The DOI matches its Crossref record; 92 of the 92 references it cites were found in a registry or an index.
Chronic psychological stress and the regulation of pro-inflammatory cytokines: A glucocorticoid-resistance model
Abstract
This study examined whether chronic stress impairs the immune system's capacity to respond to hormonal signals that terminate inflammation.Fifty healthy adults were studied; half were parents of cancer patients, and half were parents of healthy children.Parents of cancer patients reported more psychological distress than parents of healthy children.They also had flatter diurnal slopes of cortisol secretion, primarily because of reduced output during the morning hours.There was also evidence that chronic stress impaired the immune system's response to anti-inflammatory signals: The capacity of a synthetic glucocorticoid hormone to suppress in vitro production of the pro-inflammatory cytokine interleukin-6 was diminished among parents of cancer patients.Findings suggest a novel pathway by which chronic stress might alter the course of inflammatory disease.
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In the citing paper
“Additionally, these dysfunctions increase the vulnerability to inflammatory or autoimmune diseases due to inadequate glucocorticoid-mediated immune regulation [21].”
From Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation (2025) · cites this paper as [21]
In the citing paper
“Over time, the initial state of hypercortisolism may evolve into other stages: the extreme and persistent demand on the HPA axis present during chronic stress conditions may also lead to adrenal gland adaptive changes [11,21].”
From Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation (2025) · cites this paper as [21]
In the citing paper
“The results provided preliminary support: among parents of cancer patients, dexamethasone’s ability to suppress IL-6 production was significantly reduced compared to parents of medically healthy children [21].”
From Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation (2025) · cites this paper as [21]
In the citing paper
“prolonged hyperactivity of the hypothalamus–pituitary–adrenal-axis could result in blunted anti-inflammatory responses to glucocorticoids resulting in increased inflammation.35, 36”
From Association of depressive disorders, depression characteristics and antidepressant medication with inflammation (2012) · cites this paper as [35]
In the citing paper
“Evidence for GCR in response to chronic stress has been found in parents of children with cancer (10), spouses of brain-cancer patients (11) and in persons reporting high levels of loneliness (5).”
From Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk (2012) · cites this paper as [10]
In the citing paper
“Support for this account has accrued in studies of humans and animals (14,17,19,20), where chronic stressors have been shown to diminish the capacity of glucocorticoids to suppress endotoxin-stimulated cytokine production.”
From A Functional Genomic Fingerprint of Chronic Stress in Humans: Blunted Glucocorticoid and Increased NF-κB Signaling (2008) · cites this paper as [14]
In the citing paper
“Initial support for this proposition has emerged in a series of studies where chronic stressors have been shown to diminish the capacity of glucocorticoids to suppress ex vivo inflammatory cytokine production (14,17,19,20).”
From A Functional Genomic Fingerprint of Chronic Stress in Humans: Blunted Glucocorticoid and Increased NF-κB Signaling (2008) · cites this paper as [14]
In the citing paper
“Similarly, prolonged or chronic stress in humans can lead to GR insensitivity, meaning that GRs in immune cells are not able to “hear” the inhibitory signals of glucocorticoids (Cohen et al., 2012; Miller et al., 2002).”
From Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease (2017) · cites this paper as Miller et al., 2002
In the citing paper
“For instance, continued exposure to high cortisol may eventually lead to glucocorticoid insensitivity (Cohen et al., 2012; Miller et al., 2002)”
From Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease (2017) · cites this paper as Miller et al., 2002
In the citing paper
“Caregiving for a child with cancer has been associated with diminished inhibition of LPS-stimulated IL-6 production following glucocorticoid administration”
From Close relationships, inflammation, and health (2010) · cites this paper as Miller et al., 2002
In the citing paper
“Diminished sensitivity to the anti-inflammatory properties of glucocorticoids provides one potential mechanism through which chronic interpersonal stressors such as caregiving promote chronic low grade inflammation.”
From Close relationships, inflammation, and health (2010) · cites this paper as Miller et al., 2002
In the citing paper
“occurs when immune cells become less sensitive to the anti-inflammatory effects of glucocorticoids as a consequence of persistent or repeated activation of the HPA axis”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Miller et al, 2002
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“In contrast, higher slope values, as they approach zero, reflect flat diurnal rhythms and are viewed as evidence of HPA dysregulation (McEwen, 1998; Stone et al., 2001 In a very small minority of cases (3 parents of cancer patients and 1 parent of a medically healthy child), we observed a daily…”
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Cited by
Sorted by citations
Psychological stress and the human immune system: a meta-analytic study of 30 Years of inquiry
Segerstrom, S. C., & Miller, G. E. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.4.601 · Cited by 3,334
Self-citationRoux, A. V. D., & Mair, C. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.05333.x · Cited by 2,922
Uchino, B. N. (2006) · Journal of Behavioral Medicine · doi:10.1007/s10865-006-9056-5 · Cited by 2,507
Miller, G. E., Chen, E., & Zhou, E. S. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.1.25 · Cited by 2,467
Self-citationStress and Health: Psychological, Behavioral, and Biological Determinants
Schneiderman, N., Ironson, G., & Siegel, S. D. (2005) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.1.102803.144141 · Cited by 2,252
Metadata
- Authors
- Miller, G. E., Cohen, S., & Ritchey, A. K.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Miller, Gregory E.
- Venue
- Health Psychology
- Published
- 2002
- Volume
- 21
- Issue
- 6
- Pages
- 531-541
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W4242918118
- Cited by
- 769
- References
- 89
- Citations by year
- 2026: 38 · 2025: 24 · 2024: 35 · 2023: 26 · 2022: 38 · 2021: 43 · 2020: 35 · 2019: 45 · 2018: 43 · 2017: 25 · 2016: 42 · 2015: 40 · 2014: 34 · 2013: 32 · 2012: 50
- FWCI
- 4.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- Funders
- American Heart Association
- National Heart, Lung, and Blood Institute (HL65111, HL65112)
- National Institute of Mental Health (MH 50430)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Stress, Anesthesia, and Immune Response
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- chronic psychological stress, inflammatory cytokines, interleukin-6, glucocorticoid resistance, diurnal cortisol rhythm, parents of cancer patients, psychological distress, inflammation, immune regulation
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