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INTRODUCTION

Many researchers have turned their attention to psychological stressors as it strongly affects the immune system. Such effects suggested by several researchers include suppression of the immune system, which reduces the response to infectious diseases. Chronic stress has been reported to have an association with vaccination issues, autoimmunity, inflammatory response, and wound healing  (Khalil et al., 2020; Skopouli and Katsiougiannis, 2018). A stressor is a stimulus (or threat) that causes stress, examples include; exam, divorce, death of loved one, loss of job, a diagnosis of life-threatening illness, natural disasters, or violence (Godoy et al., 2018). Stress can mean the way human body respond to demands of life or threat. It can also mean human reaction when feeling or sensing danger (Khalil et al., 2020). Although the danger could be real or not, our defense system will get into action automatically. This process is coordinated by the sympathetic nervous system and it is known as fight-or-flight response (Khalil et al., 2020). This is a life-saving mechanism when the situation is real and it is the advantage of the stress mechanism. However, stress can hurt humans leading to disease conditions. The adverse effect of stress on physiological reactivity is dependent on the persistence of a particular stressor (Khalil et al., 2020).

Several studies have reported that there is a relationship between stress and the immune system. Older studies on the effect of stress and the immune system suggested that stress is immunosuppressive. The model that stress response suppresses the immune system made several scientists believe that it destroys cell cytotoxicity, reduces lymphocyte proliferative responses, and also affects the response to immunization. This was believed to be true as some studies showed a high prevalence of infectious and neoplastic diseases among persons that are exposed to chronic stress. (Khalil et al., 2020)

To understand more about the effect of stress on the immune system, an overview of the immune system would be helpful. The human immune system can be described as the system that helps fight against diseases in humans. They are numerous (billions of cells) that travel through the bloodstream, enter the tissues and organs in the body fighting against diseases such as bacteria, viruses, and other harmful substances that are harmful to our health. These fighters are components of the white blood cell-the lymphocytes. The lymphocyte is divided into two namely B cells and T cells. The B cells produce antibodies that are released into the fluid around the body’s cell to kill viruses and bacteria. The T-cells are responsible for multiplying inside the infected cells and destroying the infections. The other fighter inside the white blood cell is the phagocyte. It phagocytizes infections and diseases (Khalil et al., 2020).

During stressful conditions, the immunity to fight antigens is greatly reduced, hence we become susceptible to infections. The stress hormone known as corticosteroid suppresses our immune system. How do these occur? Two signaling pathways are responsible, they are autonomic nervous system and the hypothalamic-pituitary-adrenal axis. The brain detects and interprets the above-mentioned stressors, it activates the two major components of the stress system which include the sympathetic-adreno-medullar (SAM) axis, which is responsible for the secretion of the noradrenaline and norepinephrine (Godoyet al., 2018;). The other component is the hypothalamus-pituitary-adrenal (HPA) axis that activates the secretion of glucocorticoids. Activation of the above-mentioned stress will generate a coordinated response and appropriate strategy to enable the body to cope with stressful conditions (Godoyet al., 2018). The action of the systems may last for days while quickly responding to the stimulus to ensure that the homeostatic mechanism of the human boy is being restored (Godoyet al., 2018). The stress response mechanism suppresses digestion and reproductive systems, but increases metabolic changes, increases energy production and activation of the immune system. However, the effect of the stress response affects the non-genomic, genomic, epigenetic mechanisms, proinflammatory signaling results in altered cellular excitability and neural plasticity. These effects alter the physiology of the body resulting in disease conditions (Godoyet al., 2018). However, chronic stress can suppress the immune response by altering the type 1 and 2 cytokine balance (Takahashi et al., 2018). The action leads to inflammation and suppresses the function of immune cells. It has been that prolonged inflammation causes other destruction in human health, thereby making the individual susceptible to diseases (Khalil et al., 2020).

Also, Masafi et al reported that stress influences immune signaling in two main ways, by reducing the inhibitory effects of glucocorticoid actions, or by directly stimulating the immune system via the HPA axis and SAM axis (Masafi et al., 2018). Other researchers also agree with the role in which stress affects the immune system (Sharma, 2018). Therefore, this present study aims to determine the major effect on which chronic stress affects our immune system.

AIM

• To determine the effect of chronic stress on the immune system

SPECIFIC OBJECTIVES

• To determine the effect of chronic stress on the level of lymphocytes
• To determine the effect of chronic stress on the level of phagocytes
• To determine the effect of chronic stress on the balance of type 1 and type 2 cytokines
• To understand the association of chronic stress to infectious diseases
• To understand the relationship between chronic stress and response to vaccination

RESEARCH PROBLEMS

Stress has been identified by scientists as one of the major problems that predispose individuals to lots of diseases. Such effects suggested by several researchers include suppression of the immune system, which reduces the response to infectious diseases. Chronic stress has been reported to have an association with vaccination issues, autoimmunity, inflammatory response, and wound healing  (Khalil et al., 2020; Skopouli and Katsiougiannis, 2018). Humans are exposed to lots of stressors today. Therefore, we aim to investigate the major effect associated with chronic stress and the immune system.

RESEARCH QUESTIONS

• What is the effect of chronic stress on the level of lymphocytes?
• What is the effect of chronic stress on the level of phagocytes?
• What is the effect of chronic stress on the balance of type 1 and type 2 cytokines? 
• Is there any association of chronic stress to infectious diseases?
• Is there any relationship between chronic stress and response to vaccination?

SIGNIFICANCE OF STUDY

Several studies have reported that stress influences immune signaling in two main ways, by reducing the inhibitory effects of glucocorticoid actions, or by directly stimulating the immune system via the HPA axis and SAM axis (Masafi et al., 2018; Sharma, 2018). However, there are limited studies on the effect of chronic stress on the immune system. Therefore, this study will determine the major effect of chronic stress on the immune system to add to knowledge.

METHODOLOGY

• Study Design: This study will review current literature to determine the effect of stress on cardiovascular diseases. In the search for this literature, keywords such as “Chronic Stress”, “Stressors”, “Immune system”, “Immune suppression”, “Stress”, and other related terms will be utilized. Databases such as Pubmed/ Medline, Google Scholar, Cochrane library, will also be used to source data Also, Inclusion and exclusion criteria will be used in selecting relevant literature for this study.
• ANALYSIS

The following will be used for analysis in this review, they are; cluster analysis (CA) and/or factor analysis (FA), and/or principal component analysis (PCA). The results will be presented as odds ratios (OR).

• RISK ASSESSMENT

The risk assessment conducted for this project is provided in the table below:

Table 1:  Risk assessment

• SCHEDULE

    Table 2: Project Plan

REFERENCES

Godoy, L. D., Rossignoli, M. T., Delfino-Pereira, P., Garcia-Cairasco, N., & Umeoka, E. H. de L. (2018). A comprehensive overview on stress neurobiology: Basic concepts and clinical implications. In Frontiers in Behavioral Neuroscience (Vol. 12). Frontiers Media S.A. https://doi.org/10.3389/fnbeh.2018.00127

Khalil, A.I., Nasr, R.E. and Enar, R. E. (2018). Relationship between Stress, Immune System, and Pandemics of Coronaviruses’ COVID19: Updates Narrative Review. In European Journal of Molecular & Clinical Medicine (Vol. 7).

Masafi, S., Saadat, S. H., Tehranchi, K., Olya, R., Heidari, M., Malihialzackerini, S., Jafari, M., & Rajabi, E. (2018). Effect of stress, depression, and type d personality on the immune system in the incidence of coronary artery disease. Open Access Macedonian Journal of Medical Sciences, 6(8), 1533–1544.

Sharma DK (2018) Physiology of Stress and its Management. J Med Stud Res 1: 001.

Skopouli, F. N. and Katsiougiannis, S. (2018). How stress contributes to autoimmunity—lessons from Sjögren’s syndrome. In FEBS Letters (Vol. 592, Issue 1, pp. 5–14). Wiley Blackwell. https://doi.org/10.1002/1873-3468.12933

Takahashi, A., Flanigan, M. E., McEwen, B. S., and Russo, S. J. (2018). Aggression, social stress, and the immune system in humans and animal models. Front. Behav. Neurosci. 12:56.

Last updated: Jan 18, 2022 03:46 PM