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Wednesday July 28 1:41 PM ET
Stress slows wound-healing process
NEW YORK, Jul 28 (Reuters Health) -- Researchers believe they
have solved the mystery of why physical wounds heal best when
patients are feeling calm and stress-free.
Emotional upset appears to reduce the activity of compounds
important to the healing process, explain Dr. William Malarkey
and colleagues at Ohio State University in Columbus. The finding
may help explain why ``greater fear or distress before surgical
procedures is associated with poorer (results),'' they write in a
recent issue of the Archives of
General Psychiatry.
Malarkey's team asked 36 women to complete psychological
questionnaires focused on levels of personal stress and the
number and type of stressors in their lives.
Each woman then received 'wounds' -- a series of small blisters
on the forearm, induced in a relatively painless manner through
the use of a special suction device.
The investigators gathered fluid from these
blisters as they began to heal.
They found that fluid levels of two key 'healing compounds' --
interleukin-1 and interleukin-8 -- were ``significantly lower''
in samples gathered from women with the highest levels of stress
versus women with lower levels of stress.
The researchers also measured concentrations of the stress
hormone cortisol in the saliva of each subject. As expected,
women with the highest reported stress levels also had the
highest cortisol levels.
Numerous studies have suggested that blood concentrations of
interleukin-1 and -8 decline with increasing levels of cortisol.
According to the authors, interleukin-1 and -8 ``help protect
against infection and prepare injured tissue for repair.'' As
stress (and cortisol) levels rise, interleukin levels fall --
triggering a slowdown in the healing process.
The findings may have important implications for the treatment of
wounds and for patients undergoing surgery. Study co-author Dr.
Janice Kiecolt-Glaser notes that ``there is a lot in the medical
literature suggesting... that a patient should not be under
stress before surgery.'' The study authors comment that
stress-reducing therapies -- such as drugs or psychotherapy --
might enhance post-surgical recovery.
Kiecolt-Glaser believes the immune system may be extremely
sensitive to even subtle changes in emotional health. ``The women
in this experiment were really average in terms of the stress
they were experiencing,'' she points out. ``So this doesn't
require desperate, terrible stress levels to see effects on the
immune system.''
SOURCE: Archives of General Psychiatry 1999;56:450-456.
last update 24 Oct 1999
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