Chronic Stress, Immune Dysregulation, and Health

American Journal of Lifestyle Medicine

Volumn 5, Issue 6, 2011, Pages 476-485

  Gouin, Jean Philippe ^a  

^a RUSH UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

inflammation; psychoneuroimmunology; stress; vaccination; wound healing

Indexed keywords

EID: 84993683762     PISSN: 15598276     EISSN: 15598284     Source Type: Journal    
DOI: 10.1177/1559827610395467     Document Type: Article

References (126)

1. Cohen S., Kessler R., GordonLG, eds. Measuring Stress. New York, NY: Oxford University Press; 1995.
2. Edwards KM Burns VE Allen LM, et al. Eccentric exercise as an adjuvant to influenza vaccination in humans. Brain Behav Immun. 2007; 21: 209-217.
3. Dhabhar FS. Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection and immunopathology. Neuroimmunomodulation. 2009; 16: 300-317.
4. Elliot GR Eisdorfer C. Stress and Human Health: An Analysis and Implications of Research: A Study by the Institute of Medicine, National Academy of Sciences. New York, NY: Springer Publishing; 1982.
5. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998; 338: 171-179.
6. Segerstrom SC Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull. 2004; 130: 1-37.
7. Schleifer S Keller S Camerino M Thorton JC Stein M. Suppression of lymphocyte stimulation following bereavement. JAMA. 1983; 250: 374-377.
8. Bartrop R Luckhurst E Lazarus L Kiloh LG Penny R. Depressed lymphocyte function after bereavement. Lancet. 1977; 1: 374-377.
9. Ershler W Keller E. Age-associated increased interleukin-6 gene expression, late-life diseases, and frailty. Annu Rev Med. 2000; 51: 245-270.
10. Maggio M Guralnik JM Longo DL Ferrucci L. Interleukin-6 in aging and chronic disease: a magnificent pathway. J Gerontol A Biol Sci Med Sci. 2006; 61: 575-584.
11. Aggarwal BB Shishodia S Sandur SK Pandey MK Sethi G. Inflammation and cancer: how hot is the link? Biochem Pharmacol. 2006; 72: 1605-1621.
12. Libby P Theroux P. Pathophysiology of coronary artery disease. Circulation. 2005; 111: 3481-3488.
13. Steptoe A Hamer M Chida Y. The effects of acute psychological stress on circulating inflammatory factors in humans: a review and meta-analysis. Brain Behav Immun. 2007; 21: 901-912.
14. Bierhaus A Wolf J Andrassy M, et al. A mechanism converting psychosocial stress into mononuclear cell activation. Proc Natl Acad Sci U S A. 2003; 100: 1920-1925.
15. Brydon L Edwards S Jia HY, et al. Psychological stress activates interleukin-1 beta gene expression in human mononuclear cells. Brain Behav Immun. 2005; 19: 540-546.
16. Black PH. The inflammatory response is an integral part of the stress response: implications for atherosclerosis, insulin resistance, type II diabetes and metabolic syndrome X. Brain Behav Immun. 2003; 17: 350-364.
17. Gouin JP Hantsoo L Kiecolt-Glaser JK. Immune dysregulation and chronic stress among older adults: a review. Neuroimmunomodulation. 2008; 15: 251-259.
18. Dura JR Stukenberg KW Kiecolt-Glaser JK. Anxiety and depressive disorders in adult children caring for demented parents. Psychol Aging. 1991; 6: 467-473.
19. Vitaliano PP Zhang J Scanlan JM. Is caregiving hazardous to one-s physical health? a meta-analysis. Psychol Bull. 2003; 129: 946-972.
20. Lee S Colditz GA Berkman LF Kawachi I. Caregiving and risk of coronary heart disease in US women: a prospective study. Am J Prev Med. 2003; 24: 113-119.
21. Schulz R Beach SR. Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA. 1999; 282: 2215-2219.
22. Lutgendorf SK Garand L Buckwalter KC Reimer TT Hong S Lubaroff DM. Life stress, mood disturbance, and elevated interleukin-6 in healthy older women. J Gerontol A Biol Sci Med Sci. 1999; 54: M434-M439.
23. von Kanel R Dimsdale JE Mills PJ, et al. Effect of Alzheimer caregiving stress and age on frailty markers interleukin-6, c-reactive protein, and d-dimer. J Gerontol. 2006; 61A: 963-969.
24. Rohleder N Marin TJ Ma R Miller GE. Biologic cost of caring for a cancer patient: dysregulation of pro- and anti-inflammatory signaling pathways. J Clin Oncol. 2009; 27: 2909-2915.
25. Kiecolt-Glaser JK Preacher KJ MacCallum RC Atkinson C Malarkey WB Glaser R. Chronic stress and age-related increases in the proinflammatory cytokine IL-6. Proc Natl Acad Sci U S A. 2003; 100: 9090-9095.
26. Harris T Ferrucci L Tracy R, et al. Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med. 1999; 106: 506-512.
27. Kiecolt-Glaser JK Preacher KJ MacCallum RC Atkinson C Malarkey WB Glaser R. Chronic stress and age-related increases in the proinflammatory cytokine IL-6. Proc Natl Acad Sci U S A. 2003; 100: 9090-9095.
28. Kiecolt-Glaser JK Loving TJ Stowell JR, et al. Hostile marital interactions, proinflammatory cytokine production, and wound healing. Arch Gen Psychiatry. 2005; 62: 1377-1384.
29. Davis MC Zautra AJ Younger J Motivala SJ Attrep J Irwin MR. Chronic stress and regulation of cellular markers of inflammation in rheumatoid arthritis: implications for fatigue. Brain Behav Immun. 2008; 22: 24-32.
30. Fuligni AJ Telzer EH Bower J Cole SW Kiang L Irwin MR. A preliminary study of daily interpersonal stress and C-reactive protein levels among adolescents from Latin American and European backgrounds. Psychosom Med. 2009; 71: 329-333.
31. Miller GE Rohleder N Cole SW. Chronic interpersonal stress predicts activation of pro- and anti-inflammatory signaling pathways 6 months later. Psychosom Med. 2009; 71: 57-62.
32. Danese A Pariante CM Caspi A Taylor A Poulton R. Childhood maltreatment predicts adult inflammation in a life-course study. Proc Natl Acad Sci U S A. 2007; 104: 1319-1324.
33. Hamer M Molloy GJ de Oliveira C Demakakos P. Persistent depressive symptomatology and inflammation: to what extent do health behaviours and weight control mediate this relationship? Brain Behav Immun. 2009; 23: 413-418.
34. Dentino AN Pieper CF Rao MK, et al. Association of interleukin-6 and other biologic variables with depression in older people living in the community. J Am Geriatr Soc. 1999; 47: 6-11.
35. Stewart JC Rand KL Muldoon MF Kamarck TW. A prospective evaluation of the directionality of the depression-inflammation relationship. Brain Behav Immun. 2009; 23: 936-944.
36. Sluzewska A Rybakowski JK Laciak M Mackiewicz A Sobieska M Wiktorowicz K. Interleukin-6 serum levels in depressed patients before and after treatment with fluoxetine. Ann N Y Acad Sci. 1995; 762: 474-476.
37. Dantzer R Wollman E Vitkovic L Yirmiya R. Cytokines and depression: fortuitous or causative association? Mol Psychiatry. 1999; 4: 328-332.
38. Dantzer R O-Connor JC Freund GG Johnson RW Kelley KW. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008; 9: 46-56.
39. Capuron L Gumnick JF Musselman DL, et al. Neurobehavioral effects of interferon-alpha in cancer patients: phenomenology and paroxetine responsiveness of symptom dimensions. Neuropsychopharmacology. 2002; 26: 643-652.
40. Pace TWW Mletzko TC Alagbe O, et al. Increased stress-induced inflammatory responses in male patients with major depression and increased early life stress. Am J Psychiatry. 2006; 163: 1630-1632.
41. Glaser R Robles T Sheridan J Malarkey WB Kiecolt-Glaser JK. Mild depressive symptoms are associated with amplified and prolonged inflammatory responses following influenza vaccination in older adults. Arch Gen Psychiatry. 2003; 60: 1009-1014.
42. Brydon L Walker C Wawrzyniak A, et al. Synergistic effects of psychological and immune stressors on inflammatory cytokine and sickness responses in humans. Brain Behav Immun. 2009; 23: 217-224.
43. Miller GE Cohen S Ritchey AK. Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model. Health Psychol. 2002; 21: 531-541.
44. Miller GE Chen E Sze J, et al. A functional genomic fingerprint of chronic stress in humans: blunted glucocorticoid and increased NF-kappa B signaling. Biol Psychiatry. 2008; 64: 266-272.
45. Glaser R MacCallum RC Laskowski BS Malarkey WB Sheridan JF Kiecolt-Glaser JK. Evidence for a shift in the Th-1 to Th-2 cytokine response associated with chronic stress and aging. J Gerontol A Biol Sci Med Sci. 2001; 56: M477-M482.
46. Dhabhar FS Burke HM Epel ES, et al. Low serum IL-10 concentrations and loss of regulatory association between IL-6 and IL-10 in adults with major depression. J Psychiatr Res. 2009; 43: 962-969.
47. Baum CL Arpey CJ. Normal cutaneous wound healing: clinical correlation with cellular and molecular events. Dermatol Surg. 2005; 31: 674-686; discussion 686.
48. Hubner G Brauchle M Smola H Hadlener M Fassler R Werner S. Differential regulation of pro-inflammatory cytokines during wound healing in normal glucocorticoid-treated mice. Cytokine. 1996; 8: 548-556.
49. Scheier MF Matthews KA Owens JF, et al. Optimism and rehospitalization after coronary artery bypass graft surgery. Arch Intern Med. 1999; 159: 829-835.
50. Doering LV Moser DK Lemankiewicz W Luper C Khan S. Depression, healing, and recovery from coronary artery bypass surgery. Am J Crit Care. 2005; 14: 316-324.
51. Cole-King A Harding KG. Psychological factors and delayed healing in chronic wounds. Psychosom Med. 2001; 63: 216-220.
52. Kiecolt-Glaser JK Marucha PT Malarkey WB Mercado AM Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995; 346: 1194-1196.
53. Ebrecht M Hextall J Kirtley LG Taylor A Dyson M Weinman J. Perceived stress and cortisol levels predict speed of wound heating in healthy male adults. Psychoneuroendocrinology. 2004; 29: 798-809.
54. Marucha PT Kiecolt-Glaser JK Favagehi M. Mucosal wound healing is impaired by examination stress. Psychosom Med. 1998; 60: 362-365.
55. Bosch JA Engeland CG Cacioppo JT Marucha PT. Depressive symptoms predict mucosal wound healing. Psychosom Med. 2007; 69: 597-605.
56. Altemus M Rao B Dhabhar FS Ding W Granstein RD. Stress-induced changes in skin barrier function in healthy women. J Invest Dermatol. 2001; 117: 309-317.
57. Robles T. Stress, social support, and delayed skin barrier recovery. Psychosom Med. 2007; 69: 807-815.
58. Garg A Chren MM Sands LP, et al. Psychological stress perturbs epidermal permeability barrier homeostasis: implications for the pathogenesis of stress-associated skin disorders. Arch Dermatol. 2001; 137: 53-59.
59. Glaser R Kiecolt-Glaser JK Marucha PT MacCallum RC Laskowski BF Malarkey WB. Stress-related changes in proinflammatory cytokine production in wounds. Arch Gen Psychiatry. 1999; 56: 450-456.
60. Cobb JM Steptoe A. Psychosocial stress and susceptibility to upper respiratory tract illness in an adult population sample. Psychosom Med. 1996; 58: 404-412.
61. Kiecolt-Glaser JK Dura JR Speicher CE Trask OJ Glaser R. Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom Med. 1991; 53: 345-362.
62. Cohen S Tyrrell DA Smith AP. Psychological stress and susceptibility to the common cold. N Engl J Med. 1991; 325: 606-612.
63. Cohen S Frank E Doyle WJ Skoner DP Rabin BS Gwaltney JM. Types of stressors that increase susceptibility to the common cold in healthy adults. Health Psychol. 1998; 17: 214-223.
64. Cohen S Doyle WJ Skoner DP. Psychological stress, cytokine production, and severity of upper respiratory illness. Psychosom Med. 1999; 61: 175-180.
65. Doyle WJ Gentile DA Cohen S. Emotional style, nasal cytokines, and illness expression after experimental rhinovirus exposure. Brain Behav Immun. 2006; 20: 175-181.
66. Plotkin SA. Immunologic correlates of protection induced by vaccination. Pediatr Infect Dis. 2001; 20: 73-75.
67. Kiecolt-Glaser JK Glaser R Gravenstein S Malarkey WB Sheridan J. Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc Natl Acad Sci U S A. 1996; 93: 3043-3047.
68. Gallagher S Phillips AC Drayson MT Carroll D. Caregiving for children with developmental disabilities is associated with a poor antibody response to influenza vaccination. Psychosom Med. 2009; 71: 341-344.
69. Gallagher S Phillips AC Drayson MT Carroll D. Parental caregivers of children with developmental disabilities mount a poor antibody response to pneumococcal vaccination. Brain Behav Immun. 2009; 23: 338-346.
70. Vedhara K Cox NKM Wilcock GK, et al. Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. Lancet. 1999; 353: 627-631.
71. Glaser R Sheridan JF Malarkey WB MacCallum RC Kiecolt-Glaser JK. Chronic stress modulates the immune response to a pneumococcal pneumonia vaccine. Psychosom Med. 2000; 62: 804-807.
72. Glaser R Kiecolt-Glaser JK Bonneau RH Malarkey W Kennedy S Hughes J. Stress-induced modulation of the immune response to recombinant hepatitis B vaccine. Psychosom Med. 1992; 54: 22-29.
73. Jabaaij PM Grosheide PM Heijtink RA Duivenvoorden HJ Ballieux RE Vingerhoets AJJM. Influence of perceived psychological stress and distress on antibody response to low dose rDNA hepatitis B vaccine. J Psychosom Res. 1993; 37: 361-369.
74. Miller GE Cohen S Pressman S Barkin A Rabin BS Treanor JJ. Psychological stress and antibody response to influenza vaccination: when is the critical period for stress, and how does it get inside the body? Psychosom Med. 2004; 66: 215-223.
75. Burns VE Carroll D Drayson M Whitham M Ring C. Life events, perceived stress and antibody response to influenza vaccination in young, healthy adults. J Psychosom Res. 2003; 55: 569-572.
76. Burns VE Carroll D Ring C Harrison LK Drayson M. Stress, coping, and hepatitis B antibody status. Psychosom Med. 2002; 64: 287-293.
77. Burns VE Drayson M Ring C Carroll D. Perceived stress and psychological well-being are associated with antibody status after meningitis C conjugate vaccination. Psychosom Med. 2002; 64: 963-970.
78. Petry LJ Weems LB II Livingstone JN II. Relationship of stress, distress, and the immunologic response to a recombinant hepatitis B vaccine. J Fam Pract. 1991; 32: 481-486.
79. Vedhara K McDermott MP Evans TG, et al. Chronic stress in nonelderly caregivers: psychological, endocrine and immune implications. J Psychosom Res. 2002; 53: 1153-1161.
80. Jabaaij L van Hattum J Vingerhoets JJ Oostveen FG Duivenvoorden HJ Ballieux RE. Modulation of immune response to rDNA hepatitis B vaccination by psychological stress. J Psychosom Res. 1996; 41: 129-137.
81. Gray J Wreghitt TG Pavel P, et al. Epstein-Barr virus infection in heart and heart-lung transplant recipients: incidence and clinical impact. J Heart Lung Transplant. 1995; 14: 640-646.
82. Cruess S Antoni M Cruess D, et al. Reductions in herpes simplex virus type 2 antibody titers after cognitive behavioral stress management and relationships with neuroendocrine function, relaxation skills, and social support in HIV-positive men. Psychosom Med. 2000; 62: 828-837.
83. Koch S Larbi A Ozcelik D, et al. Cytomegalovirus infection: a driving force in human T cell immunosenescence. Ann N Y Acad Sci. 2007; 1114: 23-35.
84. Chida Y Mao X. Does psychosocial stress predict symptomatic herpes simplex virus recurrence? A meta-analytic investigation on prospective studies. Brain Behav Immun. 2009; 23: 917-925.
85. Wolf HJ Morgan AJ. Epstein-Barr virus vaccines. In: MedveczkyP, FriedmanH, BendinelliM, eds. Herpesviruses and Immunity. New York, NY: Plenum Press; 1998: 231-246.
86. McDade TW Stallings JF Angold A, et al. Epstein-Barr virus antibodies in whole blood spots: a minimally invasive method for assessing an aspect of cell-mediated immunity. Psychosom Med. 2000; 62: 560-568.
87. Glaser R Kiecolt-Glaser JK. Chronic stress modulates the virus-specific immune response to latent herpes simplex virus Type 1. Ann Behav Med. 1997; 19: 78-82.
88. McKinnon W Weisse CS Reynolds CP Bowles CA Baum A. Chronic stress, leukocyte subpopulations, and humoral response to latent viruses. Health Psychol. 1989; 8: 389-402.
89. Kiecolt-Glaser JK Fisher LD Ogrocki P Stout JC Speicher CE Glaser R. Marital quality, marital disruption, and immune function. Psychosom Med. 1987; 49: 31-34.
90. Kiecolt-Glaser JK Kennedy S Malkoff S Fisher L Speicher CE Glaser R. Marital discord and immunity in males. Psychosom Med. 1988; 50: 213-229.
91. Shirtcliff EA Coe CL Pollak SD. Early childhood stress is associated with elevated antibody levels to herpes simplex virus type 1. Proc Natl Acad Sci U S A. 2009; 106: 2963-2967.
92. Glaser R Kiecolt-Glaser JK Speicher CE Holliday JE. Stress, loneliness, and changes in herpesvirus latency. J Behav Med. 1985; 8: 249-260.
93. Glaser R Friedman SB Smyth J, et al. The differential impact of training stress and final examination stress on herpesvirus latency at the United States Military Academy at West Point. Brain Behav Immun. 1999; 13: 240-251.
94. Sarid O Anson O Yaari A Margalith M. Epstein-Barr virus specific salivary antibodies as related to stress caused by examinations. Journal of Medical Virology. 2001; 64: 149-156.
95. Sarid O Anson O Yaari A Margalith M. Human cytomegalovirus salivary antibodies as related to stress. Clin Lab. 2002; 48: 297-305.
96. Esterling BA Antoni MH Kumar M Schneiderman N. Defensiveness, trait anxiety, and Epstein-Barr viral capsid antigen antibody titers in healthy college students. Health Psychol. 1993; 12: 132-139.
97. Irwin M Costlow C Williams H, et al. Cellular immunity to varicella-zoster virus in patients with major depression. J Infect Dis. 1998; 178(suppl 1):S104-S108.
98. Vitaliano PP Scanlan JM Zhang J Savage MV Hirsch IB Siegler IC. A path model of chronic stress, the metabolic syndrome, and coronary heart disease. Psychosom Med. 2002; 64: 418-435.
99. Steptoe A Wardle J Pollard TM Canaan L Davies GJ. Stress, social support and health-related behavior: a study of smoking, alcohol consumption and physical exercise. J Psychosom Res. 1996; 41: 171-180.
100. Kiecolt-Glaser JK Glaser R. Methodological issues in behavioral immunology research with humans. Brain Behav Immun. 1988; 2: 67-78.
101. Kasapis C Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol. 2005; 45: 1563-1569.
102. Emery CF Kiecolt-Glaser JK Glaser R Malarkey WB Frid DJ. Exercise accelerates wound healing among healthy older adults: a preliminary investigation. J Gerontol A Biol Sci Med Sci. 2005; 60: 1432-1436.
103. Cohen S Line S Manuck SB Rabin BS Heise ER Kaplan JR. Chronic social stress, social status, and susceptibility to upper respiratory infections in nonhuman primates. Psychosom Med. 1997; 59: 213-221.
104. Hamer M Chida Y. Associations of very high C-reactive protein concentration with psychosocial and cardiovascular risk factors in an ageing population. Atherosclerosis. 2009; 206: 599-603.
105. Nazmi A Oliveira IO Victora CG. Correlates of C-reactive protein levels in young adults: a population-based cohort study of 3827 subjects in Brazil. Braz J Med Biol Res. 2008; 41: 357-367.
106. Hamer M Stamatakis E. The accumulative effects of modifiable risk factors on inflammation and haemostasis. Brain Behav Immun. 2008; 22: 1041-1043.
107. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997; 78: 606-617.
108. Silverstein P. Smoking and wound healing. Am J Med. 1992; 93(1A):22S-24S.
109. Vgontzas AN Zoumakis E Bixler EO, et al. Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. J Clin Endocrinol Metab. 2004; 89: 2119-2126.
110. Liukkonen T Rasanen P Ruokonen A, et al. C-reactive protein levels and sleep disturbances: observations based on the Northern Finland 1966 Birth Cohort study. Psychosom Med. 2007; 69: 756-761.
111. Nappo F Esposito K Cioffi M, et al. Postprandial endothelial activation in healthy subjects and in type 2 diabetic patients: role of fat and carbohydrate meals. J Am Coll Cardiol. 2002; 39: 1145-1150.
112. Ferrucci L Cherubini A Bandinelli S, et al. Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrinol Metab. 2006; 91: 439-446.
113. Russell L. The importance of patients- nutritional status in wound healing. Br J Nurs. 2001; 10(6 suppl):S42, S44-49.
114. Posthauer ME. The role of nutrition in wound care. Adv Skin Wound Care. 2006; 19: 43-52; quiz 53-54.
115. Doering LV Cross R Vredevoe D Martinez-Maza O Cowan MJ. Infection, depression, and immunity in women after coronary artery bypass: a pilot study of cognitive behavioral therapy. Altern Ther Health Med. 2007; 13: 18-21.
116. Kiecolt-Glaser JK Christian L Preston H, et al. Stress, inflammation, and yoga practice. Psychosom Med. 2010; 72: 113-121.
117. Vedhara K Bennett PD Clark S, et al. Enhancement of antibody responses to influenza vaccination in the elderly following a cognitive-behavioural stress management intervention. Psychother Psychosom. 2003; 72: 245-252.
118. Davidson RJ Kabat-Zinn J Schumacher J, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003; 65: 564-570.
119. Grant RW Mariani RA Vieira VJ, et al. Cardiovascular exercise intervention improves the primary antibody response to keyhole limpet hemocyanin (KLH) in previously sedentary older adults. Brain Behav Immun. 2008; 22: 923-932.
120. Fleshner M. Physical activity and stress resistance: sympathetic nervous system adaptations prevent stress-induced immunosuppression. Exerc Sport Sci Rev. 2005; 33: 120-126.
121. Woods JA Vieira VJ Keylock KT. Exercise, inflammation, and innate immunity. Immunol Allergy Clin North Am. 2009; 29: 381-393.
122. Kiecolt-Glaser JK Glaser R Williger D, et al. Psychosocial enhancement of immunocompetence in a geriatric population. Health Psychol. 1985; 4:25-24l.
123. Irwin MR Olmstead R Oxman MN. Augmenting immune responses to varicella zoster virus in older adults: a randomized, controlled trial of Tai Chi. J Am Geriatr Soc. 2007; 55: 511-517.
124. Weinman J Ebrecht M Scott S Walburn J Dyson M. Enhanced wound healing after emotional disclosure intervention. Br J Health Psychol. 2008; 13(pt 1):95-102.
125. Miller GE Cohen S. Psychological interventions and the immune system: a meta-analytic review and critique. Health Psychol. 2001; 20: 47-63.
126. Quan N Avitsur R Stark JL, et al. Social stress increases the susceptibility to endotoxic shock. J Neuroimmunol. 2001; 115: 36-45.