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Analysis found stress can worsen asthma symptoms

A meta-analysis of articles published from 1998 to 2011 found that stress may exacerbate the symptoms of asthma.

The study analyzed 43 articles — 90% written about asthma — to determine if mast cells are activated by corticotropin-releasing hormone (CRH) under conditions of stress in the lungs. Researchers hypothesized that these CRH-triggered mast cells then worsen asthma symptoms.

The investigators noted that, although asthma incidence has increased greatly in the past 20 years, studies have not definitively identified any pathogenetic triggers for this. They searched the PubMed database using the keywords anxiety, asthma, exacerbation, inflammation, mast cells, socioeconomic status, stress, violence, and worsening to choose the specific articles assessed for the study.

The study selected four primary stress types — quality of life, patient psychological status, parent psychological status, and violence or terrorism. Each was broken down into two or more subcategories, with titles such as “living in shelters” (under quality of life), “panic attacks” (under patient psychological status), and “war-related experience” (under violence or terrorism).

The association between mast cells and their effect on asthma previously has been established, but the researchers did not find conclusive evidence that mast cells are activated in the lungs by CRH during periods of stress. They said more studies are needed to analyze the levels of CRH in a patient’s lungs and to investigate the efficacy of mast-cell mediators.