From the Rocky Vista University College of Osteopathic Medicine (C.W.), Ivins, Utah; Rocky Vista University College of Osteopathic Medicine (S.P., A.L.P.), Department of Biomedical Sciences (F.T., R.R.), Department of Surgery (K.D.G.), Rocky Vista University College of Osteopathic Medicine, Parker, Colorado; and National Defense University (P.B.), Washington, District of Columbia.
J Trauma Acute Care Surg. 2023 Nov 1;95(5):664-671. doi: 10.1097/TA.0000000000004026. Epub 2023 Jun 19.
Frequent exposure to acute stress increases risk of suicide, posttraumatic stress disorder, and other stress-related disorders. Neuroendocrine and immunologic dysregulation associated with stress may underlie predispositions to psychological disorders and inflammatory disease processes in individuals, such as first-responders and other healthcare professionals, who function in high stress situations. The Hardiness Resilience Gauge (HRG) can be used to psychometrically measure resilience, a psychological modifier of the stress response. Using the HRG alongside salivary biomarker profiling, may help to identify low resilience phenotypes and allow mitigation and early therapeutic interventions. There is a paucity of knowledge regarding biomarkers of resilience. This study aims to evaluate the relationship between factors of resilience with salivary biomarker levels and fluctuations during and following acute stress.
Sixty-three first responders underwent a standardized stress-inducing training exercise, providing salivary samples before (prestress), immediately after (post-stress), and 1 hour after the event (recovery). The HRG was administered before (initial) and after (final) the event. Multiplex ELISA panels quantified 42 cytokines and 6 hormones from the samples, which were analyzed for relationships to psychometric factors of resilience measured by the HRG.
Several biomarkers correlated with psychological resilience following the acute stress event. The HRG scores correlated ( p < 0.05) with a select set of biomarkers with moderate-to-strong correlations (|r| > 0.3). These included EGF, GROα, PDGFAA, TGFα, VEGFA, interleukin (IL)1Ra, TNFα, IL18, cortisol, FGF2, IL13, IL15, and IL6. Interestingly, fluctuations of EGF, GROα, and PDGFAA in post-stress compared with recovery were positively correlated with factors of resilience, which were negatively correlated from the pre-stress to post-stress period.
This exploratory analysis discovered a small subset of salivary biomarkers that are significantly correlated with acute stress and resilience. Further investigation of their specific roles in acute stress and associations with resiliency phenotypes is warranted.
频繁接触急性应激会增加自杀、创伤后应激障碍和其他应激相关障碍的风险。与应激相关的神经内分泌和免疫失调可能是个体易患心理障碍和炎症性疾病过程的基础，例如在高应激环境下工作的急救人员和其他医护人员。坚韧(resilience) 量表可以用于心理测量来衡量韧性(resilience)，这是应激反应的一种心理调节剂。使用坚韧(resilience)量表和唾液生物标志物分析，可能有助于识别低韧性表型，并允许进行缓解和早期治疗干预。关于韧性的生物标志物知之甚少。本研究旨在评估韧性的因素与唾液生物标志物水平及其在急性应激期间和之后的变化之间的关系。
63 名急救人员接受了标准化的应激诱发训练，在应激前（应激前）、应激后即刻（应激后）和事件后 1 小时（恢复）提供唾液样本。在事件前后（初始和最终）进行坚韧(resilience) 量表评估。通过多聚酶联免疫吸附试验（ELISA）分析 42 种细胞因子和 6 种激素，分析与坚韧(resilience) 量表测量的心理韧性因素的关系。
几项生物标志物与急性应激后心理韧性相关。坚韧(resilience) 量表评分与一组具有中度至强相关性（|r|>0.3）的选定生物标志物相关（p<0.05）。这些生物标志物包括 EGF、GROα、PDGFAA、TGFα、VEGFA、白细胞介素（IL）1Ra、TNFα、IL18、皮质醇、FGF2、IL13、IL15 和 IL6。有趣的是，应激后与恢复相比，EGF、GROα 和 PDGFAA 的波动与韧性因素呈正相关，而与应激前至应激后的时间段呈负相关。
这项探索性分析发现了一小部分与急性应激和韧性显著相关的唾液生物标志物。进一步研究它们在急性应激中的特定作用及其与韧性表型的关系是必要的。
