Stress, mindfulness, and the allergic patient

ABSTRACT

Introduction: The global incidence and prevalence of allergic diseases are increasing as is the intensity and duration of excessive psychological stress due to multiple factors associated with living in today’s world such as personal, social and political unrest, increased fear and anxiety, and/or depression often leading to hopelessness. Both allergy and chronic psychological stress are characterized by immune imbalances that have similar characteristics. Thus, it is reasonable to posit that the two are interactive and stress may induce as well as complicate at least some allergic diseases.

Areas covered: Stress management/reduction has been proposed with various physical, pharmacological, and psychological interventions for both preventive and therapeutic reasons. A useful intervention involves mindfulness techniques, which allow the individual to put their life situation in context for better personal management.

Expert commentary: Future studies must be developed that will further examine the role of excess psychological stress in specific allergic diseases and evaluate the effectiveness of various stress intervention protocols, particularly those involving mindfulness, to determine which individual would best respond clinically to which intervention. When this is accomplished, assessment and treatment of psychological stress will become a standard component of clinical care for allergy, asthma, and other immune-based diseases.

KEYWORDS:

• Stress
• allergy
• asthma
• psychoneuroimmunology
• immunopathology
• mindfulness

Key issues

• The pathophysiologic immune mechanisms responsible for allergic diseases are quite similar to the imbalance produced by excessive psychological stress.

• Excessive psychological stress is known to exacerbate allergic diseases including asthma in some individuals and strongly suspected to play a role in increasing risk of developing allergic diseases in susceptible individuals.

• Active research is attempting to identify individual stress susceptibility through genetic profiles as well as identifying sensitive and specific immune, endocrine, and psychological biomarker profiles.

• Mindfulness-based stress interventions have the advantages of low to no adverse side effects, opportunity for individualization and readily demonstrated clinical effectiveness.

• Current research efforts are directed at identifying individual risk for adverse impact of excessive psychological stress on host immunity, the impact of factors including genetic, environmental, and lifestyle choices and evaluation of intervention strategies, particularly mindfulness, in order to mitigate and perhaps prevent at least some allergic disease development

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work supported in part by the R. Faser Triplett Sr., MD, endowed chair in allergy and immunology at the University of Mississippi Medical Center, Jackson, MS, USA.