Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 3-4, Pages: 209-215
https://doi.org/10.2298/SARH1104209V
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The role of psychic factors in the pathogenesis of bronchial asthma
Vučević Danijela (Institut za patološku fiziologiju, Medicinski fakultet, Beograd)
Radosavljević Tatjana (Institut za patološku fiziologiju, Medicinski fakultet, Beograd)
Mladenović Dušan (Institut za patološku fiziologiju, Medicinski fakultet, Beograd)
Todorović Vera (Institut za medicinska istraživanja, Beograd)
Bronchial asthma is a chronic inflammatory disorder of the airways in which
many cells play a role, in particular mast cells, eosinophils, neutrophils,
T-lymphocytes and epithelial cells. In susceptible individuals this
inflammation causes recurrent episodes of wheezing, breathlessness, chest
tightness and cough, particularly at night and/or in the early morning. These
symptoms are usually associated with variable and extensive limitations of
airflow in the bronchi reversible spontaneously or by treatment. It has been
shown that restrain of the effectors of stress response participate in the
pathogenesis of bronchial asthma. Anger that is not expressed and
frustrations may activate the limbic stress pathway. Thus, the released
neurotransmitters followed by excitation thus causing psychogenic (mental or
emotional) stress. It is also known that emotional stress may be responsible
for the exacerbation of asthma. Namely, pronounced emotions cause
hyperventilation and hypocapnia inducing bronchospasm. Certain psychological
personality features are related to adaptive or inadequate body response to
numerous life events. Thus, until the beginning of the last century,
bronchial asthma was referred to as asthma nervosa, because clinicians
clearly observed the psychological profile of patients with predominant fear
of asphyxia and recurrent attacks of paroxysmal dyspnoea. Besides, increased
sensitivity, repression of aggressive feelings and expressive empathy have
been identified as the most frequent psychological characteristics of
asthmatic patients. However, scientists are still far from a full
understanding of bronchial asthma pathogenesis. The contribution of psychic
factors has become meaningful in the understanding of the development of
bronchial asthma. Having in mind that in the majority of patients asthma is a
lifelong condition, there is a hope that further investigations of bronchial
asthma psychogenesis will improve prevention and treatment of this disease.
Keywords: bronchial asthma, psychic factors, emotional stress
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