Citation

Malan L, Hamer M, von Känel R, van Wyk RD, Wentzel A, Steyn HS, van Vuuren P, Malan NT. Brain Behav. Immun. Health 2020; 2.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.bbih.2019.100027

PMID

unavailable

Abstract

BACKGROUND: Psychobiological processes linking stress and vascular diseases remain poorly understood. The retina and the brain share a common embryonic-diencephalon origin and blood-barrier physiology e.g. ongoing ischemia facilitates S100B release with astrocytic activity and glial-fibrillary-acidic-protein expression (GFAP). However, GFAP decreases revealed astrocyte pathology in the prefrontal cortex of depression/suicide cases; and might be a key mechanism in stress - disease pathways.

METHODS: A chronic emotional stress phenotype independent of age, ethnicity or sex was used to stratify the current prospective cohort (N ​= ​359; aged 46 ​± ​9 years) into Stress (N ​= ​236) and no-Stress groups (N ​= ​123). Prospective data for glia ischemia risk markers were obtained, including 24 ​h BP, fasting S100B, GFAP, HbA1C and tumor-necrosis-factor-α (TNF-α). At 3-yr follow-up: diastolic-ocular-perfusion-pressure (indicating hypo-perfusion risk) was measured and retinal vessel calibers were quantified from digital images in the mydriatic eye.

RESULTS: Higher hypertension (75% vs. 16%), diabetes (13% vs. 0%) and retinopathy (57% vs. 45%) prevalence was observed in Stress compared to no-Stress individuals. Stressed individuals had consistently raised S100B, TNF-α, HbA1C and higher diastolic-ocular-perfusion-pressure, but decreases in GFAP and GFAP:S100B. Furthermore stroke risk markers, arterial narrowing and venous widening were associated with consistently raised S100B, GFAP:S100B (p ​= ​0.060), TNF-α and higher diastolic-ocular-perfusion-pressure [Adj. R2 0.39-0.41, p ​≤ ​0.05]. No retinal-glia associations were evident in the no-Stress group.

CONCLUSIONS: Retinal-glia ischemia and inflammation was induced by chronic stress. Persistent higher inflammation and S100B with GFAP decreases further reflected stress-induced astrocyte pathology in the human retina. It is recommended to increase awareness on chronic stress and susceptibility for brain ischemia. © 2019 North-West University

Language: en

Keywords

adult; human; Stress; female; male; depression; Inflammation; scoring system; major clinical study; controlled study; disease association; follow up; emotional stress; prospective study; DSM-IV; diabetic retinopathy; hemoglobin A1c; Article; systolic blood pressure; phenotype; Ischemia; diastolic blood pressure; chronic stress; glial fibrillary acidic protein; tumor necrosis factor; retina ischemia; Retina; protein S100B; hypertension retinopathy; Patient Health Questionnaire 9; limit of quantitation; carotid intima-media thickness; Glia; perfusion; retinal glia ischemia