Psychological stress in asthma: repercussions on epigenetics-genetics, immune responses, and pulmonary function in the pediatric population
Main Article Content
Keywords
asthma, epigenetics, immune response, lung function, stress psychological
Abstract
In the assessment of childhood asthma, identifying the risk factors associated with exacerbations and broadening this view to understand psychological stress and its repercussions on the inflammatory process of asthma allow a different perspective on this biopsychosocial disease. Psychological stress, as a risk factor for the onset and noncontrol of asthma, has been increasingly evaluated from the perspective of the repercussions on the body of the stimulus generated in the hypothalamic-pituitary axis and adrenal glands, with cortisol release and immune system action. These processes trigger changes in T helper 2 cells, which polarize allergic processes, and dysfunctions in immune tolerance mechanisms, with a decrease in regulatory T cells. Genetic and epigenetic changes in β2-adrenergic and glucocorticoid receptors, with decreased response to these drugs, were also identified in studies, in addition to changes in respiratory function patterns, with worsening of obstruction and inflammation identified via decreased forced expiratory volume in one second and increased exhaled inflammatory gases in allergic asthma. Therefore, the present review sought to identify studies on the effect of personal and parental acute or chronic psychological stress, emphasizing the repercussions on genetics, epigenetics, and immune and pulmonary functional and inflammatory responses in the pediatric population.
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7. Engelkes M, Janssens HM, De Jongste JC, Sturkenboom MCJM, Verhamme KMC. Medication adherence and the risk of severe asthma exacerbations: a systematic review. Eur Respir J. 2015;45(2):396–407. 10.1183/09031936.00075614
8. Tsartsali L, Papadopoulos M, Lagona E, Papadimitriou A, Kanaka-Gantenbein C, Louizou E, et al. Association of hypothalamic-pituitary-adrenal axis-related polymorphisms with stress in asthmatic children on inhaled corticosteroids. Neuroimmunomodulation. 2012;19(2):88–95. 10.1159/000329592
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10. Guttman HA. The epigenesis of the family system as a context for individual development. Fam Process. 2002;41(3):533–45. 10.1111/j.1545-5300.2002.41315.x
11. Akcan N, Bahceciler NN. Headliner in physiology and management of childhood asthma: hypothalamic-pituitary-adrenal axis. Curr Pediatr Rev. 2019;16(1):43–52. 10.2174/1573396315666191026100643
12. Bucci M, Silve S, Oh D, Harris NB. Toxic stress in children and adolescents. Adv Pediatr. 2016;63:403–28. 10.1016/j.yapd.2016.04.002
13. Lee AG, Wright RJ. Evidence establishing a link between prenatal and early-life stress and asthma development. Curr Opin Allergy Clin Immunol. 2018;18(2):148–58. 10.1097/ACI.0000000000000421
14. Lim R, Fedulov AV, Kobzik L. Maternal stress during pregnancy increases neonatal allergy susceptibility: role of glucocorticoids. Am J Physiol Lung Cell Mol Physiol. 2014;307(2):L141–L148. 10.1152/ajplung.00250.2013
15. Beijers R, Jansen J, Riksen-Walraven M, de Weerth C. Maternal prenatal anxiety and stress predict infant illnesses and health complaints. Pediatrics. 2010;126(2):e401–e409. 10.1542/peds.2009-3226
16. Gruenberg DA, Wright RJ, Visness CM, Jaffee KF, Bloomberg GR, Cruikshank WW, et al. Relationship between stress and cytokine responses in inner-city mothers. Ann Allergy Asthma Immunol. 2015;115(5):439-45. 10.1016/j.anai.2015.07.021
17. Ritz T, Ayala ES, Trueba AF, Vance CD, Auchus RJ. Acute stress-induced increases in exhaled nitric oxide in asthma and their association with endogenous cortisol. Am J Respir Crit Care Med. 2011;183(1):26–30. 10.1164/rccm.201005-0691OC
18. Garner AS. Home visiting and the biology of toxic stress: opportunities to address early childhood adversity. Pediatrics. 2013;132(Suppl):S65–S73. 10.1542/peds.2013-1021D
19. Farias FR. Sobre o conceito de estresse. Arq. bras. Psic. 1985;38(4):97–105.
20. Margis R, Picon P, Cosner AF, Silveira RDO. Stressfull life-events, stress and anxiety. R Psiquiatr. 2003;25(Suppl 1):65–74. 10.1590/S0101-81082003000400008
21. Pagliarone AC, Sforcin JM. Stress: review about the effects on the immune system. Biosaúde. 2009;11(1):57–90.
22. Chen E, Miller GE. Stress and inflammation in exacerbations of asthma. Brain Behav Immun. 2007;21(8):993–99. 10.1016/j.bbi.2007.03.009
23. Pereira ME. Medidas do estresse: uma revisão narrativa. André Faro & Marcos Emanoel Pereira. Psicologia Saúde & Doenças. 2013;14(1):101–24.
24. Elenkov IJ. Glucocorticoids and the Th1/Th2 balance. Ann N Y Acad Sci. 2004;1024:138–46. 10.1196/annals.1321.010
25. Khansari DN, Murgo AJ, Faith RE. Effects of stress on the immune system. Immunol Today. 1990;11(5):170–5. 10.1016/0167-5699(90)90069-L
26. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96. 10.2307/2136404
27. Rosenkranz MA, Busse WW, Sheridan JF, Crisafi GM, Davidson RJ. Are there neurophenotypes for asthma? Functional brain imaging of the interaction between emotion and inflammation in asthma. PLoS One. 2012;7(8):1–12. 10.1371/journal.pone.0040921
28. Siqueira Reis R, Ferreira Hino AA, Romélio Rodriguez Añez C. Perceived stress scale. J Health Psychol. 2010;15(1):107–14. 10.1177/1359105309346343
29. Handa RJ, Weiser MJ. Gonadal steroid hormones and the hypothalamo-pituitary-adrenal axis. Front Neuroendocrinol. 2014;35(2):197–220. 10.1016/j.yfrne.2013.11.001
30. Plourde A, Lavoie KL, Raddatz C, Bacon SL. Effects of acute psychological stress induced in laboratory on physiological responses in asthma populations: a systematic review. Respir Med. 2017;127:21–32. 10.1016/j.rmed.2017.03.024
31. Barsegyan A, Mackenzie SM, Kurose BD, McGaugh JL, Roozendaal B. Glucocorticoids in the prefrontal cortex enhance memory consolidation and impair working memory by a common neural mechanism. Proc Natl Acad Sci U S A. 2010;107(38):16655–16660. 10.1073/pnas.1011975107
32. Wiley RE, Cwiartka M, Alvarez D, Mackenzie DC, Johnson JR, Goncharova S, et al. Transient corticosteroid treatment permanently amplifies the Th2 response in a murine model of asthma. J Immunol. 2004;172(8):4995–5005. 10.4049/jimmunol.172.8.4995
33. Olsen PC, Kitoko JZ, Ferreira TP, De-Azevedo CT, Arantes AC, Martins MA. Glucocorticoids decrease treg cell numbers in lungs of allergic mice. Eur J Pharmacol. 2015;747:52–8. 10.1016/j.ejphar.2014.11.034
34. Okuyama K, Dobashi K, Miyasaka T, Yamazaki N, Kikuchi T, Sora I, et al. The involvement of glucocorticoids in psychological stress-induced exacerbations of experimental allergic asthma. Int Arch Allergy Immunol. 2014;163(4):297–306. 10.1159/000360577
35. Sommershof A, Aichinger H, Engler H, Adenauer H, Catani C, Boneberg EM, et al. Substantial reduction of naïve and regulatory T cells following traumatic stress. Brain Behav Immun. 2009;23(8):1117–24. 10.1016/j.bbi.2009.07.003
36. Jergović M, Bendelja K, Vidović A, Savić A, Vojvoda V, Aberle N, et al. Patients with posttraumatic stress disorder exhibit an altered phenotype of regulatory T cells. Allergy Asthma Clin Immunol. 2014;10(1):1–9. 10.1186/1710-1492-10-43
37. Freier E, Weber CS, Nowottne U, Horn C, Bartels K, Meyer S, et al. Decrease of CD4+FOXP3+ T regulatory cells in the peripheral blood of human subjects undergoing a mental stressor. Psychoneuroendocrinology. 2010;35(5):663–73. 10.1016/j.psyneuen.2009.10.005
38. Bierhaus A, Wolf J, Andrassy M, Rohleder N, Humpert PM, Petrov D, et al. A mechanism converting psychosocial stress into mononuclear cell activation. Proc Natl Acad Sci U S A. 2003;100(4):1920–25. 10.1073/pnas.0438019100
39. Haczku A, Panettieri RA. Social stress and asthma: the role of corticosteroid insensitivity. J Allergy Clin Immunol. 2010;125(3):550–58. 10.1016/j.jaci.2009.11.005
40. Miyasaka T, Dobashi-okuyama K, Takahashi T. Allergology international the interplay between neuroendocrine activity and psychological stress-induced exacerbation of allergic asthma. Allergol Int. 2018;67(1):32–42. 10.1016/j.alit.2017.04.013
41. Rican P, American A. Current perspectives stress and asthma: novel insights on genetic, epigenetic, and immunologic mechanisms. J Allergy Clin Immunol. 2014;134(5):1009-15. 10.1016/j.jaci.2014.07.005
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Mar 1, 2022
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Araújo Gueiros Lira, G. V. de, Pontes da Silva, G. A., Wandalsen, G. F., & Cavalcanti Sarinho, E. S. (2022). Psychological stress in asthma: repercussions on epigenetics-genetics, immune responses, and pulmonary function in the pediatric population. Allergologia Et Immunopathologia, 50(2), 78-88. https://doi.org/10.15586/aei.v50i2.546
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How to Cite
Araújo Gueiros Lira, G. V. de, Pontes da Silva, G. A., Wandalsen, G. F., & Cavalcanti Sarinho, E. S. (2022). Psychological stress in asthma: repercussions on epigenetics-genetics, immune responses, and pulmonary function in the pediatric population. Allergologia Et Immunopathologia, 50(2), 78-88. https://doi.org/10.15586/aei.v50i2.546