Effects of Acute Stress or Centrally Injected Interleukin-1beta on Neuropeptide Expression in the Immune System

Acute stress stimulates the expression and release of corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP) from the hypothalamus, and the pro-opiomelanocortin products beta-endorphin and ACTH from the anterior pituitary. These neuropeptides are also expressed in immune tissues, and it has been proposed that they may modulate immune responses to stress through paracrine mechanisms. We subjected rats to restraint stress or central injection of interleukin (IL)-1beta to determine whether these acute stimuli can alter the expression of neuropeptides in the spleen and thymus. Restraint stress significantly increased the contents of all these neuropeptides in thymic, but not splenic, extracts. A single icv injection of IL-1beta increased contents of CRH, AVP, ACTH and beta-endorphin in the spleens of both sham-operated and adrenalectomised (ADX) rats. IL-1beta increased thymic contents of CRH and ACTH in sham-operated rats but these increases were not observed in ADX rats. These results suggest that the effects of IL-1beta on neuropeptide expression in the spleen are independent of glucocorticoids, whereas IL-1beta stimulation of neuropeptide expression in the thymus is dependent on circulating glucocorticoids. There were significant correlations between increases in CRH, ACTH and beta-endorphin in the spleen, and between CRH and ACTH in the thymus, consistent with the suggestion that IL-1beta-induced increases in ACTH and beta-endorphin may be mediated through CRH. These results provide evidence that stressors can directly influence neuropeptide expression in immune tissues. Thus stress may influence immune functions through paracrine mechanisms involving locally synthesised neuropeptides as well as through activation of the hypothalamo-pituitary-adrenal axis.     

Should protections for research with humans who cannot consent apply to research with nonhuman primates?

Research studies and interventions sometimes offer potential benefits to subjects that compensate for the risks they face. Other studies and interventions, which I refer to as “nonbeneficial” research, do not offer subjects a compensating potential for benefit. These studies and interventions have the potential to exploit subjects for the benefit of others, a concern that is especially acute when investigators enroll individuals who are unable to give informed consent. US regulations for research with human subjects attempt to address this concern by mandating strict protections for nonbeneficial research with subjects who cannot consent. Typically, humans who cannot consent, such as children, may be enrolled in nonbeneficial research only when it poses low risks and has the potential to gather information of sufficient value to justify the risks, an appropriate surrogate gives permission on the individual’s behalf and the individual agrees (assents). In contrast, US regulations for nonbeneficial research with nonhuman primates do not include these protections, even though it too involves subjects who cannot consent and who face risks for the benefit of others. Is this difference in regulatory protections justified? Or does the principle of fairness—treat like cases alike—imply that regulations for nonbeneficial research with nonhuman primates should include protections similar to those that apply to nonbeneficial research with humans who cannot consent?     

When should "riskier" subjects be excluded from research participation?

The exclusion of potential subjects based on increased risks is a common practice in human subjects research. However, there are no guidelines to ensure that this practice is conducted in a systematic and fair way. This gap in the literature and regulation is addressed by a specific account of a "condition on inclusion risks" (CIR), a condition under which potential subjects should be excluded from research on the basis of increased risks. This account provides a general framework for assessing standard exclusions as well as more controversial ones such as the exclusion of pregnant women and women of childbearing potential from certain types of research.     

Adolescents in Residential Treatment: Caregiver and Peer Predictors of Risk Behavior and Academic Performance

The purpose of this research was to better understand the substance use and sexual risk taking behavior among high-risk adolescent populations placed in residential treatment facilities, including those in the foster care and juvenile justice systems. The primary predictors considered in this study included caregiver support, caregiver closeness, other adult support, adolescent self-disclosure/communication with caregiver, caregiver expectations about sexual behavior, and peer influence regards to drugs/alcohol and sexual behavior. Participants included 120 adolescent females in grades 7 to 12 (median grade?=?10; mean age 15.7 years), primarily African American (57.2 %) and White (29 %), in a residential treatment setting in a large urban area in the Midwest. Caregiver support and self-disclosure/communication with caregivers predicted condom use at most recent intercourse, but variables related to substance use were most consistently predictive of sexuality variables including onset and frequency of behavior. None of these support variables significantly predicted onset and frequency of substance use. Caregiver support was the contributing variable in predicting academic achievement.     

When clinical care is like research: the need for review and consent

The prevailing “segregated model” for understanding clinical research sharply separates it from clinical care and subjects it to extensive regulations and guidelines. This approach is based on the fact that clinical research relies on procedures and methods—research biopsies, blinding, randomization, fixed treatment protocols, placebos—that pose risks and burdens to participants in order to collect data that might benefit all patients. Reliance on these methods raises the potential for exploitation and unfairness, and thus points to the need for independent ethical review and more extensive informed consent. In contrast, it is widely assumed that clinical care does not raise these ethical concerns because it is designed to promote the best interests of individual patients. The segregation of clinical research from clinical care has been largely effective at protecting research participants. At the same time, this approach ignores the fact that several aspects of standard clinical care, such as clinician training and scheduling, also pose some risks and burdens to present patients for the benefit of all patients. We argue that recently proposed learning health care systems offer a way to address this concern, and better protect patients, by developing integrated review and consent procedures. Specifically, current approaches base the need for independent ethical review and more extensive informed consent on whether an activity is categorized as clinical research or clinical care. An ethically sounder approach, which could be incorporated into learning health care systems, would be to base the need for independent ethical review and more extensive informed consent on the extent to which an activity poses risks to present patients for the benefit of all patients.     

Universal‐Diverse Orientation,Cognitive Complexity,and Sociopolitical Advocacy in Counselor Trainees

The authors investigated counselor trainees' levels of cognitive complexity and sociopolitical advocacy as predictors of universal‐diverse orientation (UDO). Participants included 120 master's‐ and doctoral‐level trainees from 4 midwestern counseling psychology programs. Results revealed that, after accounting for multicultural social desirability and training experience, actual time spent engaging in sociopolitical advocacy activities uniquely predicted 1 subscale of UDO. Los autores investigaron los niveles de complejidad cognitiva y defensoría sociopolítica de los consejeros en formación como indicadores de predicción de su orientación universal‐diversa (UDO, por sus siglas en inglés). Entre los participantes había 120 estudiantes de maestríay doctorado de 4 programas de psicología clínica en el Medio Oeste de EE.UU. Los resultados revelaron que, después de tomar en cuenta el atractivo social multicultural y la experiencia en formación, el tiempo real dedicado a la participación en actividades de defensoría sociopolítica solo predijo 1 sub‐escala de UDO.