Psychological Stress, Immunoregulatory Balance and Human Inflammatory Diseases

prof Gailen Marshall

A recent review published in the journal Immunology and Allergy Clinics of North America provides a brief but comprehensive overview of the major immune mechanisms affected by stress, and the relationships linking stress with various inflammatory diseases.

In this review, Gailen Marshall from the University of Mississippi Medical Center outlines recent data indicating that immunoregulatory dysfunctions may play a more central role in stress-induced immune alterations, in contrast to the ‘old view’ that stress is causing a generalized immunosuppression.

In the past the ‘mainstream’ medical research community has often overlooked the potential effects of stress as a confounder for therapeutic response or even a risk factor for immune-based inflammatory diseases. Over the past decade, however, the field has advanced significantly. Thus, now it is known that beyond its immunosuppressive effects stress is able to alter immunoregulatory networks, including the T helper (Th)1/Th2 balance and may contribute to an increased risk for allergic and autoimmune diseases.

The author discusses the impact of psychological stress on immunoregulation and immunoregulatory balance, and the need to find stable biomarkers, or surrogate markers and stress susceptibility tests, useful to assess the impact of chronic stress on host immunity.

According to the author, a major limitation of the stress research is the expected variability in population data. This can significantly limit the ability to identify the most stress susceptible patients. Importantly, the solution may involve defining criteria, such as biomarkers, that can identify stress-susceptible individuals in the long term and higher-risk subpopulations in the short term.

In conclusion, it is suggested that it is no longer tenable to use statistical methodology based solely on population analysis, but maybe more important is to define reliable criteria, such as biomarkers that can identify stress-susceptible individuals in the long term and higher-risk subpopulations in the short term. This approach may help researchers and clinicians to identify whether stress susceptibility is permanent, temporary, or both, as well as make clear the duration and clinical impact of these changes.

Source: Immunol Allergy Clin North Am. 2011 Feb; 31(1): 133–140
Read more: Immunology and Allergy Clinics of North America

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