ABSTRACT
OBJECTIVE: Tension affects the functions in physiology, psychology and immunity. The immune reaction induced may affect other physiological functions and psychological feelings, resulting in reaction in physiology and/or behavior. The present state in the studies on organic molecular changes during stress at home and broad was synthesized so as to explore the change of immune function in psychological stress and its significance.DATA SOURCE: Relevant literatures on early rehabilitation of cerebral apoplexy were looked up in Medline from January 1997 to December 2003.The retrieved words: "stress, immune, depression, neuropsychiatric disorder", limited in English.STUDY SELECTION: By first examination of data, the literatures with stress group and the control involved were selected, and then researches on randomized clinical experimental study and laboratory experiment were included. Excluded criteria: the researches without randomized clinical experiment, repeated research and synthetic literature were excluded.DATA EXTRACTION: Totally, 43 papers on randomized-controlled clinical experimental research and laboratory experiment on organic molecular changes in stress were collected and 25 papers of them were employed. Of 18 excluded papers, 7 papers referred to therepeated research and 11 papers are Meta analyzing study. Totally 25 experiments have evaluated the change of immunocytes, change of cytokines and their receptors and neuroendocrinal factors in change of immune function during psychological stress.DATA SYNTHESIS:DATA SYNTHESIS: The molecule mechanism of stress on physiological,psychological and immunological functions is based on feedback regulation of multiple direct information net, neuroendocrinal cell, immunoctye and immunological medium. ① Change of immunocyte: Stress is associated with inhibition of neurokinin cell activity, reduced proliferation and inhibition of lymphocyte to mitogen and to IL-2 and IFN-γ respectively. Senile depression is related with the increased subgroup of neurokinin-T cell. Levels of monocyte reactive oxygen species are remarkably correlative with decreased natural killer cell activity in patient with depressive disorder. ② Change of cytokines and their receptors: Psychological stress and neuropsychiatric disorder threaten the safety of immune function, the mechanism of which is probably related to the activity of cytokines in immune system and other regulating factors of inflammation. ③ Neuroendocrinal factors in change of immune function: Cytokine transports actively to central nerve system and is also released from neurogial cell to activate neurogial cell in central nerve system to produce other cytokines. The chain between stress and disease is as follows: tension-stress response-alternation of neuroendocrine-imbalance of immune response-incidence of disease.CONCLUSION: The mechanism of the effects of psychological stress on immune function is very complicated, involving the coordination of central neuroendocrinal system and immune system. Only the relationship between the alternations of neuroendocrinology and immunology in psychology with health and disease is searched more extensively, does the understanding be enhanced on the interconnection of stress, depression, health and disease and the defensive capacity intensified.