of sleep quality, psychological stress perception, and evening salivary cortisol concentration with self-esteem, optimism and happiness in parents of children with type 1 diabetes and developmental disorders compared to parents of healthy, typically developing children.

METHODS

We studied 196 parents of children with chronic conditions, including autistic spectrum disorder (N = 33), cerebral palsy (N = 18), Down syndrome (N = 33), and diabetes mellitus type 1 (N = 40) and parents of healthy children (N = 72). We evaluated parental sleep quality, evening salivary cortisol levels, self-esteem, optimism and happiness. Multiple linear regression models were used to assess associations between variables.

RESULTS

Compared with those of the control group, the parents of children with autistic spectrum disorders had higher evening cortisol concentrations (β = 0.17; p = 0.038) and lower perceptions of happiness (β=-0.17; p = 0.017), while parents of children with type 1 diabetes had disrupted sleep quality (β = 0.25; p = 0.003). Optimism was negatively associated with the evening cortisol concentration (β=-0.18; p = 0.023) and sleep quality index (β=-0.20; p = 0.012).

CONCLUSIONS

Public health programs aimed at lifestyle habit improvement, respite care, and relaxation for parents of children with chronic conditions would be useful for improving parental sleep quality, self-esteem, optimism and happiness.

Deciphering the role of cytokines in aging: Biomarker potential and effective targeting

Aging is often characterized by chronic inflammation, immune system dysregulation, and cellular senescence with chronically elevated levels of pro-inflammatory cytokines. These small glycoproteins are mainly secreted by immune cells, mediating intercellular communication and immune system modulation through inflammatory signaling. Their pro- and anti-inflammatory effects make them a noteworthy research topic as well as a promising ally in combating inflammation and the aging process. Cytokines exert a synergistic role in aging and disease and may prove useful biomarkers of tissue-specific dysregulation, disease diagnosis and monitoring, presenting potential therapeutic options as anti-inflammatory and senolytic medications. In this review, we address the cellular and molecular mechanisms implicating cytokines in the aging process and related diseases, highlighting their biomarker potential. We focus on the current therapeutic strategies, including specific pharmaceutical agents, supplements, a balanced diet, and healthy habits such as exercise, stress management, and caloric restriction.

Chronic stress-mediated dysregulations in inflammatory, immune and oxidative circuitry impairs the therapeutic response of methotrexate in experimental autoimmune disease models

Chronic stress is significantly implicated in the worsening of autoimmune disorders, contributing to elevated inflammation and diminished therapeutic efficacy. Here, in this study, we investigated the detrimental impact of an 8-week chronic unpredictable stress (CUS) protocol on the progression of arthritis and psoriasis using collagen-induced arthritis (CIA) and imiquimod (IMQ)-induced psoriasis rat models, respectively. Our objective was to elucidate how prolonged stress exacerbates disease severity and impairs the effectiveness of treatment drug. Following the induction of CIA and IMQ, rats were subjected to an 8-week CUS paradigm designed to simulate chronic stress conditions. Moreover, after 5 weeks of CUS, methotrexate (MTX; 2 mg/kg, administered once weekly for 3 weeks, intraperitoneally) was introduced as a therapeutic intervention. The severity of CUS-induced effects and the therapeutic impairment of MTX in arthritis and psoriasis rats were assessed through pathological examination of joint and epidermal tissues, respectively. Additionally, we measured various pro-inflammatory cytokine levels, including NF-κB (nuclear factor kappa B), IFN-γ (interferon-gamma), TNF-α (tumour necrosis factor alpha), IL (interleukin)-1β, IL-6, IL-17 and IL-23 using enzyme-linked immunosorbent assay (ELISA), analysed immune cells through complete haematological profiling and evaluated oxidative stress markers. Our findings revealed that CUS significantly aggravated the pathological features of both arthritis and psoriasis. Prolonged stress exposure led to heightened inflammatory responses, increased oxidative stress and more severe tissue damage. Moreover, the therapeutic efficacy of MTX was notably reduced in stressed rats compared to non-stressed, underscoring the detrimental effects of chronic stress on treatment outcomes. Taken together, our results emphasize the importance of considering chronic stress as a critical factor in the management of autoimmune diseases.

Mindfulness, coping, and disruptions as predictors of college student distress at the beginning of the COVID-19 pandemic

Methods: Students completed an online survey about pandemic-related disruptions, depressive symptoms, mindfulness, coping, and demographics.

Results: Students whose families had more financial difficulties reported more disruptions. Depression and avoidant coping were positively correlated with distress, while mindfulness was inversely correlated with distress and depression. Disruptions, family financial status, depressive symptoms, mindfulness, and avoidant coping significantly predicted distress, controlling for university site and student sex, age, race, and ethnicity in multiple regression analyses. Avoidant coping significantly moderated (amplified) the effect of disruptions on distress. Conclusions: College student well-being can be supported through Campus programming that includes mindfulness practices and alternatives to avoidant strategies for coping with stress.

Impact of heart rate on the outcome of hypothermic patients

Objective

This study aimed to identify prognostic factors for hypothermia, including hormone levels.

Materials and Methods

This retrospective analysis used data from our department's database from November 2018 to December 2023. Inclusion criteria comprised cases with a prehospital diagnosis of hypothermia (body temperature <35°C) established by emergency medical technicians. Patients in cardiac arrest upon arrival were excluded from the study. This study investigated various parameters, including age, sex, body temperature, systolic blood pressure, heart rate, Glasgow Coma Scale (GCS) score, and adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), C-reactive protein, total protein, albumin levels, and outcomes. Patients were categorized into two groups based on the discharge outcome: fatal and survival groups. This study compared the variables between the two groups.

Results

There were 28 and 53 patients in the fatal and survival groups, respectively. The average heart rate and FT3 levels in the fatal group were significantly lower than those in the survival group. The average cortisol and CRP levels in the fatal group were significantly higher than those in the survival group.

Conclusion

This is the first report to demonstrate that hypothermic patients with a fatal outcome tend to have low heart rate, low FT3 levels, high cortisol levels, and inflammation upon arrival at the hospital. Further studies with larger sample sizes are needed to confirm the clinical significance of our findings.

Different action of glucocorticoid receptor in adipose tissue remodelling to modulate energy homeostasis by chronic restraint stress

BACKGROUND

Chronic stress in daily life is a well-known trigger for various health issues. Despite advancements in obesity research, the mechanisms governing lipid metabolism in adipose tissue during cachexia remain poorly understood.

METHODS

A chronic restraint stress (CRS) model was used to induce significant physiological and psychological stress in mice. Mice were subjected to 6 h of restraint daily in 50 mL plastic tubes for seven consecutive days. A fasting control group was included for comparison. Post-stress assessments included behavioural tests, glucose and insulin tolerance tests and indirect calorimetry. Blood and adipose tissue samples were collected for mRNA and protein analyses.

RESULTS

CRS induced significant psychological and physiological changes in mice, including depression-like behaviours, weight loss and reduced insulin sensitivity. Notably, CRS caused extensive adipose tissue remodelling. White adipose tissue (WAT) underwent significant 'browning' accompanied by an increase in the expression of thermogenic proteins. This counteracted the stress-induced 'whitening' of brown adipose tissue (BAT), which exhibited impaired thermogenesis and functionality, thereby maintaining energy balance systematically. The glucocorticoid receptor (GR) plays a crucial role in lipid metabolism regulation during these changes. GR expression levels were inversely correlated in BAT and WAT, but aligned with the expression patterns of thermogenic proteins across adipose tissues. These findings suggest that under chronic metabolic stress, GR mediates tissue-specific responses in adipose tissues, driving functional and phenotypic transitions in BAT and WAT to maintain energy homeostasis.

CONCLUSIONS

This study provides novel insights into the contrasting thermogenic phenotypes of BAT and WAT under emaciation and highlights the critical role of GRs in adipose tissue remodelling during CRS and its potential as a therapeutic target. Addressing GR-mediated changes in adipose tissues may help alleviate BAT dysfunction in cachexia and promote WAT browning, enhancing metabolic stress resistance.

Does Vagal Nerve Activity Predict Performance in a Naval Commando Selection Test?

Special operations forces (SOF) soldiers are elite fighters and tactical professionals who perform in high-stress environments. SOF selection processes aim to identify candidates who can sustain performance in high-stress and changing conditions. The vagal nerve is a crucial moderator of stress responses, and its activity (indexed by heart rate variability, HRV) has been shown to predict performance and psycho-physiological resilience in various settings. However, its predictive validity needs to be clarified. This study examined the relationship between HRV and success in an intensive selection procedure. In a historical prospective study, we derived an HRV parameter (root mean square of successive differences between normal heartbeats, RMSSD) from a 10-second ECG of 365 candidates for an SOF naval unit. The ECG was taken approximately two months before the selection procedure. The predictive validity of other routinely obtained measures was also considered. High RMSSD was significantly associated with success, but this relation disappeared after controlling for confounders (e.g., running score). However, after matching pairs of successful and non-successful candidates on confounders, HRV was again significantly related to course performance. The results of this study support the predictive value of HRV for tactical professionals. Given the high cost of training elite soldiers and the burden they undergo, improving accuracy of the selection processes may reduce the burden on candidates and lead to resource savings. Future studies should measure HRV at several time points with longer ECG records.

The impact of endocrine disrupting chemicals on adrenal corticosteroids - A systematic review of epidemiological studies

BACKGROUND

The role of endocrine disrupting chemicals (EDCs) in the development of metabolic syndrome has gained increasing recognition in recent years. The underlying mechanisms are largely unresolved. Disruption of corticosteroid action and hypothalamic-pituitary-adrenal (HPA) axis are considered possible mechanisms.

OBJECTIVE

To summarise epidemiological studies investigating an association between EDC concentration and altered levels of corticosteroids and the adrenocorticotropic hormone (ACTH).

METHODS

Following the PRISMA guidelines, we searched PubMed and the Cochrane Library for epidemiological studies published from database inception until April 1st, 2024. Various groups of EDCs were evaluated with the prerequisite of direct measurement of the chemical, a metabolite, or biomarker.

RESULTS

We identified 2094 articles. After removing duplicates and screening, 27 studies were included. Studies focused predominantly on glucocorticoids (n = 26) compared to mineralocorticoids (n = 5) and ACTH (n = 2). The most studied EDCs were pesticides (n = 9) and phthalates (n = 8). Significant associations between the concentrations of specific EDCs and hormone levels were found in all but three studies. Only one study described an association between EDCs, and hormone concentration and metabolic features.

CONCLUSION

There is clear evidence for the impact of specific EDCs on plasma corticosteroid concentrations in different age groups worldwide, however, results varied according to EDC class, study population and study methodology. Further research combining EDC and hormone concentrations, and clinical features, complemented by experimental investigations to study cell mechanisms, is needed to gain holistic knowledge of EDCs' influence on glucocorticoid- and mineralocorticoid-related disorders.

Research progress in modulating the auditory system by the cochlear circadian clock system in response to noise exposure

The circadian clock is an endogenous system evolved to adapt to environmental changes. Recent studies confirmed that the cochlea exhibits circadian oscillations regulating auditory function. These oscillations are linked to brain-derived neurotrophic factor and glucocorticoid levels. Circadian rhythms influence cochlear sensitivity to noise by regulating the secretion of brain-derived neurotrophic factors and glucocorticoids. This study explores the regulatory mechanism of the circadian clock system, its impact on the auditory system, and its potential role in noise-induced hearing loss. Understanding the regulatory mechanisms of circadian rhythms in auditory function will provide new ideas for developing treatments for noise-induced hearing loss.

Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia

BACKGROUND

The elevated prolactin levels in first-episode drug-naïve (FEDN) schizophrenia patients may correlate with long-term stress caused by childhood trauma. This study aimed to assess the relationship between elevated prolactin levels and childhood trauma in FEDN schizophrenia patients, while also considering sex differences.

METHODS

Utilizing a cross-sectional design, the study involved 88 FEDN schizophrenia patients and 76 healthy controls (HCs). Evaluations encompassed measuring prolactin levels in peripheral blood and assessing mental health using the Positive and Negative Syndrome Scale (PANSS), the Childhood Trauma Questionnaire - Short Form (CTQ-SF), as well as evaluating resilience with the Connor-Davidson Resilience Scale (CD-RISC), perceived social support with the Perceived Social Support Scale (PSSS), and demographic characteristics to control for confounding factors. A mediation model was constructed using the RMediation package of the R software.

METHODS

The results suggested prolactin levels in FEDN schizophrenia patients were higher than in HCs(t=-9.938, p = 0.000). Group classification (HCs vs. FEDN schizophrenia patients) (t = 9.291, p = 0.000) and sex (t = 3.282, p = 0.001) were influential factors for prolactin levels. Elevated prolactin(OR = 1.007, p = 0.000), along with higher scores for childhood emotional(OR = 1.469, p = 0.006)andsexual abuse(OR = 1.592, p = 0.018) and lower social support(OR = 0.946, p = 0.026), were associated with the onset of schizophrenia. Positive correlations were found between prolactin levels and childhood emotional (r = 0.268, p = 0.002) /sexual abuse(r = 0.264, p = 0.002), with no sex differences. No significant relationship was observed between prolactin levels and PANSS scores. Mediation analysis revealed that childhood emotional abuse (95% CI: [0.059 ~ 0.293]) and sexual abuse (95% CI: [0.086 ~ 0.439]) had significant indirect effects on schizophrenia, mediated by elevated prolactin levels.

CONCLUSION

These findings suggest that childhood trauma may be associated with the onset of schizophrenia by influencing prolactin levels, highlighting the complex interplay between hormonal disruptions and early-life stress in the development of schizophrenia.

Unveiling Gestational Diabetes: An Overview of Pathophysiology and Management

Gestational diabetes mellitus (GDM) is characterized by an inadequate pancreatic β-cell response to pregnancy-induced insulin resistance, resulting in hyperglycemia. The pathophysiology involves reduced incretin hormone secretion and signaling, specifically decreased glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), impairing insulinotropic effects. Pro-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), impair insulin receptor substrate-1 (IRS-1) phosphorylation, disrupting insulin-mediated glucose uptake. β-cell dysfunction in GDM is associated with decreased pancreatic duodenal homeobox 1 (PDX1) expression, increased endoplasmic reticulum stress markers (CHOP, GRP78), and mitochondrial dysfunction leading to impaired ATP production and reduced glucose-stimulated insulin secretion. Excessive gestational weight gain exacerbates insulin resistance through hyperleptinemia, which downregulates insulin receptor expression via JAK/STAT signaling. Additionally, hypoadiponectinemia decreases AMP-activated protein kinase (AMPK) activation in skeletal muscle, impairing GLUT4 translocation. Placental hormones such as human placental lactogen (hPL) induce lipolysis, increasing circulating free fatty acids which activate protein kinase C, inhibiting insulin signaling. Placental 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) overactivity elevates cortisol levels, which activate glucocorticoid receptors to further reduce insulin sensitivity. GDM diagnostic thresholds (≥92 mg/dL fasting, ≥153 mg/dL post-load) are lower than type 2 diabetes to prevent fetal hyperinsulinemia and macrosomia. Management strategies focus on lifestyle modifications, including dietary carbohydrate restriction and exercise. Pharmacological interventions, such as insulin or metformin, aim to restore AMPK signaling and reduce hepatic glucose output. Emerging therapies, such as glucagon-like peptide-1 receptor (GLP-1R) agonists, show potential in improving glycemic control and reducing inflammation. A mechanistic understanding of GDM pathophysiology is essential for developing targeted therapeutic strategies to prevent both adverse pregnancy outcomes and the progression to overt diabetes in affected women.

MiR-186-5p inhibition restores synaptic transmission and neuronal network activity in a model of chronic stress

Chronic stress exerts profound negative effects on cognitive and emotional behaviours and is a major risk factor for the development of neuropsychiatric disorders. However, the molecular links between chronic stress and its deleterious effects on neuronal and synaptic function remain elusive. Here, using a combination of in vitro and in vivo approaches, we demonstrate that the upregulation of miR-186-5p triggered by chronic stress may be a key mediator of such changes, leading to synaptic dysfunction. Our results show that the expression levels of miR-186-5p are increased both in the prefrontal cortex (PFC) of mice exposed to chronic stress and in cortical neurons chronically exposed to dexamethasone. Additionally, viral overexpression of miR-186-5p in the PFC of naïve mice induces anxiety- and depressive-like behaviours. The upregulation of miR-186-5p through prolonged glucocorticoid receptor activation in vitro, or in a mouse model of chronic stress, differentially affects glutamatergic and GABAergic synaptic transmission, causing an imbalance in excitation/inhibition that leads to altered neuronal network activity. At glutamatergic synapses, we observed both a reduction in synaptic AMPARs and synaptic transmission, whereas GABAergic synaptic transmission was strengthened. These changes could be rescued in vitro by a miR-186-5p inhibitor. Overall, our results establish a novel molecular link between chronic glucocorticoid receptor activation, the upregulation of miR-186-5p and the synaptic changes induced by chronic stress, that may be amenable to therapeutic intervention.

Altered Sensory and Stress Responses in Atopic Dermatitis: Effects of Acute Stress on Lesional and Non-Lesional Skin

Itch and pain are both mediated by small sensory fibres. Atopic dermatitis (AD) patients usually report stress-induced flares, but the impact of stress on sensory fibres in lesional and non-lesional skin remains inconclusive. This observational study assessed the effect of acute stress on sensory profiles in subjects with AD (n = 18) and healthy controls (HC, n = 21). Participants completed clinical and psychological questionnaires, and quantitative sensory testing was performed on lesional and non-lesional skin in AD and healthy skin in HC. Assessments were done before and after the Montreal Imaging Stress Task, an acute stress protocol. Stress responses were evaluated by anxiety ratings, heart rate (HR) and salivary cortisol (CORT). Cortisol binding globulin (CBG) was quantified as an indirect measure for circulating CORT. AD participants reported higher anxiety, depression and stress perception than HC. HR was similar between groups, but AD participants showed a blunted CORT response post-stress and lower CBG levels, suggesting altered stress regulation. Acute stress reduced cold sensitivity in HC and non-lesional AD skin but had no effect on lesions. These findings indicate that the effects of stress on small fibres depend on the condition of the skin and emphasise the sensory alterations experienced by AD patients.

Interactions of chronic stress exposure and stress appraisal on vascular endothelial function among young adults

We investigated the associations of ongoing, chronic stress exposure and stress appraisal on vascular endothelial function (VEF) in young adults. In 72 healthy young adults (74% female; age = 25 ± 1 yr), we assessed chronic stress exposure and appraisal with a measure that quantified chronic stress exposure and chronic stress appraisal related to eight specific stressors over the last year. Participants completed the perceived stress scale (PSS) as a measure of global, proximal stress appraisal. VEF was assessed using the brachial artery flow-mediated dilation technique. We examined relations among ongoing, chronic stress exposure and stress appraisal versus VEF adjusted for age and sex, and then assessed whether stress appraisal moderated the effect of chronic stress exposure on VEF. Chronic stress exposure (β = -0.24, P = 0.045), but not chronic stress appraisal (β = 0.07, P = 0.56) or perceived stress (β = -0.20, P = 0.11), was related to VEF. Perceived stress (P = 0.046), but not chronic stress appraisal (P = 0.54), moderated the association between chronic stress exposure and VEF. The effect of chronic stress exposure on VEF ceased to be significant at a PSS score of ∼22. Subsequent exploratory stratified analysis indicated that those with PSS ≥22 had increased exposure to adverse childhood experiences (+1.6 ± 0.6, P = 0.01), greater depressive symptoms (+10.2 ± 2.7, P < 0.001), and reduced psychological resilience (-7.6 ± 3.5, P = 0.036). Chronic stress exposure significantly predicts impaired VEF among young adults. Furthermore, this relation is influenced by proximal perceived stress, such that the association of chronic stress exposure on VEF may be obscured at high levels of proximal perceived stress.NEW & NOTEWORTHY Our findings indicate that ongoing chronic stress exposure over the last year is significantly associated with reduced vascular endothelial function among apparently healthy young adults. Our data provide important insights into the interplay of chronic stress exposure versus proximal perceived stress and may also support the hypothesis that young adults who are sensitized to stress may be particularly vulnerable to stress-related impairments in vascular endothelial function.

Chlorogenic Acid Ameliorates Chronic Unpredictable Stress-Induced Diminished Ovarian Reserve Through Ovarian Renin-Angiotensin System

Chronic stress could impair ovarian reserve through hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to reduced oocyte quality and endocrine dysfunction. The ovarian renin-angiotensin system (OVRAS) modulates follicular development, and excessive activation of the ACE-AngII-AT1R axis increases oxidative stress, disrupting ovarian function. This study investigates OVRAS's role in chronic unpredictable stress (CUS)-induced diminished ovarian reserve (DOR) and explores the protective effects of chlorogenic acid (CGA). Female mice were subjected to CUS (10 intervention methods were randomly applied to mice according to low, medium, and high frequency) and CGA treatment. Hormone levels, estrous cycles, ovarian morphology, oxidative stress, and apoptosis were evaluated. Results demonstrated that CUS overactivated the ACE-AngII-AT1R axis, increasing oxidative stress and apoptosis in granulosa cells (GCs). CGA improved ovarian function, reduced oxidative stress, and downregulated ACE-AngII-AT1R axis activity. CGA may alleviate stress-induced DOR by mitigating oxidative stress and apoptosis via modulation of the ACE-AngII-AT1R axis.

Stress, hardiness and eating disorder symptoms in military academy cadets

Eating disorders are a persistent and debilitating problem, especially among college age men and women. This problem is exacerbated in occupations such as the military, where maintenance of strict standards regarding weight, fitness and appearance is important for job retention and promotion. Also, previous research confirms that stress is a contributing element to eating disorders. It is thus important to identify factors that may assist individuals to remain resilient and avoid stress-related health and eating difficulties. The present study utilizes historical data to examine the impact of stress on health and eating disorder symptoms in a representative sample of West Point military academy cadets, while testing the role of gender and hardiness as stress moderators in this relation. A survey containing measures of stress, hardiness and eating disorders symptoms was completed by 387 cadets in the fall and spring of 2000-2001. Moderation effects were tested with advanced conditional process analysis procedures developed recently by Hayes (2022). Results show that hardiness was a significant moderator, with cadets low in hardiness showing increased eating disorder symptoms and more general health symptoms. While gender was not a significant moderator with respect to eating disorder symptoms, it was significant for general health symptoms; female cadets showed more stress-related health symptoms than their male counterparts. These results suggest that eating disorder symptoms in military academy cadets and college students more generally may be reduced through programs aimed at developing hardiness attitudes and stress coping approaches.

Hormone circuit explains why most HPA drugs fail for mood disorders and predicts the few that work

Elevated cortisol in chronic stress and mood disorders causes morbidity including metabolic and cardiovascular diseases. There is therefore interest in developing drugs that lower cortisol by targeting its endocrine pathway, the hypothalamic-pituitary-adrenal (HPA) axis. However, several promising HPA-modulating drugs have failed to reduce long-term cortisol in mood disorders, despite effectiveness in other hypercortisolism conditions such as Cushing's syndrome. The reasons for these failures remain unclear. Here, we use a mathematical model of the HPA axis to demonstrate that the pituitary and adrenal glands compensate for drug effects by adjusting their functional mass, a feedback mechanism absent in Cushing tumors. Our systematic in silico analysis identifies two interventions targeting corticotropin-releasing hormone (CRH) as effective for lowering long-term cortisol. Other targets either fail due to gland mass compensation or harm other aspects of the HPA axis. We propose CRH-neutralizing antibodies and CRH-synthesis inhibitors as potential targets for reducing long-term cortisol in mood disorders and chronic stress. More generally, this study indicates that understanding the slow compensatory mechanisms in endocrine axes can be crucial to prioritize drug targets.

Rapid Mental Stress Evaluation Based on Non-Invasive, Wearable Cortisol Detection with the Self-Assembly of Nanomagnetic Beads

The rapid and timely evaluation of the mental health of emergency rescuers can effectively improve the quality of emergency rescues. However, biosensors for mental health evaluation are now facing challenges, such as the rapid and portable detection of multiple mental biomarkers. In this study, a non-invasive, flexible, wearable electrochemical biosensor was constructed based on the self-assembly of nanomagnetic beads for the rapid detection of cortisol in interstitial fluid (ISF) to assess the mental stress of emergency rescuers. Based on a one-step reduction, gold nanoparticles (AuNPs) were functionally modified on a screen-printed electrode to improve the detection of electrochemical properties. Afterwards, nanocomposites of MXene and multi-wall carbon nanotubes were coated onto the AuNPs layer through a physical deposition to enhance the electron transfer rate. The carboxylated nanomagnetic beads immobilized with a cortisol antibody were treated as sensing elements for the specific recognition of the mental stress marker, cortisol. With the rapid attraction of magnets to nanomagnetic beads, the sensing element can be rapidly replaced on the electrode uniformly, which can lead to extreme improvements in detection efficiency. The detected linear response to cortisol was 0-32 ng/mL. With the integrated reverse iontophoresis technique on a flexible printed circuit board, the ISF can be extracted non-invasively for wearable cortisol detection. The stimulating current was set to be under 1 mA for the extraction, which was within the safe and acceptable range for human bodies. Therefore, based on the positive correlation between cortisol concentration and mental stress, the mental stress of emergency rescuers can be evaluated, which will provide feedback on the psychological statuses of rescuers and effectively improve rescuer safety and rescue efficiency.

Molecular mechanism underlying stress response and adaptation

Stress, a common life experience, impacts both mental and physical health, contributing to conditions such as anxiety and cardiovascular disease. It triggers physiological and psychological responses, primarily through the Hypothalamic-Pituitary-Adrenal (HPA) and Sympathetic-Adrenal-Medullary (SAM) axes, which are coordinated by the autonomic nervous system. Dysregulation of the glucocorticoid system, mediated by mineralocorticoid and glucocorticoid receptors, plays a critical role in neurodegenerative disorders like Alzheimer's disease. Cellular pathways like PI3K/Akt, NF-κB, and AP-1 transcription factors maintain homeostasis during stress and are targets for therapeutic research. Epigenetic influences and genomic modifications highlight the long-lasting effects of stress on gene expression. Adaptive responses, such as allostasis, allow the body to maintain stability amid stress. However, excessive stress leads to allostatic load, negatively impacting the immune, endocrine, and nervous systems. Current treatments include pharmacological and lifestyle interventions, with emerging approaches such as psychobiotics and precision medicine offering future potential.

Long-term consumption of hydrogen-rich water provides hepatoprotection by improving mitochondrial biology and quality control in chronically stressed mice

BACKGROUND

Chronic stress has emerged as a prevalent facet of contemporary existence, significantly jeopardizing overall bodily health. The liver, a pivotal organ responsible for metabolic equilibrium, is particularly vulnerable to its adverse effects. This study delves into the hepatoprotective properties of extended consumption of HRW in mice subjected to chronic stress.

METHODS

Mice subjected to chronic stress via CUMS and HRW administration for seven months underwent liver pathological examination. Key liver function indicators (AST, ALT), oxidative stress markers (SOD, CAT, GSH), and markers related to lipid peroxidation and ferroptosis (MDA, Fe) were measured using standard kits. ELISA determined corticosterone and 4-HNE levels. Immunofluorescence evaluated ROS, Nrf2, and apoptosis in liver tissues. Western blotting analyzed markers for ferroptosis (GPX4, SLC7A11, HO-1, Nrf2), apoptosis (Bax, Bcl-2, Cytc, Caspase-3, Caspase-8), mitochondrial biogenesis (Nrf1, PGC-1α, Tfam), and quality control (Drp1, Fis1, Mfn1, Mfn2, OPA1, PINK1, Parkin, LC3 I/II).

RESULTS

The findings indicate a noteworthy improvement in liver health among mice exposed to HRW, as evidenced by histological analysis. Furthermore, the consumption of HRW exhibited hepatoprotection, as evidenced by the normalization of AST and ALT levels. Mechanistically, our results indicate that HRW elevates the levels of SOD, CAT, and GSH, while effectively clearing ROS within mitochondria. It was observed led to a regulation in the expression of mitochondrial quality control proteins, consequently improving mitochondrial biogenesis (Nrf1, PGC-1α, Tfam), and increasing ATP production. Furthermore, HRW decreased Cytc, Bax, Caspase-3, and Caspase-8 levels, and increasing the expression of Bcl-2. Additionally, HRW reduced MDA and 4-HNE levels, alleviating ferroptosis through the Nrf2/HO-1 pathway, and upregulating the expression of GPX4 and SLC7A11. By mitigating hepatocyte death through the aforementioned mechanisms, HRW fulfills its crucial role in safeguarding liver health.

CONCLUSIONS

This study reveals that long-term hydrogen-rich water (HRW) consumption provides significant hepatoprotection in mice under chronic stress. HRW normalizes liver enzyme levels, enhances antioxidant capacity, and reduces lipid peroxidation and ferroptosis. It improves mitochondrial biogenesis, function, and ATP production, and attenuates apoptosis by modulating related proteins. Behavioral tests show HRW alleviates stress-induced anxiety and enhances exploratory behavior. These findings suggest HRW is a promising non-invasive intervention for preventing and treating stress-related liver disorders by targeting oxidative stress and mitochondrial dysfunction.

A qualitative analysis of the psychedelic mushroom come-up and come-down

Psychedelic therapy has the potential to become a revolutionary and transdiagnostic mental health treatment, yielding enduring benefits that are often attributed to the experiences that coincide with peak psychedelic effects. However, there may be an underrecognized temporal structure to this process that helps explain why psychedelic and related altered states of consciousness can have an initially distressing but ultimately distress-resolving effect. Here we present a qualitative analysis of the self-reported 'come-up' or onset phase, and 'come-down' or falling phase, of the psychedelic experience. Focusing on psilocybin or psilocybin-containing mushroom experience reports submitted to Erowid.org, we use phenomenological, thematic content and word frequency analysis to show that the come-up is more often characterized by negatively valenced feeling states that resemble an acute stress reaction, while the come-down phase is more often characterized by positively valenced feeling states of the sort often observed following recovery from illness or resolution of stress. The therapeutic and theoretical relevance of these findings are discussed.

Chronic stress-induced cholesterol metabolism abnormalities promote ESCC tumorigenesis and predict neoadjuvant therapy response

Recent studies have demonstrated that chronic stress can enhance the development of multiple human diseases, including cancer. However, the role of chronic stress in esophageal carcinogenesis and its underlying molecular mechanisms remain unclear. This study uncovered that dysregulated cholesterol metabolism significantly promotes esophageal carcinogenesis under chronic stress conditions. Our findings indicate that the persistent elevation of glucocorticoids induced by chronic stress stimulates cholesterol uptake, contributing to esophageal carcinogenesis. The activated glucocorticoid receptor (GCR) enrichment at the promoter region of High Mobility Group Box 2 (HMGB2) facilitates its transcription. As a transcription coactivator, HMGB2 enhances Sterol Regulatory Element Binding Transcription Factor 1 (SREBF1) transcription and regulates cholesterol metabolism through LDL particle uptake into cells via Low Density Lipoprotein Receptor (LDLR). These results emphasize the significant impact of chronic stress on esophageal carcinogenesis and establish cholesterol metabolism disorder as a crucial link between chronic stress and the development of ESCC. The implications suggest that effectively managing chronic stress may serve as a viable strategy for preventing and treating ESCC.

Mitochondrial and Stress-Related Psychobiological Regulation of FGF21 in Humans

FGF21 is a metabolic hormone induced by fasting, metabolic stress, and mitochondrial oxidative phosphorylation (OxPhos) defects that cause mitochondrial diseases (MitoD). Here we report that acute psychosocial stress alone (without physical exertion) decreases serum FGF21 by an average of 20% (p<0.0001) in healthy controls but increases FGF21 by 32% (p<0.0001) in people with MitoD-pointing to a functional interaction between the stress response and OxPhos capacity in regulating FGF21. We further define co-activation patterns between FGF21 and stress-related neuroendocrine hormones and report novel associations between FGF21 and psychosocial factors related to stress and wellbeing, highlighting a potential role for FGF21 in meeting the energetic needs of acute and chronic psychosocial stress.

Introduction to neurobiology and pharmacology of stress

In order to improve individual and community health outcomes, stress research is crucial for developing our understanding of human biology, psychology, and social dynamics. It also informs therapeutic practices, public health campaigns, and educational activities. The chapter explores how neurotransmitters, including glutamate, GABA, adrenaline, norepinephrine, serotonin, dopamine, and adrenaline, mediate stress responses, impact mood and behavior, and play a part in a number of stress-related disorders. The relevance of focused research and therapy approaches aimed at reestablishing equilibrium within these systems is highlighted by the fact that dysregulation of these neurotransmitters can exacerbate health problems. Additionally, it is investigated how the amygdala, hippocampus, and prefrontal cortex interact to process emotions, build resilience, and determine an individual's susceptibility to stress. These interactions are regulated by both neuroplasticity and hereditary and epigenetic factors. The chapter discusses the pharmaceutical approach to stress management, which includes a variety of drugs such as beta-blockers, anxiolytics, and antidepressants that work by targeting different neurotransmitter systems to reduce anxiety and mood disorders. Even while these therapies work, they may have negative consequences and side effects that should be carefully considered in clinical settings. The chapter promotes a comprehensive approach to stress management that combines medication, lifestyle changes, psychotherapy, and stress-reduction methods. Healthcare workers can improve patient care and ultimately the health and quality of life for people with stress-related disorders by knowing the complexity of pharmaceutical therapies and how they affect the stress response.

Investigation of the expression of Cis P-tau and Pin1 proteins following air pollution induction in the brain tissue of C57BL/6 mice

Alzheimer's disease (AD) is a multifactorial disease in which environmental factors play a role. Among environmental factors, air pollution is a vital issue in modern life. Despite extensive considerations, it remains uncertain how pollution mediates neurodegeneration in AD. Beta-amyloids and hyperphosphorylated tau proteins are the two main pathological markers that have been studied in AD so far. Tau protein is basically a phosphoprotein whose functions are controlled by phosphorylation. The function of tau protein is to be located on the surface of microtubules and stabilize them. Studies have shown that phosphorylated tau protein (p-tau) exists in cis and trans conformations at Thr231, among which cis is highly neurotoxic. The Pin1 enzyme performs the conversion of cis to trans or vice versa. In this study, an experimental mouse model was designed to investigate the formation of cis p-tau by inducing air pollution. In this way, mice were randomly exposed to pollution at 2-week, 1-month, and 2-month intervals. We investigated the formation of phosphorylated cis tau form during air pollution on mouse brains using Western blots and immunofluorescence. The fluorescent imaging results and Western blotting analysis of mouse brains revealed a significant accumulation of cis p-tau in pollution-treated mice models compared to the healthy control mice. According to Western blot results, air pollution induction caused a significant decrease in Pin1 protein. The results clearly show that the tauopathy observed during air pollution is mediated through the formation of cis tau. Our findings unravel tauopathy mysteries upon pollution and would help find a possible therapeutic target to fight the devastating disorder caused by modern life.

Psychological and biological stress pathways as common mechanisms underlying a psycho-neurological symptom cluster in cancer patients: Perceived stress, cortisol, and ACTH

PURPOSE

This study aimed to examine (a) whether psychological stress is associated with experiencing multiple psycho-neurological symptoms (depression, cognitive impairment, fatigue, sleep disturbance, and pain) as a cluster and (b) whether stress hormones (adrenocorticotropic hormone [ACTH] and cortisol) are associated with psychological stress and symptom cluster experience.

METHODS

This cross-sectional study analyzed data from 133 patients with hematologic cancer awaiting chemotherapy. Enzyme-linked immunosorbent assays analyzed the morning stress hormone levels (ACTH and cortisol). Latent profile analyses identified the group experiencing a psycho-neurological symptom cluster. Factors influencing the experience of the psycho-neurological symptom cluster were included as covariates and analyzed using multinomial logistic regression.

RESULTS

Thirty-three percent (n = 44) experienced all five psycho-neurological symptoms as a cluster and experienced each symptom in a higher severity than those who did not experience the symptom cluster (ps < 0.05). Thereby, this group legitimately experienced the psycho-neurological symptom cluster. The major determinant of this group was the perceived psychological stress (OR = 8.05, 95% CI = 3.08; 20.99). Further, each symptom demonstrated a positive association with stress levels (correlation r ranged from 0.22 to 0. 56, all ps < 0.05). Participants with higher stress were more likely to experience the symptom cluster. Stress hormones levels (ACTH and cortisol) were neither associated with the symptom cluster experience nor with psychological stress levels.

CONCLUSIONS

Psychological stress, rather than biological stress response, is involved in experiencing the psycho-neurological symptom cluster. Managing stress levels would help alleviate this symptom cluster.

The Utility of Prolonged Chronic Unpredictable Stress to Study the Effects of Chronic Fluoxetine, Eicosapentaenoic Acid, and Lipopolysaccharide on Anxiety-Like Behavior and Hippocampal Transcriptomic Responses in Male Rats

Chronic stress is a common trigger of multiple neuropsychiatric illnesses. Animal models are widely used to study stress-induced brain disorders and their interplay with neuroinflammation and other neuroimmune processes. Here, we apply the prolonged 12-week chronic unpredictable stress (PCUS) model to examine rat behavioral and hippocampal transcriptomic responses to stress and to chronic 4-week treatment with a classical antidepressant fluoxetine, an anti-inflammatory agent eicosapentaenoic acid (EPA), a pro-inflammatory agent lipopolysaccharide and their combinations. Overall, PCUS evoked anxiety-like behavioral phenotype in rats, corrected by chronic fluoxetine (alone or combined with other drugs), and EPA. PCUS also evoked pronounced transcriptomic responses in rat hippocampi, involving > 200 differentially expressed genes. While pharmacological manipulations did not affect hippocampal gene expression markedly, Gpr6, Drd2 and Adora2a were downregulated in stressed rats treated with fluoxetine, EPA and fluoxetine + EPA, suggesting their respective protein products (G protein-coupled receptor 6, dopamine D2 receptor and adenosine A2A receptor) as potential evolutionarily conserved targets under chronic stress. Overall, these findings support the validity of rat PCUS paradigm as a useful model to study stress-related anxiety pathogenesis, and call for further research probing how various conventional and novel drugs may (co)modulate behavioral and neurotranscriptomic biomarkers of chronic stress.

Impact of individual differences in cognitive reserve, stress, and busyness on episodic memory: an fMRI analysis of the Alabama Brain Study On Risk for Dementia

Cognitive reserve (CR) and busyness can boost memory, whereas stress can impair memory. Nevertheless, extant research has not yet examined busyness in conjunction with CR and stress, nor whether CR or stress moderate the relationship between busyness and episodic memory. Middle-aged and older adult participants (N = 71; ages 50-74; 31% African-American) answered lifestyle questionnaires and completed a visual paired-associate memory fMRI task. Dimension reduction techniques identified two latent CR factors-personal CR (own education; occupation complexity; socioeconomic status) and parental education (mother's/father's education), and identified two latent stress factors-external stress (neighborhood stress/violence; financial strain) and personal stress (perceived stress; work/personal stress). We cast these latent factors into a series of regression models, revealing that (1) in isolation, higher busyness predicted better episodic memory, (2) higher external stress predicted worse memory, (3) both greater personal CR and greater parental education predicted better memory, (4) busyness did not interact with stress nor with CR, and (5) in a combined model, higher parental education and lower external stress were significant independent predictors. Neuroimaging data revealed that higher CR was associated with more efficient brain activity in the hippocampus and posterior cingulate during successful episodic memory retrieval, whereas higher personal stress was associated with heightened activity in the precuneus. No interactions or main effects of busyness were observed for the fMRI data. Thus, although busyness was associated with superior episodic memory, busyness did not modulate brain activity during episodic memory retrieval, nor did CR or stress moderate the relationship between busyness and associative memory.

From cell to organ: Exploring the toxicological correlation of organophosphorus compounds in living system

Malathion is an organophosphate compound widely used as an insecticide in the agriculture sector and is toxic to humans and other mammals. Although several studies have been conducted at different levels in different animal models. But there is no work has been conducted on the toxicological correlation from cellular to behavioral level in surviving species model. Addressing this gap through further research is essential for a comprehensive understanding of malathion's impact on biological systems, facilitating better risk assessment and management strategies. Current research systemically evaluated the effects of malathion on the central nervous system and peripheral immune cells using immunological techniques in the BALB/c mice models. For this, animals were placed inside an inhalation chamber containing malathion (dose of 89.5 mg/ml/m3) for a specific exposure time. The group exposed for 6 minutes has shown a significant change in plasma-neurotransmitter (serotonin, dopamine) levels and decreased expression of Tyrosine hydroxylase in striatum and SNPC region of brain. The depolarized mitochondria and increased level of cleaved caspase-3 level and mature neurons in DG, CA1 and CA3 were also observed in the brain. Peripheral blood analysis illustrated a decrease in total leukocyte count and an increased level of early apoptosis at the same time point. From neurobehavioral results a significant locomotor hyperactivity, restlessness, and risk-taking behavior was observed. Taken together, results from the current study indicate that exposure to malathion at prolonged time durations induces neuronal and immune cell toxicity, and its toxicity may be mediated via changes in neurotransmitter levels and metabolite concentrations.

An aptamer-responsive microneedle patch sensor platform combining with hybridization chain reaction amplification for detection of steroid hormone cortisol in skin interstitial fluid

Fluctuations in cortisol levels from stressors are critical for the evaluation of endocrine function in body, and abnormal levels of cortisol may indicate serious health risks. Common strategies for cortisol detection are limited by the drawbacks of the intricate and time-consuming operations and the generation of body trauma. Herein, an aptamer-responsive microneedle patch sensor combining with hybridization chain reaction (HCR) amplification (Apt-HCR MN COR patch) was prepared for easy, accurate and minimally-invasive detection of cortisol in skin interstitial fluid (ISF). In this microneedle patch, swellable methacrylated hyaluronic acid (MeHA) was employed as the matrix for ISF extraction and probes loading. When cortisol bound its aptamer, the trigger DNA initiated the HCR in microneedle patch, producing a fluorescent signal proportional to the cortisol content. Under optimized conditions, in vitro and in vivo investigation confirmed the feasibility of the Apt-HCR MN COR patch for cortisol assay, and good biocompatibility was demonstrated. Benefiting from the aptamer recognition and HCR amplification, the Apt-HCR MN COR patch exhibited excellent selectivity and a detection limit (LOD = 0.048 μM) which could cover cortisol levels in ISF. As a proof of concept, after the established mouse model had shown a circadian rhythm of cortisol secretion, the patch was further used to track cortisol response in short duration of running fatigue exercise on this mouse model. It was demonstrated the detection results agreed well with those obtained by the classical enzyme-linked immunosorbent assay (ELISA). We believed that this strategy will inspire the development of MN sensors for cortisol-related disorders monitoring.