Stress may worsen asthma by inducing resistance to anti-inflammatory properties of glucocorticoids

Stress is known to worsen the course of asthma, but the underlying mechanisms are poorly understood.

Remembering that there is a yin and yang to everything helps us resolve the paradox between production of stress-induced cortisol, which is an anti-inflammatory hormone, and worsening of asthma:

1. Stress elicits secretion of cortisol -- a hormone that generally dampens airway inflammation and ameliorates asthma symptoms.

2. However, stress could also induce resistance to the anti-inflammatory properties of glucocorticoids.

In a study of 67 children with asthma and 76 healthy children, questionnaires asked about support from their parents.

Peripheral Blood Mononuclear Cells (PBMCs) were collected and incubated with a mitogen cocktail in physiologic concentrations of hydrocortisone. Production of IL-5, IL-13, and IFN-γ was measured by ELISA.

Children with asthma who perceived low support from their parents were more resistant to hydrocortisone's anti-inflammatory effects on IL-5 and IFN-γ production and had higher circulating levels of eosinophil cationic protein.

Parental support and cytokine activity in childhood asthma: The role of glucocorticoid sensitivity. Gregory E. Miller et al. JACI, Volume 123, Issue 4, Pages 824-830 (April 2009).
Stress and acquired glucocorticoid resistance: A relationship hanging in the balance. Rosalind J. Wright. JACI, Volume 123, Issue 4, Pages 831-832 (April 2009).
Chronic stress at work can make you sick
Image source: Cortisol, Wikipedia, public domain.

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