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      Mind-body interactions in the regulation of airway inflammation in asthma: A PET study of acute and chronic stress

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          Abstract

          Background

          Psychological stress has long been recognized as a contributing factor to asthma symptom expression and disease progression. Yet, the neural mechanisms that underlie this relationship have been largely unexplored in research addressing the pathophysiology and management of asthma. Studies that have examined the mechanisms of this relationship in the periphery suggest that it is the superimposition of acute stress on top of chronic stress that is of greatest concern for airway inflammation.

          Methods

          We compared asthmatic individuals with high and low levels of chronic life stress in their neural and peripheral physiological responses to the Trier Social Stress Test and a matched control task. We used FDG-PET to measure neural activity during performance of the two tasks. We used both circulating and airway-specific markers of asthma-related inflammation to assess the impact of acute stress in these two groups.

          Results

          Asthmatics under chronic stress had a larger HPA-axis response to an acute stressor, which failed to show the suppressive effects on inflammatory markers observed in those with low chronic stress. Moreover, our PET data suggest that greater activity in the anterior insula during acute stress may reflect regulation of the effect of stress on inflammation. In contrast, greater activity in the mid-insula and perigenual anterior cingulate seems to reflect greater reactivity and was associated with greater airway inflammation, a more robust alpha amylase response, and a greater stress-induced increase in proinflammatory cytokine mRNA expression in airway cells.

          Conclusions

          Acute stress is associated with increases in markers of airway inflammation in asthmatics under chronic stress. This relationship may be mediated by interactions between the insula and anterior cingulate cortex, that determine the salience of environmental cues, as well as descending regulatory influence of inflammatory pathways in the periphery.

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          Author and article information

          Journal
          8800478
          1990
          Brain Behav Immun
          Brain Behav. Immun.
          Brain, behavior, and immunity
          0889-1591
          1090-2139
          4 May 2016
          30 March 2016
          November 2016
          01 November 2017
          : 58
          : 18-30
          Affiliations
          [a ]Waisman Laboratory for Brain Imaging & Behavior and Center for Investigating Healthy Minds, University of Wisconsin-Madison, 1500 Highland Ave, Madison, Wisconsin 53705, USA
          [b ]Department of Medicine, University of Wisconsin-Madison, 600 Highland Ave, Madison, Wisconsin 53792, USA
          [c ]Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, Wisconsin 53705, USA
          [d ]Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson St. Madison, Wisconsin 53706, USA
          [e ]Department of Counseling Psychology, University of Wisconsin-Madison, 1000 Bascom Mall, Madison, Wisconsin 53706, USA
          [f ]Osher Center for Integrative Medicine, University of California, San Francisco, 1701 Divisadero St #150, San Francisco, CA 94115, USA
          [g ]Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA
          Author notes
          Address Correspondence to: Melissa A. Rosenkranz, University of Wisconsin-Madison, Center for Investigating Healthy Minds, 1500 Highland Avenue, Madison, WI 53705, marosenk@ 123456wisc.edu , Phone: 608-262-5050, Fax: 608-262-9440
          Article
          PMC5045317 PMC5045317 5045317 nihpa782546
          10.1016/j.bbi.2016.03.024
          5045317
          27039241
          a342b1c0-7d72-4fe3-92c1-907dcfdb17c8
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