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Ronald Glaser, PhD; Janice K. Kiecolt-Glaser, PhD; Phillip T. Marucha, DMD, PhD; Robert C. MacCallum, PhD; Bryon F. Laskowski, BS; William B. Malarkey, MD

Arch Gen Psychiatry. 1999;56:450-456.

Background  Several recent studies have shown that stress markedly delays wound healing. This study assessed the relationship between psychological stress and the secretion of proinflammatory cytokines at an actual wound site, providing in vivo data on the development of local immune responses that are central in the early stages of wound repair.

Methods  To study the dynamics of inflammation, skin blisters were induced on the forearm of 36 women (mean age, 57 years) by suction. After the blister roofs were removed, a plastic template was taped to the arm, and wells were filled with 70% autologous serum in buffer. Specimens were aspirated from blister chamber wells 5 and 24 hours after wounding.

Results  Women with higher perceived stress scores demonstrated significantly lower levels of 2 key cytokines—interleukin 1 and interleukin 8—at wound sites. In addition, subjects who had low levels of both cytokines after 24 hours reported more stress and negative affect, and they had higher levels of salivary cortisol than those who had high cytokine levels.

Conclusion  Consistent with the evidence that stress delays wound healing, these data suggest a possible mechanism: psychological stress has measurable effects on proinflammatory cytokine production in the local wound environment.

From the Departments of Medical Microbiology and Immunology (Drs Glaser, Marucha, and Malarkey and Mr Laskowski), Psychiatry (Dr Kiecolt-Glaser), Periodontology (Dr Marucha), Psychology (Dr MacCallum), and Internal Medicine (Dr Malarkey), The Institute for Behavioral Medicine Research (Drs Glaser, Kiecolt-Glaser, Marucha, MacCallum, and Malarkey), and the Comprehensive Cancer Center (Drs Glaser, Kiecolt-Glaser, Marucha, and Malarkey), The Ohio State University, Columbus.

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