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Biomedical subjects

Christopher Ring

Publications and source records attributed to Christopher Ring.

At least 19 recordsLinked to original sources

Effects of opioid blockade with naltrexone and distraction on cold and ischemic pain in hypertension.

Essential hypertension is characterised by reduced pain sensitivity. Hypertensive hypoalgesia has been attributed to elevated endogenous opioids and/or increased activation of descending pain modulation systems. A double-blind placebo-controlled design compared the effects of naltrexone and placebo on cold and ischemic pain in unmedicated newly-diagnosed patients with essential hypertension. Patients performed a cold pressor task while resting and while performing a distracting secondary task. They also performed a forearm ischemia task while resting. Although the cold pressor and ischemia tasks elicited significant increases in pain and blood pressure, pain ratings and pressor responses did not differ between naltrexone and placebo. Cold pain was reduced by distraction compared to rest. The finding that opioid blockade with naltrexone did not moderate the pain and pressor responses to cold and ischemia suggests that pain and associated blood pressure responses are not modulated by opioids in hypertension. The finding that the distracting secondary task successfully reduced pain ratings suggests normal supraspinal pain modulation in essential hypertension.

Adult↗

Eccentric exercise as an adjuvant to influenza vaccination in humans.

The immune response to vaccination in animals can be enhanced by exposure to acute stress at the time of vaccination. The efficacy of this adjuvant strategy for vaccination in humans requires investigation. The current study employed a randomised controlled trial design to examine the effects of eccentric exercise prior to influenza vaccination on the antibody and cell-mediated responses. Sixty young healthy adults (29 men, 31 women) performed eccentric contractions of the deltoid and biceps brachii muscles of the non-dominant arm (exercise group) or rested quietly (control group), and were vaccinated 6h later in the non-dominant arm. Change in arm circumference and pain were measured to assess the physiological response to exercise. Antibody titres were measured pre-vaccination and at 6- and 20-week follow-ups. Interferon-gamma in response to in vitro stimulation by the whole vaccine, an index of the cell-mediated response, was measured 8 weeks post-vaccination. Interferon-gamma responses were enhanced by exercise in men, whereas antibody titres were enhanced by eccentric exercise in women but not in men. Men showed greater increase in arm circumference after eccentric exercise than women but there was no difference in reported pain. The interferon-gamma response was positively associated with the percentage increase in arm circumference among the exercise group. Eccentric exercise exerted differential effects on the response to vaccination in men and women, with enhancement of the antibody response in women, but enhancement of the cell-mediated response in men. Eccentric exercise of the muscle at the site of vaccine administration should be explored further as a possible behavioural adjuvant to vaccination.

Adjuvants, Immunologic↗

Time course and mechanisms of hemoconcentration in response to mental stress.

Hemoconcentration with mental stress exposure may be involved in the triggering of acute cardiovascular events. In the present study, hematocrit was measured repeatedly at baseline, during a 4 min mental stress task and during 20 min of recovery. Blood was sampled every 1-2 min throughout. Blood pressure, heart rate and R-wave to pulse interval, a measure of cardiac contractility, were measured with the same periodicity. The stress task elicited a 1.3% increase in hematocrit, which was sustained with full return to baseline level occurring only after 16 min of recovery. Between-subject correlations between hematocrit and hemodynamic activity were low. Aggregate within-subject coefficients were more impressive; the temporal profile of hematocrit correlated significantly with all hemodynamic variables. Similar within-subject analyses indicated that whereas cardiac contractility was correlated with hematocrit both during stress-related increase and subsequent recovery, blood pressure was related to hematocrit only during the increase. This suggests that stress-induced hemoconcentration may driven by different mechanisms than those which underlie its recovery.

Adult↗

Systolic inhibition of nociceptive responding is moderated by arousal.

Inhibition of the nociceptive flexion reflex during systole could be due to activation of the arterial baroreceptors. Physiological arousal, characterized by raised blood pressure, increases afferent activity from the arterial baroreceptors but attenuates the baroreflex. This study examined the effects of arousal on systolic inhibition of the nociceptive flexion reflex in 38 adults. The threshold current to elicit the reflex in the leg was determined, and participants were stimulated at threshold intensity for 12 trials in two conditions: rest (low arousal) and mental arithmetic (high arousal). In each trial, stimulation was delivered 0 ms, 300 ms, or 600 ms after the R-wave of the electrocardiogram. Nociceptive responding was inhibited for stimulation at 300 ms after the R-wave during rest but not mental arithmetic. This moderation of systolic inhibition of nociception could be due to attenuation of the baroreflex with increased arousal.

Adult↗

Bereavement and marriage are associated with antibody response to influenza vaccination in the elderly.

Stressful life events exposure including bereavement, an event commonly experienced by elderly people, social support, marital status, and satisfaction were examined in relation to antibody response to the annual trivalent influenza vaccination in an elderly community sample (N=184). Antibody response was assessed at baseline, and at 1 and 12 months following vaccination. Taking into account baseline antibody titer, overall life events exposure and social support were not associated with response to any of the influenza strains. However, bereavement in the year prior to vaccination was negatively associated with the 1-month response to the A/Panama and B/Shangdong strains. Being married and having higher marital satisfaction was also associated with higher peak responses to the A/Panama influenza strain at 1 month. The positive association between marital satisfaction and A/Panama response was particularly evident in the younger half of the married sample. These associations largely withstood adjustment for potential confounders. Thus, in the elderly, peak antibody response was associated with bereavement and marriage, and not the more general factors, life events and social support, related to antibody response in student samples. This suggests the importance of taking a life course approach to examining relationships between psychosocial factors and immunity, and that interventions to modify the impact of these factors should address those most salient for each age group.

Aged↗

Acute stress exposure prior to influenza vaccination enhances antibody response in women.

Animal studies have shown that an acute stressor in close temporal proximity to immune challenge can enhance the response to delayed-type hypersensitivity and antibody response to vaccination. The current study examined the effects of acute exercise or mental stress prior to influenza vaccination on the subsequent antibody response to each of the three viral strains. Sixty young healthy adults (31 men, 29 women) were randomly allocated to one of three task conditions: dynamic exercise, mental stress, or control. After an initial baseline, participants completed their allocated 45 min task and then received the influenza vaccine. Plasma cortisol and interleukin-6 were determined at the end of baseline, after the task, and after 60 min recovery. Antibody titres were measured pre-vaccination and at 4 weeks and 20 weeks post-vaccination follow-ups. For the A/Panama strain, women in both the exercise and mental stress conditions showed higher antibody titres at both 4 and 20 weeks than those in the control condition, while men responded similarly in all conditions. Interleukin-6 at +60 min recovery was found to be a significant predictor of subsequent A/Panama antibody response in women. In line with animal research, the current study provides preliminary evidence that acute stress can enhance the antibody response to vaccination in humans.

Acute Disease↗

Sex differences in the interleukin-6 response to acute psychological stress.

Interleukin-6 (IL-6), an immune regulator that helps coordinate the inflammatory response, may mediate inflammatory disease exacerbation associated with stress. Twenty men and twenty women completed a single session, comprising baseline (20 min), mental arithmetic task (8 min), and recovery (60 min). Blood samples, taken at baseline, immediately after the task, and at +30 and +60 min recovery were analysed for plasma IL-6. Overall, IL-6 increased linearly from baseline to +60 min recovery, and a sex difference was found in the IL-6 response, with men peaking earlier than women. These findings confirm a small delayed IL-6 increase after acute laboratory stress, and reveal sex differences in the profile of the IL-6 response.

Adult↗

Hemodynamic, hemostatic, and endothelial reactions to psychological and physical stress in coronary artery disease patients.

Episodes of psychological and physical stress may elicit thrombotic cardiac events, such as myocardial infarction. These events are triggered when there are concurrent hemodynamic, hemostatic, and endothelial abnormalities. Hemodynamic, hemostatic, and endothelial reactions of 72 (15 women, 57 men) coronary artery disease patients to psychological and physical stress were examined. Blood pressure, electrocardiography, and impedance cardiography were recorded during rest, mental arithmetic, and exercise. Blood was collected, via catheter, at rest and after each task. Mental arithmetic elicited increases in blood pressure, heart rate, cardiac output, and cardiac contractility, but no consistent changes in hemostatic and endothelial markers. In contrast, exercise, in addition to increasing blood pressure, heart rate, cardiac output, cardiac contractility, and lowering peripheral resistance, elicited increases in plasma viscosity, hematocrit, platelets, and tissue plasminogen activator together with a decrease in plasminogen activator inhibitor. This pattern of hemodynamic, hemostatic, and endothelial reactions suggests that acute psychological and physical stress influence the thrombotic system differently in these high risk patients. Future research is needed to investigate how these stress responses are prospectively related to acute cardiac events.

Acute Disease↗

Assessment of opiate modulation of pain and nociceptive responding in young adults with a parental history of hypertension.

This double blind, placebo-controlled study examined the effects of an opiate antagonist, naltrexone, on nociceptive flexion reflex (NFR) thresholds and subjective pain in individuals with and without a parental history of hypertension. Using a repeated measures design, NFR threshold was repeatedly assessed on two testing days after administration of either placebo or naltrexone. Immediately after NFR threshold was determined, participants rated the level of pain experienced during the preceding NFR assessment, and at the end of each session participants' electrocutaneous pain threshold was assessed. Two primary findings were obtained. First, individuals with a parental history of hypertension exhibited attenuated pain sensitivity. Second, endogenous opioid blockade was associated with increased pain ratings in women but with increased pain threshold in men. In sum, the present study did not support a direct involvement of the endogenous opioid system in the attenuated pain sensitivity observed in individuals at increased risk for hypertension.

Adolescent↗

Factors influencing influenza vaccination uptake in an elderly, community-based sample.

This study investigated predictors of influenza vaccination uptake since the introduction of the policy to target over 65s. Four hundred and forty-four participants completed a cross-sectional structured interview. The predictors of vaccination uptake were: having a doctor or nurse who explained why the vaccination is important and possible side effects; living with others; higher occupational status; and having a car or being able to walk to the GPs rather than reliant on others or public transport. Most participants who had received the vaccination reported having done so in response to reminders or advice from medical professionals. The most common explanations given by those who had chosen not to receive the vaccination were fear of side effects and concerns regarding vaccination efficacy. Current national campaigns and general practitioners' reminder programmes appear to have been successful in improving awareness; however, these results suggest that a more informational campaign, focused on the evidence that the vaccine is efficacious and that side effects are limited, may further improve uptake.

Aged↗

Effects of competition, exercise, and mental stress on secretory immunity.

It has been suggested that the psychological stress associated with competitive sports events may help to explain the increased susceptibility to respiratory infections due to reductions in secretory immunity. In the current study, we investigated the influence of competitive exercise and psychological stress on secretory immunoglobulin A (s-IgA). Salivary s-IgA and heart rate were measured in 62 healthy young recreationally active men at rest and, in a between-subjects design, following one of four 8-min tasks: mental arithmetic, cycling at workloads of 60 to 180 W (mean = 146 W), mental arithmetic while cycling, or competitive cycling. Mental arithmetic was associated with significant increases in s-IgA concentration (mean = 49 microg.min(-1)) and s-IgA secretion rate (mean = 25 microg.ml(-1)) compared with rest, while mental arithmetic combined with exercise was associated with a significant increase in s-IgA concentration only (mean = 124 microg.min(-1)). In contrast, competitive exercise and exercise alone did not influence s-IgA concentration or secretion rate. Heart rate increased modestly to mental arithmetic (mean = 7 beats.min(-1)) and substantially, and similarly, to the three exercise tasks (mean = 56(62 beats.min(-1)). The hypothesis that the psychological stress of competitive exercise contributes to increased susceptibility to infection via reductions in s-IgA requires further investigation.

Adult↗

Nociception and baroreceptor stimulation in hypertension-prone men and women.

We examined the effects of baroreceptor stimulation on nociceptive responding in men and women with a positive or negative parental history of hypertension. The effects of three baroreceptor conditions (stimulation, inhibition, and control) on subjective pain and nociceptive responding were evaluated during electrocutaneous sural nerve stimulation. Pain ratings were lower in men with positive parental history relative to men with negative parental history, but this difference was not found in women. Both stimulatory and inhibitory baroreceptor conditions were associated with reduced pain reports compared to the control condition. There were no significant differences in nociceptive responding as a function of parental history of hypertension. Although this study confirms a link between hypoalgesia and risk for hypertension in men, it does not support the hypothesis that this attenuated pain perception is due to enhanced baroreceptor activity.

Adult↗

The influence of hydration status on stress-induced hemoconcentration.

This study examined the effects of hydration status on rheological and hemodynamic activity during rest, mental stress, postural stress, and combined mental/postural stress in 24 men when euhydrated and hyperhydrated. The stress tasks elicited hemoconcentration, although the effects were less pronounced during mental stress. Hyperhydration was associated with higher plasma volume throughout. All stress tasks also perturbed hemodynamic activity, irrespective of hydration status, with the exception of heart rate reactivity, which was attenuated when hyperhydrated. As expected the combined stress during euhydration was associated with an unfavorable rheological and cardiovascular profile, which may help explain the increased incidence of cardiovascular events in the morning.

Adult↗

Life events and hemodynamic stress reactivity in the middle-aged and elderly.

Recent versions of the reactivity hypothesis, which consider it to be the product of stress exposure and exaggerated hemodynamic reactions to stress that confers cardiovascular disease risk, assume that reactivity is independent of the experience of stressful life events. This assumption was tested in two substantial cohorts, one middle-aged and one elderly. Participants had to indicate from a list of major stressful life events up to six they had experienced in the previous 2 years. They were also asked to rate how disruptive and stressful they were, at the time of occurrence and now. Blood pressure and pulse rate were measured at rest and in response to acute mental stress. Those who rated the events as highly disruptive at the time of exposure and now exhibited blunted systolic blood pressure reactions to acute stress. The present results suggest that acute stress reactivity may not be independent of stressful life events experience.

Aged↗

The association between life events, social support, and antibody status following thymus-dependent and thymus-independent vaccinations in healthy young adults.

This study determined whether stressful life events and social support were related to antibody status following both thymus-dependent and thymus-independent vaccinations. Life events in the previous year and customary social support were measured in 57 healthy students at baseline. Antibody status was also assessed at baseline and at five weeks and five months following vaccination with the trivalent influenza vaccine and the meningococcal A+C polysaccharide vaccine. Taking into account baseline antibody titre, high life events scores prior to vaccination were associated with lower responses to the B/Shangdong influenza strain at both five weeks and five months and meningococcal C at five weeks. Life event scores were not associated with response to the other two influenza viral strains nor response to meningococcal A. Those with high social support scores had stronger 5-week and 5-month antibody responses to the A/Panama influenza strain, but not to any of the other strains. These associations could not be accounted for by demographic or health behaviour factors, and also emerged from analyses comparing those who exhibited a fourfold increase in antibody titre from baseline with those who did not. Life events and social support were related to antibody status following influenza vaccination in distinctive ways that may be partly determined by vaccine novelty and prior naturalistic exposure. Life events also predicted poor antibody response to meningococcal C polysaccharide vaccination after previous meningococcal C conjugate vaccination. Neither psychosocial factor was associated with response to primary meningococcal A polysaccharide vaccination.

Adult↗

Reductions in secretory immunoglobulin A to cold pressor stress are not influenced by timing of saliva sampling.

Acute psychological stress has been shown to alter secretory immunity, principally secretory immunoglobulin A (S-IgA). Most acute stress tasks result in increases in S-IgA, but decreases have been reported in response to the cold pressor. However, the evidence is mixed, with increases and no changes in S-IgA in response to the cold pressor also being reported. It was hypothesised that differences in the timing of saliva sampling may provide an explanation for these discrepant results. Participants completed two 4-min cold pressor tasks, each preceded by a rest period in which baseline S-IgA was measured. In one condition, S-IgA was assessed during the final 2 min of the cold pressor; in the other, it was measured immediately after completion of the task. S-IgA decreased from baseline to task, regardless of timing of saliva sampling. It was concluded that differences in timing of sampling do not account for the mixed reports in the literature.

Adult↗

Increases in lipids and immune cells in response to exercise and mental stress in patients with suspected coronary artery disease: effects of adjustment for shifts in plasma volume.

This study examined the role of shifts in plasma volume on lipid and immune reactions to stress. Lipid, immune, rheological, and cardiovascular reactions to exercise and mental stress in 51 patients with suspected coronary artery disease were determined. Blood pressure and heart rate were measured during and blood samples taken at the end of each rest and task. Lipids (total cholesterol, triglycerides, HDL, LDL) and immune cells (lymphocytes, monocytes, granulocytes) increased with exercise, whereas cholesterol, LDL, and lymphocytes increased with mental stress. Plasma volume decreased by 1 and 5% following mental and exercise stress, respectively. The task-induced increases in lipids were no longer statistically significant following adjustment for changes in plasma volume, whereas the increases in immune cell numbers survived such correction. This study provides evidence that, in coronary artery disease patients, exercise and mental stress-induced increases in lipids but not immune cells can be largely accounted for by shifts in plasma volume.

Adult↗