Chronic stress and asthma in adolescents

Abstract

A literature search was conducted for human studies on stressors or stress and asthma between 2000 and 2020. Studies that were published in English, contained a full text, and included adolescents were considered for inclusion in this review. Results: Compared with the available body of evidence in children and adults, relatively few studies have been published in adolescents. Current evidence suggests that exposure to stressors (at the individual, family, and community levels) or stress (acute and chronic) is associated with asthma and worse asthma outcomes, but such evidence must be cautiously interpreted owing to limitations in the design or the analytical approach of the published studies. Conclusion: Future large studies with a prospective design should determine whether and how stressors or stress causes or worsens asthma in adolescents. At present, clinicians should assess exposure to stressors (eg, violence or abuse) and screen for anxiety and depressive disorders when caring for adolescents with asthma in addition to providing referrals to social workers or mental health professionals when appropriate. Public health policies are needed to reduce psychosocial stressors, such as gun violence and racism, in adolescents.

Exposure to violence, chronic stress, nasal DNA methylation, and atopic asthma in children

“…The United States has the highest rate of firearm‐related deaths of all industrialized countries 1 . As recently reviewed, exposure to violence (ETV, including gun violence) affects stress responses, and both ETV and chronic stress may influence asthma pathogenesis 2,3 . Prolonged ETV can lead to chronic and frequent activation of the body's stress responses, disrupting neuroendocrine, autonomic nervous system, and immune responses.…”

“…Prolonged ETV can lead to chronic and frequent activation of the body's stress responses, disrupting neuroendocrine, autonomic nervous system, and immune responses. Chronic stress, both related and unrelated to ETV, may cause or worsen asthma by altering circulating levels of and response to catecholamines and glucocorticoids, as well as by affecting immune responses, leading to airway inflammation and airflow obstruction 2–4 . ETV and chronic stress may also cause or worsen asthma through indirect effects mediated by other risk factors 2 .…”

“…Based on prior findings, 2,3,8,9 we hypothesized that both ETV and chronic stress would increase asthma risk through DNA methylation of genes regulating autonomic, neuroendocrine, and immune responses in airway epithelium, a tissue relevant to asthma. To examine this hypothesis, we first tested for association between ETV or chronic stress measures and genome‐wide DNA methylation in nasal epithelium, as DNA methylation in nasal (airway) epithelium is well correlated with that in bronchial (airway) epithelium, 10–13 and epigenetic regulation of airway epithelial gene expression has been implicated in asthma pathogenesis 14 .…”

The Association between Vigorous Physical Activity and Stress in Adolescents with Asthma

“…A stress management model is needed for asthma management [ 10 ]. Asthma that is associated with mental health problems leads to more frequent healthcare utilization by these patients, increasing the healthcare requirement for this condition [ 11 ].…”

Psychological stress, immune dysfunction, and allergy

“…Excessive psychological stress can affect people of all ages. Landro-Guiterrez and Celedon 5 discuss the special circumstances of chronic stress in adolescents with allergy and asthma. Even with the limited body of literature for this age population, they reveal the adverse relationships between excessive stress and asthma (both incidence and activity) in teens.…”