Discrimination in the Workplace Linked to Psychological Distress: A Longitudinal Study in the United States.

OBJECTIVE: To explore the relationship between workplace discrimination and psychological distress across nine years using data from the Midlife in the Unites States (MIDUS) study. METHODS: Workplace discrimination was measured with a validated 6-item scale at baseline with three categories (low, intermediate, and high), and psychological distress was measured with the Kessler-6 scale at baseline and follow-up. In total, 1,546 workers were analyzed by linear regression. RESULTS: High levels of workplace discrimination were significantly associated with increased psychological distress at follow-up (crude ß = 0.633, 95% CI = 0.307, 0.959). After adjusting for demographic factors, socioeconomic status, and health-related behaviors, associations were slightly attenuated (fully adjusted ß = 0.447, 95% CI = 0.115, 0.780). CONCLUSIONS: High workplace discrimination was longitudinally associated with higher levels of psychological distress. Organizations should actively prevent discrimination which may improve workers' mental health consequently.

Pediatric nurses' fatigue descriptions in occupational injury reports: A descriptive qualitative study1.

Background: Despite the high risks associated with occupational fatigue in healthcare, few organizations require nurses to screen and report fatigue symptoms. As a result, little is known about if and how nurses would report fatigue while on the job. Objective: To determine if hospital-based pediatric nurses reported fatigue as part of an active injury reporting method. Methods: This secondary analysis of qualitative data used a descriptive design with content analysis. Data from the parent study were collected at a U.S. pediatric hospital where nurses verbally reported on-shift injuries or near misses and pre- and post-shift health status via a digital voice recorder. Researchers used content analysis to independently code data for nurses' references to fatigue. Codes were then analyzed for patterns and themes. Results: Approximately 30% (n = 104) of participants reported fatigue-related content. Emergent themes were Work Stressors, Individual Risk Factors, Fatigue Descriptors, Adverse Outcomes from Fatigue, Fatigue Buffers, Descriptors for Buffered Fatigue, and Favorable Outcomes from Buffered Fatigue. Fatigue descriptions align with prior literature, demonstrating the accuracy of the voice recorder data collection method. In addition, nurses expressed uncertainty about the appropriateness of reporting fatigue symptoms. Conclusion: Findings from this study support pediatric nurses will report fatigue, when provided an opportunity. Additional efforts are needed to better understand effective ways to improve fatigue reporting among nurses, including harnessing current technology for real-time reporting and how to change the culture around fatigue reporting.

"[It] Does Harden a Person Working in Such a Stressful Environment": U.S. Correctional Nurses Share Spillover Effects of Their Work.

BACKGROUND: The United States makes up 4.4% of the world's population but nearly a quarter of the world's incarcerated population. Despite caring for nearly 2 million incarcerated persons and managing their unique needs, little is known about how this work spills over and affects the nurses who work in correctional settings. STUDY OBJECTIVE: This descriptive study aimed to (a) examine write-in answers regarding correctional nurse perceptions of how their work impacts their health and their home lives and (b) explore correctional nurse responses for how to improve the work environment to better support their well-being. METHOD: The researchers compiled and analyzed qualitative data from a cross-sectional study where U.S. correctional nurses (N = 270) completed an online survey. Manifest content analysis was used to analyze optional write-in data. RESULTS: Approximately 41% (n = 111) of participants answered qualitative questions. Participants were primarily White (77.3%) and non-Hispanic or Latino (88.7%), working in prisons (65.8%), and employed by the state (63.8%) as registered nurses (70%). Three major themes emerged: (a) "personal impact": increased stress and burnout, overwhelming work hours, and emotional and physical effects; (b) "social relationships and family impacts": withdrawn, strained homelife, and uncertainty; and (c) "need for change": improved staffing, reduced mandatory overtime, and better support from management. CONCLUSIONS: Correctional organizations may consider ways to support the well-being of their nurses through adequate staffing, flexible scheduling, decreased mandatory overtime, and hiring effective nurse managers as key members of the correctional team.

Unlocking Prevalence Data: Describing the Job Stress and Well-being of U.S. Correctional Nurses.

BACKGROUND: Little is known about the health and well-being of U.S. correctional nurses. To protect correctional nurses, a better understanding of organizational characteristics, job stress, and well-being must be undertaken. METHOD: A cross-sectional design was used in the form of an online survey. Correctional nurses were conveniently recruited using national listservs and snowball sampling. Variables were measured with the Health & Safety Executive Management Standards Indicator Tool, Nurse Wellbeing Index, and the Perceived Stress Scale. Data were analyzed using descriptive statistics and analyses of variance. FINDINGS: Two hundred seventy participants (142 registered nurses, 83 licensed practical nurses/licensed vocational nurses, and 42 advanced practice nurses) completed the survey. Job stress scored moderate (M = 16.26, SD = 7.14), and well-being levels were just below the risk for adverse events (M = 1.8, SD = 3.06). Lower scores were noted for managerial support (M = 3.13, SD = 0.35) and job demands (M = 3.56, SD = 0.92), but slightly better for job control (M = 3.57, SD = 0.77), peer support (M = 3.85, SD = 0.64), and workplace relationships (M = 3.73, SD = 0.95). CONCLUSIONS: Significant differences between organizational characteristics, job stress, and well-being were found across nursing licensure, workplace environments, biological sex, and employment through state or private agencies. Registered nurses working in U.S. prisons experienced the highest job stress and worse well-being. APPLICATION TO PRACTICE: This work is an essential next step in promoting healthy workspaces, urging the need for further research establishing the impact of organizational characteristics and job stress on nurse well-being.

Effects of Origanum majorana on Breast Cancer Cells: An Alternative to Chemotherapy?

Recent studies have reported several beneficial effects of natural compounds on cancerous cells, highlighting their use for future treatments. These preliminary findings have encouraged experiments with natural substances, such as plant extracts, to examine both cytotoxic and mitogenic effects and find alternative treatments for diseases such as breast cancer. This study examines the effects of microwave-assisted and ethanol maceration of marjoram (Origanum majorana) on MCF-7 breast cancer cell lines and normal breast tissue cell lines used as controls. Marjoram extracts displayed a cytotoxic effect on the MCF-7 cell lines and a mitogenic effect on the control cell lines at the MTS test. The metabolic profiles of MCF-7 and control cell lines were also assessed using the Biolog Phenotype Mammalian Metabolic (PM-M) platform and revealed statistically significant differences in the utilization of energy sources, metabolic activity in the presence of certain ionic species, and responses to metabolic effectors, such as stimulant/catabolic compounds and steroid hormones. Exposure to marjoram extracts exerted positive effects on the MCF-7 cells on the abnormal utilization of energy sources and the responses to metabolic effectors, while no major effects were detected on control cells. These effects were compared to the metabolic impact of the chemotherapeutic agent doxorubicin, which showed profound cytotoxic effects on both cancerous and normal breast cells. In conclusion, our in vitro evidence indicates that marjoram extracts are a promising alternative to chemotherapy in breast cancer since they can successfully eliminate cancerous cells by affecting their metabolic capacity to proliferate without inducing noticeable adverse effects on normal breast tissue.

Urban flask measurements of CO2ff and CO to identify emission sources at different site types in Auckland, New Zealand.

As part of the CarbonWatch-NZ research programme, air samples were collected at 28 sites around Auckland, New Zealand, to determine the atmospheric ratio (RCO) of excess (local enhancement over background) carbon monoxide to fossil CO2 (CO2ff). Sites were categorized into seven types (background, forest, industrial, suburban, urban, downwind and motorway) to observe RCO around Auckland. Motorway flasks observed RCO of 14 ± 1 ppb ppm-1 and were used to evaluate traffic RCO. The similarity between suburban (14 ± 1 ppb ppm-1) and traffic RCO suggests that traffic dominates suburban CO2ff emissions during daytime hours, the period of flask collection. The lower urban RCO (11 ± 1 ppb ppm-1) suggests that urban CO2ff emissions are comprised of more than just traffic, with contributions from residential, commercial and industrial sources, all with a lower RCO than traffic. Finally, the downwind sites were believed to best represent RCO for Auckland City overall (11 ± 1 ppb ppm-1). We demonstrate that the initial discrepancy between the downwind RCO and Auckland's estimated daytime inventory RCO (15 ppb ppm-1) can be attributed to an overestimation in inventory traffic CO emissions. After revision based on our observed motorway RCO, the revised inventory RCO (12 ppb ppm-1) is consistent with our observations. This article is part of the Theo Murphy meeting issue 'Radiocarbon in the Anthropocene'.

Modeling wellbeing for U.S. correctional nurses: A cross sectional survey.

BACKGROUND: Nurses work in stressful environments, and this stress has negative consequences on health. Correctional nurses experience unique job stress in their roles. However, there has been limited research exploring how the correctional environment impacts nurse health and wellbeing. OBJECTIVE: This study aimed to evaluate the relationship between the variables of organizational characteristics (i.e., job demands, job control, manager support, peer support, workplace relationships), job stress, and wellbeing levels in a sample of U.S. correctional nurses, while exploring socio-demographic covariates. METHODS: Using a convenience sampling method, 270 U.S. correctional nurses completed a cross-sectional online survey. Informed by the Job Demands-Resources Theory, a conceptual model was created and tested in this sample. Analysis involved multiple linear regression and structural equation modeling. RESULTS: The model significantly fit the data (CI: 0.71-0.83, CFI = 0.51, SRMR: 0.37, and RMSEA = 0.08) revealing the direct relationship between job stress, job demands, job control, and workplace relationships and wellbeing. This study also provided evidence that job stress mediates the relationship of job control and job demands with wellbeing. CONCLUSION: Results underscore the opportunity for correctional organizations to consider targeting job demands, job control, workplace relationships, and job stress in future interventions to improve the correctional nursing work environment and support correctional nurse wellbeing. TWEETABLE ABSTRACT: A recent study found evidence for a relationship between organizational characteristics & job stress and U.S. correctional nurse wellbeing.

Tiredness Takes Its Toll: An Integrative Review on Sleep and Occupational Outcomes for Long-Term Care Workers.

Poor sleep quality and duration among health care professionals have negative impacts on worker safety, work readiness, and well-being. However, the consequences of impaired sleep among long-term care (LTC) workers remain understudied. The current integrative review sought to explore associations between sleep and occupational outcomes in LTC workers. Multiple database searches yielded 1,543 articles; nine articles met inclusion criteria. Results synthesized from included articles revealed sleep-associated occupational outcomes across three themes, Burnout/Fatigue, Mental and Physical Health, and Well-Being, which may affect performance measures and predict injuries/errors. Exploring outcomes of poor sleep quality and duration among LTC workers has highlighted the needs of this population and may inform future intervention development. LTC organizations should consider implementing strategies to better support the sleep quality of their workforce. In addition, further research is needed to explore how impaired sleep contributes to negative worker outcomes and patient care quality. [Journal of Gerontological Nursing, 49(1), 27-33.].

A time to 'make amends and bring pieces together': A phenomenological study of family experiences and considerations when a parent returns home from incarceration.

Nearly 1 in every 14 youth have had a parent incarcerated at some point. In any given year, over 9 million adults from jail and 700,000 adults from prison return to their families and communities. However, few studies have explored the family experiences during re-entry or have provided suggestions on how to best support children during this time. The goal of this qualitative study was to describe family experiences and provide their considerations on how to better support children during the period of parent's re-entry. Qualitative data was gathered from 26 participants using semi-structured, in-depth phone interviews from March to August 2020. The sample included 10 youth (12-18 years) who have had a parent incarcerated, 10 custodial caregivers of youth who have had incarcerated parents, and 6 parents released from incarceration. Qualitative content analysis and open-coding procedures were used to determine themes across raters. Experiences centred on the challenges of assimilating to new family roles upon the parent returning home and to the community. Families also shared the difficulty in navigating parole restrictions and managing fears surrounding the recidivism of the parent. Three primary themes were deduced as relationship-building obstacles, unaligned family expectations and parole-related family burdens. Results from this study revealed suggestions that may address youth, caregiver and returning parent's needs during the re-entry phase. Family counselling and peer support groups may improve the process of mending or forming relationships. Access to re-entry programs, mental health services, and parental education may better align family expectations. Transparent wrap-around social services and decreasing legal challenges may reduce the parole-related burdens on the family.

Examining the Impact of Stressors during COVID-19 on Emergency Department Healthcare Workers: An International Perspective.

Emergency department healthcare workers are known to face a unique combination of pressures from their careers and work environments regularly. Caring for dying patients and making difficult lifesaving decisions not only continued but also became more prevalent for emergency department healthcare workers during the COVID-19 pandemic. A growing body of literature revealed that the mental and emotional toll of COVID-19 has been tremendous. However, the burden of COVID-19 on the overall physical health and work-life balance on this group needs to be understood. This study aimed to describe the impact of stress on wellbeing and health across the globe among emergency department healthcare workers. A cross-sectional survey comprising work-family and family-work conflict scale, work-life balance, physical symptoms inventory, Oldenburg Burnout Inventory, satisfaction with job and life, and life change index scale was distributed to a convenience sample through listservs and social media. In total, 287 participants responded, 109 completing all questions. Fatigue was the most common symptom reported to occur daily (28.4%, n = 31), followed by muscle pain (13.8%, n = 15) and backache (11.9%, n = 13). Nurse practitioners reported the highest number of physical symptoms and the highest average scores and counts of stressful life events, while registered nurses indicated the highest work-family conflict levels. Linear regressions showed that stressful life events are significantly associated with both physical symptoms and work-family conflict. Results underscore the need to better support emergency department workers to mitigate the risks associated with occupational stress. Protective organizational policies and increased support strategies may be employed to improve wellbeing and cultivate a more sustainable workforce.

Unsafe and Unsettling: An Integrative Review on Correctional Nursing Work Environments and Stressors.

BACKGROUND: Stress remains a major occupational hazard among nurses. As the United States maintains the largest correctional system in the world, little is understood regarding the occupational stress of correctional nurses and how that stress impacts their overall health and well-being. QUESTION ADDRESSED: What are the occupational/environmental stressors and professional burnout factors experienced by correctional nurses? REVIEW METHODS: Guided by Whittemore and Knafl's methodology, an integrative review was conducted using online databases of Scopus, CINAHL, NIOSH-tic, and PubMed in July of 2021 for peer-reviewed articles ever published internationally. Key concepts of "correctional health nursing" and "occupational stress" were used in our search. REVIEW RESULTS: One hundred fifty-two articles were identified. Eleven articles met eligibility criteria and were included in this review. Three key themes emerged: conflict , fear , and demands . DISCUSSION: Conflict arose from ethical and relational issues among coworkers, management, and incarcerated patients. Fear stemmed from physical safety concerns and workplace violence, whereas demands involved high workloads paired with a lack of organizational support. Findings revealed evidence on the unique occupational environment of correctional nursing professionals that impacted levels of stress and burnout across all types of correctional settings (e.g., jails and prisons). IMPLICATIONS: Better assessment and consistent evaluation of the health and well-being of correctional nurses and their correctional nursing environments are needed. Additional resources to reduce stress, along with ensuring policies that mitigate ethical challenges, workplace violence, and bullying, may promote professional and safe workspaces.

Improving Health Equity Through Public Health Referrals.

Healthcare providers face certain barriers to fully assessing different social needs and referring patients to community resources appropriately, perpetuating healthcare disparities. The purpose of this quality improvement study was to create an intervention to increase assessment of social determinants of health (SDOH) and referrals. A module incorporating concepts of SDOH was developed and delivered during two training sessions. This module focused on: Partnership, Acceptance, Compassion, and Evocation (PACE). It was found that the public health providers at a local public health center were able to appropriately refer 55% of all new and annual patients screened with specific SDOH needs after the educational module was implemented. An overall increase in SDOH understanding and referrals was also found. SDOH training and ongoing social needs screenings could be incorporated in public health centers to decrease healthcare inequities present among minorities and individuals who live in poverty.

Global environmental consequences of twenty-first-century ice-sheet melt.

Government policies currently commit us to surface warming of three to four degrees Celsius above pre-industrial levels by 2100, which will lead to enhanced ice-sheet melt. Ice-sheet discharge was not explicitly included in Coupled Model Intercomparison Project phase 5, so effects on climate from this melt are not currently captured in the simulations most commonly used to inform governmental policy. Here we show, using simulations of the Greenland and Antarctic ice sheets constrained by satellite-based measurements of recent changes in ice mass, that increasing meltwater from Greenland will lead to substantial slowing of the Atlantic overturning circulation, and that meltwater from Antarctica will trap warm water below the sea surface, creating a positive feedback that increases Antarctic ice loss. In our simulations, future ice-sheet melt enhances global temperature variability and contributes up to 25 centimetres to sea level by 2100. However, uncertainties in the way in which future changes in ice dynamics are modelled remain, underlining the need for continued observations and comprehensive multi-model assessments.

Impact of Maternal Serotonin Transporter Genotype on Placental Serotonin, Fetal Forebrain Serotonin, and Neurodevelopment.

Biomarker, neuroimaging, and genetic findings implicate the serotonin transporter (SERT) in autism spectrum disorder (ASD). Previously, we found that adult male mice expressing the autism-associated SERT Ala56 variant have altered central serotonin (5-HT) system function, as well as elevated peripheral blood 5-HT levels. Early in gestation, before midbrain 5-HT projections have reached the cortex, peripheral sources supply 5-HT to the forebrain, suggesting that altered maternal or placenta 5-HT system function could impact the developing embryo. We therefore used different combinations of maternal and embryo SERT Ala56 genotypes to examine effects on blood, placenta and embryo serotonin levels and neurodevelopment at embryonic day E14.5, when peripheral sources of 5-HT predominate, and E18.5, when midbrain 5-HT projections have reached the forebrain. Maternal SERT Ala56 genotype was associated with decreased placenta and embryonic forebrain 5-HT levels at E14.5. Low 5-HT in the placenta persisted, but forebrain levels normalized by E18.5. Maternal SERT Ala56 genotype effects on forebrain 5-HT levels were accompanied by a broadening of 5-HT-sensitive thalamocortical axon projections. In contrast, no effect of embryo genotype was seen in concepti from heterozygous dams. Blood 5-HT levels were dynamic across pregnancy and were increased in SERT Ala56 dams at E14.5. Placenta RNA sequencing data at E14.5 indicated substantial impact of maternal SERT Ala56 genotype, with alterations in immune and metabolic-related pathways. Collectively, these findings indicate that maternal SERT function impacts offspring placental 5-HT levels, forebrain 5-HT levels, and neurodevelopment.

Independent evaluation of point source fossil fuel CO2 emissions to better than 10%.

Independent estimates of fossil fuel CO2 (CO2ff) emissions are key to ensuring that emission reductions and regulations are effective and provide needed transparency and trust. Point source emissions are a key target because a small number of power plants represent a large portion of total global emissions. Currently, emission rates are known only from self-reported data. Atmospheric observations have the potential to meet the need for independent evaluation, but useful results from this method have been elusive, due to challenges in distinguishing CO2ff emissions from the large and varying CO2 background and in relating atmospheric observations to emission flux rates with high accuracy. Here we use time-integrated observations of the radiocarbon content of CO2 ((14)CO2) to quantify the recently added CO2ff mole fraction at surface sites surrounding a point source. We demonstrate that both fast-growing plant material (grass) and CO2 collected by absorption into sodium hydroxide solution provide excellent time-integrated records of atmospheric (14)CO2 These time-integrated samples allow us to evaluate emissions over a period of days to weeks with only a modest number of measurements. Applying the same time integration in an atmospheric transport model eliminates the need to resolve highly variable short-term turbulence. Together these techniques allow us to independently evaluate point source CO2ff emission rates from atmospheric observations with uncertainties of better than 10%. This uncertainty represents an improvement by a factor of 2 over current bottom-up inventory estimates and previous atmospheric observation estimates and allows reliable independent evaluation of emissions.

Precipitation isoscapes for New Zealand: enhanced temporal detail using precipitation-weighted daily climatology.

Predictive understanding of precipitation δ(2)H and δ(18)O in New Zealand faces unique challenges, including high spatial variability in precipitation amounts, alternation between subtropical and sub-Antarctic precipitation sources, and a compressed latitudinal range of 34 to 47 °S. To map the precipitation isotope ratios across New Zealand, three years of integrated monthly precipitation samples were acquired from >50 stations. Conventional mean-annual precipitation δ(2)H and δ(18)O maps were produced by regressions using geographic and annual climate variables. Incomplete data and short-term variation in climate and precipitation sources limited the utility of this approach. We overcome these difficulties by calculating precipitation-weighted monthly climate parameters using national 5-km-gridded daily climate data. This data plus geographic variables were regressed to predict δ(2)H, δ(18)O, and d-excess at all sites. The procedure yields statistically-valid predictions of the isotope composition of precipitation (long-term average root mean square error (RMSE) for δ(18)O = 0.6 ‰; δ(2)H = 5.5 ‰); and monthly RMSE δ(18)O = 1.9 ‰, δ(2)H = 16 ‰. This approach has substantial benefits for studies that require the isotope composition of precipitation during specific time intervals, and may be further improved by comparison to daily and event-based precipitation samples as well as the use of back-trajectory calculations.

Screening with MRI for Accurate and Rapid Stroke Treatment: SMART.

OBJECTIVE: The objective of this study was to demonstrate the feasibility of timely multimodal MRI screening before thrombolysis in acute stroke patients. METHODS: Quality improvement processes were initiated in 2013 to reduce door-to-needle (DTN) time at the 2 hospitals where the NIH stroke team provides clinical care. Acute ischemic stroke (AIS) patients who received IV tissue plasminogen activator (tPA) ≤4.5 hours from last known normal were identified. Demographic and clinical characteristics and timing metrics were analyzed comparing the time periods before, during, and after the quality improvement processes. RESULTS: There were 157 patients treated with IV tPA for AIS during 2012-2013, of whom 135 (86%) were screened with MRI. DTN time was significantly reduced by 40% during this period from a median of 93 minutes in the first half of 2012 to 55 minutes in the last half of 2013 (p < 0.0001) with a significant 4-fold increase in the proportion of treated patients with DTN time ≤60 minutes from 13.0% to 61.5%, respectively (p < 0.00001). Improvement in DTN time was associated with reduced door-to-MRI time, and there were no differences in demographic or clinical characteristics (p = 0.21-0.76). CONCLUSIONS: It is feasible and practical to consistently and rapidly deliver IV tPA to AIS patients within national benchmark times using MRI as the routine screening modality. The processes used in the SMART (Screening with MRI for Accurate and Rapid Stroke Treatment) Study to reduce DTN time have the potential to be widely applicable to other hospitals.

An assessment of non-communicable diseases, diabetes, and related risk factors in the Federated States of Micronesia, State of Pohnpei: a systems perspective.

Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Pohnpei and describes the burden due to selected NCD (diabetes, heart disease, hypertension, stroke, chronic kidney disease); and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifies the issues that need to be addressed. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors lead to overweight and obesity and subsequent NCD that are significant factors in the morbidity and mortality of the population. Leading causes of death were due to heart disease, diabetes, cancer, and hypertension. Population survey data show that 32.1% of the adult population had diabetes with a higher rate among women (37.1%) when compared to men (26.4%). The data also showed that 73.1% of the adult population was overweight or obese. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCD. There is no overall planning document for the prevention and control of NCDs or diabetes. There is evidence of little communication among the medical and health care providers which leads to fragmentation of care and loss of continuity of care. Based on some of the findings, priority issues and problems that need to be addressed for the administrative and clinical systems are identified.

Perinatal undernutrition: changes in brain opiate receptor density.

The present work sought to study the binding properties of central mu-opiate receptors in whole brain and in different central areas in adult rats undernourished at perinatal age. Rats were undernourished with a hypoproteic diet containing 8% casein from day 14 of gestation until 50 days of age. The animals were thereafter fed a balanced commercial chow until 140 days of age. At this time point the experiments started. 3H-D-Ala2, N-Me-Phe4, Gly5-ol-enkephalin (3H-DAMGO) was used to selectively label the mu-receptors. The results obtained demonstrated that perinatal undernutrition induced, in the adult animal, a decreased mu-receptors density (Bmax) both in whole brain as well as in midbrain, without significant changes in affinity. In addition, no changes were found in mu-specific binding in the cortex of these undernourished animals. Taking into account that recent evidences from our laboratory have demonstrated a lower stress-induced analgesia following exposure to different stressful situations in rats undernourished in early life, the present findings seem to suggest that this lower analgesic response could be due, at least in part, to a lower density of mu-opiate receptors in the brain.

El perfil neuroendocrino especifico es critico para una correcta respuesta inmune T-dependiente / The specific neuroendocrine profile is critically involved in an adequate T-dependent immune response

Existe una relación funcional entre los sistemas neuroendocrino e inmune. Examinamos el rol de los cambios neuroendocrinos, particularmente hormona liberadora de tirotrofina (TRH) y prolactina (PRL), durante el curso de la respuesta inmune T-dependiente. En ratas inmunizadas ip con eritrocitos de carnero (SRBC, antígeno T-dependiente), se observó: a) un incremento del ARNm de TRH hipotalámica entre las 4 y 24 h post-inmunización (ej: SRBC vs salina: 4 h, 2,8x), en contraste a una disminución del ARNm de TRH observado por tratamiento con antígenos T-independientes (ej: LPS vs salina: 4 h, 1,6x); b) un incremento del ARNm del receptor de TRH y de los niveles de PRL plasmática sin observarse cambios, en los niveles plasmáticos de hormona de crecimiento y tirotrofina. La inyección intracerebroventricular (icv) en ratas conscientes y en movimiento de oligonucleótidos antisentido al mRNA de TRH produjo: a) una inhibición en la producción de anticuerpos anti-SRBC [ELISA 7 días: Ig(M+G): TRH sentido vs TRH-antisentido: 384 + 27 vs 193 + 22 (n = 11); p < 0.001, ANOVA con test de Scheffé's]; b) una incapacidad en producir el pico de liberación de PRL luego de la inmunización (12 h post-inmunización, TRH-sentido vs TRH-antisentido: 8.3 + 1.4 vs 2.2 + 0.5 (n = 6), p < 0.01, ANOVA con test de Scheffé's); c) una dismunución del ARNm de TRH hipotalámica (TRH-sentido vs TRH-antisentido: 12 h, 1.7x). Estos estudios demuenstran que un antígeno T-dependiente requiere de una activación temprana de TRH y PRL, instrumental para montar una respuesta adecuada, en contraste a la inhibición inducida por antígenos T-independientes.