Stress hormones, proinflammatory and antiinflammatory cytokines, and autoimmunity.
Recent evidence indicates that glucocorticoids and catecholamines, the major stress hormones, inhibit the production of proinflammatory cytokines, such as interleukin (IL)-12, tumor necrosis factor (TNF)-alpha, and interferon (IFN)-gamma, whereas they stimulate the production of antiinflammatory cytokines, such as IL-10, IL-4, and transforming growth factor (TGF)-beta. Thus, systemically, an excessive immune response, through activation of the stress system, stimulates an important negative feedback mechanism, which protects the organism from an "overshoot" of proinflammatory cytokines and other products of activated macrophages with tissue-damaging potential. Conversely, in certain local responses and under certain conditions, stress hormones actually may boost regional immune responses, through induction of TNF-alpha, IL-1, and IL-8, and by inhibiting TGF-beta production. Therefore, conditions that are associated with significant changes in stress system activity, such as acute or chronic stress, cessation of chronic stress, severe exercise, and pregnancy and the postpartum period, through modulation of the systemic or local pro/antiinflammatory cytokine balance, may suppress or potentiate autoimmune diseases activity and/or progression.
Division of Rheumatology, Immunology and Allergy, Georgetown University Medical Center, Washington, DC 20007, USA. ije@georgetown.edu
Ilia J
IJ
Elenkov
George P
GP
Chrousos
D000818:Animals; D017951:Antigen Presentation; D001327:Autoimmune Diseases / Q000276:immunology / Q000503:physiopathology; D015551:Autoimmunity / Q000502:physiology*; D002395:Catecholamines / Q000502:physiology*; D016207:Cytokines / Q000096:biosynthesis / Q000235:genetics / Q000502:physiology*; D005246:Feedback; D005260:Female; D005786:Gene Expression Regulation / Q000502:physiology; D005938:Glucocorticoids / Q000502:physiology*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D018836:Inflammation Mediators / Q000502:physiology*; D008262:Macrophage Activation; D008297:Male; D018448:Models, Immunological; D015213:Neuroimmunomodulation / Q000235:genetics / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology / Q000503:physiopathology; D011644:Puerperal Disorders / Q000276:immunology / Q000503:physiopathology; D051381:Rats; D011917:Rats, Inbred Lew; D013312:Stress, Physiological / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
D002395:Catecholamines; D016207:Cytokines; D005938:Glucocorticoids; D018836:Inflammation Mediators