ASSOCIATION OF CHRONIC STRESS AND RESPONSES TO ACUTE STRESS IN MEN

男性慢性压力与急性压力反应的关联

• 批准号: 7717884
• 负责人: RODNEY U ANDERSON
• 金额: $ 0.19万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-12-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7717884
• 关键词: Acute; Affect; Age; Ancillary Study; Area; Blood specimen; Cell physiology; Chronic; Chronic Prostatitis; Chronic stress; Classification; Cognitive Therapy; Collection; Communities; Computer Retrieval of Information on Scientific Projects Database; Development; Disruption; Enrollment; Evaluation; Event; Experimental Designs; Funding; Glucocorticoids; Goals; Grant; Home environment; Hydrocortisone; Immune; Immunity; Institution; Instruction; Investigation; Knowledge; Lead; Link; Measurement; Mediating; Methods; Myalgia; Pain; Pathogenesis; Patients; Pelvic Pain; Pelvis; Personality Traits; Physiological; Prevention approach; Prostaglandins; Psychological Stress; Psychosocial Factor; Recruitment Activity; Research; Research Personnel; Resistance; Resources; Risk Factors; Role; Saliva; Salivary; Sampling; Source; Stress; Stress Tests; Surveys; Symptoms; Tube; United States National Institutes of Health; Visit; Week; Workplace; acute stress; biological adaptation to stress; chronic pelvic pain; cohort; cytokine; day; developmental genetics; hypothalamic-pituitary-adrenal axis; indexing; innovation; men; psychological distress; response; social stress

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Hypotheses: 1. Risk factors that mediate the onset of chronic pelvic pain syndrome (CPPS) may be identified by comparing psychosocial variables (stress, affect and personality traits) in subjects with CPPS vs. normal controls. 2. Measurement of free cortisol responses to awakening, as an index of hypothalamic-pituitary adrenal (HPA) axis activity/dysregulation, will be changed as a result of experimentally-induced acute social stress. 3. Stress will induce alterations in immune cell function and cytokine secretion associated with the HPA axis and cortisol response. Goals: Stress triggers a cascade of pathophysiological events that involve disruption of the HPA axis which may be linked to the development and persistence of CPPS. Chronic activation of the physiologic stress response induces putative glucocorticoid resistance and altered immunity, release of proinflammatory cytokines and prostaglandins that may contribute to pelvic tension myalgia, and ultimately to cycling psychological distress. No systematic evaluation of the physiological role of acute and chronic stress in pathogenesis of CPPS in men has been undertaken, however, clinicians have anecdotally observed that stress exacerbates symptoms. Certain inherent personality traits (genetic and developmental factors) modulate reactivity to stress. We have strong preliminary evidence from our CPPS patients indicating that physiotherapeutic myofascial release and cognitive behavioral therapy, proven methods to relieve stress, have provided both curative and partial relief of pain in some CPPS sufferers. Knowledge of how stress-induced neurobiochemical changes evoke pelvic pain in men may lead to development of new and innovative approaches for the prevention and treatment of CPPS. Experimental Design: We intend to enroll 24 to 32 subjects per yr at Stanford to participate in this stress analysis ancillary study. The cohort of normal control subjects will be recruited from the Stanford community area and age-matched with the subjects in this study with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). The stress and psychological surveys, saliva collection tubes for cortisol and instructions will be provided on the day of baseline visit. Participation in the Trier Acute Stress Test with collection of salivary cortisol and blood samples will occur two to three weeks later. Specific Aim 1: Characterization and investigation of the relationships of psychosocial variables (stress, affect, and personality traits) in subjects with CPPS versus controls. Specific Aim 2: Measurement of salivary cortisol response. Samples will be obtained upon awakening and during a normal day in the home/work setting. Subjects then undergo the experimental acute stress test and we collect salivary cortisol samples and blood samples in the GCRC at Stanford.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目和 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 假设： 1. 介导慢性盆腔疼痛综合征 (CPPS) 发作的危险因素可以通过比较 CPPS 受试者与正常对照者的心理社会变量（压力、情感和人格特征）来确定。 2. 作为下丘脑-垂体肾上腺（HPA）轴活动/失调的指标，游离皮质醇对觉醒反应的测量将由于实验引起的急性社会压力而改变。 3. 压力会引起与 HPA 轴和皮质醇反应相关的免疫细胞功能和细胞因子分泌的改变。 目标： 压力会引发一系列涉及 HPA 轴破坏的病理生理事件，这可能与 CPPS 的发生和持续存在相关。生理应激反应的慢性激活会导致假定的糖皮质激素抵抗和免疫力改变，促炎细胞因子和前列腺素的释放可能导致骨盆紧张性肌痛，并最终导致循环心理困扰。目前尚未对急性和慢性应激在男性 CPPS 发病机制中的生理作用进行系统评估，但临床医生观察到应激会加剧症状。某些固有的人格特征（遗传和发育因素）会调节对压力的反应。我们从 CPPS 患者那里得到了强有力的初步证据，表明理疗肌筋膜释放和认知行为疗法是行之有效的缓解压力的方法，可以治愈和部分缓解一些 CPPS 患者的疼痛。了解压力引起的神经生化变化如何引起男性盆腔疼痛可能会导致开发预防和治疗 CPPS 的创新方法。 实验设计： 我们打算每年在斯坦福大学招募 24 至 32 名受试者参加这项压力分析辅助研究。正常对照受试者队列将从斯坦福社区区招募，并与本研究中患有慢性前列腺炎/慢性盆腔疼痛综合征 (CP/CPPS) 的受试者年龄匹配。压力和心理调查、皮质醇唾液收集管和说明将在基线访视当天提供。两到三周后将参加特里尔急性压力测试，收集唾液皮质醇和血液样本。 具体目标 1：描述和调查 CPPS 受试者与对照组的心理社会变量（压力、情感和人格特质）之间的关系。 具体目标 2：测量唾液皮质醇反应。样本将在醒来时以及正常一天的家庭/工作环境中获取。然后受试者接受实验性急性压力测试，我们在斯坦福大学的 GCRC 中收集唾液皮质醇样本和血液样本。