Aspects of Psychological Stress in Success of Parathyroid Allotransplantation

Year 2022, , 29 - 32, 18.03.2022

Sule Terzioglu-usak , Birsen Elibol , Cigdem Sahbaz , Erhan Ayşan

https://doi.org/10.26650/experimed.2021.1038062

Abstract

Parathyroid auto/allotransplant (PA) may be a valuable alternative in the treatment of permanent hypoparathyroidism which is defined by insufficient levels of parathyroid hormone (PTH). Here, we aimed to investigate a possible association between the PTH levels of the patients who had undergone PA and their psychological stress conditions. The three patients with hypoparathyroidism were reported before and after PA for three-month-follow-up period. The examinations of patients were assessed by biochemical parameters [intact PTH (iPTH), Ca, and P]. The anxiety and stress levels of patients were assessed by self-report measures: State-Trait Anxiety Inventory (STAI-S/T) and Perceived Stress Scale (PSS). Although iPTH levels of all patients had a tendency to increase after PA, one of the patients with a low level of anxiety and stress only reached the normal range of PTH levels. The recovery of the serum iPTH levels at month 1 post-PA was negatively correlated with PSS scores of patients (r =-0.999, p=0.028). The outcomes of this report showed for the first time that insufficient PTH release, even after PA, might be related to the stress level of patients. By taking all results into consideration, PTH could be speculated as a stress biomarker

Keywords

Parathyroid allotransplantation, parathyroid hormone, psychological stress, STAI, PSS

Supporting Institution

Bezmialem Vakif University Research Council

Project Number

BAP-9.2015/24

Thanks

This work was supported by the Bezmialem Vakif University Research Council [grant number: BAP-9.2015/24]

Paratiroid Allotransplantasyonu Başarısında Psikolojik Stresin Boyutları

Abstract

Paratiroit oto/allotransplantasyonu (PA), paratiroit hücrelerinden paratiroit hormonunun (PTH) düşük seviyelerde salgılanmasıyla gelişen nadir kalıcı bir durum olan hipoparatiroidizm tedavisinde önemli bir alternatif yöntem olabilme potansiyeline sahiptir. Bu çalışmada biz PA uygulanan hastaların PTH düzeyleri ile psikolojik stres durumları arasındaki olası ilişki araştırmayı amaçladık. Kalıcı hipoparatiroidizmli üç hasta paratiroit allotransplantasyonu öncesi ve sonrası üç aylık süreçte takip edildi. Bu hastaların muayeneleri biyokimyasal parametreler (iPTH, Ca, ve P) ile değerlendirildi. Hastaların stres ve anksiyete düzeyleri ise Durum-Sürekli Anksiyete Ölçeği (STAİ) ve Algılanan Stress Ölçeği (PSS) gibi psikolojik testlerle belirlendi. Tüm hastaların PA sonrasında iPTH seviyelerinde belirli oranlarda artış gözlendi. Hastalar arasında düşük anksiyete ve stres düzeyine sahip hasta 2’nin, PA sonrası PTH seviyeleri fizyolojik olarak normal kabul edilen değerlere ulaştı. Ayrıca hastaların PA 1. ay sonrası serum iPTH düzeyindeki iyileşme ile PSS skoru arasında negatif bir korelasyonun olduğu tespit edildi (r =-0.999, p = 0.028). Bu raporun sonuçları ilk kez paratiroit allotransplantasyonu sonrası PTH salınımının artarak normal seviyelere ulaşamamasının nedenlerinden birinin hastaların stres düzeyi olabileceğini göstermiştir. Sonuç olarak, bu çalışma, PTH’nın bir stres biyobelirteci olabileceğini düşündürmektedir.

Keywords

Paratiroit Allotransplantasyon, Paratiroid hormon, Psikolojik stres, STAİ, PSS

Project Number

BAP-9.2015/24

References

• 1. Aggarwal S, Kailash S, Sagar R, Tripathi M, Sreenivas V, Sharma R, et al. Neuropsychological dysfunction in idiopathic hypopara-thyroidism and its relationship with intracranial calcification and serum total calcium. Eur J Endocrinol 2013; 168(6): 895-903. [CrossRef] google scholar
• 2. Testini M, Gurrado A, Lissidini G, Nacchiero M. Hypoparathyroid-ism after total thyroidectomy. Minerva Chir 2007; 62(5): 409-15. google scholar
• 3. Khan MI, Waguespack SG, Hu MI. Medical management of post-surgical hypoparathyroidism. Endoc Pract 2011; 17(Suppl 1): 1825. [CrossRef] google scholar
• 4. Safioleas M, Stamatakos M, Rompoti N, Mouzopoulos G, Iannes-cu R, Salichou V, et al. Complications of thyroid surgery. Chirurgia (Bucur) 2006; 101: 571-81. google scholar
• 5. Nawrot I, Wozniewicz B, Tolloczko T, Sawicki A, Gorski A, Chudzinski W, et al. Allotransplantation of cultured parathyroid progenitor cells without immunosuppression: Clinical results. Transplanta-tion 2007; 83: 734-40. [CrossRef] google scholar
• 6. Aysan E, Altug B, Ercan C, Kesgin Toka C, Idiz UO, Muslumanoglu M. Parathyroid allotransplant with a new technique: A prospective clinical trial. Exp Clin Transplant 2016; 14(4): 431-5. google scholar
• 7. Barczynski M, Golkowski F, Nawrot I. Parathyroid transplantation in thyroid surgery. Gland Surg 2017; 6: 530-6. [CrossRef] google scholar
• 8. Yucesan E, Goncu B, Basoglu H, Ozten Kandas N, Ersoy YE, Akbas F, et al. Fresh tissue parathyroid allotransplantation with short-term immunosuppression: 1-year follow-up. Clin Transplant 2017; 31(11). [CrossRef] google scholar
• 9. Goncu B, Yucesan E, Ozdemir B, Basoglu H, Kandas NO, Akbas F, et al. A new transport solution for parathyroid allotransplantation: Effects on cell viability and calcium-sensing receptors. Biopreser Biobank 2018; 16(4): 278-84. [CrossRef] google scholar
• 10. Geffken GR, Ward HE, Staab JP, Carmichael SL, Evans DL. Psychi-atric morbidity in endocrine disorders. Psychiatr Clin North Am 1998; 21(2): 473-89. [CrossRef] google scholar
• 11. Ang AW, Ko SM, Tan CH. Calcium, magnesium, and psychotic symptoms in a girl with idiopathic hypoparathyroidism. Psycho-som Med 1995; 57(3): 299-302. [CrossRef] google scholar
• 12. Rosa RG, Barros AJ, de Lima AR, Lorenzi W, Da Rosa RR, Zambonato KD, et al. Mood disorder as a manifestation of primary hypoparathy-roidism: a case report. J Medical Case Rep 2014; 8: 326. [CrossRef] google scholar
• 13. Tigranian RA, Orloff LL, Kalita NF, Davydova NA, Pavlova EA. Changes of blood levels of several hormones, catecholamines, prostaglandins, electrolytes and cAMP in man during emotional stress. Endocrinol Exp 1980; 14(2): 101-12. google scholar
• 14. Spielberger CD. Manual for the state-trait anxiety inventory form y, self evaluation questionnaire. Palo Alto, CA: Consulting Psychol-ogists Press, 1983. [CrossRef] google scholar
• 15. Cohen S, Kamarck T, Mermelstein R. A global measure of per-ceived stress. J Health Soc Behav 1983; 24: 385-96. [CrossRef] google scholar
• 16. Le Compte WA, Oner N. Development of the Turkish edition of the State-trait anxiety inventory. Cross-Cultural Anxiety 1976; 1: 5167. google scholar
• 17. Mane Abhaya B, Krishnakuma, MK, Niranjan PC, Hiremath SG. Dif-ferences in perceived stress and its correlates among students in professional courses. J Clin Diagn Res 2011; 5(6): 1228-33. google scholar
• 18. Baltaş Z, Atakuman Y, Duman Y. Standardization of the perceived stress scale: Perceived stress in Turkish middle managers. Stress and Anxiety Research Society. 1998: In 19th International Confer-ence, İstanbul. google scholar
• 19. Joborn H, Hjemdahl P, Wide L, Akerström G, Ljunghall S. Reduction of serum parathyroid hormone levels during sympathetic stimula-tion in man. J Endocrinol Invest 1987; 10(2): 153-6. [CrossRef] google scholar
• 20. Bartrop RW, Lazarus L, Luckhurst E, Kiloh LG. Depressed lympho-cyte function after bereavement. Lancet 1987; I: 834-6. [CrossRef] google scholar
• 21. Elovainio M, Aalto AM, Kivimaki M, Pirkola S, Sundvall J, Lönn-qvist J, Reunanen A. Depression and C-reactive protein: Popula-tion-based health 2000 study. Psychosom Med 2009; 71: 423-30. [CrossRef] google scholar
• 22. Tilg H, Wilmer A, Vogel W, Herold M, Nolchen B, Judmaier G, et al. Serum levels of cytokines in chronic liver disease. Gastroenterolo-gy 1992; 103: 264-74. [CrossRef] google scholar
• 23. Kok-van Alphen CC, Völker-Dieben HJ. Emotional stress and re-jection, cause and effect. Doc Ophthalmol 1983; 56(1-2): 171-5. [CrossRef] google scholar
• 24. Dobbels F, Skeans MA, Snyder JJ, Tuomari AV, Maclean JR, Kasis-ke BL. Depressive disorder in renal transplantation: An analysis of medicare claims. Am J Kidney Dis 2008; 51: 819. [CrossRef] google scholar
• 25. Terzioglu-Usak S, Elibol B, Dallı T, Guler C, Aysan E. Effect of re-straint stress on parathyroid hormone secretion in wistar rats. Int J Endocrinol Metabol 2018; 16(4): e66979. google scholar