Article

McEwen BS. Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol 583: 174-185

Laboratory of Neuroendocrinology, The Rockefeller University, 1230 York Avenue Box 165, New York, NY 10065, United States.
European Journal of Pharmacology (Impact Factor: 2.53). 05/2008; 583(2-3):174-85. DOI: 10.1016/j.ejphar.2007.11.071
Source: PubMed

ABSTRACT

Stress begins in the brain and affects the brain, as well as the rest of the body. Acute stress responses promote adaptation and survival via responses of neural, cardiovascular, autonomic, immune and metabolic systems. Chronic stress can promote and exacerbate pathophysiology through the same systems that are dysregulated. The burden of chronic stress and accompanying changes in personal behaviors (smoking, eating too much, drinking, poor quality sleep; otherwise referred to as "lifestyle") is called allostatic overload. Brain regions such as hippocampus, prefrontal cortex and amygdala respond to acute and chronic stress and show changes in morphology and chemistry that are largely reversible if the chronic stress lasts for weeks. However, it is not clear whether prolonged stress for many months or years may have irreversible effects on the brain. The adaptive plasticity of chronic stress involves many mediators, including glucocorticoids, excitatory amino acids, endogenous factors such as brain neurotrophic factor (BDNF), polysialated neural cell adhesion molecule (PSA-NCAM) and tissue plasminogen activator (tPA). The role of this stress-induced remodeling of neural circuitry is discussed in relation to psychiatric illnesses, as well as chronic stress and the concept of top-down regulation of cognitive, autonomic and neuroendocrine function. This concept leads to a different way of regarding more holistic manipulations, such as physical activity and social support as an important complement to pharmaceutical therapy in treatment of the common phenomenon of being "stressed out". Policies of government and the private sector play an important role in this top-down view of minimizing the burden of chronic stress and related lifestyle (i.e. allostatic overload).

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Available from: Bruce S Mcewen, Jun 01, 2015
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    • "Social disruption, isolation, and neglect are major sources of stress and can negatively impact health and well-being (McEwen, 2008), as well as contribute to dysregulation of the hypothalamicpituitary-adrenal (HPA) axis (Smith and Wang, 2012). Long-lasting social relationships and positive social interactions can serve as resilience factors against stressors. "
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    • "Buffardi et al. 2008; Krieger 2012; Leslie and Lentle 2006; Yamada and Palmer 2007), Latin American Social Medicine (e.g. de Almeida-Filho 2000; Granda 2008; Krieger 2011; Muntaner 2013; Tajer 2003), theorisation of psychosocial determinants of health and disease (e.g. Marmot 2004; McEwen 2008; Wilkinson and Pickett 2009) and complex systems frameworks (e.g. Diez-Roux 2007; Jayasinghe 2011). "
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    • "It influences the desire to work, performance at work and attitude toward life. Chronic stress has been linked to a range of health problems [2]. Previous studies have shown a correlation between long-term exposure to stress and risk factors such as cardiovascular diseases [3] [4]. "

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