Mucosal Wound Healing Is Impaired by Examination Stress

Marucha, Phillip T.; Kiecolt‐Glaser, Janice K.; Favagehi, Mehrdad

doi:10.1097/00006842-199805000-00025

Cited by 436 publications

(313 citation statements)

References 19 publications

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“…The general pattern seems to be the emphasis of Th2 response through the decrease in pro-inflammatory cytokines (TNF-α, IL-6, IL-1, INF-γ) and higher levels of anti-inflammatory cytokines (IL-10 and IL-4) (Kang and Fox 2001;Marshall et al 1998). Similar to these studies, delayed wound healing and a decrease in IL-1β, a key interleukin involved in this process, have been demonstrated in young healthy students during an examination period compared to a non-stressful holiday period (Marucha et al 1998). The opposite is the case in students with higher anxiety where levels of pro-inflammatory cytokines rise just before the important exam (Kamezaki et al 2012;Maes et al 1998).…”

Section: Psychological Stress and Immunitysupporting

confidence: 66%

Stress, ageing and their influence on functional, cellular and molecular aspects of the immune system

Vitlić

Lord

Phillips

2014

AGE

100

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The immune response is essential for keeping an organism healthy and for defending it from different types of pathogens. It is a complex system that consists of a large number of components performing different functions. The adequate and controlled interaction between these components is necessary for a robust and strong immune response. There are, however, many factors that interfere with the way the immune response functions. Stress and ageing now consistently appear in the literature as factors that act upon the immune system in the way that is often damaging. This review focuses on the role of stress and ageing in altering the robustness of the immune response first separately, and then simultaneously, discussing the effects that emerge from their interplay. The special focus is on the psychological stress and the impact that it has at different levels, from the whole system to the individual molecules, resulting in consequences for physical health.

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Section: Psychological Stress and Immunitysupporting

confidence: 66%

Stress, ageing and their influence on functional, cellular and molecular aspects of the immune system

Vitlić

Lord

Phillips

2014

AGE

100

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“…Stress, in these conditions may have caused a reduction in the formation of the bone matrix, osteoblasts, and collagen fibers 18 . A determining factor in the bone formation rate is linked to pro-inflammatory interleukins 19 , which exhibit more intense activity during the early stages of the repair process, including the activation of the base formed by fibroblasts, which in turn synthesize collagen, a key element in the formation and organization of the connective tissue of the jaws.…”

Section: Discussionmentioning

confidence: 99%

Effect of chronic stress on implant osseointegration into rat's mandible

et al. 2015

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“…This proposal emerged from pioneering research examining the relationship between psychological distress and the healing of experimental wounds in non-clinical populations. For example, acute examination stress has been associated with a 40% delay in the healing of punch biopsy wounds [7,8]. Similarly, chronic care-giving stress was associated with a 25% delay in the healing of similar wounds [8,9].…”

Section: Introductionmentioning

confidence: 99%

Coping style and depression influence the healing of diabetic foot ulcers: observational and mechanistic evidence

et al. 2010

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Aims/hypothesis Experimental evidence suggests that the healing of diabetic foot ulcers is affected by psychosocial factors such as distress. We examined this proposal in a prospective study, in which we considered the role of psychological distress and coping style in the healing of diabetic foot ulcers over a 24 week period. We also explored the role of salivary cortisol and matrix metalloproteinases (MMPs) as potential mechanisms. Methods For this prospective observational study we recruited 93 (68 men; mean age 60 years) patients with neuropathic or neuroischaemic diabetic foot ulcers from specialist podiatry clinics in secondary care. Clinical and demographic determinants of healing, psychological distress, coping, salivary cortisol and both MMP2 and MMP9 were assessed at baseline. Ulcers were assessed at baseline and at 6, 12 and 24 weeks post-baseline. Diabetologia (2010) 53:1590-1598 DOI 10.1007/s00125-010-1743 However, change in ulcer size over the observation period was associated with depression only (p=0.04, d=0.31). Healed ulcers by 24 weeks were also associated with lower evening cortisol, higher precursor MMP2 and a greater cortisol awakening response. Conclusions/interpretation Confrontation coping and depression predict ulcer healing. Our preliminary enquiry into biological mechanisms suggests that cortisol and precursor MMP2 may underlie these relationships.

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Mucosal Wound Healing Is Impaired by Examination Stress

Abstract: These data suggest that even something as transient, predictable, and relatively benign as examination stress can have significant consequences for wound healing.

Cited by 436 publications

References 19 publications

Stress, ageing and their influence on functional, cellular and molecular aspects of the immune system

Stress, ageing and their influence on functional, cellular and molecular aspects of the immune system

Effect of chronic stress on implant osseointegration into rat's mandible

Coping style and depression influence the healing of diabetic foot ulcers: observational and mechanistic evidence

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