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Biochemical Pharmacology
journal homepage: www.elsevier.com/locate/biochempharm
Commentary
A R T I C L E I N F O
A B S T R A C T
Article history:
Received 23 June 2014
Accepted 17 July 2014
Available online 12 August 2014
Emotions and feelings are the bricks of our social life and yet we often forget that they have a signicant
impact on our physical wellbeing. Indeed, a growing number of studies have shown that both an
imbalanced or improved emotional state can signicantly inuence the way our immune system
responds. In this commentary, we have summarized the most recent studies on the effects of different
types of emotional states on the immune system and we have also explored the effects of mood
modulator approaches on the immune response. We hope this commentary will prompt scientists and
clinicians to think about the therapeutic value and potential of emotions and feelings in immune-related
diseases. At the same time, we think that this commentary will shed some light on the scientic truth
behind the very famous expression Its in my blood when we talk about feelings and personality.
2014 Elsevier Inc. All rights reserved.
Keywords:
Emotions
Immunomodulation
Inammation
Autoimmunity
Mental health
1. Introduction
The progress we have made since the birth of our ancestor
homo sapiens has given the word wellbeing a completely new
meaning [1,2]. Looking back to the time of the dinosaurs, our main
preoccupation was to ght with other species and survive at their
expense. Nowadays, physical survival is not an impending issue
anymore (unfortunately, not the case in all the countries) while
emotional and psychological integrity has taken the center stage.
What is even more important, the effects of emotional distress
seem to have spilled over from the realm of our social interaction to
the physicality of our living.
How do emotions inuence our physical wellbeing? Stressors
and dangers of mental health often populate the front pages of the
daily news and include a wide range of settings and situations
including working long hours, social pressure, relationship
problems or constant reminders of what one should be eating
or doing to be well. Interestingly, stressors and dangers are also
buzzwords in the immunology eld and now more than ever on the
front pages of scientic news [36]. What seems to be just a mere
coincidence might instead hide an interesting link. Indeed, we have
now come to realize that often stressors for the immune system are
* Corresponding author. Tel.: +44 207 882 6081; fax: +44 207 882 6076.
E-mail address: F.Dacquisto@qmul.ac.uk (F. DAcquisto).
http://dx.doi.org/10.1016/j.bcp.2014.07.016
0006-2952/ 2014 Elsevier Inc. All rights reserved.
288
Stressful task
EMOTIONS
Opmism
Pessimism
Traumac stress
Aachment
Anxiety
Corsol
CD4+ and CD8+ T cells
Fig. 1. Emotional control of the immune response. The scheme summarizes a few examples of different types of emotions and their impact on the immune response.
289
290
Yoga
10 days
Music therapy
Meditaon
Acve
(singing)
10 days
Passive
(listening)
Corsol levels
IL-10
Corcosterone levels
Risk of cardiovascular
events in obese subjects
Producon of
CD4+CD25+Foxp3+ regulatory
cells in allogeneic cardiac
allogras
Fig. 2. Modulation of the immune response by mind-body therapies. The gure shows a few selected examples of psychological therapies with immuno-modulatory effects and
their relative mechanisms of action.
response signicantly affects multiple pathways through mitochondrial signaling that may promote cellular and systemic
adaptive plasticity responses [57,58]. More specically, the
increased production of energy in the form of ATP, through the
ATP synthase electron transport complex, results in an enhanced
mitochondrial reserve. This saved energy is then used to meet
the metabolic demand that emerges in many stress-related
diseases. This is a rather interesting idea since it links with what
we have discussed before regarding the plasticity of the neuronal
and immune system at the early stages of life. It is indeed well
known that mitochondrial respiratory malfunction is associated
with aging-related complex diseases [59,60]. It is thus possible to
hypothesize that these therapies might indeed work better when
administered during the rst half of life as a preventive measure for
the development of autoimmune and chronic inammatory
diseases that classically are up in adult age.
5. Conclusions and perspectives
The studies we have summarized so far clearly support the idea
that our emotional state changes the way our immune system
functions. Most importantly, we have provided evidence that
therapies targeting mood and emotions can have a measurable
(and hence translational) impact on the immune response. Thus, in
our opinion, the most obvious next step should be to bring the
best of both and test the effect of classical drug-based therapies
in conjunction with alternative ones to achieve better and more
personalized therapeutic programs. We think that this would be an
important stepping-stone towards the most longed for personalized medicinethis being personalized not on the basis of your
genomic imprinting but rather on what makes you feel better.
The success of this proposed approach seems to be far from
becoming reality because of skepticisms and territorial attitudes
in clinical and experimental research. Reading one of the latest
Nature news feature articles, Immunology: the pursuit of happiness [61], it is clear that there is a split in the scientic community
between those that are open to the idea that the context (social,
emotional, physical, etc.) has a great deal of inuence on our
immune response and those that will not be satised and
convinced by this research until a proper mechanism of action
for these effects has been identied. And yet, we seem to forget
that most current medical challenges are not around the
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