The relationship between stress, ageing and asthma

The study found that a person with mild asthma has the same amount of ‘wear and tear’ on their body due to stress as someone eight years older without asthma. — Queen’s University Belfast

Most people will experience a chronic disease such as asthma, in their lifetimes.

In the United Kingdom, approximately a quarter of people aged over 18 are currently being treated for multiple chronic diseases.

Chronic stress has been identified as a risk factor in the development or worsening of many of these conditions.

“Allostatic load” is the concept used to measure early ageing or “wear and tear” on the body, which accumulates when an individual is exposed to chronic stress in everyday life.

To conduct their study, the researchers compared allostatic load in adults with and without asthma in the UK.

These included 9,219 adults without asthma, 198 adults with mild asthma that did not require anti-inflammatory treatment with inhaled corticosteroids, and 388 adults with moderate asthma treated with inhaled corticosteroids.

To do this, the team used data that measured levels of stress-related biomarkers in the blood of each participant.

The team found higher allostatic load – early ageing – even among the mildest asthma group (those who did not require corticosteroids).

They also found that a person with mild asthma had an allostatic load equivalent to a person without asthma who is eight years older.

Those with moderate asthma (requiring treatment with corticosteroids) had a higher allostatic load than those without asthma, although this may be confounded by their corticosteroid use, which can also affect measurements of allostatic load.

This is why it was important to also examine individuals with asthma who did not have a prescription for corticosteroids.

First author and Queen’s University Belfast Centre for Public Health research fellow Luke Barry says: “This study provides objective measures of a relationship between stress and asthma.

“Understanding this stress-disease link is important for the management of asthma and in potentially reducing its lifetime burden.

“Our aim with this research is to encourage clinicians to consider stress resilience as part of an individual’s healthcare plan or treatment.”

The researchers suggest that active management of stress or policies that aim to remove or reduce social disparities such as income inequality, which contribute to chronic stress, may delay how early an individual experiences chronic disease in their lifetime or the rate at which their condition worsens.

Corresponding author and the university’s Wellcome-Wolfson Institute for Experimental Medi-cine professor of respiratory medicine Dr Liam Heaney says: “Modern lifestyles and social inequalities are important drivers of stress-related disease, which, as our research above demonstrates, includes asthma.

“Stress resilience may be something that could help patients in their daily lives to reduce the effects of chronic disease and potential worsening of pre-existent chronic conditions.

“Practices, such as mindfulness-based CBT (cognitive behavioural therapy) have been shown to promote stress resilience and may be an important way to protect against the impacts of chronic disease.”

The next step for the research is to develop a more robust causal understanding of the relationship between stress and asthma through, for example, the use of genetic markers in a person with asthma.

The research was made possible using data from Understanding Society.

Understanding Society is an initiative funded by the UK Economic and Social Research Council and various UK government departments, with scientific leadership by the UK Institute for Social and Economic Research and the University of Essex, and survey delivery by NatCen Social Research and Kantar Public.

The research data are distributed by the UK Data Service.

The research paper was published on Aug 13 (2020) in the journal Thorax.