Estresse de aculturação e carga alostática entre mulheres imigrantes mexicanas / Acculturation stress and allostatic load among Mexican immigrant women / Estrés aculturativo y carga alostática en las mujeres inmigrantes mexicanas

Objetivos este estudo de caso-controle comparou os níveis de estresse e carga alostática (CA) entre mulheres mexicanas nos EUA ( n = 19) e no México ( n = 40). Método medidas de estresse incluíram a Escala de Estresse Percebido (EEP) e a Escala de Estresse Social das Mulheres Hispânicas (EESMH). Uma medida composta por 8 indicadores de CA (pressão arterial sistólica e diastólica, índice de massa corporal (IMC), relação cintura-quadril, colesterol total, hemoglobina glicada (hemoglobina A1C), triglicerídeos e proteína C-reativa) foi calculada. Resultados não houve diferenças significativas entre os grupos na CA entre mulheres mexicanas imigrantes e não imigrantes ( t = 1,55, p = 0,126). Uma análise fatorial de componentes principais foi realizada nos 8 indicadores de CA; uma solução de 2 fatores explicou 57% da variância. As diferenças entre grupo nos dois fatores CA foram analisadas usando MANOVA. O IMC e a relação cintura-quadril foram menores, mas a pressão arterial e os triglicerídeos foram maiores no grupo dos EUA e foram mediados pelo tempo nos EUA. O maior estresse de aculturação foi significativamente relacionado ao aumento da relação cintura-quadril ( r = 0,57, p = 0,02). Considerações finais os resultados sugerem que algumas medidas de CA aumentam com o tempo nos EUA e o estresse de aculturação pode ser um fator significativo.

Objectives this case-control study compared levels of stress and allostatic load (AL) among Mexican women in the US ( n =19) and Mexico ( n = 40). Method measures of stress included the Perceived Stress Scale (PSS) and the Hispanic Women's Social Stressor Scale (HWSSS). A composite measure of 8 indicators of AL (systolic and diastolic blood pressure, body mass index (BMI), waist-to-hip ratio, total cholesterol, glycated hemoglobin (hemoglobin A1C), triglycerides and C-reactive protein) was calculated. Results there were no significant group differences in AL between Mexican and Mexican immigrant women ( t = 1.55, p = .126). A principal component factor analysis was conducted on the 8 AL indicators; a 2-factor solution explained 57% of the variance. Group differences in the two AL factors were analyzed using MANOVA. BMI and waist-to-hip ratios were lower, but blood pressure and triglycerides were higher in the US group and were mediated by time in the US. Greater acculturation stress was significantly related to increased waist-to-hip ratio ( r = .57, p = .02). Final remarks findings suggest some measures of AL increased with time in the US, and acculturation stress may be a significant factor.

Objetivos este estudio de casos y controles ha comparado los niveles de estrés y carga alostática (CA) en mujeres mexicanas en los EE.UU. ( n = 19) y México ( n = 40). Método las medidas de estrés incluyeron la Escala de Estrés Percibido (EEP) y la Escala de Estrés Social de las Mujeres Hispanas (HWSSS, por sus siglas en inglés). Se calculó una medida compuesta de 8 indicadores de CA (presión arterial sistólica, presión arterial diastólica, índice de masa corporal (IMC), relación cintura/cadera, colesterol total, hemoglobina glicosilada (HbA1c), triglicéridos, y proteína C reactiva). Resultados no hubo diferencias significativas de CA entre los grupos de mujeres mexicanas e inmigrantes mexicanas ( t = 1,55, p = 0,126). Se realizó un análisis factorial de componente principal de los 8 indicadores de CA; una solución de 2 factores explicó el 57% de la varianza. Las diferencias de grupo en los dos factores de CA se analizaron utilizando MANOVA. El IMC y la relación cintura/cadera disminuyeron, pero la presión arterial y los triglicéridos aumentaron en el grupo de los EE.UU. y estuvieron influenciados por el tiempo de residencia en los EE.UU. Un mayor estrés aculturativo se relacionó significativamente con el aumento de la relación cintura/cadera (r = 0,57, p = 0,02). Comentarios finales los hallazgos sugieren que algunas medidas de CA aumentan con el tiempo de residencia en los EE.UU. y el estrés aculturativo puede ser un factor importante.

In immune defense: redefining the role of the immune system in chronic disease.

The recognition of altered immune system function in many chronic disease states has proven to be a pivotal advance in biomedical research over the past decade. For many metabolic and mood disorders, this altered immune activity has been characterized as inflammation, with the attendant assumption that the immune response is aberrant. However, accumulating evidence challenges this assumption and suggests that the immune system may be mounting adaptive responses to chronic stressors. Further, the inordinate complexity of immune function renders a simplistic, binary model incapable of capturing critical mechanistic insights. In this perspective article, we propose alternative paradigms for understanding the role of the immune system in chronic disease. By invoking allostasis or systems biology rather than inflammation, we can ascribe greater functional significance to immune mediators, gain newfound appreciation of the adaptive facets of altered immune activity, and better avoid the potentially disastrous effects of translating erroneous assumptions into novel therapeutic strategies.

Durante la última década, el reconocimiento de la alteración de la función del sistema inmune en muchas enfermedades crónicas ha demostrado ser un avance central en la investigación biomédica. En diversos trastornos metabólicos y anímicos, esta actividad inmune alterada ha sido caracterizada como inflamación, asumiendo concomitantemente que la respuesta inmune es aberrante. Sin embargo, la evidencia acumulada desafía esta suposición y sugiere que el sistema inmune puede estar estructurando respuestas adaptativas a estresores crónicos. Además, un modelo simplista y binario no es capaz de dar cuenta de la excesiva complejidad de la función inmune ni hacer comprensibles los mecanismos internos esenciales. En este contexto, este artículo de perspectiva se propone entregar paradigmas alternativos para la comprensión del papel del sistema inmune en la enfermedad crónica. Al invocar la alostasis o la biología de sistemas antes que la inflamación, se puede atribuir un mayor significado funcional a los mediadores inmunes, obtener una nueva apreciación de los aspectos adaptativos de la actividad inmune alterada, y evitar mejor los efectos potencialmente desastrosos de traducir suposiciones erróneas en nuevas estrategias terapéuticas.

Ces 10 dernières années, l'identification d'une altération du système immunitaire dans de nombreuses maladies chroniques est au centre des avancées de la recherche biomédicale. Dans de nombreux troubles métaboliques ou de l'humeur, cette activité immunitaire modifiée se caractérise par une inflammation, ce qui suppose une réponse immunitaire anormale. Cette hypothèse est néanmoins mise en défaut car un nombre croissant d'arguments suggère que le système immunitaire développerait des réponses adaptatives aux facteurs de stress chroniques. De plus, un modèle simpliste, binaire, ne peut rendre compte de l'extraordinaire complexité de la fonction immunitaire et n'est pas suffisant pour en restituer les mécanismes fondamentaux. Dans ce contexte, nous proposons dans cet article d'autres modèles pour comprendre le rôle du système immunitaire dans la maladie chronique. En invoquant l'allostase ou la biologie de systèmes plutôt que l'inflammation, nous pouvons accorder une plus grande importance fonctionnelle aux médiateurs immunitaires, réviser notre conception des capacités d'adaptation d'une activité immunitaire altérée et mieux éviter les effets potentiellement désastreux d'une traduction d'hypothèses erronées en nouveaux traitements.

Variation in the Calculation of Allostatic Load Score: 21 Examples from NHANES.

After decades of resistance, there is now a genuine consensus that disease cannot be prevented or even successfully treated unless the role of stress is addressed alongside traditionally recognized factors such as genes and the environment. Measurement of allostatic load, which is quantified by the allostatic load score (ALS), is one of the most frequently used methods to assess the physiologic response to stress. Even though there is universal agreement that in the calculation of ALS, biomarkers from three categories should be included (cardiovascular, metabolic and immune), enormous variation exists in how ALS is calculated. Specifically, there is no consensus on which biomarkers to include or the method which should be used to determine whether the value of a biomarker represents high risk. In this perspective, we outline the approach taken in 21 different NHANES studies.

Exploring the relationship between childhood adversity and oral health: An anecdotal approach and integrative view.

During the past two decades, increasing recognition has been given to a relationship between oral health and systemic diseases. Associated systemic conditions include cardiovascular disease, diabetes, low birth weight and preterm births, respiratory diseases, rheumatoid arthritis, obesity, osteoporosis, and, in particular among oral conditions, periodontal disease. Low-grade inflammation is a common denominator linking these disorders. Applying an anecdotal approach and an integrative view, the medical and dental histories of two women document increasing ill health subsequent to incidences of maltreatment and sexual abuse, including oral penetration, at an early age. Comprehensive oral rehabilitation was required in both cases. These cases open for medical insight with regard to their implicit patho-physiology, when integrated with current evidence from neuroscience, endocrinology, and immunology, converging in the concepts of allostasis and allostatic load. In cases such as those presented in this paper, primary care physicians (family doctors, General Practitioners) and dentists may be the first to identify an etiological pattern. This report underlines the importance of increased and enhanced multidisciplinary research cooperation among health professionals. Our hypothesis is that childhood adversity may affect all aspects of human health, including adult oral health.

The effect of allostatic load on hypothalamic-pituitary-interrenal (HPI) axis before and after secondary vaccination in Atlantic salmon postsmolts (Salmo salar L.).

The experiment consisted of three experimental groups: (1) "vaccine and stress", (2) "stress and vaccine" and (3) control. All groups have previously been vaccinated 6 months prior to the start of the experiment. At the start of the experiment, the "vaccine and stress" group was vaccinated with Pentium Forte Plus for the second time (25.02.2008) and then given a daily stressor (confinement stressor 267 kg m-3 in 15 min) for a period of 4 weeks. The "stress and vaccine" group was given a similar daily stressor for 4 weeks and then vaccinated for the second time. The control group was neither stressed nor vaccinated a second time. The results indicates that fish in the "stress and vaccine" group may have entered an allostatic overload type 2 due to oversensitivity to ACTH, a reduced efficient negative feedback system with elevated baseline levels of plasma cortisol and reduced immune response with pronounced effects on the well-being of the animal. The "vaccine and stress" group may likewise have entered an allostatic overload type 1 response, with oversensitivity to ACTH and transient reduced efficient negative feedback system. This study shows that if plasma cortisol becomes elevated prior to vaccination, it could perhaps instigate an allostatic overload type 2 with dire consequences on animal welfare. To reduce the risk of compromising the animal welfare during commercial vaccination of salmon, one propose to grade the fish minimum a week prior to vaccination or grade simultaneously with vaccination. This could reduce the overall allostatic load during handling and vaccination and secure a healthy fish with intact immune response and improved animal welfare.

Psychobiological correlates of allostatic overload in a healthy population.

The concept of allostatic load (AL) represents the cost of the continual adjustment of the internal milieu required by an organism to adapt to different challenges. The majority of studies concerning AL have focused mainly on identifying its biological components. Recently, new criteria for a clinimetric evaluation of AL have been introduced, adding a new definition of allostatic overload (AO). This study aims to identify psychological and biological correlates of AO in a population of blood donors, according to this new definition of AO. Participants included 240 blood donors recruited from May 2007 to December 2009 in 4 different blood Centers. Blood samples from each participant were collected for laboratory analysis and self-rating instruments were administered on the same day. Biological parameters included those usually assessed during blood donation. Individuals were selected based on the criteria for the clinimetric evaluation of AO. Differences in biomarkers between subjects with and without allostatic overload were performed using the GLM with biological measures as dependent variables, AO groups as the fixed factor and specific confounders as covariates. Based on the selection criteria for allostatic overload, 98 subjects have been identified as presenting with AO. Results showed that individuals with allostatic overload presented lower levels of serum proteins, erythrocytes and immune differential count than donors without allostatic overload. Further, greater mean corpuscular volume has been found in persons included in the AO group. The evaluation of the AO correlates, along with a biomarker profile, may help to identify those conditions that, by exceeding individual resources, may constitute a danger to health.

Allostatic load among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin: effects of ethnicity, nativity, and acculturation.

OBJECTIVES: We investigated ethnic differences in allostatic load in a population-based sample of adults living in Texas City, TX, and assessed the effects of nativity and acculturation status on allostatic load among people of Mexican origin. METHODS: We used logistic regression models to examine ethnic variations in allostatic load scores among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin. We also examined associations between measures of acculturation and allostatic load scores among people of Mexican origin only. RESULTS: Foreign-born Mexicans were the least likely group to score in the higher allostatic load categories. Among individuals of Mexican origin, US-born Mexican Americans had higher allostatic load scores than foreign-born Mexicans, and acculturation measures did not account for the difference. CONCLUSIONS: Our findings expand on recent research from the National Health and Nutrition Examination Survey with respect to ethnicity and allostatic load. Our results are consistent with the healthy immigrant hypothesis (i.e., newer immigrants are healthier) and the acculturation hypothesis, according to which the longer Mexican immigrants reside in the United States, the greater their likelihood of potentially losing culture-related health-protective effects.