Proinflammatory cytokines and negative emotions

Townsend Letter for Doctors and Patients, May, 2007 by Robert A. Anderson

Negative affect and lack of supportive interpersonal relationships loom large in the picture of modulation of immune dysregulation. Immune dysregulation may be one core mechanism for a spectrum of conditions associated with aging, including cardiovascular disease, osteoporosis, arthritis, metabolic syndrome, type 2 diabetes, certain cancers, and frailty and functional decline. Production of proinflammatory cytokines that influence these conditions can be stimulated directly by negative emotions and indirectly by prolonged infection. The ability to unwind after stressful encounters downregulates the total stress burden. In contrast, prolonged intrusive ruminations following a stressful trauma appear to be one avenue by which immune functions are downregulated, including reduced natural killer cell activity. Higher salivary immune responses are associated with days of more positive mood. Higher social support is robustly associated with higher NK cell activity and mitogenic leukocyte responsiveness in those under stress, whereas chronically abrasive close personal relationships are seen to provoke persistent immune downregulation. Different perceptions to the same event provoke different endocrine and immune responses. Benefits of disclosure-based interventions vary, depending on the degree to which subjects become emotionally and cognitively involved in the process, reorganize the meaning of the traumatic event, and reduce avoidance of the issue.

Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Psychoneuro-immunology: Psychological influences on immune function and health. J Consult Clin Psychol. 2002; 70:537-47.

COMMENT: Enormous contributions to the understanding of mind-body pathways have been made by Ronald Glaser and Janice Kiecolt-Glaser at Ohio State. Here, they highlight several quintessential clinical principles. Proinflammatory cytokines play enormous roles in downregulating immune functions, contributing to a host of aging conditions including diabetes. Stimulation of these cytokines results directly from increased input of negative emotions. The major categories of the latter are threefold: 1) grief, sadness, depression; 2) anger, irritation, rage; and 3) anxiety, fear, panic. All these, of course, are normal; it is when they are generated at high and prolonged levels that they become toxic. Emotions are generated by neural pathways integrated with perceptions and thinking. To again quote the Glasers from this study, "Different perceptions to the same event provoke different endocrine and immune responses." To the extent that therapists and physicians are able to help patients modulate their perceptions and shorten and reduce the intensity of times of negative emotional arousal, the health benefits to the patient are sustained and substantial. Equanimity should be one prime goal of all physical and psychological care plans.