Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ann Acad Med Singap. 2010 Mar;39(3):191-6.
This review addresses the importance of psychoneuroimmunology (PNI) studies in understanding the role of acute and chronic psychological stressors on the immune system and development of coronary artery disease (CAD). Firstly, it illustrates how psychological stressors change endothelial function and lead to chemotaxis. Secondly, acute psychological stressors lead to leukocytosis, increased natural killer cell cytotoxicity and reduced proliferative response to mitogens while chronic psychological stressors may lead to adverse health effects. This will result in changes in cardiovascular function and development of CAD. Thirdly, acute and chronic psychological stressors will increase haemostatic factors and acute phase proteins, possibly leading to thrombus formation and myocardial infarction. The evidence for the effects of acute and chronic psychological stress on the onset and progression of CAD is consistent and convincing. This paper also highlights potential research areas and implications of early detection of immunological changes and cardiovascular risk in people under high psychological stress.
这篇综述探讨了心理神经免疫学(PNI)研究在理解急性和慢性心理应激源对免疫系统和冠状动脉疾病(CAD)发展的作用方面的重要性。首先,它说明了心理应激源如何改变内皮功能并导致趋化性。其次,急性心理应激源导致白细胞增多、自然杀伤细胞细胞毒性增加和对有丝分裂原的增殖反应减少,而慢性心理应激源可能导致不良健康影响。这将导致心血管功能的变化和 CAD 的发展。第三,急性和慢性心理应激源会增加止血因子和急性期蛋白,可能导致血栓形成和心肌梗死。急性和慢性心理应激对 CAD 发病和进展的影响的证据是一致且令人信服的。本文还强调了在高心理压力人群中早期检测免疫变化和心血管风险的潜在研究领域和意义。