Wound Healing

Perhaps the strongest, albeit indirect, evidence for clinical health consequences of stress-induced immu-nosuppression derives from studies examining differences in stressed and nonstressed individuals in length of time to heal from standardized wounds. In these studies, women who were caring for relatives with dementia and age- and income-matched controls received a standard 3.5-mm punch biopsy wound resulting in identical tissue damage to all participants. Results revealed that the chronically stressed care-

givers took significantly longer to heal than controls. In addition, stimulated peripheral leukocytes from caregivers produced significantly less IL-1 b (a cytokine involved in the initial stages of wound healing) than did leukocytes from controls. Therefore, chronic stress appears to slow wound healing and affect a cytokine that serves multiple functions in early stage wound repair. Subsequent research examined a less chronically stressed sample and found that it took 3 days longer on average for dental students to heal from an oral biopsy wound during examinations than during summer vacation. In addition, IL-1b production was significantly lower during the exam period. These results demonstrate that relatively mild, everyday stressors can also have effects on immune activity and healing. However, neither study examined the relationship between IL-1b levels and healing, making conclusions concerning the role of stress-induced immunosuppression in slowed healing difficult.

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