Allergy and the Nervous System - ReadingSample
نویسنده
چکیده
Stress has been associated as an important contributor to asthma in some patients. The mechanisms, however, which underlie this relationship remain unclear. In this review, the role of stress will be examined in relationship to the development of airway inflammation. As will be discussed, stress may not cause inflammation but enhances its expression when it develops to a second signal. In addition, recent studies using function magnetic resonance imaging (fMRI) have shown that specific circuits in the brain, i.e., anterior cingulate cortex and insula, are activated in relationship and intensity to the development of a latephase response (LPR) to inhaled antigen, and that these brain signals are predictive and associated with the development of airway inflammation as measured by sputum eosinophils. Finally, in studies with mice, chronic stress enhances airway inflammation to an inhaled antigen, and these effects are associated with the development of corticosteroid unresponsiveness. Collectively, these data suggest that chronic stress enhances asthma severity through a number of novel mechanisms and the resulting increase in severity of asthma may not be responsiveness to standardly used treatments. Copyright © 2012 S. Karger AG, Basel Asthma is characterized by reversible airflow obstruction, bronchial hyperresponsiveness, and airway inflammation [1]. Of these characteristics, airway inflammation is central to the pathogenesis and pathophysiology of asthma, as well as being a principal target for treatment. In addition, it is well demonstrated that environmental factors interact with the atrisk host to initiate immune responses that lead to airway inflammation [2– 4]. These factors include allergens, respiratory infections, microbes, dietary factors, and stress [5]. Understanding how these factors may affect asthma and its underlying features has provided insight into the pathophysiology of airway dysfunction seen in this disease. Following on this concept, considerable insight has been gained into the pathophysiology of asthma through the study of the influence of respiratory infections and allergic sensitization [6]. In contrast, the role and contribution of stress to asthma has turned out to be a more complex, and at times, confusing
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تاریخ انتشار 2015