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Understanding Stress in Medicine: General Adaptation Syndrome Experiment Found in 1929

Learn about the wide-ranging impact of stress on the body, including the General Adaptation Syndrome (GAS) and the Neuroendocrine responses influenced by Locus ceruleus-norepinephrine and the Hypothalamus-pituitary-adrenal cortex system. Explore the effects of stress on various body systems, such as the cardiovascular, immune, and metabolic systems, and discover common stress-related diseases like Essential Hypertension and Stress Peptic Ulcer.

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Understanding Stress in Medicine: General Adaptation Syndrome Experiment Found in 1929

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  1. Chapter 8 Stress Zhao Mingyao BMC.ZZU

  2. General Adaptation Syndrome Experiment found in 1929: ? ? ? Stress GAS

  3. stress in medicine ? protect effect Non-specific response harmful effect Disease cause Specific response Body

  4. Stress over low —— suitable —— over high Pathological status Physiological status New Pathological status when against pathological process

  5. Stress wide meaning in medicine physiological & pathological somatical & schycological eustress & distress narrow meaning here somatical & pathological & distress

  6. Stress around us Exam now Tour now Healthy person without any disease Traffic accident Injury person with gastric ulcer

  7. Section 1Terminology of stress 1.Stress ---- Non-specific response 2.Stressor ---- stimuli that induces stress 3.General Adaptation Syndrome, GAS

  8. General Adaptation Syndrome

  9. ⑴LC/NE( locus ceruleus-norepinephrine /sympathetic-adrenal meddula axis )----- Cannon ⑵HPA( Hypothalamus-pituitary-adrenal cortex system )-----Selye ⑶Other hormones ⑷AP( Acute phase protein ) ⑸HSP(Heat shock protein, stress protein ) Mechanism of stress ‘ Flight or Fight Response’

  10. Section 2Neuroendocrine response

  11. 1.Locus ceruleus-norepinephrine /sympathetic-adrenal meddula axis, LC/NE (1)Central site of LC/NE Limbic system: emotion/cognition/action Lateral horn of spinal cord: sympathetic-adrenal meddula

  12. (2)Effects of catecholamine during stress Central: exiting , alert / tension, anxiety Peripheral: ?/? Locus Ceruleus arouses the Brain Sympathetics activate entire body

  13. 1)Peripheral beneficial effects : ①Cardiovascular function ②hypermetabolism: glycogenolysis ③respiration ④promoting secretion of other hormone ⑤hyperglycemia

  14. 2)Peripheral detrimental effects : ①hypertension & ischemia ②thrombosis ③O2 overconsumption: HR ④lipid peroxidation Methyl transferase Vanillylmandelic acid (VMA) Adr • monoamine oxidase 80% during stress O2 -·  adrenochrome

  15. SAM-Route Stress “Rest and Digest” “Fight or Flight”

  16. 2.Hypothalamus-pituitary-adrenal cortex system, HPA (1) HPA axis constitution

  17. (2) Effects of HPA Central: CRH ↑, endophin ↑ adaptation, euphoria; anxiety, depression

  18. Effects of Glucocorticoids (GC) Central: CRH → ACTH → GC Peripheral:?/? CNS - Sex gland axis -

  19. 1) Peripheral beneficial effects of GC ① blood glucose↑ ② permit role for CA and glucagon mobilizing fat ③ maintain response for CA in circulatory system ④ stabilizing lysosomal membrane: macrocortin （lipomodulin）inhibits PLA2 ⑤ anti-inflammation & anti-anaphylactic reaction: GR,

  20. 2)Peripheral detrimental effects ① inhibit immune: ② inhibit growth and development ③ abnormal behavior ④ inhibit sex gland axis and thyroid gland axis ⑤ metabolism change

  21. 3. Effects of Other hormonesduring stress Thyroid hormone system↓ Sex gland hormone system ↓ insulin ↓ other hormone ↑ Central ? Peripheral ?

  22. Section 3Cellular and humoral response

  23. 1. Acute phase protein A group of proteins changing abruptly in plasma during acute phase response of stress positive APP↑ negative APP↓

  24. (1) AP origin : comes from liver cell (C-reactive protein) monocyte (complement components) endothelium cell fibroblast

  25. pro

  26. (2) AP function Inhibiting proteinase Coagulation and fibronolysis Cleaving foreign body and necrotic tissue Cleaving OFR: ceruloplasmin Other: anti-infection

  27. 2. Heat shock protein (HSP) a group of proteins present in all cells in all life forms, induced by stressor protein folding, intracellular trafficking of proteins, & coping with proteins denatured Drosophila

  28. (1) Features of HSP 7subfamilies High conserved Little quantity Drosophila HSPs20, 40, 60, 70, 90, 110, ubiquitin

  29. (2)Molecule structure of HSP ？ ATPase activity 450aa Matrix recognition domain 200aa N-terminal C-terminal HSP70

  30. （3）Function of HSP Molecular chaperone ------- guides protein folding and translocation in cell

  31. 3. Endoplasmic reticulum stress • Misfolded pro, unfolded pro or Ca2+ overload triggers response of ER • ER chaperones or activation apoptosis • Adaptation or apoptosis

  32. Section 4Functional and metabolic response

  33. Total tendency sympathetic nerve system +++ vagal nerve system - - - metabolism: syntheses↓ decompose↑，but katolysis directive stressor stimulation & AP/HSP: immune: eustress or distress

  34. Positive & negative effect 1.CNS 2.Immune system 3.Cardiovascular ~ 4.Digestive ~ 5.Gnitourinary ~ 6.Metabolism

  35. Section 5 Stress-related diseases

  36. Common stress-related disease * Essential Hypertension * Stress Heart Disease * Stress Peptic Ulcer * Tumor * Depression * Psychosocial dwarf

  37. 1. Stress Peptic Ulcer mechanism: (1)ischemia (2)counter-diffusion of gastric H+ to mucosa

  38. Multiple stress ulcers of the stomach, highlighted by the dark digested blood in their bases.

  39. 2. Cardiovascular diseases (1)Essential Hypertension (2)Stress Heart Disease: coronary artery disease arrhythmia

  40. 3. Endocrine disorder (1)Disturbance in growth-thyroid function pschycosocial dworf (2)Disturbance in gonadal axis

  41. 4.Pschycosocial disturbance Post-traumatic stress disorder (PTSD) a whole family with 8 persons made a tour, faced Tsunami, only one return. How does this person response?

  42. PTSD symptome cluster Re-experiencing — intrusive recollections of a traumatic event, often through flashbacks or nightmares avoidance or numbing — efforts to avoid anything associated with the trauma and numbing of emotions Hyperarousal — often manifested by difficulty in sleeping and concentrating and by irritability

  43. Section 6 Prevention and treatment 1.remove serious stressor 2.decrease stress degree 3.supply GC 4.supply nutrients 5.psychosocial comforting

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