Stress and Peptic Ulcer Disease

Levenstein, Susan; Ackerman, Sigurd H.; Kiecolt‐Glaser, Janice K.; Dubois, A.

doi:10.1001/jama.281.1.10

Cited by 85 publications

(42 citation statements)

References 28 publications

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“…Psychosocial stress and/or elevated inflammatory mediators induce abnormalities in sympathetic activity with H. pylori infection [283], the bacteria associated with chronic gastritis that leads to peptic ulcer development. These events skew the immune response towards a Th2 profile and promote the onset and/or progression of the H. pylori infection [discussed in 284,285,286].…”

Section: Sns and Infectionsmentioning

confidence: 99%

Sympathetic modulation of immunity: Relevance to disease

Bellinger

Millar

Perez

et al. 2008

Cellular Immunology

225

185

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Optimal host defense against pathogens requires cross-talk between the nervous and immune systems. This paper reviews sympathetic-immune interaction, one major communication pathway, and its importance for health and disease. Sympathetic innervation of primary and secondary immune organs is described, as well as evidence for neurotransmission with cells of the immune system as targets. Most research thus far as focused on neural-immune modulation in secondary lymphoid organs, and have revealed complex sympathetic modulation resulting in both potentiation and inhibition of immune functions. SNS-immune interaction may enhance immune readiness during disease-or injury-induced 'fight' responses. Research also indicate that dysregulation of the SNS can significantly affect the progression of immune-mediated diseases. However, a better understanding of neural-immune interactions is needed to develop strategies for treatment of immune-mediated diseases that are designed to return homeostasis and restore normal functioning neural-immune networks.

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Section: Sns and Infectionsmentioning

confidence: 99%

Sympathetic modulation of immunity: Relevance to disease

Bellinger

Millar

Perez

et al. 2008

Cellular Immunology

225

185

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“…These include asthma, 41,[121][122][123][124] tinnitus, 35 diabetes, 38,[125][126][127][128][129][130] chronic obstructive pulmonary disease, 40 recovery after stroke (muscle re-education using biofeedback), 45,54 dermatologic conditions, 131,132 allergies, 133 irritable bowel syndrome, 134 -140 peptic ulcer, 141 pregnancy outcomes (where there is strong evidence that emotional support, ie, presence of a doula, has beneficial effects), 59,142 and human immunodeficiency virus infection. 143,144 …”

Section: Additional Clinical Areasmentioning

confidence: 99%

Mind-Body Medicine: State of the Science, Implications for Practice

Astin¹,

Shapiro²,

Eisenberg³

et al. 2003

The Journal of the American Board of Family Medicine

422

255

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Background: Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to examine the efficacy of representative psychosocial-mind-body interventions, including relaxation, (cognitive) behavioral therapies, meditation, imagery, biofeedback, and hypnosis for several common clinical conditions.Methods: An electronic search was undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a manual search of the reference sections of relevant articles for related clinical trials and reviews of the literature. Studies examining mind-body interventions for psychological disorders were excluded. Owing to space limitations, studies examining more body-based therapies, such as yoga and tai chi chuan, were also not included. Data were extracted from relevant systematic reviews, metaanalyses, and randomized controlled trials.Results: Drawing principally from systematic reviews and meta-analyses, there is considerable evidence of efficacy for several mind-body therapies in the treatment of coronary artery disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence, chronic low back pain, disease and treatmentrelated symptoms of cancer, and improving postsurgical outcomes. We found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis. Additional research is required to clarify the relative efficacy of different mind-body therapies, factors (such as specific patient characteristics) that might predict more or less successful outcomes, and mechanisms of action. Research is also necessary to examine the cost offsets associated with mind-body therapies.Conclusions: There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions. Evidence emerging within the past several decades suggests that psychosocial factors from emotional states, such as depression, behavioral dispositions, such as hostility, and psychosocial stress can directly influence both physiologic function and health outcomes. [1][2][3][4] Evidence from several converging lines of research, however, also suggests that despite seemingly widespread acknowledgment of and support for the importance of the biopsychosocial model, 5-7 psycho-

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“…On the other hand, a large body of research in both animal and human studies has examined the effect of psychological stress on the gastrointestinal tract. For instance, in accordance to Levenstein et al, (1999), susceptibility to gastric lesions is increased in rats by social stressors as premature separation of the rat pup from its mother (Ackerman et al, 1975). Also, subjects with psychological distress, self-described "stress or strain," or concrete life stressors at baseline have increased incidence of ulcer over 9 to 15 years (Levenstein et al, 1995;Levenstein et al, 1999).…”

Section: Oxidative Stressmentioning

confidence: 99%

“…For instance, in accordance to Levenstein et al, (1999), susceptibility to gastric lesions is increased in rats by social stressors as premature separation of the rat pup from its mother (Ackerman et al, 1975). Also, subjects with psychological distress, self-described "stress or strain," or concrete life stressors at baseline have increased incidence of ulcer over 9 to 15 years (Levenstein et al, 1995;Levenstein et al, 1999). In this sense, according to Chang (2008), stressors can be acute or chronic and range from daily hassles to life-threatening situations like natural disasters and violence that trigger the "fight or flight" response.…”

Section: Oxidative Stressmentioning

confidence: 99%

“…Furthermore, stress seems to have different effects on gastric motility including delayed gastric emptying, which could increase the risk of gastric ulcer, while accelerated emptying could increase the net acid load delivered to the duodenum, enhancing the risk of duodenal ulcer. Psychological stress may also promote the growth of H. pylori in the duodenum if it increases duodenal acid load, since the H. pyloriinhibitory effects of bile seem to be reversed by acid (Levenstein et al, 1999).…”

Section: Oxidative Stressmentioning

confidence: 99%

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