title: Monocyte chemotactic protein-1 (MCP-1) and growth factors called into question as markers of prolonged psychosocial stress.
abstract: BACKGROUND
  Psychosocial stress is becoming a major contributor to increased mental ill-health and sick leave in many countries. Valid markers of chronic stress would be valuable for diagnostic and prognostic purposes. A recent study suggested monocyte chemotactic protein-1 (MCP-1), epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) as markers of chronic stress. We aimed to confirm these potential biomarkers of prolonged psychosocial stress in female patients.
  
  
  RESULTS
  Circulating levels of MCP-1, EGF and VEGF, along with several other cytokines, were measured in plasma from 42 female patients suffering from exhaustion due to prolonged psychosocial stress and 42 control subjects, using a protein biochip immunoassay. There were no significant differences between patients and controls in any of the cytokines or growth factors analyzed. Furthermore, when using a different protein bioassay and reanalyzing MCP-1 and VEGF in the same samples, markedly different levels were obtained. To further explore if inflammation is present in patients with exhaustion, the classical inflammatory marker C-reactive protein (CRP) was measured in another group of patients (n=89) and controls (n=88) showing a small but significant increase of CRP levels in the patients.
  
  
  CONCLUSIONS
  MCP-1, EGF and VEGF may not be suitable markers of prolonged psychosocial stress as previously suggested. Furthermore, significant differences were obtained when using two different protein assays measuring the same samples, indicating that comparing studies where different analytic techniques have been used might be difficult. Increased levels of CRP indicate that low-grade inflammation might be present in patients with exhaustion due to prolonged stress exposure but this inflammation does not seem to be reflected by increase in circulating MCP-1 or other cytokines measured.
authors.affiliation: The Institute of Stress Medicine, Gothenburg, Sweden. inga.jonsdottir@stressmedicin.com
authors.forename: Ingibjörg H
authors.initials: IH
authors.lastname: Jonsdottir
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hägg
authors.forename: Kristina
authors.initials: K
authors.lastname: Glise
authors.forename: Rolf
authors.initials: R
authors.lastname: Ekman
mesh_terms: D000328:Adult; D001681:Biological Assay; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000096:biosynthesis; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood*; D004815:Epidermal Growth Factor / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation; D008875:Middle Aged; D040081:Protein Array Analysis; D013315:Stress, Psychological / Q000097:blood*; D011795:Surveys and Questionnaires; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D042461:Vascular Endothelial Growth Factor A; D004815:Epidermal Growth Factor; D002097:C-Reactive Protein