Chapter 10 Stress
Stress
is ……
What is stress?
• Stress is the nonspecific and systemic
response of the body to a wide range of
stimulations.
• Stress is your mind and body’s response
or reaction to a real or imagined threat,
event or change.
What is stressor?
The stimuli or agents that induce stress
are termed stressor.
Stressor
Physical, chemical,
biological
Cold, heat, toxins, drugs, bacteria.
intrinsic factor of body
Homeostasis, disease, cancer.
Psychological or sociocultural
Threat to self esteem,
with other people.
relationships
What is eustress?
Eustress or positive stress occurs
when your level of stress is high
enough to motivate you to move into
action to get things accomplished.
What is distress?
Distress or negative stress occurs
when your level of stress is either
too high or too low and your body
and/or mind begin to respond
negatively to the stressors.
General adaptation syndrome (GAS)
• Alarm stage
• Resistance stage
• Exhaustion stage
Basic manifestation to stress
response
Stressor
Neuroendocrine
response
Cellular and
humoral responses
CA、GC↑
AAP、HSP↑
Functional and metabolic
responses
Neuroendocrine response
Locus ceruleus-norepinephrine neuronssympathetic/adrenal medulla axis↑
神
经
内
分
泌
反
应
CA↑
Hypothalamus-pituitary-adrenal cortex axis↑↑
GC↑
Rest hormonal responses to stress
Locus ceruleus - Norepinephrine
（LC-NE）
社会心理应激
Cerebralcortex
情绪
反应
Limbic system
Paraventricular
nucleus
躯体刺激
CRH
Locus ceruleus
Pituitary
ACTH
Adrenal medulla
Adrenal cortex
GC
CA
Basic effects of LC-NE
• Effects of CNS
• Effects of peripheral
• Functional and metabolic responses
in body
Energy metabolism
Stress
A cell  receptor（+）
CA↑
Glucagon↑
B cell  receptor （+）
Insulin↓
Blood sugar↑
Glycogenolysis ↑
Lipodieresis↑
Meeting the require
to energy
Energy consumption↑
Tissue decomposition↑
（bad results）
Neuroendocrine response
Locus ceruleus-norepinephrine neuronssympathetic/adrenal medulla axis↑
神
经
内
分
泌
反
应
CA↑
Hypothalamus-pituitary-adrenal cortex axis↑↑
GC↑
Rest hormonal responses to stress
Hypothalamic-pituitary-adrenal（HPA）
社会心理应激
Cerebralcortex
情绪
反应
Limbic system
Paraventricular
nucleus
躯体刺激
CRH
Locus ceruleus
Pituitary
ACTH
Adrenal medulla
Adrenal cortex
GC
CA
Rest hormonal responses to stress
Stress hormones
Secretive site
Alteration
Endophin
Adenohypophysis
↑
ADH
Hypothalamus
↑
Growth hormone
Adenohypophysis
↑in acute stress
↓in chronic stress
Glucagons
A cell in islet
↑
Prolactin
Adenohypophysis
↑
Insulin
B cell in islet
↓
TRH
Hypothalamus
↓
TSH
Adenohypophysis
↓
T3、T4
GhRH
Thyroid gland
↓
Hypothalamus
↓
Cellular and humoral responses
• Acute phase proteins (APP)
• Heat shock proteins (HSP)
Acute phase proteins (APP)
• Acute phase response
• Acute phase protein
• Negative acute phase protein
Cellular and humoral responses
• Acute phase proteins (APP)
• Heat shock proteins (HSP)
What is HSP?
• HSP are a family of stress protein
whose synthesis is upregalated in
response to a variety of enviromental
insults such as “heat stress”.
Classification of HSP
■结构性HSP
为细胞的结构蛋白,正常时即存在于细胞内，帮助
新生的蛋白质进行正确的折叠(folding) 、移位(translocation ) 、
复性(renaturation)和降解( degradation ) ，称为“Molecular
chaperone”。
■诱生性HSP
由各种应激原诱导生成，参与受损蛋白质的修复
或移除，保护细胞免受严重损伤，加速修复；提高细胞
对应激原的耐受性。
Stress
Regulation of HSP gene expresion
Stress
Effects of stress on the body
1. Effects stress on metabolism
【Characteristic】 Metabolic rate↑ Decomposition↑ Synthesis↓
（1）High metabolic rate
（2）Glycometabolism
（3）Fat metabolism
（4）Protein metabolism
Coping with Stress
• Don’t let it start. Even though you can’t always control the situations
you are in, you can control the way you respond to it.
• Make a goal. Setting goals helps you stay in better control of your life.
• Decide what’s important. Prioritize what is important in your life.
• Take a rest. Take time to do things you like doing.
• Believe in yourself. Believe that you can do it, and that you can get rid of
it. Fight for it!
• Think “I can”. Believe that you can stop your stress.
• Laugh at yourself. Being able to laugh at yourself when you make a
mistake can keep you from becoming stressed.
• Talk it out. When you have a problem, instead of holding it in, talk to
someone.
• Make up your mind. Make up your mind about what you have to do
with your stress, and how to control it.
• Get some help. You're not the only person to have this problem, so get
help from someone that has had the same experience.
Try to avoid or relieve stress and you’ll be happier and healthier.
Case presentation
A 32-year-old man was severely burned by gasoline. The
examination showed a 78% of skin surface was burned, most of
which were Ⅱ degree. After an emergent treatment of
debridement and fluid replacement, the patient was hospitalized
into burn ward. On the second day, the patient complained of
discomfort in the upper part of abdomen, and then vomited about
200 ml of coffer-colored bloody juice. Endoscopic examination
revealed scattered erosions throughout the stomach, most of
which were shallow, round shaped, and in diameter of about 2
mm. A bigger ulcer was found in the fundus of stomach, and
oozing of blood from it was obvious. The bleeding was stopped by
endoscopic hemostasis. The patient negated any history of
“stomach disease”.
Discussion:
• Why has the patient the erosion, bleeding in his stomach? What is
the name of this disease?
• What is the pathogenic mechanism of this patient’s stomach
problem?
• Does this kind of stomach erosion specifically occur in burned