Neuroendocrine mechanisms of immune dysregulation: applications to allergy and asthma.
OBJECTIVE
To review the current information and hypotheses related to the underlying mechanisms that link psychological stress and asthma activity via a neuroimmune network dysfunction that may manifest as increased morbidity of immune diseases, such as asthma.


METHODS
Literature searches of MEDLINE for published human and animal studies and review articles published in English-language periodicals. Keywords searched included individual and various combinations of psychoneuroimmunology, neuroimmune, neuroimmunology, stress, immunity, allergy, asthma, and inflammation. Both review articles and specific hypothesis-driven articles that focused on immune effects of stress were included. Manuscripts that focused on animal studies were excluded from this review.


METHODS
Representative studies that reflect the consensus of the field based on the expert opinion of the author.


RESULTS
This article demonstrates the established relationships between the neuroendocrine and immune systems and the impact of both acute and chronic psychological stress on neuroendocrine and immune network function. The adverse impact of stress appears to occur more on immune dysregulation rather than immune suppression.


CONCLUSIONS
Psychological stress, allergy and asthma morbidity, and allergy and asthma incidence are all steadily increasing in our society. Establishing a firm relationship can provide a possible new therapeutic direction for evaluation and management of difficult-to-treat patients and possible prophylactic strategies in susceptible populations.
Division of Allergy and Clinical Immunology, The University of Texas Medical School at Houston, Houston, Texas 77030-1501, USA. Gailen.d.marshall@uth.tmc.edu
Gailen D
GD
Marshall
D001249:Asthma / Q000276:immunology; D005544:Forecasting; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology; D007107:Immune System / Q000276:immunology; D009490:Neurosecretory Systems / Q000276:immunology*; D013315:Stress, Psychological / Q000276:immunology