Stress-related changes in proinflammatory cytokine production in wounds

Background: Several recent studies have shown that stress markedly delays w ound healing. This study assessed the relationship between psychological st ress and the secretion of proinflammatory cytokines at an actual wound site , providing in vivo data on the development of local immune responses that are central in the early stages of wound repair. Methods: To study the dynamics of inflammation, skin blisters were induced on the forearm of 36 women (mean age, 57 years) by suction. After the blist er roofs were removed, a plastic template was taped to the arm, and wells w ere filled with 70% autologous serum in buffer. Specimens were aspirated fr om blister chamber wells 5 and 24 hours after wounding. Results: Women with higher perceived stress scores demonstrated significant ly lower levels of 2 key cytokines-interleukin 1 alpha and interleukin 8-at wound sites. In addition, subjects who had low levels of both cytokines af ter 24 hours reported more stress and negative affect, and they had higher levels of salivary cortisol than those who had high cytokine levels. Conclusion: Consistent with the evidence that stress delays wound healing, these data suggest a possible mechanism: psychological stress has measurabl e effects on proinflammatory cytokine production in the local wound environ ment.