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1.
Fig. 1.

Fig. 1. From: Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection and Immunopathology.

The relationship among stress, immune function, and health outcomes. Acute stress experienced during vaccination, wounding, or infection may enhance immunoprotective responses. Acute stress experienced during immune activation in response to self/innocuous antigens or allergens may exacerbate proinflammatory and autoimmune disorders. Chronic stress-in duced increases in proinflammatory or type-2 cytokine-mediated immune responses may also exacerbate inflammatory and autoimmune disease. Chronic stress-induced suppression of immune responses may decrease the efficacy of vaccination and wound healing and decrease resistance to infection and cancer.

Firdaus S. Dhabhar. Neuroimmunomodulation. 2009 June;16(5):300-317.
2.
Fig. 2.

Fig. 2. From: Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection and Immunopathology.

The stress spectrum model. We have proposed a definition of stress as a constellation of events, consisting of a stimulus (stressor), that precipitates a reaction in the brain (stress perception & processing), that activates physiologic fight-or-flight systems in the body (physiological stress response) [9] . The duration of a physiological stress response is the critical determinant of its effects on immune function and health. The stressor itself may be acute (e.g. narrowly missing being hit by a car) or chronic (e.g. caring for a chronicallyill child, spouse or parent). Stress perception and processing by the brain are critical for determining the duration and magnitude of the physiological stress response stimulated by any given stressor. Acute or chronic stress is generally superimposed on a psychophysiological health maintenance steady state. The extent and efficiency with which an organism returns to its health maintenance steady state after stress depends on resilience, which we define as the capacity of psychological and interacting physiological systems to recover from challenging conditions. Factors such as coping mechanisms, sense of control, optimism, social support, early life experiences, learning, genetics, and sleep are important mediators of psychological resilience . Factors such as neuroendocrine reactivity, genetics, environment, nutrition, and sleep are important mediators of physiological resilience . Psychological resilience mechanisms are especially important in humans because they can limit the duration and magnitude of chronic stress responses. By the same token, psychogenic stressors can be particularly detrimental in human subjects because they may generate stress responses long after stressor exposure or even in the absence of physical stressors or salient threats. The physiological stress response is the ultimate effector arm of the stress spectrum. It may consist of acute or chronic physiological activation (neurotransmitters, hormones, and their molecular, cellular, organ-level and systemic effects) that results in psychophysiological states that have different effects on health. Acute stress generally results in activation of mechanisms that include enhancement of immune function, while chronic stress results in health-aversive conditions that result in dysregulation or suppression of immune function. The molecular mechanisms me diating conversion from positive to negative effects of stress on immune function and health are slowly beginning to emerge, and merit further investigation. Reprinted from Dhabhar and McEwen [17], with permission.

Firdaus S. Dhabhar. Neuroimmunomodulation. 2009 June;16(5):300-317.

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