Environmental and occupational stress and autoimmunity.

The immune system and the neuroendocrine system machinery modulate each other, including life events-induced stresses and interpersonal conflicts, promoting the synthesis of proinflammatory cytokines, overproduction of which influence behaviour. In addition, the balance of systemic and local pro-inflammatory cytokines to systemic and local anti-inflammatory cytokines, is impaired to such an extent that, in genetically-predisposed individuals, this aberrancy may lead to autoimmune diseases. Occupational stress likely influences their onset. For example, subclinical autoimmune hypothyroidism has been identified in numerous shift-workers of an Italian hospital. Such a threat impacts the policy of health surveillance of the workers and requires dedication of further studies to the relationship between occupational stress and autoimmunity.