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Firdaus Dhabhar Department of Psychiatry & Behavioral Sciences Institute for Immunity, Transplantation, & Infection Stanford University
Mother Nature did not give us the stress response to kill us. She gave us the stress response to help us survive!
STRESS
Stress is a constellation of events that begins with a stimulus (stressor), that precipitates a reaction in the brain (stress perception), that subsequently results in the activation of fight / flight systems in the body (stress response). Acute / Short-term stress = minutes to hours Chronic / Long-term stress = months to years
(Dhabhar & McEwen, Brain Behavior & Immunity, 1997, 11: 286.)
Central Hypothesis: Just as the stress response prepares the cardiovascular, musculoskeletal, and neuroendocrine systems for fight or flight, it may also prepare the immune system for challenges (wounding or infection) that may be imposed by a stressor (Brain, Behavior, & Immunity, 1994) Short-term stressors will ENHANCE immune function in compartments (e.g. skin) that are likely to be compromised by the actions of a stressor (e.g. predator, surgery, etc.)
We believe that it is also important to investigate, and harness the protective effects of short-term / acute stress.
What does this acute stress induced UP-DOWN change in immune cell numbers signify?
BLOOD
cell number
# defenders firepower
early late
duration of stress
Short-term stress activates the bodys defenses even before there is wounding or infection!
Q: Does a short-term stress response experienced during surgery, vaccination, or cancer progression, enhance immune function?
YES
RECOVERY
FROM SURGERY
(Rosenberger et al., JBJS, 2009)
ANTI-CANCER
IMMUNITY
(Dhabhar et al., BBI, 2010)
VACCINE RESPONSE
(Dhabhar et al., AJP, 2005, Viswanathan, et al., 2005)
surgery stress
-- ?
++ ?
during surgery
earlier recovery
during surgery
One of our goals is to maximally harness the protective biology of short-term stress during surgery, vaccination, and cancer therapy.
Q: How do we reconcile immuno-enhancement findings with the well-known stress-induced suppression / dysregulation of immune function Q: How does an adaptive system become maladaptive? Transition from acute to chronic stress
Chronic stress is BAD protective immunity chronic inflammation biological aging mental & physical health susceptibility to: infection cancer cardiovascular disease depression
STRESS SPECTRUM
GOOD stress LOW stress (resting zone) BAD stress
Sleep, nutrition, exercise, meditation, yoga, dance, What you want exercise, art, music, fishing, for good health is: neurosurgery COMPASSION?
SELF-COMPASSION stress, anxiety, depression Dont be too hard on yourself but dont go too easy either MAKE TIME: for stress-reducing activities TAKE ACTION: meditation, yoga, hiking, dancing, exercise, painting, music, friends, neurosurgery different strokes for different folks does not HAVE to be meditation, levitation
compassion
chronic stress
resting equilibrium
fight-or-flight protection
Our Goals
Maximally harness the biology of GOOD stress. Reduce/eliminate BAD stress, and maximize the zone of health and healing.
http://www.hufngtonpost.com/project-compassion-stanford/stress-reduction_b_1677439.html
Link to article
Thank You!
Dhabhar Lab
Nicole Bricker* Jean Tillie* Kavitha Viswanathan* Alison Saul* Christine Daugherty* Allison Litzinger Tuong Phan Tanaz Chhor Jayce Pangilinan Nora Nguyen
Yale Stanford
David Spiegel* et al. James Gross et al. Ruth OHara Joachim Hallmayer Shelli Kesler Donna Bouley* Tyson Holmes* David Lyons et al. Jamie Zeitzer Jeannette Ickovics* Patty Rosenberger* Peter Jokl, et al.*
UCSF
Elissa Epel* Owen Wolkowitz* Elizabeth Blackburn*
UC Davis
Cliff Saron
Rockefeller University
Bruce McEwen* Ralph Steinman*
Ohio State
Tatiana Oberyszyn* William Malarkey* Stanley Lemeshow* Randy Nelson
Cornell
Marty Altemus
M. D. Anderson
Donna Kusewitt* dhabhar@gmail.com
NIH: AI48995, AR46299, CA107498 Univ. Louisville Sandie Sephton Dana Foundation MacArthur Foundation