Dhabhar · Immunologic research 2014 · narrative review · n=?

Effects of stress on immune function: the good, the bad, and the beautiful.

Cited 1330 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and mechanistic framework without systematic search methodology

PubMed 24798553 · doi:10.1007/s12026-014-8517-0 · record verified 2026-08-31

What was done

This narrative review synthesized evidence on the immunological effects of biological stress responses induced by psychological, physiological, or physical stressors (such as exercise). The authors proposed a conceptual framework classifying immune responses into protective, pathological, and regulatory categories to distinguish acute from chronic stress effects.

What was found

The abstract reports no numerical data or statistical metrics. It describes qualitative findings: short-term stress lasting minutes to hours enhances innate and adaptive immune responses by modifying dendritic cell, neutrophil, macrophage, and lymphocyte trafficking, maturation, and function, as well as cytokine production. In contrast, long-term chronic stress suppresses immune function, alters Type 1-Type 2 cytokine balance, induces low-grade chronic inflammation, and suppresses protective T cells while increasing regulatory T cell activity.

Why it matters

It provides a conceptual distinction between beneficial acute stress responses and harmful chronic stress, outlining potential mechanistic targets to harness acute stress pathways to improve vaccine responses, wound healing, and anti-tumor immunity.

Limits

The abstract describes a narrative review without systematic search criteria, meta-analytic pooling, or sample size reporting. It does not provide quantitative thresholds separating beneficial short-term stress from harmful chronic stress, nor does it specify the proportion of findings derived from animal models versus human trials.

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