Physical and psychological stress has been implicated in the development of autoimmune diseases, since numerous studies in animals and humans have demonstrated the effect of several stressors on immune function. In addition, many retrospective studies have found that a high proportion (up to 80%) of patients reported unusual emotional stress before the onset of the disease. Unfortunately, not only does stress cause disease, but the disease itself also causes significant stress in patients, creating a vicious cycle. Recent reviews discuss the possible role of psychological stress and the main factors related to stress in the pathogenesis of autoimmune disease. It is assumed that the neuroendocrine hormones triggered by stress lead to immunological dysregulation, which ends up resulting in autoimmune disease, altering or amplifying the production of cytokines.
The role of stress in autoimmune diseases
It is assumed that repeated episodes of acute illness or chronic psychological stress can induce an acute response, triggering a subsequent chronic inflammatory process, such as atherosclerosis and certain metabolic diseases. There is evidence that the liver, endothelium and fat cell deposits are the primary sources of cytokines. Particularly IL-6 and C-reactive protein are strongly associated and probably play a dominant role in the development of such an inflammatory process, which leads to insulin resistance, type II diabetes mellitus and metabolic syndrome. The fact that psychological stress can activate an acute phase response, which is part of the innate response, is evidence that the inflammatory response is contained within stress, and that stress can induce an inflammatory process.
Association of stress with immune dysregulation
Epidemiological research increasingly suggests that exposure to traumatic and psychological stressors is related to increased use of health care, adverse health outcomes, the onset of specific diseases, and premature death. To date, studies have associated exposures to stress with cardiovascular diseases, diabetes, gastrointestinal disease, fibromyalgia, chronic fatigue syndrome, and musculoskeletal disorders. Recent findings indicate that victims of posttraumatic stress disorder have a higher number of T lymphocytes. Still, patients were more likely to have clinically higher T-cell counts, hyperreactive immune responses in standardized skin hypersensitivity tests, and clinically higher levels of immunoglobulin-M. The latest clinical evidence confirms the presence of markers consistent with a wide range of inflammatory diseases, including cardiovascular and autoimmune diseases.
Clinical practice
Stress affects the immune system. Therefore, different stress reactions should be discussed with autoimmune patients. In addition, questionnaires about triggers are needed, which should include psychological stress, in addition to other common triggers.
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Article: Stress and autoimmune diseases
– Stojanovich L, Marisavljevich D. Stress as a trigger of autoimmune disease. Rev Autoimmun
. 2008;7(3):209-213. doi:10.1016/j.autrev.2007.11.007
