The role of stress in the mosaic of autoimmunity: An overlooked association.
Level 5 - mechanism / opinion, no new human data
Narrative review of mechanisms and clinical literature without systematic review methodology or primary data
PubMed 30118900 · doi:10.1016/j.autrev.2018.04.005
What was done
This was a narrative review evaluating the physiological mechanisms and clinical literature regarding the impact of psychological stress on the pathogenesis, onset, exacerbations, and management of various autoimmune diseases.
What was found
The abstract reports no numerical data or quantitative effect sizes. It describes that stress triggers catecholamine and glucocorticoid release, altering cytokine profiles via increases in IL-4 and IL-10 and a decrease in IL-12, thereby favoring T-helper 2 over T-helper 1 cell differentiation. The authors report that stress is linked to disease onset and exacerbation in rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, multiple sclerosis, and Graves' disease, as well as delayed lesion clearance in psoriasis, while psychological interventions were noted to improve clinical outcomes.
Why it matters
The paper synthesizes pathways linking stress-induced neuroendocrine responses with immune dysregulation, supporting consideration of psychological stress management in autoimmune disease care.
Limits
No numerical findings, sample sizes, or effect estimates are reported in the abstract. As a narrative review, it lacks systematic search criteria, quality appraisal of cited studies, and controls for confounding.
Cited by
- supports Stress triggers flares in people with autoimmune diseases.