Abstract
BackgroundPsychosocial stress is becoming a major contributor to increased mental ill-health and sick leave in many countries. Valid markers of chronic stress would be valuable for diagnostic and prognostic purposes. A recent study suggested monocyte chemotactic protein-1 (MCP-1), epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) as markers of chronic stress. We aimed to confirm these potential biomarkers of prolonged psychosocial stress in female patients.Methodology/Principal FindingsCirculating levels of MCP-1, EGF and VEGF, along with several other cytokines, were measured in plasma from 42 female patients suffering from exhaustion due to prolonged psychosocial stress and 42 control subjects, using a protein biochip immunoassay. There were no significant differences between patients and controls in any of the cytokines or growth factors analyzed. Furthermore, when using a different protein bioassay and reanalyzing MCP-1 and VEGF in the same samples, markedly different levels were obtained. To further explore if inflammation is present in patients with exhaustion, the classical inflammatory marker C-reactive protein (CRP) was measured in another group of patients (n = 89) and controls (n = 88) showing a small but significant increase of CRP levels in the patients.Conclusions/SignificanceMCP-1, EGF and VEGF may not be suitable markers of prolonged psychosocial stress as previously suggested. Furthermore, significant differences were obtained when using two different protein assays measuring the same samples, indicating that comparing studies where different analytic techniques have been used might be difficult. Increased levels of CRP indicate that low-grade inflammation might be present in patients with exhaustion due to prolonged stress exposure but this inflammation does not seem to be reflected by increase in circulating MCP-1 or other cytokines measured.
Highlights
Increased long-term sick leave is a substantial problem in many countries, and a major reason for this increase is generally believed to be related to psychosocial stress [1,2,3]
One interesting aspect of biological consequences of prolonged stress is low-grade inflammation. Inflammatory markers such as Creactive protein (CRP) and interleukin-6 are associated with depression [9], and inflammatory processes have been suggested to be an important link between psychosocial stress and cardiovascular diseases such as atherosclerosis [10]
For monocyte chemotactic protein-1 (MCP-1), epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF), no significant differences were observed between the two groups (Table 4)
Summary
Increased long-term sick leave is a substantial problem in many countries, and a major reason for this increase is generally believed to be related to psychosocial stress [1,2,3]. Burnout is one of several mental health variables defined as a psychological outcome of long term stress, and emotional exhaustion is thought to be an important manifestation of burnout [4,5]. One interesting aspect of biological consequences of prolonged stress is low-grade inflammation Inflammatory markers such as Creactive protein (CRP) and interleukin-6 are associated with depression [9], and inflammatory processes have been suggested to be an important link between psychosocial stress and cardiovascular diseases such as atherosclerosis [10]. We aimed to confirm these potential biomarkers of prolonged psychosocial stress in female patients
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