Stressed Mind, Stressed Cells?

by Brad

Last Friday I attended a talk by Dr. Elissa Epel called “Telomeres, telomerase and mental states: Stressed mind, stressed cells?” According to the abstract Dr. Epel supplied in advance of her seminar:

"I will discuss our UCSF research on the telomere/telomerase maintenance system and relationships to stress and other psychological states and lifestyle factors. The length of our telomeres is a predictor of health status – early disease and mortality, and may serve as an index of biological aging. We now know from 8 years of research that shorter telomere length is related to states of suffering—anxiety, depression, trauma exposure, and chronic stress. Just how much can people stabilize their telomere length through interventions such as exercise and meditation? I will discuss initial findings, suggesting that this marker appears somewhat malleable."

Dr. Epel is an Associate Professor in the Department of Psychiatry at UCSF.  She is also a co-founder of Telome Health, Inc., a relatively new company located in the Bay Area to promote the use of telomere testing as a measure of biological age and overall health status. The basic idea that Dr. Epel was promoting is that chronic stress has a negative impact on telomere length, and that stress reduction through diet, exercise, and possibly other lifestyle changes can have preserve telomere length.

You may remember I posted a piece on this subject a couple months ago that discussed telomeres, yoga and aging ("Science, Aging and Yoga"). As a recap, telomeres are sequence of nucleotides or base pairs at the ends of your DNA that serve cap off and protect DNA integrity. One of the theories of aging asserts that decreased telomere length resulting from the failure of certain cell type in the body (immune cells, stem cells, etc.) to properly renew their telomere length after rounds of cell division via the action of telomerases (enzymes that add back lost telomere DNA) can lead to cellular senescence (a terminal, not dividing state) that could play a role in aging, acting as a sort of molecular clock. The question as to whether a reduction or low telomere length is responsible human aging or diseases is still hotly debate (see NY Times article here), despite many studies showing a correlation of shortened telomeres with cancer, diabetes, osteoporosis, Alzheimer’s and other chronic diseases of aging.

Ferns by Joan Webster

Personally, I found much of the data presented by Dr. Epel not especially convincing, as it was mostly correlative, and did not provide much if any mechanistic insight. However, I was intrigued by her attempt to link the physical and mental state of “stress” that we experience daily (you know, “I’m so stressed out”) to cellular stress and damage (alteration in the physiological state of cells or tissues that can lead to damage at the molecular and cellular level). Although we are all familiar with the former use of the term “stress,” this second usage of the term “stress” is quite different, and its effects can remain hidden until it manifests into a pathological or disease state.

It is well known that emotional stress can lead to an increase in cortisol and insulin levels, as well as increases in catecholamines and inflammatory cytokines. What is less clear is how these signals are integrated at the cellular and tissue level, especially under chronic stress, some of which are not at all obvious. Most studies measuring telomere length are on carried out on immune cells present in blood, as these cells are relatively easy to collect and originate from actively dividing cells. 

The notion that chronic stress could alter telomerase activity in these proliferating immune cell types, resulting in the shortening of the telomeres and causing these cells to lose their capacity to divide (“Immunosenescence”) is certainly an interesting hypothesis. Indeed, immunosenescence is increasingly being seen as a new target for drugs and/or biologics therapy by both pharmaceutical and biotech companies. According to data presented by Dr. Epel, one group of people that apparently has a statistically significant decrease in telomere length are long-term primary caregivers, a group that is regarded as suffering from chronic stress. People with long-term depression apparently also have a similar phenotype.

And as I have discussed in an earlier post, meditation and mindfulness practices have been proposed as ways to ward off the presumed negative effects of telomere shortening. (I say presumed, because it’s still not clear to what extent shortened telomeres are by definition a bad thing, or how much shortening of telomeres is required for any negative consequences.) The science on all this is still in the very early days. It may turn out that telomere length will be one more false lead in the ongoing search for biochemical measures of biological aging. And I would be extremely wary of any company advertising to measure your telomere length or that suggests that taking supplements to increase telomere length makes any sense at all. Unfortunately, there are a growing number of companies out there they do indeed make such claims. (To their credit, Telome Health appears to be considerably more circumspect in their claims and services than most.)

I suppose what interested me the most from Dr. Epel’s seminar is that it once again reminded me of the many avenues of medical research that are converging on the notion that chronic stress is a negative factor in human health and possibly a driver in premature or accelerated aging. While the details of how this actually happens is unclear, it is interesting to consider that one of the main, if not primary, benefits of practicing yoga might be to reduce stress.  Who knows, maybe it will turn out that yoga reduces stress at both the psychological and cellular level? Too early to tell, but stay tuned….