The Role of Stress in Asthma

Abstract

Asthma, a chronic inflammatory disease of the airways, is greatly influenced by psychosocial factors and stress. This review looks at clinical studies that have shown strong associations between psychological stress and asthma to identify potential mechanisms for these interactions. Furthermore, we review animal studies involving stress and airway inflammation or airway hyperresponsiveness, and discuss possible mechanisms of stress action in asthma. In conclusion, further research, both in humans and in animal models, into the mechanisms of stress-induced changes in asthma exacerbation are required to help better understand the complex makeup of asthma and assist in the development of therapies directed at the interplay between the nervous system and airway inflammation.

Effects of Repeated Stress on Distal Airway Inflammation, Remodeling and Mechanics in an Animal Model of Chronic Airway Inflammation

“…These authors also showed that the amount of these cells was reduced when animals were under fluoxetine treatment. The studies mentioned above and other authors suggest that the stress protocol performed in the present study can be considered a model of chronic stress [24,27,28] .…”

“…Asthma is considered a chronic airway inflammatory disease in which clinical features may be worsened by several factors including stress and emotions [24] . Although epidemiological data corroborate this assumption, experimental information is scarce, and few studies have been dedicated to analyze the effects of emotions and stress on distal airway inflammation and remodeling.…”

An Asthma Patient with Steroid-resistant Decrease in Peak Expiratory Flow after the Great East Japan Earthquake Showing Spontaneous Recovery after 1 Month

“…The pathophysiology of asthma includes reversible airflow limitations induced by underlying allergic inflammation in the airways. Although the main cause of this inflammatory reaction may be an allergic response, it is often thought that psychological stress may contribute to asthma exacerbation (10)(11)(12)(13)(14). A predisposition to psychological stress is also positively correlated with the prevalence of asthma (15).…”

Inactivation of capsaicin-sensitive nerves reduces pulmonary remodeling in guinea pigs with chronic allergic pulmonary inflammation

“…It has been established that neurokinins, such as substance P and neurokinin A, can induce smooth muscle contraction (3), facilitation of cholinergic neurotransmission, submucosal gland secretion (4), vasodilation (4), increases in vascular permeability (5), chemoattraction of eosinophils (5) and neutrophils (4), vascular adhesion of neutrophils, and stimulation of mast cells, B and T lymphocytes and macrophages (4). Approximately 20 to 35% of asthmatics were shown to have their exacerbations modulated by stress responses, and primary afferent sensitive C fiber stimulation and nonadrenergic, non-cholinergic responses were found to be the main pathways involved (6).…”