Stress, Aging, andWound Healing
Stress appears to promote senescence of immune cells in a manner comparable to chronological aging. This chapter will expand on this by reviewing the human literature on stress and wound healing, and by highlighting the phenomenological and mechanistic similarities of this literature with the findings from aging research. The balance of evidence indicates that it is not aging per se, but aging in the presence of other risk factors that creates a wound healing disparity between younger and older adults. In this context, stress and depression appear to be significant risk factors for impaired healing in aging adults and, by affecting shared biological pathways, may synergistically interact with other prevalent risk factors, such as co-morbidities (e.g., diabetes), pain, malnutrition, physical inactivity, and poor self-care to impair wound healing.
KeywordsDepression Pain Health behavior Inflammation Scarring Menopause HPA axis Sympathetic nervous system Cortisol Norepinephrine.
- Ashcroft GS, Mills SJ, Lei K, Gibbons L, Jeong MJ, Taniguchi M et al (2003b) Estrogen modulates cutaneous wound healing by downregulating macrophage migration inhibitory factor. J Clin Invest 111:1309–1318Google Scholar
- Berczi I (1986) The influence of pituitary-adrenal axis on the immune system. In: Berczi I (ed) Pituitary function and immunity. CRC Press, Boca Raton, p 49Google Scholar
- DeRijk R, Michelson D, Karp B, Petrides J, Galliven E, Deuster P et al (1997) Exercise and circadian rhythm-induced variations in plasma cortisol differentially regulate interleukin-1 beta (IL-1 beta), IL-6, and tumor necrosis factor-alpha (TNF alpha) production in humans: high sensitivity of TNF alpha and resistance of IL-6. J Clin Endocrinol Metab 82:2182–2191PubMedCrossRefGoogle Scholar
- Engeland CG, Graham JE (2011) Psychoneuroimmunological aspects of wound healing and the role of pain. In: Upton D (ed) Psychological impact of pain in patients with wounds. Wounds UK Limited, London, pp 87–114Google Scholar
- Engeland CG, Marucha PT (2009) Wound healing and stress. In: Granstein RD, Luger TA (eds) Neuroimmunology of the skin: basic science to clinical relevance. Springer, Berlin, pp 233–247Google Scholar
- Hawkley LC, Bosch JA, Engeland CG, Cacioppo JT, Marucha PT (2007) Loneliness, dysphoria, stress, and immunity: a role for cytokines. In: Plotnikoff NP, Faith RE, Murgo AJ (eds) Cytokines: stress and immunity. CRC Press, Boca RatonGoogle Scholar
- Koopman CF (1995) Cutaneous wound healing, an overview. Otolaryngol Clin N Am 28:835–845Google Scholar
- Shankar A, McMunn A, Banks J, Steptoe A (2011) Loneliness, social isolation, and behavioral and biological health indicators in older adults. Health PsycholGoogle Scholar
- US Census Bureau (2004) Interim projections consistent with Census 2000. US Census Bureau, Washington, DCGoogle Scholar
- US Census Bureau (2009) State and county quick facts. US Census Bureau, Washington, DCGoogle Scholar
- Walburn J, Vedhara K, Hankins M, Rixon L, Weinman J (2009) Psychological stress and wound healing in humans: a systematic review and meta-analysis. J Psychosom Res 67:253–271Google Scholar