stress

Zhao Mingyao
BMC.ZZU
2005-4-22
 General Adaptation Syndrome, GAS

Stress
Hans Selye
 SAM-Route

“Rest and Digest” Stress “Fight or Flight”

1.What is stress in medicine ?

protect effect
Non-specific response
harmful effect
 THE STRESS MODEL

BLACK
BOX RESPONSE CONSEQUENCES

WELLNESS

?
FLIGHT
STRESSOR FIGHT
ADAPT ILLNESS
 Beneficial Effects of Stress
• Prepares body and mind for action
• Might make reinforcers more effective
• Can makes experiences memorable
• Suppresses immune responses
2.What is mechanism of stress
 Mechanism of stress
⑴ 　 LC/NE (locus ceruleus-norepinephrine
/sympathetic-adrenal meddula axis)
⑵ 　 HPA (Hypothalamus-pituitary-adrenal cortex
system)

⑶ 　 Other hormones
⑷ 　 AP (Acute phase protein)
⑸ 　 HSP( Heat shock protein, stress protein)
***locus ceruleus-norepinephrine
/sympathetic-adrenal meddula
axis, LC/NE

locus ceruleus －－－－ central site of LC/NE

Limbic system: emotion/cognition/action
Lateral horn of spinal cord: sympathetic-adrenal
meddula
 Stress NE released
Amyg
CRH
PVN

Locus Coeruleus
３． What are effects of
catecholamine during stress
Central
Peripheral

Locus Ceruleus arouses the Brain

Sympathetics activate entire body
 SAM-Route

“Rest and Digest” Stress “Fight or Flight”

４． What are effects of GC
during stress
Central
Peripheral
******Hypothalamus-pituitary-
adrenal cortex system, HPA

Central: CRH
Peripheral: Glucocorticoids interact with
adrenaline to affect glucose, blood flow,
cardiac output, respiration
 The HPA-Axis

Cortisol

• Energy Mobilization
• Immune System Regulation
 
 Stress
Amyg Hippocampus
CRH
PVN
CRH

Pituitary

ACTH

Adrenal

HPA
Cortisol
5.What are effects of Other
hormones during stress
Central
Peripheral
6.what are effects of AP
during stress?
positive
negative
AP origin : comes from

• liver cell (C-reactive protein)

• monocyte (complement components)
• endothelium cell
• fibroblast
 AP roles
Leukocytosis
fever
certain hormones↑
serum iron↓ and zinc↓
activation of the proteolytic enzyme cascade
(clotting, complement, kinin-forming and
fibrinolytic pathways)
negative nitrogen balance
transfer of amino acids from muscles to the
liver
7.What are HSP
and its effects
?

Drosophila

molecular chaperone
HSP
8.Which three stages are divided
during stress(GAS)?

Alarm ~
Resistance ~
Exhaustion ~
9.What are the major effects of
stress to body?

directive stressor (eg heat )stimulation

sympathetic nerve system +++
metabolism: synthesize↓
decompose↑ ， but katolysis
immune: eustress or distress
10.How many common stress-related disease exist
now
* Essential Hypertension
* Stress Heart Disease
* Stress Peptic Ulcer
* Tumor
* Depression
* Psychosocial dwarf
 Nervous System-Related
Disorders
• bronchial asthma • irritable bowel
• tension headaches syndrome
• migraine • ulcers and colitis
headaches • coronary heart
• temporomandi- disease
bular joint
dysfunction
Research indicates that
–70 % ~ 80% of health-related problems
may be precipitated or aggravated by
stress
11.How to treat and prevent the
detriment effects of stress?
remove serious stressor
decrease stress degree
supply GC
supply nutrients
psychosocial comforting
 Infectious agents
-HSV1
- chlamydia pneumoniae
Aging & apoptosis free radicals


 

Neurotransmitter Pathological Cascade in Inflammation

failures  Alzheimer’s Disease  -activation of microglia,
astrocytes


 
Genetics amyloid plaques
FAD early onset - chrom 1,14 neurofibrillary tangles
Low education FAD late onset -chromc 12,21
APOE4-chrom19
?other genes
 Stress
Amyg
CRH
PVN
 Stress
Amyg
CRH
PVN
CRH

Pituitary

ACTH

Adrenal

Cortisol
PAC-Route

The HPA-Axis

Cortisol
• Energy Mobilization
• Immune System Regulation
 Stress and Illness

• Stress: Stress reaction: flight or flight;

Chronic stress;
• Stressors can have positive impact or
negative impact- depending on interpretation
(threat to our well-being, status, self image,
etc.,).
– New job can be perceived as a source of
challenge or threat
• Walter Cannon (1929)- Extreme conditions (cold, lack of
oxygen, emotion arousing conditions): Sympathetic reaction
(increased heart rate, blood to muscles, respiration) –
Prepare fight-flight reaction
• Hans Selye (1936,1976)- Studied hormones, injected a
mouse and found new reactions (e.g., adrenal gland
enlargement, bleeding ulcers).
– New Hormone? No- Reactions to stress
– Same reactions with other stressors (electric shock, restraint, etc.,).
– HENCE: GAS (General Adaptation Syndrome):
• 1. Alarm reaction- Resources mobilized (heart rate, blood to muscles).
• 2. Resistance: All systems remain on “high”.
• 3. Exhaustion: Depletion of energy’s reserves (vulnerability to illness
fatigue; in extreme cases: collapse and death ).
Life Style Modification and Heart Disease
 Stress Responses Prepare for
Action
• Locus Ceruleus arouses the Brain
• Sympathetics activate entire body
• Glucocorticoids interact with adrenaline to
affect glucose, blood flow, cardiac output,
respiration
 Mechanisms of Beneficial
Effects have Costs
• Reinforcer enhancement makes drug
abuse more likely
• Effects on memory mechanisms can
enhance or impair memory
• Modulation of immune system can lead to
disease susceptibility
 Stress and Reinforcement
• Cort at stress levels is itself reinforcing
– Rats will work to receive oral cort
• Stress increases DA release in accumbens (shell)
• Cort increases sensitivity of DA neurons to drugs
• Stress increases rewarding effect of drugs
• In animals, stress facilitates drug self-administration
and relapse (cocaine, morphine)
 Psychoneuroimmunology
• Pelletier defines it as the study of
the intricate interaction of
– consciousness (psycho)
– brain and central nervous system
(neuro), and
– the body’s defense against external
infection and internal aberrant cell
division (immunology).
 Adaptive value of cort/reward
link
• Stress is aversive, may need greater
reward value to persevere toward goals
• Not clear in what circumstances stress
makes other rewards more effective
How Does a Get in the Body?

PAC-Route SAM-Route
• o hypothalamus

• - thalamus

• - limbic system

• o hippocampus: formation of memories

• o amygdala: emotional control and formation of emotional

memories