Stress affects how the body responds to infections through modulating the various immune response pathways in all age groups. There’s an increasing trend of appendicitis in children as they continue to feed on refined foods. However, the processes that lead to paediatric appendicitis remain elusive. Diseases affect people differently due to the distinct changes that occur as their bodies respond to such ailments. In a new study, published in nature, Johanna G et al. linked biologic stress and the risks of paediatric appendicitis. They also assessed its association to a complicated disease. We summarise their findings.
Johanna G et al. assessed biologic stress by measuring cortisol concentration in the children’s hair: to ascertain whether long-term stress increases the risks of and complicates acute appendicitis. They enrolled 51 children with appendicitis and compared them with 86 healthy ones. They evaluated the activity of the hypothalamus-pituitary-adrenal (HPA) axis by measuring the hair cortisol concentrations (HCC) between 0-3 and 4-6 months before sampling. They then compared the results from the two groups and noted that an increase in the HCC between the two measurement points (0-3 and 4-6 months) substantiated the risks of acute appendicitis. They also noted that an increased HCC before appendicitis increased the odds of a complicated disease.
Stress increases cortisol secretion from the HPA axis.
Between patients that suffer self-limiting appendicitis and those that get a complicated one: the difference is in how their immunity responds to the offending organisms. Several types of T-helper cells provide immunological responses to diseases. For simplicity, T-helper (Th) cell-2 immune response propels uncomplicated appendicitis, whereas Th1 and Th17 drive the complicated disease trajectory.
Stress increases cortisol secretion from the HPA axis. Cortisol suppresses immune responses via the Th1 pathway and shifts them towards the Th2 avenue. For this reason, the investigators thought that increased levels of HCC would translate into an indolent disease in children; however, the study deduced the converse findings.