Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, Università degli Studi di Roma La Sapienza, Internal Medicine Unit, ICOT Hospital, Latina, Italy.
Dipartimento di Medicina Clinica, Università degli Studi dell'Aquila, Sanita Pubblica Scienze della Vita e dell'Ambiente, L'Aquila, Italy.
Ann N Y Acad Sci. 2019 Feb;1437(1):31-42. doi: 10.1111/nyas.13728. Epub 2018 May 15.
In the last decades, psychoneuroendocrineimmunology research has made relevant contributions to the fields of neuroscience, psychobiology, epigenetics, molecular biology, and clinical research by studying the effect of stress on human health and highlighting the close interrelations between psyche, brain, and bodily systems. It is now well recognized that chronic stress can alter the physiological cross-talk between brain and biological systems, leading to long-lasting maladaptive effects (allostatic overload) on the nervous, immune, endocrine, and metabolic systems, which compromises stress resiliency and health. Stressful conditions in early life have been associated with profound alterations in cortical and subcortical brain regions involved in emotion regulation and the salience network, showing relevant overlap with different psychiatric conditions. This paper provides a summary of the available literature concerning the notable effects of stress on the brain and immune system. We highlight the role of epigenetics as a mechanistic pathway mediating the influences of the social and physical environment on brain structure and connectivity, the immune system, and psycho-physical health in psychiatric diseases. We also summarize the evidence regarding the effects of stress management techniques (mainly psychotherapy and meditation practice) on clinical outcomes, brain neurocircuitry, and immune-inflammatory network in major psychiatric diseases.
在过去的几十年中，通过研究压力对人类健康的影响，并强调心理、大脑和身体系统之间的密切关系，心理神经内分泌免疫学研究为神经科学、心理生物学、表观遗传学、分子生物学和临床研究领域做出了重要贡献。现在人们已经认识到，慢性压力会改变大脑和生物系统之间的生理相互作用，导致神经系统、免疫系统、内分泌系统和代谢系统出现持久的适应不良效应（适应超负荷），从而损害压力的适应能力和健康。生命早期的应激条件与情绪调节和突显网络中涉及的皮质和皮质下脑区的深刻改变有关，与不同的精神疾病有明显的重叠。本文总结了关于压力对大脑和免疫系统的显著影响的现有文献。我们强调了表观遗传学作为一种介导社会和物理环境对大脑结构和连接、免疫系统以及精神生理健康的影响的机制途径的作用，在精神疾病中。我们还总结了关于应激管理技术（主要是心理治疗和冥想练习）对主要精神疾病的临床结果、大脑神经回路和免疫炎症网络的影响的证据。
