Psychological Stress, Cytokine Production, and Severity of Upper Respiratory Illness

Cohen, Sheldon; Doyle, William J.; Skoner, David P.

doi:10.1097/00006842-199903000-00009

Cited by 356Stress Responses and CortisolTryptophan and brain disordersCancer, Stress, Anesthesia, and Immune Response

Psychological Stress, Cytokine Production, and Severity of Upper Respiratory Illness

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Cohen, Sheldon, Doyle, William J., Skoner, David P.·1999·Psychosomatic Medicine

DOI 10.1097/00006842-199903000-00009

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Abstract

OBJECTIVE: The purpose of this study is to assess the role of psychological stress in the expression of illness among infected subjects and to test the plausibility of local proinflammatory cytokine production as a pathway linking stress to illness. METHODS: After completing a measure of psychological stress, 55 subjects were experimentally infected with an influenza A virus. Subjects were monitored in quarantine daily for upper respiratory symptoms, mucus production, and nasal lavage levels of interleukin (IL)-6. RESULTS: Higher psychological stress assessed before the viral challenge was associated with greater symptom scores, greater mucus weights, and higher IL-6 lavage concentrations in response to infection. The IL-6 response was temporally related to the two markers of illness severity, and mediation analyses indicated that these data were consistent with IL-6 acting as a major pathway through which stress was associated with increased symptoms of illness. However, this pattern of data is also consistent with increases in IL-6 occurring in response to tissue damage associated with illness symptoms. CONCLUSIONS: Psychological stress predicts a greater expression of illness and an increased production of IL-6 in response to an upper respiratory infection.

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Chronic stress is associated with increased susceptibility to developing a common cold among persons experimentally exposed to an upper respiratory virus.
“A series of studies have shown that chronic stress is associated with increased susceptibility to developing a common cold among persons experimentally exposed to an upper respiratory virus (e.g., refs.[14][15][16][17].”
From Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk (2012) · cites this paper as [16]
There is evidence consistent with stress effects resulting in increased disease risk because of their association with exaggerated local release of inflammatory cytokines.
“there is evidence consistent with stress effects resulting in increased disease risk because of their association with exaggerated local (in the nose) release of inflammatory cytokines (16).”
From Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk (2012) · cites this paper as [16]
These data are consistent with those of other viral-challenge studies that found a positive association between proinflammatory cytokine levels and symptom expression.
“These data are consistent with those of other viral-challenge studies that found a positive association between proinflammatory cytokine levels and symptom expression (16).”
From Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk (2012) · cites this paper as [16]

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Psychological stress, cytokine production, and severity of upper respiratory illness. Psychosom Med 61
Cohen, S., Doyle, W. J., David, & Skoner, P. (1999)
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Authors: Cohen, S., Doyle, W. J., & Skoner, D. P.
Affiliations: Carnegie Mellon University (US)
University of Pittsburgh (US)
ORCID: Cohen, Sheldon
Doyle, William J.
Skoner, David P.
Venue: Psychosomatic Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1999
Volume: 61
Issue: 2
Pages: 175-180
ISSN: 0033-3174 (ISSN-L)
DOI: 10.1097/00006842-199903000-00009
OpenAlex: W2055500474
Semantic Scholar: 2d98f8254ce30bd4fed98401edd452b8dc503eb5
Cited by: 356
References: 30
Citations by year: 2026: 5 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 15 · 2020: 14 · 2019: 8 · 2018: 15 · 2017: 14 · 2016: 13 · 2015: 9 · 2014: 16 · 2013: 14 · 2012: 20
FWCI: 4.82
Type: journal article
Language: en
Open access: green
doi.org
Locations: Psychosomatic Medicine (publishedVersion)
PubMed (publishedVersion)
KiltHub Repository (submittedVersion)
KiltHub Repository
Funders: National Institutes of Health (5r01mh050429-08, 5r01dc002833-02)
National Institute of Mental Health (MH-50429, MH00721)
National Institute on Deafness and Other Communication Disorders (DC02833)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
Keywords: psychological stress, cytokine production, interleukin-6, upper respiratory tract infection, influenza A virus, disease severity, nasal irrigation, mucus production, inflammatory cytokines, tissue damage
MeSH terms: Haemophilus Infections, Humans, Quarantine, Respiratory Tract Infections, Severity of Illness Index, Stress, Psychological, Cohort Studies, Cytokines, Nasal Lavage Fluid

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Psychological Stress, Cytokine Production, and Severity of Upper Respiratory Illness

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