Cytokine dysregulation associated with exam stress in healthy medical students
Cytokine dysregulation associated with exam stress in healthy medical students
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DOI：
10.1006/brbi.1998.0537
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发表时间：
1998-12-01
影响因子：
15.1
通讯作者：
Morris, GJ
中科院分区：
文献类型：
--
作者：
Marshall, GD;Agarwal, SK;Morris, GJ
应激相关免疫改变的机制尚未完全阐明。据报道，细胞介导的免疫反应以及抗体和某些细胞因子在高压力下被抑制。然而，抑制与失调的作用尚未在人类应激模型中建立。通过在考试前4周和考试后48 h检测PHA/ pma刺激后72 h PBMC中1型（ifn - γ）和2型（IL-10）细胞因子，评估考试应激对16名健康医学生调性细胞因子的影响。结果显示，在考试压力下，ifn - γ降低，同时IL-10升高，导致ifn - γ:IL-10比值降低。细胞因子对PHA/PMA的反应与日常烦恼的数量和主观调整有显著的相关性。此外，报告孤独程度较高的学生也报告了更多和更差的主观适应麻烦。这种差异在男性和女性中都是一致的，但与AM皮质醇水平无关。此外，当个体被分为高和低考前烦恼水平时，ifn - γ:IL-10比率的1型/ 2型变化仅发生在低烦恼组。这些数据表明，心理应激情境将1型/ 2型细胞因子平衡转向2型，导致免疫失调，而不是整体免疫抑制。这可能部分解释了高压力期间2型介导的疾病（如病毒感染、潜伏病毒表达、过敏/哮喘反应和自身免疫反应）发生率增加的原因。(C) 1998学术出版社。
The mechanisms of stress-related immune alterations have not been fully elucidated. Cell-mediated immune responses as well as antibody and certain cytokines are reported as being suppressed during times of high stress. However, the role of suppression vs dysregulation has not been established in human stress models. The effect of exam stress on regulatory cytokines in 16 healthy medical students was assessed by measuring type-1 (IFN-gamma) and type-2 (IL-10) cytokines from 72-h PHA/PMA-stimulated PBMC 4 weeks before and 48 h after exams. Results demonstrated decreased IFN-gamma accompanied by increased IL-10 during exam stress that resulted in a decreased IFN-gamma:IL-10 ratio. There was a significant correlation between the cytokine response to PHA/PMA and number and subjective adjustment to daily hassles. Additionally, students who reported greater levels of loneliness also reported greater numbers of and poorer subjective adjustment to hassles. The differences were consistent in both males and females but did not correlate with AM cortisol levels. Additionally, when individuals were grouped into high vs low preexam hassle levels, the type-1/type-2 shift in the IFN-gamma:IL-10 ratio occurred in the low hassles group only. These data suggest that psychologically stressful situations shift type-1/type-2 cytokine balance toward type-2 and result in an immune dysregulation rather than overall immunosuppression. This may partially explain the increased incidence of type-2-mediated conditions such as increased viral infections, latent viral expression, allergic/asthmatic reactions, and autoimmunity reported during periods of high stress. (C) 1998 Academic Press.