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psychoneuroimmunology was created decades ago to provide an opportunity to monitor one’s resilience, or
acknowledge the effects of psychological distress on health one’s ability to effectively respond to a stressor through
conditions, primarily through the mechanism of increased production of inflammatory markers.
inflammation. Whereas an inability to regulate emotional states and
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It is now well established that these stress states can labile mood have been associated with immune system
significantly alter not just wound healing but exacerbate suppression and virus shedding, 54,55 stress reduction and/
inflammatory immune states such as autoimmune disease, or management has been shown to reduce infection and
asthma, and allergy. They have also been implicated in the severity of infection. A systematic review of mind-
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the morbidity and mortality seen in diseases of immune body practices indicated that several practices such as
dysregulation, including cancer, HIV, and inflammatory yoga, meditation, mindfulness, tai chi, qigong, relaxation
bowel disease. More specifically, chronic stress is response, and breath regulation result in favorable gene
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associated with increased risk of viral infection like expression patterns that benefit immune regulation. At
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the common cold. Furthermore, stress affects both the molecular level, these practices downregulate NF-kB
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respiratory disease susceptibility and severity. and positively influence a set of molecular factors referred
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There are several proposed mechanisms by to as a conserved transcriptional response to adversity
which stress impacts immune function. In general, (CTRA), known to be associated with less resistance
earlier scientific discussion alluded to stress as to viral infections from herpes simplex viruses, HIV-1,
immunosuppressive. More recent thinking suggests that Epstein-Barr virus, and cytomegalovirus, to name a few.
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stress causes immune dysregulation or an ‘inappropriate’ In a small study with long-term qigong practitioners versus
response, such as shifting the Th1/Th2 cytokine balance controls who did not practice, it was shown that the qigong
toward the Th2 side, resulting in lowered defense against practitioners had 132 downregulated and 118 upregulated
infection and increasing hypersensitivity diseases. For genes (of the 12 000 genes measured in neutrophils, which
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example, even a brief mental stress condition in healthy are most important in fighting infection) that translated
adults can significantly reduce Treg cells, resulting in less into improved immune response and even delayed cell
self-tolerance and greater propensity toward autoimmune death. Several studies have found that gardening may
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conditions. 48 contribute to a sense of mental and physical well-being, 57-60
The process of stress is two-fold. First, the sympathetic as well as improving mood and reducing stress. Overall,
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nervous system stimulates the release of epinephrine and the collective literature on these mind-body and stress
norepinephrine. These compounds activate inflammation reducing practices would suggest that favorable responses
through the production of transcription factors that come with repetition and consistent practice. 50
bind to genes to increase the synthesis of inflammatory
cytokines. Second, the hypothalamus-pituitary-adrenal Sleep
(HPA) axis produces glucocorticoids like cortisol. Long-
term secretion of these compounds can lead to lower Overall Recommendations: Due to its restorative
proinflammatory cytokines (which are needed at the start and regulatory abilities, sleep has a major influence on
of infection), matrix metalloproteinase activity, bacterial immune function and inflammatory signals. Therefore,
peptide activation, hypoxia, and, eventually, higher risk getting good quality, sufficient quantity (seven to eight
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for infection, inflammatory-based diseases, accelerated hours) and adequate deep phasic bouts of sleep is of
aging, and even early mortality. utmost importance as part of immune maintenance, as
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Due to the chronically elevated baseline of stress that well as during times of recovery from illness. It is advised
most people have and fail to recognize because they have to have patients practice good sleep hygiene and maintain
become accustomed to higher levels over time (allostasis), consistent sleep hours by turning off screens, ensuring the
it is helpful to have assessments that gauge stress level. room is cool, quiet, and dark, and setting reminders to go
Simple pen-and-paper tests are available through the to bed on time.
IFM Toolkit or through the American Institute of Stress.
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There are also biofeedback and metric devices such One of the common recommendations from experts
as heart rate variability (HRV) technologies and even when it comes to improving immune function is to ensure
continuous HRV monitors to provide an indication of good quality (e.g., perceived quality as much as adequate
the overall balance of the autonomic nervous system. deep rapid eye movement [REM] sleep) and sufficient
HRV is a known marker for a variety of health outcomes, quantity of sleep due to the bidirectional relationship
including loss of vagal activation and heightened release of between sleep and immunity. 62,63 Sleep is inherently
inflammatory markers. In a study with 30 healthy women restorative and enables an internal resetting or regulatory
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subjected to an acute psychosocial stressor, reductions in aspect of one’s physiology. There is substantial evidence to
HRV measurements during the stressor were associated suggest that sleep disturbance such as insomnia or lack of
with elevated levels of TNF-alpha and IL-6 just one hour quality sleep, or even one night of reduced sleep, is
after being exposed to the stressor. Therefore, HRV may associated with disturbances in the innate immune system
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Minich—Nutrition & Lifestyle Practices for Strengthening Host Defense Integrative Medicine • Vol. 19, No. S1 • Epub Ahead of Print 57