How stress and anxiety can alter immediate and late phase skin test responses in allergic rhinitis

Abstract

Summary Allergic rhinitis (AR) is the fifth most common chronic disease, and the association between allergic disorders and anxiety is well-documented. To investigate how anxiety and stressors modulate skin prick test (SPT) responses and associated inflammatory responses, 28 men and women with AR were selected by clinical history and skin test responses. The participants were admitted twice to a hospital research unit for 4 hours in a crossover trial. Changes in SPT wheals were assessed before and after a standardized laboratory speech stressor, as well as again the following morning; skin responses assessed twice during a lab session without a stressor and again the following morning served as the contrast condition. Anxiety heightened the magnitude of allergen-induced wheals following the stressor. As anxiety increased, SPT wheal diameters increased after the stressor, compared to a slight decrease following the control task. Anxiety also substantially enhanced the effects of stress on late phase responses: even skin tests performed the day after the stressor reflected the continuing impact of the speech stressor among the more anxious participants. Greater anxiety was associated with more IL-6 production by Con A-stimulated leukocytes following the stressor compared to the control visit. The data suggest that stress and anxiety can enhance and prolong AR symptoms.

Evaluation of the Psychological Status in Seasonal Allergic Rhinitis Patients

“…Tonelli et al [11] studied the pharmacogenetics of this relationship, using molecular biology, psychoneuroimmunology and pharmacogenetics, and suggested that the allergy could directly influence the biochemical response of the central nervous system, which might lead to psychological disorders. Psychological disorders in allergic individuals, such as anxiety and depression, have been proposed to affect AR in turn, not only resulting in an aggravation of allergic symptoms but also impacting the results of laboratory examinations [12,13] . Thus, a full understanding of the patients' psychological status is eminently important.…”

Psychiatric analysis of treatment-resistant allergic rhinitis and evaluation of the effects of antidepressant use

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Relationship Between Allergic Rhinitis and Mental Health in the General Korean Adult Population

“…Psychological disorders in allergic patients have been proposed to affect AR, consequently enhancing and prolonging AR symptoms. 24,25 Postolache et al 14 hypothesized that allergens could trigger suicide in patients who have triple vulnerability to suicide, mood disorders, and allergic sensitization probably via the presence of cytokines. In a physiological aspect, the role of nasal obstruction and its impairing effects on the quality of sleep subsequently result in negative effects on psychiatric symptoms.…”