Article

Stress effects on lung function in asthma are mediated by changes in airway inflammation

Department of Environmental Health, Harvard University, Boston, MA, USA.
Psychosomatic Medicine (Impact Factor: 4.09). 06/2008; 70(4):468-75. DOI: 10.1097/PSY.0b013e31816f9c2f
Source: PubMed

ABSTRACT To examine the association of changes in current negative mood and long-term daily hassles with changes in lung function and airway inflammation in patients suffering from asthma and in healthy controls. Associations between psychological factors and asthma symptoms have been documented, but the relationship between airway inflammation and psychological factors has been largely unexplored.
Data were analyzed from 46 asthma patients and 25 controls who completed questionnaires on current mood and daily hassles at two assessments 3 months apart. Lung function was measured by spirometry (forced expiratory volume in the first second (FEV(1))) and airway inflammation by the fraction of nitric oxide in exhaled air (FeNO). Regression analyses controlling for allergen load and air pollution (ozone) were calculated to study the association between changes in psychological factors and changes in lung function and airway inflammation, and to examine the mediational role of airway inflammation in the stress-lung function association.
In patients with asthma, increases in negative affect were associated with decreases in FEV(1) and increases in FeNO. For daily hassles, a reverse pattern of associations was found, with decreases in daily hassles linked to decreases in FEV(1) and increases in FeNO. Mediation analyses showed that FeNO was a significant mediator of the association of both negative affect and daily hassles with lung function changes. No significant associations were found for healthy controls.
Psychological variables are consistently associated with spirometric lung function and airway inflammation in asthma patients. For asthma patients, effects of acute negative affect must be distinguished from more chronic distress due to daily hassles.

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    • "In contrast, Ritz et al. (2011) found that, in both healthy and asthmatic participants, acute psychosocial laboratory stress led to an increase in airway NO at the point when cortisol was the highest after stress, whereas Chen et al. (2010) found elevations of airway NO following a stressful interview in asthmatic children with low socioeconomic status. Another study found that higher momentary negative affect was related to greater airway NO levels; in contrast, daily hassles in the previous three months were related to lower airway NO in asthma patients but not in healthy controls (Kullowatz et al., 2008). Taken together, these findings suggest that the relationship between psychological factors and NO may differ depending on the psychological construct that is examined. "
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    ABSTRACT: Psychosocial factors such as social support and depression have long been associated with health outcomes. Elevated depressive symptoms are usually associated with worse health outcomes, whereas social support has been related to improvements in health. Nitric oxide levels are an important marker of both cardiovascular health and immune function. Research suggests that exhaled nitric oxide is affected by stress, negative affect, and depression; however, the effect of social support has not been previously explored. Thus, we sought to examine the association of social support, negative affect, and depression with exhaled nitric oxide in a group of 35 healthy individuals (10 males and 25 females) with a mean age of 20.5years across five weekly assessments. Results showed that changes in social support within individuals were positively associated with levels of exhaled nitric oxide independent of other psychosocial factors. Further exploration of the health implications of this positive relationship between airway nitric oxide and social support is necessary.
    International journal of psychophysiology: official journal of the International Organization of Psychophysiology 05/2014; 93(3). DOI:10.1016/j.ijpsycho.2014.05.011 · 2.65 Impact Factor
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    • "In contrast, Ritz et al. (2011) found that, in both healthy and asthmatic participants, acute psychosocial laboratory stress led to an increase in airway NO at the point when cortisol was the highest after stress, whereas Chen et al. (2010) found elevations of airway NO following a stressful interview in asthmatic children with low socioeconomic status. Another study found that higher momentary negative affect was related to greater airway NO levels; in contrast, daily hassles in the previous three months were related to lower airway NO in asthma patients but not in healthy controls (Kullowatz et al., 2008). Taken together, these findings suggest that the relationship between psychological factors and NO may differ depending on the psychological construct that is examined. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Psychosocial factors such as social support and depression have long been associated with health outcomes. Elevated depressive symptoms are usually associated with worse health outcomes, whereas social support has been related to improvements in health. Nitric oxide levels are an important marker of both cardiovascular health and immune function. Research suggests that exhaled nitric oxide is affected by stress, negative affect, and depression; however, the effect of social support has not been previously explored. Thus, we sought to examine the association of social support, negative affect, and depression with exhaled nitric oxide in a group of 35 healthy individuals (10 males and 25 females) with a mean age of 20.5 years across five weekly assessments. Results showed that changes in social support within individuals were positively associated with levels of exhaled nitric oxide independent of other psychosocial factors. Further exploration of the health implications of this positive relationship between airway nitric oxide and social support is necessary.
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    • "We hypothesized that higher depressive mood across time in both low stress and high stress periods would be related to lower FeNO values and lung function. In line with earlier findings (Höglund et al., 2006; Kullowatz et al., 2008), we expected decreases in FeNO during the periods of prolonged stress such as final exam periods that lasts several days. Our secondary aim was to replicate previous findings by examining the impact of state negative affect on FeNO and lung function in healthy college students with no prior history of asthma, allergies, or cardiovascular conditions . "
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    ABSTRACT: Nitric oxide (NO) has beneficial effects on cardiovascular and immune health. Stress and depression have been linked to a reduction in serum NO. In this study, we examined the effect of academic exam stress on the fraction of NO in exhaled air (FeNO) and spirometric lung function in 41 healthy college students. Participants completed assessments at mid-semester as well as in the early and late phase of an academic exam period. Negative affect, depressive mood, and salivary cortisol were elevated during exams, whereas FeNO and lung function decreased. Higher depressive mood was associated with lower FeNO, whereas higher negative affect was associated higher FeNO across time. These findings provide initial evidence that depression and prolonged stress can alter FeNO and lung function in healthy individuals, which could have adverse consequences for cardiovascular, airway, and immune health.
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