RE-THINKING DISEASE: Asthma
Conventional Medical Thinking: Asthma is idiopathic (cause unknown), with narrowing and spasm of airways. Treatment uses inhaled corticosteroids, anti-inflammatory meds – and in emergencies, a rescue inhaler, epinephrine and systemic steroids.
Systems Biology Thinking: Asthma is an inflammatory disease. Systems Biology research points to over-activation of the deep brain as the instigating factor as well as lack of restorative sleep.
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Ohno I. Neuropsychiatry phenotype in asthma: psychological stress-induced alterations of the neurobiology-endocrine system in allergic airway inflammation. Allergol Int 2017. FREE FULL TEXT ARTICLE
Highlights: Critical role of psychological stress in activation of signals in the development and exacerbation of allergic asthma.
Classic Articles
Miyasaka T, Dobashi-Okuyama K, Takahaski T, et.al. The interplay between neuroendocrine activity and psychological stress-induced exacerbation of allergic asthma. Allergot Int 2017
Highlights: How stress activates events in CNS-endocrine systems resulting in asthma. Describes consecutive pathological events from brain to lung, resulting in eosinophilic airway inflammation.
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Dube SR, et.al. Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med 2009. FREE FULL TEXT
Retrospective study of 15,357 adults demonstrated that persons with 2+ ACEs were at a 70% increased risk of autoimmune disease and 100% increased risk of rheumatic disease.
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Classic Articles
Dong M, Giles WH, Felitti VJ, et al. Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation. 2004. FREE FULL TEXT ARTICLE
Relation of ACEs to risk of ischemic heart disease (IHD). The ACE-IHD relation was mediated more strongly by individual psychological risk factors, such as depressed affect and anger, than by traditional IHD risk factors (smoking, physical inactivity, obesity, diabetes and hypertension).
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Bethell C, et al. Adverse childhood experiences, resilience and mindfulness-based approaches: common denominator issues for children with emotional, mental, or behavioral problems. Child Adolesc Psychiatr Clin N Am. 2016
Perry-Parrish C, et al. Improving self-regulation in adolescents: current evidence for the role of mindfulness-based cognitive therapy. Adolesc Health Med Ther. 2016.
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Rotem AY, Sperber AD, Krugliak P, et.al. Polysomnographic and actigraphic evidence of sleep fragmentation in patients with irritable bowel syndrome. Sleep. 2003.
RE-THINKING DISEASE: Hypertension
Conventional Medical Thinking: Hypertension is idiopathic (cause unknown), identified when a person’s measured blood pressure is higher than desirable (using criteria from the American College of Cardiology). Hypertension is seen as a “risk factor” for other heart disease and other vascular diseases.
Systems Biology Thinking: Hypertension is one phase of inflammatory vascular disease, resulting from inflammatory infiltration of lining of arteries, resulting in stiffening and narrowing. Systems Biology
research points to hyperarousal of the deep brain as an instigating factor.
Trauma-Health Equity-Neurobiology Lens – Severity of Hypertension correlates with severity of adverse experiences, especially experience of Everyday Discrimination. In the USA, black men are particularly at risk. Research has shown that transition from normal blood pressure to hypertension in black boys can start at age 8.
New Articles
Moody DLB, et al. Everyday Discrimination Prospectively Predicts Blood Pressure Across 10 Years in Racially/Ethnically Diverse Midlife Women. Ann Behavior Med. Sept 2018.
Highlights: Exposure to Everyday Discrimination predicts systolic and diastolic blood pressure, regardless of race or ethnicity.
Classic Articles
Hardy ST, et al. Heterogeneity in Blood Pressure Transitions Over the Life Course: Age-Specific Emergence of Racial/Ethnic and Sex Disparities in the United States. JAMA Cardiology. June 2017. FREE FULL TEXT ARTICLE
Highlights: Tracked blood pressure readings in 17,000 people. Found that young black men had twice the risk of hypertension compared to white youth. Transition from normal blood pressure to hypertension in black youth started at age 8.
Rodriguez-Iturbe B et al. Role of the Immune System in Hypertension. Physiol Rev. July 2017. FREE FULL TEXT ARTICLE
Highlights: Updated review of physiology underlying hypertension: infiltration of immune cells, oxidative stress, and stimulation of angiotensin system, vascular relaxation, and over-reactivity of sympathetic nervous system.
Solak Y, Afsar B, Vaziri ND, et al. Hypertension as an autoimmune and inflammatory disease. Hypertension Research (2016) FREE FULL TEXT ARTICLE.
Developments in the pathophysiology of hypertension with a focus on the oxidant stress-autoimmunity-inflammation interaction.
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Carnevale D and Lembo G. Immunological Aspects of Hypertension. High Blood Press Cardiovasc Prev 2016
McMaster et.al. Inflammation, Immunity and Hypertensive End-Organ Damage. Circ Res 2015. FREE FULL TEXT ARTICLE
Mathis KW et.al. Autoimmunity: An underlying factor in the pathogenesis of hypertension. Curr Hypertens Rep 2014. FREE FULL TEXT ARTICLE
Tomfohr L et.al. Everyday Discrimination and Nocturnal Blood Pressure Dipping in Black and White Americans. Psychosom Med 2010. FREE FULL TEXT ARTICLE
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Kwarteng JL, et al. Independent Effects of Neighborhood Poverty & Psychosocial Stress on Obesity. Urban Health. 2017.
Community sample of 157 Black, White, and Hispanic adults. Neighborhoods with high concentrations of poverty and everyday unfair treatment independently heighten risk of increased central adiposity.
Classic Articles
Mason SM, Austin SB, Bakalar JL, et al. Child maltreatment’s heavy toll: the need for trauma-informed obesity prevention. Am J Prev Med 2016. FREE FULL TEXT ARTICLE
REVIEW ARTICLE: Evidence of child maltreatment-obesity association and existing research on physiologic mechanisms. Highlights impact of physical and sexual abuse, community violence, and peer bullying.
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Masodkar K, et al. A Review of Posttraumatic Stress Disorder and Obesity: Exploring the Link. Prim Care Companion CNS. 2016. FREE FULL TEXT ARTICLE
Richardson A. et.al. The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health. Pediatric Obesity 2014. FREE FULL TEXT ARTICLE
Richardson A. et.al. The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health. Pediatric Obesity 2014. FREE FULL TEXT ARTICLE
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Francis B, et al. Racial discrimination and perinatal sleep quality. Sleep Health. 2017
Everyday racial discrimination is independently associated with poorer sleep quality among pregnant women, associated with adverse perinatal outcomes.
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Smith MV et.al. Early Childhood Adversity and Pregnancy Outcomes. Matern Child Health J. 2016. FREE FULL TEXT
Study of 2303 pregnant women using Early Trauma Inventory Self Report Form found that ACEs have an enduring effort on reproductive health, with each ACE associated with a decreased birth weight and shorter gestatational age.
Hills SD, et.al. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics 2004.
Retrospective study of 9159 women aged 18+. Teen pregnancy was strongly associated with childhood adversity in a dose-response relationship. Of women with no reported ACEs, 16% had a teenage pregnancy, while of the women with 7-8 ACEs, 53% had teenage pregnancy. Childhood adversity was also associated with increased fetal death.
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Yonkers KA, et.al. Pregnant women with posttraumatic stress disorder and risk of preterm birth. JAMA Psychiatry. 2014. FREE FULL TEXT
Study of 2654 women followed from first trimester. Women with PTSD and episode of major depression were at a 4-fold increased risk of preterm birth, independent of medication or mood.
Frankenberger D, et al. The association between adverse childhood experiences and alcohol use during pregnancy in a representative sample of adult women. Womens Health Issues. 2015. FREE FULL TEXT ARTICLE
Jacobs MB, Boynton-Jarrett RD, Harville EW. Adverse childhood event experiences, fertility difficulties, and menstrual cycle characteristics. J Psychosom Obstet Gynaecol. 2015. FREE FULL TEXT ARTICLE