Year: 2013
Type: article
Abstract: Chronic inflammatory diseases (autoimmunity, allergy and inflammatory bowel diseases) are increasing in prevalence in urban communities in high-income countries. One important factor is reduced exposure to immunoregulation-inducing macro- and microorganisms and microbiota that accompanied mammalian evolution (the hygiene hypothesis or 'Old Friends' mechanism). Reduced exposure to these organisms predisposes to poor regulation of inflammation. But inflammation is equally relevant to psychiatric disorders. Inflammatory mediators modulate brain development, cognition and mood, and accompany low socioeconomic status and some cases of depression in developed countries. The risk of all these conditions (chronic inflammatory and psychiatric) is increased in urban versus rural communities, and increased in immigrants, particularly if they move from a low- to a high-income country during infancy, and often the prevalence increases further in second generation immigrants, suggesting that critical exposures modulating disease risk occur during pregnancy and infancy. Diminished exposure to immunoregulation-inducing Old Friends in the perinatal period may enhance the consequences of psychosocial stressors, which induce increased levels of inflammatory mediators, modulate the microbiota and increase the risk for developing all known psychiatric conditions. In later life, the detrimental effects of psychosocial stressors may be exaggerated when the stress occurs against a background of reduced immunoregulation, so that more inflammation (and therefore more psychiatric symptoms) result from any given level of psychosocial stress. This interaction between immunoregulatory deficits and psychosocial stressors may lead to reduced stress resilience in modern urban communities. This concept suggests novel interpretations of recent epidemiology, and novel approaches to the increasing burden of psychiatric disease.
DOI: 10.1093/emph/eot004
Language: English
Subfield: Biological Psychiatry
Field: Neuroscience
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $3,629
Funders: National Science Foundation, Brain and Behavior Research Foundation, Brain Research Foundation, Eli Lilly and Company, Pfizer, National Alliance for Research on Schizophrenia and Depression, National Institutes of Health, Johnson and Johnson, National Institute of Mental Health, National Institute on Drug Abuse, National Center for Complementary and Alternative Medicine, Division of Integrative Organismal Systems, National Center for Complementary and Integrative Health
Awards: Mechanisms of Meditation, Inflammation, Stress, and Social Behavior: Using Ecological Assessments and Model, Neural Sensitivity to Stress During Drug Withdrawal, Glucocorticoid Negative Feedback: Intrinsic and Extrinsic Mechanisms, Mechanisms Underlying Stress-Induced Activation of Serotonergic Systems, Role of Serotonin and CRF Pathways in Anxiety and HPA Regulations
OpenAlex ID: W2107688012