Ritz Thomas
Southern Methodist University Dallas, TX, USA.
Front Physiol. 2012 Sep 5;3:343. doi: 10.3389/fphys.2012.00343. eCollection 2012.
Psychosocial factors have been found to impact airway pathophysiology in respiratory disease with considerable consistency. Influences on airway mechanics have been studied particularly well. The goal of this article is to review the literature on airway responses to psychological stimulation, discuss potential pathways of influence, and present a well-established emotion-induction paradigm to study airway obstruction elicited by unpleasant stimuli. Observational studies have found systematic associations between lung function and daily mood changes. The laboratory-based paradigm of bronchoconstrictive suggestion has been used successfully to elicit airway obstruction in a substantial proportion of asthmatic individuals. Other studies have demonstrated modulation of airway responses to standard airway challenges with exercise, allergens, or pharmacological agents by psychological factors. Standardized emotion-induction techniques have consistently shown airway constriction during unpleasant stimulation, with surgery, blood, and injury stimuli being particularly powerful. Findings with various forms of stress induction have been more mixed. A number of methodological factors may account for variability across studies, such as choice of measurement technique, temporal association between stimulation and measurement, and the specific quality and intensity of the stimulus material, in particular the extent of implied action-orientation. Research has also begun to elucidate physiological processes associated with psychologically induced airway responses, with vagal excitation and ventilatory influences being the most likely candidate pathways, whereas the role of specific central nervous system pathways and inflammatory processes has been less studied. The technique of emotion-induction using films has the potential to become a standardized challenge paradigm for the further exploration of airway hyperresponsiveness mediated by central nervous system processes.
人们发现，社会心理因素对呼吸系统疾病气道病理生理学的影响具有相当的一致性。对气道力学的影响已得到特别深入的研究。本文的目的是回顾关于气道对心理刺激反应的文献，讨论潜在的影响途径，并介绍一种成熟的情绪诱导范式，以研究由不愉快刺激引发的气道阻塞。观察性研究发现肺功能与日常情绪变化之间存在系统性关联。基于实验室的支气管收缩暗示范式已成功用于在相当比例的哮喘患者中引发气道阻塞。其他研究表明，心理因素可调节气道对运动、过敏原或药物等标准气道刺激的反应。标准化的情绪诱导技术始终显示，在不愉快刺激期间气道会收缩，手术、血液和损伤刺激尤其强烈。各种形式的应激诱导研究结果则更为复杂。一些方法学因素可能导致不同研究结果存在差异，如测量技术的选择、刺激与测量之间的时间关联，以及刺激材料的具体性质和强度，特别是隐含的行动导向程度。研究也已开始阐明与心理诱导气道反应相关的生理过程，迷走神经兴奋和通气影响是最可能的候选途径，而特定中枢神经系统途径和炎症过程的作用研究较少。使用电影进行情绪诱导的技术有可能成为一种标准化的挑战范式，用于进一步探索由中枢神经系统过程介导的气道高反应性。
