Kim Lauren Y, Schüssler-Fiorenza Rose Sophia Miryam, Mengelkoch Summer, Moriarity Daniel P, Gassen Jeffrey, Alley Jenna C, Roos Lydia G, Jiang Tao, Alavi Arash, Thota Durga Devi, Zhang Xinyue, Perelman Dalia, Kodish Tamar, Krupnick Janice L, May Michelle, Bowman Katy, Hua Jenna, Liao Yaping Joyce, Lieberman Alicia F, Butte Atul J, Lester Patricia, Thyne Shannon M, Hilton Joan F, Snyder Michael P, Slavich George M
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
Department of Genetics, Stanford University, Stanford, CA, USA.
Stress. 2024 Jan;27(1):2401788. doi: 10.1080/10253890.2024.2401788. Epub 2024 Dec 2.
Adverse Childhood Experiences (ACEs) are very common and presently implicated in 9 out of 10 leading causes of death in the United States. Despite this fact, our mechanistic understanding of how ACEs impact health is limited. Moreover, interventions for reducing stress presently use a one-size-fits-all approach that involves no treatment tailoring or precision. To address these issues, we developed a combined cross-sectional study and randomized controlled trial, called the California Stress, Trauma, and Resilience Study (CalSTARS), to (a) characterize how ACEs influence multisystem biological functioning in adults with all levels of ACE burden and current perceived stress, using multiomics and other complementary approaches, and (b) test the efficacy of our new California ision ntervention for tress and Rsilience (PRECISE) in adults with elevated perceived stress levels who have experienced the full range of ACEs. The primary trial outcome is perceived stress, and the secondary outcomes span a variety of psychological, emotional, biological, and behavioral variables, as assessed using self-report measures, wearable technologies, and extensive biospecimens (i.e. DNA, saliva, blood, urine, & stool) that will be subjected to genomic, transcriptomic, proteomic, metabolomic, lipidomic, immunomic, and metagenomic/microbiome analysis. In this protocol paper, we describe the scientific gaps motivating this study as well as the sample, study design, procedures, measures, and planned analyses. Ultimately, our goal is to leverage the power of cutting-edge tools from psychology, multiomics, precision medicine, and translational bioinformatics to identify social, molecular, and immunological processes that can be targeted to reduce stress-related disease risk and enhance biopsychosocial resilience in individuals and communities worldwide.
童年不良经历（ACEs）非常普遍，目前在美国十大主要死因中，有九种与之相关。尽管如此，我们对ACEs如何影响健康的机制理解仍然有限。此外，目前减轻压力的干预措施采用的是一刀切的方法，没有针对性的治疗或精准度。为了解决这些问题，我们开展了一项结合横断面研究和随机对照试验的研究，即加利福尼亚压力、创伤与复原力研究（CalSTARS），目的是：（a）使用多组学和其他补充方法，描述ACEs如何影响不同ACE负担水平和当前感知压力的成年人的多系统生物功能；（b）测试我们新的加利福尼亚压力与复原力精准干预（PRECISE）对经历了各种ACEs且感知压力水平升高的成年人的疗效。主要试验结果是感知压力，次要结果涵盖各种心理、情感、生物和行为变量，这些变量通过自我报告测量、可穿戴技术以及广泛的生物样本（即DNA、唾液、血液、尿液和粪便）进行评估，这些生物样本将接受基因组、转录组、蛋白质组、代谢组、脂质组、免疫组和宏基因组/微生物组分析。在本方案文件中，我们描述了促使本研究开展的科学空白以及样本、研究设计、程序、测量方法和计划分析。最终，我们的目标是利用心理学、多组学、精准医学和转化生物信息学的前沿工具，识别可作为靶点的社会、分子和免疫过程，以降低与压力相关的疾病风险，并增强全球个人和社区的生物心理社会复原力。
