Stress Response Syndromes Research Articles

COVID-19 vaccine adverse events: Evaluating the pathophysiology with an emphasis on sulfur metabolism and endotheliopathy.

In this narrative review, we assess the pathophysiology of severe adverse events that presented after vaccination with DNA and mRNA vaccines against COVID-19. The focus is on the perspective of an undersulfated and degraded glycocalyx, considering its impact on immunomodulation, inflammatory responses, coagulation and oxidative stress. The paper explores various factors that lead to glutathione and inorganic sulfate depletion and their subsequent effect on glycocalyx sulfation and other metabolites, including hormones. Components of COVID-19 vaccines, such as DNA and mRNA material, spike protein antigen and lipid nanoparticles, are involved in possible cytotoxic effects. The common thread connecting these adverse events is endotheliopathy or glycocalyx degradation, caused by depleted glutathione and inorganic sulfate levels, shear stress from circulating nanoparticles, aggregation and formation of protein coronas; leading to imbalanced immune responses and chronic release of pro-inflammatory cytokines, ultimately resulting in oxidative stress and systemic inflammatory response syndrome. By understanding the underlying pathophysiology of severe adverse events, better treatment options can be explored.

Interrelation between the parameters of endogenous vascular regulation, oxidative stress and the markers of inflammatory response in COVID-19 patients while on extracorporeal membrane oxygenation

Introduction. Extracorporeal membrane oxygenation has found wide application in clinical practice during the COVID-19 pandemic. Oxidative stress, endothelial dysfunction, and systemic inflammatory response syndrome play an important role in the pathogenesis of COVID-19. Our research was designed to study correlations in-between those factors and the impact of extracorporeal membrane oxygenation on them.Aim. The study of systemic inflammatory response and endothelial function in patients with COVID-19 during extracorporeal membrane oxygenation.Material and methods. In the course of a prospective study, we examined 100 COVID-19 patients aged 26 to 75 years, median 55 years [47;60], who were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine, using extracorporeal membrane oxygenation. As a control group (normal), 25 practically healthy people whose median age was 32 years [25;39] were examined. The function of the vascular endothelium was assessed by the content of nitric oxide stable metabolites in the blood serum and the level of angiotensin-converting enzyme. Next, the ratio of nitric oxide metabolite to angiotensin-converting enzyme level was calculated, reflecting the imbalance between endotheliumdependent vasodilation and vasoconstriction. To assess the severity of oxidative stress in blood serum, malondialdehyde was determined as a marker of lipid peroxidation. The state of the antioxidant system was assessed in terms of total antioxidant status of blood serum. The presence of an imbalance in the system of lipid peroxidation and the antioxidant system total antioxidant status was judged by the oxidative stress coefficient, i.e. the ratio of malondialdehyde to the total antioxidant activity.Results. The analysis showed the presence and progression of endothelial dysfunction, impaired vascular regulation, activation of free radical processes, the presence of an imbalance in the prooxidant/antioxidant system, as well as the progression of the inflammatory process with a decrease in the level of markers of the COVID-19 severity.Conclusion. Further studies of the correlation between endothelial damage and the severity of the systemic inflammatory response syndrome may be of fundamental importance for explaining the pathophysiological mechanisms of COVID-19 course and developing new treatments for such patients.

Cross-Cultural Comparison of ICD-11 Adjustment Disorder Prevalence and Its Risk Factors in Japanese and Lithuanian Adolescents.

Background: Although there is increasing knowledge about adjustment disorder (AjD) based on the new diagnostic criteria of the International Classification of Diseases (ICD-11), less is known on AjD in adolescents. This study aimed to examine the prevalence of AjD and its risk factors in Japanese and Lithuanian adolescents. Methods: The cross-sectional study sample comprised 1745 adolescents from Japan (n = 913) and Lithuania (n = 832). AjD was assessed using the Adjustment Disorder New Module-8 (ADNM-8). We compared the prevalence of AjD in Japanese and Lithuanian adolescents. Using multinominal logistic regression analysis, we examined the effects of age, gender, socioeconomic status, and cumulative stressors as societal and cultural factors, resilience as an intrapersonal factor, and loneliness and perceived support as interpersonal factors on adolescent AjD. Results: The prevalence of probable AjD was 11.7% in Lithuanian adolescents and 6.9% in Japanese adolescents. Gender, socioeconomic status, cumulative stressors, resilience, loneliness, and perceived positive social support were each significantly associated with AjD risk. Conclusions: This cross-cultural comparative study revealed characteristics of the stressors and prevalence of AjD among Japanese and Lithuanian adolescents. In terms of the socio-interpersonal framework model for the stress–response syndrome, sociocultural, intrapersonal, and interpersonal factors were found to be risk factors associated with AjD in adolescents.

Stages of Psychotherapy for Trauma and Stress-related Disorders.

Psychotherapy technique should change as the stages of treatment for stress response syndromes progress. A formulation helps clinicians determine what to do at each stage. This progression should allow for integration of modalities of therapy. Configurational analysis provides 4 categories for organizing clinical inferences. It begins with an assessment of key symptoms and then the states of mind in which the symptoms vary because of degrees of emotional regulation. Unresolved emotional topics that lead to symptoms are then addressed in stages of exploring the meaning of memories. Finally, the self and relational schemas that lead to maladaptive patterns are inferred and lead toward integrative techniques for re-narrations and re-schematizations.

Validation of the International Adjustment Disorder Questionnaire in Israel and Switzerland.

The ICD-11 has introduced a new conceptualization of adjustment disorder (AjD) as a stress response syndrome with core symptoms of preoccupations and failure to adapt to the stressor. The current study aimed to assess the reliability and validity of the International Adjustment Disorder Questionnaire (IADQ) in two culturally distinct samples from Israel and Switzerland. Two samples were recruited in Israel (N = 1142) and Switzerland (N = 699) during the initial stages of the COVID-19 pandemic. Confirmatory factor analysis indicated that a correlated two-factor model provided an excellent fit to the Israeli and Swiss sample data. The IADQ scores correlated strongly with another measure of AjD symptoms and with symptoms of depression, anxiety, acute stress and negative emotions, whereas correlations with posttraumatic stress disorder, complex posttraumatic stress disorder and positive emotions were weaker. In the Swiss sample, 18.8% met diagnostic criteria for probable AjD and 10.2% in the Israeli sample. The current study provides the first evidence of the validity of the German and Hebrew versions of the IADQ and can be used for the screening of this debilitating condition.

Litopenaeus vannamei Sma and Mad related protein 5 gene is involved in stress response and white spot syndrome virus infection

Cell survival is based on the stability of intracellular state. It was well known that biochemical reactions in cells require specific intracellular environments, such as pH and calcium concentration. While the mechanism of stabilizing the intracellular environment is complex and far from clear. In this study, a Sma and Mad related protein 5 gene (LvSmad5) of Litopenaeus vannamei was cloned. LvSmad5 was located to both cytoplasm and nucleus. And subcellular localization of LvSmad5 was responsed to the changing of cells internal and external environment. Besides, it was found that subcellular localization of LvSmad5 was also regulated by unfolded protein response. Moreover, it was proved that nucleic localization of LvSmad5 could significantly increase the white spot syndrome virus (WSSV) infection in shrimp, and knockdown expression of LvSmad5 decreased the cumulative mortality of WSSV infection shrimp. Further investigation revealed that cytoplasm LvSmad5 could interplay with shrimp hexokinase 1, and contribute to glycolysis. These results indicated that LvSmad5 played a role in L. vannamei environmental stress response, and was used by WSSV for its replication.

Pterygopalatine fossa block and dexmedetomidine as components of stress-limiting anesthesia in ophthalmic surgery

BACKGROUND: To date, surgical interventions continue to be accompanied by a high proportion of complications and even death. In half of the cases, mortality and serious postoperative complications could have been prevented. After a comprehensive study of the factors affecting the prolongation of hospitalization and rehabilitation (Kehlet H., 1997; Kehlet H., Wilmore D., 2002), surgical stress response was identified as the most significant inducer of dysfunction among various organs and systems. General anesthesia, in its classical sense, is not able to provide patients with complete protection against surgical trauma. Comprehensive protection can be obtained through a combination of general and local anesthesia and stress-protective drugs.
 OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of the proposed scheme of stress-limiting anesthesia in ophthalmic surgery patients with corneal transplantation.
 MATERIALS AND METHODS: This study provides a comparative characterization of the severity of the stress response and pain syndrome in patients operated under the conditions of classical general anesthesia (group K) and those who received the scheme of stress-limiting anesthesia (group DB). Multicomponent anesthesia was administered in both groups. Sibazone was used for sedation in group K, whereas dexmedetomidine was used in group DB. The patients in group DB underwent local anesthesia before surgery. The main criteria for assessing the results were as follows: hemodynamic stability, blood glucose, level of venous blood leukocytes, and severity of pain according to the VAS in the postoperative period.
 RESULTS: Both schemes helped avoid pronounced fluctuations in hemodynamic and gas exchange parameters at all stages of the study. The analysis of blood glucose and leukocyte counts showed that patients in group K had a more significant deviation for both indicators from the preoperative level than those in group DB. In the study of pain syndrome, group K showed higher levels of pain according to the VAS than group DB.
 CONCLUSION: The scheme of stress-limiting anesthesia enables the control of postoperative pain without the additional use of narcotic analgesics and blockades in the postoperative period.

Childhood trauma, the stress response and metabolic syndrome: A focus on DNA methylation.

Childhood trauma (CT) is well established as a potent risk factor for the development of mental disorders. However, the potential of adverse early experiences to exert chronic and profound effects on physical health, including aberrant metabolic phenotypes, has only been more recently explored. Among these consequences is metabolic syndrome (MetS), which is characterised by at least three of five related cardiometabolic traits: hypertension, insulin resistance/hyperglycaemia, raised triglycerides, low high-density lipoprotein and central obesity. The deleterious effects of CT on health outcomes may be partially attributable to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which coordinates the response to stress, and the consequent fostering of a pro-inflammatory environment. Epigenetic tags, such as DNA methylation, which are sensitive to environmental influences provide a means whereby the effects of CT can be biologically embedded and persist into adulthood to affect health and well-being. The methylome regulates the transcription of genes involved in the stress response, metabolism and inflammation. This narrative review examines the evidence for DNA methylation in CT and MetS in order to identify shared neuroendocrine and immune correlates that may mediate the increased risk of MetS following CT exposure. Our review specifically highlights differential methylation of FKBP5, the gene that encodes FK506-binding protein 51 and has pleiotropic effects on stress responding, inflammation and energy metabolism, as a central candidate to understand the molecular aetiology underlying CT-associated MetS risk.

STRESS-LIMITING ANESTHESIA IN OPHTHALMOSURGERY

Despite the significant advances made by modern anesthesiology in the perioperative management of patients, surgical interventions are still accompanied by a high proportion of complications and even deaths. At the same time, it is known that in 50% of cases mortality and serious postoperative complications could be prevented. After performing a thorough study of the factors affecting the increase in hospitalization and postoperative recovery (Kehlet H., 1997; Kehlet H., Wilmore D., 2002), it was determined that the surgical stress response is the most significant inducer of dysfunction of various organs. and systems. To date, it has been established that general anesthesia in its classical sense does not allow achieving complete protection of the patient from surgical trauma. More complete protection can be achieved by combining general anesthesia with regional blockages and adjuvant drugs with stress-protective properties. In the present study, we compared the severity of the surgical stress response and pain syndrome in patients operated on under conditions of multicomponent balanced general anesthesia (group K) with patients who received a stress-limiting anesthesia regimen (group DB). In both groups, multicomponent anesthesia was performed, in group K, sibazone was used for sedation, in group DB, dexmedetomidine was used. Also, patients of the DB group underwent regional blockade (blockade of the pterygo-palatine fossa) before surgery. The main criteria for evaluating the results were: hemodynamic stability, blood glucose, the level of venous blood leukocytes and the severity of pain according to the VAS in the postoperative period. Both schemes made it possible to avoid pronounced fluctuations in hemodynamic and gas exchange parameters at all stages of the study. When analyzing blood glucose and leukocyte counts, it was found that patients in the control group had a more significant deviation of both indicators from the preoperative level than in the stress-limiting anesthesia group. In the study of pain syndrome, it was determined that in the control group the level of pain according to the VAS was higher at all stages of the study compared to patients in the group of stress-limiting anesthesia.

Treatment of Stress Response Syndromes, Second Edition

Treatment of Stress Response Syndromes, Second Edition

Stress Response Syndrome: The Struggles of PSD SHS Students who are Distressed in Certain Situations

Stress Response Syndrome: The Struggles of PSD SHS Students who are Distressed in Certain Situations

장애인생활체육지도자의 자기효능감이 스트레스 대처방식 및 번아웃 증후군에 미치는 영향

장애인생활체육지도자의 자기효능감이 스트레스 대처방식 및 번아웃 증후군에 미치는 영향

Effects of thermal stress on oxidative stress and antioxidant response, heat shock proteins expression profiles and histological changes in Marsupenaeus japonicus

Water temperature is a crucial ecological factor in aquatic environments. In the context of global warming, aquatic organisms are inevitably subject to thermal stress. The kuruma shrimp Marsupenaeus japonicus is an important commercial crustacean and has become one of the most important species in shrimp fisheries and aquaculture in China. However, M. japonicus showed relatively poor thermotolerance and frequently suffers mass mortalities during the summer months. The thermally sensitive properties of this species also make it a potential indicator species to reflect thermal alteration. Since this species raises both commercial and scientific interests, we investigated the effects of thermal stress on M. japonicus with special emphases on oxidative stress and antioxidant response, heat shock proteins expression profiles and histological changes. The results revealed that transcription of antioxidant enzymes (MjSeGpx and MjGSTMu) and heat shock proteins (Mjhsp60, Mjhsp70 and Mjhsp90) were all dramatically induced in both hepatopancreas and gill of M. japonicus under thermal stress with various expression patterns, and the up-regulated extent of the five genes exhibited a tendency of increasing with temperature. Several oxidative stress biomarkers, including MDA content, CAT activity, SOD activity and GST activity were assessed. The CAT activity was found to be more inducible than SOD and GST activities under thermal stress. In contrast to the higher basal antioxidant enzymes activities in the gill than that in the hepatopancreas, the hepatopancreas exhibited higher MDA content than that of gill. In consistent with the relatively higher MDA content, histological alterations appeared in the hepatopancreas of M. japonicus under thermal stress. This study provided comprehensive clues for uncovering the mechanisms underlying the thermal stress response and summer mortality syndrome of M. japonicus and evaluating the bioindicator potential of this species.

The psychobiology of stress, depression, adjustment disorders and resilience

Objectives: This paper focuses on the psychobiology of stress, depression, adjustment disorders (ADs), and resilience. Since the ADs fall under the rubric in DSM-5 of Trauma and Stressor-Related Disorders, essentials of the psychobiology of stress-response syndromes will be reviewed.Methods: A narrative review of the psychobiology of stress-response syndromes is undertaken, and the implications for our understanding of ADs are discussed.Results: Advances in our understanding of the psychobiology of stress-response syndromes provide an important foundation for understanding ADs, and for conceptualizing their diagnosis, as well as issues of resilience.Conclusions: Future investigations of the psychobiology of trauma- and stressor-related disorders may shed additional light on ADs, and ultimately improve their treatment.

Patterns of phenotypic plasticity and local adaptation in the wide elevation range of the alpine plant Arabis alpina

Abstract Local adaptation and phenotypic plasticity are two important characteristics of alpine plants to overcome the threats caused by global changes. Among alpine species, Arabis alpina is characterised by an unusually wide altitudinal amplitude, ranging from 800 to 3,100 m of elevation in the French Alps. Two non‐exclusive hypotheses can explain the presence of A. alpina across this broad ecological gradient: adaptive phenotypic plasticity or local adaptation, making this species especially useful to better understand these phenomena in alpine plant species. We carried out common garden experiments at two different elevations with maternal progenies from six sites that differed in altitude. We showed that (1) key phenotypic traits (morphotype, total fruit length, growth, height) display significant signs of local adaptation, (2) most traits studied are characterised by a high phenotypic plasticity between the two experimental gardens and (3) the two populations from the highest elevations lacked morphological plasticity compared to the other populations. By combining two genome scan approaches (detection of selection and association methods), we isolated a candidate gene (Sucrose‐Phosphate Synthase 1). This gene was associated with height and local average temperature in our studied populations, consistent with previous studies on this gene in Arabidopsis thaliana. Synthesis. Given the nature of the traits involved in the detected pattern of local adaptation and the relative lack of plasticity of the two most extreme populations, our findings are consistent with a scenario of a locally adaptive stress response syndrome in high elevation populations. Due to a reduced phenotypic plasticity, an overall low intra‐population genetic diversity of the adaptive traits and weak gene flow, populations of high altitude might have difficulties to cope with, e.g. a rise of temperature.

An empirical assessment of adjustment disorder as proposed for ICD-11 in a general population sample of Israel

BackgroundA new diagnostic concept of Adjustment Disorder (AjD) was proposed for inclusion in the International Classification of Diseases, 11th version (ICD-11). However, the symptom structure of AjD is poorly understood. The aim of the present study was to investigate the dimensionality of AjD as a stress-response syndrome. MethodsA general population sample of the Israeli population (N = 1003) completed the Adjustment Disorder – New Module 20 and the WHO-5 Wellbeing Scale. We compared seven alternative models of AjD using confirmatory factor analysis (CFA). A latent profile analysis (LPA) was performed to determine if subtypes of AjD were present. The performance of the unidimensional and multidimensional models of AjD were evaluated using regression analyses. ResultsCFA results supported a unidimensional model of AjD. The LPA identified three quantitatively distinct classes (low, medium, and high) with no evidence of any subtypes of AjD. The criterion validity of AjD was superior when treated as unidimensional. AjD was associated with lower levels of psychological wellbeing (β = −.32, p < .001). ConclusionsOur results suggest that AjD is better conceptualised as a unidimensional construct. Future work should focus on a reduction of required symptoms in order to improve clinical utility and validity of the diagnosis.

A socio-interpersonal approach to adjustment disorder: the example of involuntary job loss

ABSTRACTBackground: Adjustment disorder (AjD) was redefined for ICD-11 with core symptoms of preoccupation with a stressor and failure to adapt. The socio-interpersonal framework model for stress-response syndromes suggests that interpersonal factors, besides intrapersonal processes, substantially contribute to the development of AjD.Objective: The current study aimed to identify predictive factors in the development of AjD symptoms by the application of a framework model for stress-response syndromes.Method: N = 321 recently laid-off participants (47.7% female) were assessed with a newly developed standardized clinical diagnostic interview section on ICD-11 AjD. Self-report questionnaires measured AjD symptom severity, and interpersonal and intrapersonal predictors. Path analysis was used to model the associations between AjD symptom severity and the predictor variables. We conducted logistic regression to identify associated characteristics of diagnostic status.Results: AjD symptoms were highly prevalent and 25.6% of participants met the diagnostic criteria. Higher loneliness, higher dysfunctional disclosure, and lower self-efficacy were associated with both higher symptom severity and higher likelihood of meeting the diagnostic criteria for AjD. Higher perceived social support was associated with higher likelihood for AjD diagnosis.Conclusions: Research on risk factors for AjD is still sparse. This study provided empirical evidence on the role of interpersonal factors supporting the socio-interpersonal model for stress-response syndromes.

Descriptive study of adjustment disorders in a mental health unit.

IntroductionAdjustment disorders are a common psychiatric disorder in primary care and mental health units, with point prevalence estimates ranging from 0.9% to 2.3%. These disorders have been recently defined as a stress response syndrome in the fifth edition of the DSM, causing emotional and social difficulties and also a large economic burden on society.ObjectivesThe aim of this descriptional study was to analyse the socio-demographic characteristics and treatment of the patients diagnosed with adjustment disorders in the first visit in a mental health unit.MethodsThe study sample consisted of 128 patients admitted for a psychiatric consultation in a mental health unit in Alicante (Spain) from their primary care physician, between February and July 2016. Variables of gender, age, current employment status, diagnosis and treatment were measured. Data analysis was conducted using SPSS software.ResultsThe data from 31 patients who were diagnosed with adjustment disorders meant a 24% of the sample. The median age was 47 years old in the adjustment disorders group. Among those with adjustment disorders, 61% were women, and 52% of them were unemployed. Almost 60% of them had at least one pychotropic prescription and only 22% were derived to psychology.ConclusionsAdjustment disorders are considered as an intermediate category between no mental disorder and affective disorders. Most authors recommend to start with a psychotherapeutic intervention. Despite starting with medication has not proved effectiveness in the studies, most of the patients had at least one psychotropic prescription before the psychiatric evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Self-help interventions for adjustment disorder problems: a randomized waiting-list controlled study in a sample of burglary victims

Adjustment disorders (AjD) are among the most frequent mental disorders yet often remain untreated. The high prevalence, comparatively mild symptom impairment, and transient nature make AjD a promising target for low-threshold self-help interventions. Bibliotherapy represents a potential treatment for AjD problems. This study investigates the effectiveness of a cognitive behavioral self-help manual specifically directed at alleviating AjD symptoms in a homogenous sample of burglary victims. Participants with clinical or subclinical AjD symptoms following experience of burglary were randomized to an intervention group (n = 30) or waiting-list control group (n = 24). The new explicit stress response syndrome model for diagnosing AjD was applied. Participants received no therapist support and assessments took place at baseline, after the one-month intervention, and at three-month follow-up. Based on completer analyses, group by time interactions indicated that the intervention group showed more improvement in AjD symptoms of preoccupation and in post-traumatic stress symptoms. Post-intervention between-group effect sizes ranged from Cohen’s d = .17 to .67 and the proportion of participants showing reliable change was consistently higher in the intervention group than in the control group. Engagement with the self-help manual was high: 87% of participants had worked through at least half the manual. This is the first published RCT of a bibliotherapeutic self-help intervention for AjD problems. The findings provide evidence that a low-threshold self-help intervention without therapist contact is a feasible and effective treatment for symptoms of AjD.

Stress triggers mitochondrial biogenesis to preserve steroidogenesis in Leydig cells

Adaptability to stress is a fundamental prerequisite for survival. Mitochondria are a key component of the stress response in all cells. For steroid-hormones-producing cells, including also Leydig cells of testes, the mitochondria are a key control point for the steroid biosynthesis and regulation. However, the mitochondrial biogenesis in steroidogenic cells has never been explored. Here we show that increased mitochondrial biogenesis is the adaptive response of testosterone-producing Leydig cells from stressed rats. All markers of mitochondrial biogenesis together with transcription factors and related kinases are up-regulated in Leydig cells from rats exposed to repeated psychophysical stress. This is followed with increased mitochondrial mass. The expression of PGC1, master regulator of mitochondrial biogenesis and integrator of environmental signals, is stimulated by cAMP-PRKA, cGMP, and β-adrenergic receptors. Accordingly, stress-triggered mitochondrial biogenesis represents an adaptive mechanism and does not only correlate with but also is an essential for testosterone production, being both events depend on the same regulators. Here we propose that all events induced by acute stress, the most common stress in human society, provoke adaptive response of testosterone-producing Leydig cells and activate PGC1, a protein required to make new mitochondria but also protector against the oxidative damage. Given the importance of mitochondria for steroid hormones production and stress response, as well as the role of steroid hormones in stress response and metabolic syndrome, we anticipate our result to be a starting point for more investigations since stress is a constant factor in life and has become one of the most significant health problems in modern societies.