Quantitative aspects of stress-induced immunomodulation.

Recent studies indicate that neuroendocrine-immune interactions can cause sufficient immunosuppression to adversely affect human health, but quantitative relationships between stress-related hormones or neurotransmitters and immune function have not been well documented. The mechanisms of stress-induced immunomodulation cannot be fully understood solely by identifying the hormones, neurotransmitters, and cytokines involved. Quantitative relationships and interactions must also be understood. Depending on the nature and duration of the stressor and the immunological parameter under investigation, stress responses can enhance, have no effect, or suppress immunological parameters. These quantitative relationships have implications with regard to safety assessment of drugs and chemicals and with regard to potential development of pharmacological interventions to ameliorate some of the immunosuppressive effects of stress. This review describes selected studies that relate the quantity and duration of exposure to stress-related neuroendocrine mediators to modulation of the immune system. These studies provide a useful starting point, but they also illustrate how much work remains to achieve a fully integrated qualitative and quantitative understanding of stress-induced immunomodulation.