Acute stress-induced increases in exhaled nitric oxide in asthma and their association with endogenous cortisol.
Level 3 - non-randomized controlled study
Non-randomized controlled laboratory study comparing asthma patients to healthy controls
PubMed 20709818 · doi:10.1164/rccm.201005-0691OC
What was done
Airway inflammation and cortisol responses to acute psychosocial stress induced by the Trier Social Stress Test were evaluated in 20 adult patients with asthma and 19 healthy control subjects. Fraction of exhaled nitric oxide (FeNO) and salivary cortisol were sampled before and up to 45 minutes after the challenge. Respiratory inductive plethysmography was used to control for changes in ventilatory activity that could affect FeNO measurements.
What was found
Asthma patients generally had higher baseline FeNO and lower salivary cortisol levels than healthy controls. Salivary cortisol increased post-stress in both groups (P < 0.001). FeNO levels at peak cortisol increase were significantly higher than pre-stress baseline in both groups (P < 0.05), independent of changes in ventilation. In patients with asthma, higher baseline cortisol and stronger post-stress cortisol increases were significantly associated with smaller increases in FeNO (P < 0.05). Exact numerical values and confidence intervals were not reported in the abstract.
Why it matters
This study indicates that acute psychosocial stress in isolation can directly provoke an increase in airway inflammatory markers, and that endogenous cortisol reactivity may attenuate this inflammatory response in asthma.
Limits
The study is limited by a small sample size (39 total participants) in an artificial laboratory environment. The abstract does not provide exact numerical means, effect sizes, asthma severity classifications, medication use details, or longer-term follow-up beyond 45 minutes.
Cited by
- supports Psychosocial stress increases the severity of asthma symptoms and lung inflammation.