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JACI Highlights - May 2006
Chen et al – Socioeconomic status and inflammatory processes in childhood asthma: the role of psychological stress
Children from lower socioeconomic status (SES) backgrounds are at greater risk for a variety of poor health outcomes, including asthma. A variety of explanations have been proposed for the SES gradient in asthma morbidity. These include greater exposure to allergens, reduced access to care, and gene-by-environment interactions. Recently, explanations have begun to focus on the role of psychosocial factors. Stress, in particular, has been suggested to be an important contributor to asthma. In the May 2006 issue of the Journal of Allergy and Clinical Immunology, Chen et al tested whether SES was associated with psychological stress and inflammatory markers associated with asthma. They found that lower SES was associated with higher levels of chronic stress and greater perceptions of threat in a sample of children with asthma. In addition, higher levels of chronic stress and greater perceptions of threat were associated with heightened production of immune signaling molecules that have been linked to asthma. These findings provide some of the first empirical evidence connecting factors across epidemiological, psychological, and biological levels of analysis. The findings suggest that growing up in a lower SES family is associated with both experiencing greater chronic life stress and being more likely to perceive a given situation as threatening. In turn, these stress experiences are associated with dysregulated immune processes that may have implications for exacerbations of clinical symptoms in children with asthma and high stress. These associations among SES, psychological stress, and immune pathways suggest that the experience of stress, particularly among lower SES children, has implications for childhood asthma morbidity.
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