Stress, the neuroendocrine system and mast cells: current understanding of their role in psoriasis.

Department of Dermatology, Kuopio University Hospital and University of Eastern Finland, 70210 Kuopio, Finland. ilkka.harvima@kuh.fi

Expert review of clinical immunology 2012 Mar

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Psychological stress can activate the hypothalamic-pituitary-adrenal axis and sensory nerves in the brain and skin, resulting in the release of neuroendocrine and neural mediators such as, corticotropin-releasing hormone, neuropeptides, neurotrophins and α-melanocyte-stimulating hormone. These factors can activate mast cells to release proinflammatory mediators and some of them, for example, histamine, tryptase and nerve growth factor, can stimulate sensory C-fibers. Since corticotropin-releasing hormone, sensory nerves and mast cell numbers are increased in the psoriatic lesion, a feedforward loop can exist potentiating the inflammation. Studies in rats and mice have shown that mast cells are activated during standardized stress through corticotropin-releasing hormone and sensory nerves. Therefore, the role of stress, the neuroendocrine system and mast cells in psoriasis is discussed in this article.

Citation

Ilkka T Harvima, Gunnar Nilsson. Stress, the neuroendocrine system and mast cells: current understanding of their role in psoriasis. Expert review of clinical immunology. 2012 Mar;8(3):235-41