Blunted Cortisol Stress Response and Depression-Induced Hypocortisolism Is Related to Inflammation in Patients With CAD

Waller, Christiane; Bauersachs, Johann; Hoppmann, Uta; Höch, Julia; Krause, Sabrina; Szabo, Franziska; Engler, Harald; Rottler, Edit; Herrmann‐Lingen, Christoph; Gündel, Harald

doi:10.1016/j.jacc.2015.12.031

Cited by 27 publications

(28 citation statements)

References 5 publications

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“…Glucocorticoid resistance, in turn, leads to excessive inflammation as well as hyperactivity of corticotropin-releasing hormone and SNS pathways ( 94 ), which may contribute to development of diseases, including atherosclerosis, diabetes, neurodegeneration and tumor metastasis ( 11 ). Interestingly, CHD patients show a blunted cortisol stress response (less cortisol release in response to acute stress) ( 140 ), and depressed individuals with CHD have increased inflammatory marker expression and decreased GR expression and GR sensitivity compared with nondepressed CHD patients ( 89 ).…”

Section: Pathways Affected By Loneliness—the Molecular Linkmentioning

confidence: 99%

Loneliness, Social Isolation, and Cardiovascular Health

Xia

2018

Antioxidants & Redox Signaling

307

231

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Significance: Social and demographic changes have led to an increased prevalence of loneliness and social isolation in modern society.Recent Advances: Population-based studies have demonstrated that both objective social isolation and the perception of social isolation (loneliness) are correlated with a higher risk of mortality and that both are clearly risk factors for cardiovascular disease (CVD). Lonely individuals have increased peripheral vascular resistance and elevated blood pressure. Socially isolated animals develop more atherosclerosis than those housed in groups.Critical Issues: Molecular mechanisms responsible for the increased cardiovascular risk are poorly understood. In recent reports, loneliness and social stress were associated with activation of the hypothalamic–pituitary–adrenocortical axis and the sympathetic nervous system. Repeated and chronic social stress leads to glucocorticoid resistance, enhanced myelopoiesis, upregulated proinflammatory gene expression, and oxidative stress. However, the causal role of these mechanisms in the development of loneliness-associated CVD remains unclear.Future Directions: Elucidation of the molecular mechanisms of how CVD is induced by loneliness and social isolation requires additional studies. Understanding of the pathomechanisms is essential for the development of therapeutic strategies to prevent the detrimental effects of social stress on health. Antioxid. Redox Signal. 28, 837–851.

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Section: Pathways Affected By Loneliness—the Molecular Linkmentioning

confidence: 99%

Loneliness, Social Isolation, and Cardiovascular Health

Xia

2018

Antioxidants & Redox Signaling

307

231

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“…This may be of particular interest in view of cardiovascular risk as flat diurnal slopes and raised evening levels of cortisol have been shown to predict cardiovascular mortality in a community-dwelling population [44]. Previous studies have also reported flatter cortisol slopes, as well as blunted cortisol responses to stress, in patients with manifest CAD, and even more so in those with CAD and depression [17,19,45,46]. In the present study, we did not find any correlation between GR-a mRNA levels and depressive symptoms but the sample may have been too small to evaluate the impact of clinical depression.…”

Section: Discussionmentioning

confidence: 96%

Glucocorticoid sensitivity and inflammatory status of peripheral blood mononuclear cells in patients with coronary artery disease

et al. 2018

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PBMCs from CAD patients displayed an inflammatory gene expression profile. This was not explained by reduced glucocorticoid sensitivity. Instead, inflammation was associated with increased expression of GR-α mRNA, suggesting a hypocortisolemic state. Key messages • Peripheral blood mononuclear cells from patients with coronary artery disease (CAD) display an inflammatory gene expression profile. • This inflammatory state cannot be explained by reduced glucocorticoid sensitivity in CAD patients. • Instead, the inflammatory gene expression profile is associated with upregulated levels of glucocorticoid receptor-α mRNA, suggesting a hypocortisolemic state.

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“…Waller C, et al (2016) в исследовании 91 пациента с ИБС и депрессией обнаружили изменение паттерна секреции (снижение) кортизола, которое было индуцировано депрессией. Они отмечают, что такое состояние может способствовать прогрессированию атеросклероза и его осложнению [25]. Poole L, et al (2016) показали, что у больных после операции аорто-коронарного шунтирования более резкое снижение дневного уровня кортизола на 60-й день после операции является предиктором депрессивного состояния спустя год после операции.…”

Section: воспалениеunclassified

A Psychosomatic Vicious Circle of Myocardial Infarction

Таратухин¹,

Гордеев²,

Лебедева³

2018

Russ J Cardiol

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Представлен обзор исследований, демонстрирующих соматические изменения при психологических процессах, принятых как факторы риска острого инфаркта миокарда: депрессия, стресс, тревога. На основании метафорического обозначения "идеальный шторм" показаны воспалительные, иммунологические, нейрогуморальные предпосылки развития инфаркта миокарда, а равно таковые изменения, являющиеся соматическим субстратом психологических состояний, способствующих развитию инфаркта миокарда посредством поведенческих и биологических факторов риска: "болезненное поведение", "депрессионная болезнь". Два эти процесса входят в психосоматический "порочный круг". В статье делается акцент на важности индивидуализации подхода к реабилитации и вторичной профилактике инфаркта миокарда, поскольку с биопсихосоциальной точки зрения восходящие и нисходящие психосоматические связи у каждого пациента уникальны.

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Blunted Cortisol Stress Response and Depression-Induced Hypocortisolism Is Related to Inflammation in Patients With CAD

Cited by 27 publications

References 5 publications

Loneliness, Social Isolation, and Cardiovascular Health

Loneliness, Social Isolation, and Cardiovascular Health

Glucocorticoid sensitivity and inflammatory status of peripheral blood mononuclear cells in patients with coronary artery disease

A Psychosomatic Vicious Circle of Myocardial Infarction

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