Palabras clave
Sistema inmunológico
Revisión sistemática
Cómo citar
Resumen
Objetivo: Este estudio tuvo como objetivo investigar los efectos de la ansiedad sobre el sistema inmunológico a través de una revisión sistemática de la literatura.
Métodos: Se realizó una revisión sistemática de la literatura con el objetivo de investigar los efectos de la ansiedad sobre el sistema inmunológico. Las búsquedas se llevaron a cabo en las bases de datos PubMed, ScienceDirect y Scopus, incluyendo estudios originales publicados en los últimos diez años, en portugués o inglés, realizados en seres humanos y que evaluaran parámetros inmunológicos asociados a la ansiedad. La calidad metodológica y el riesgo de sesgo fueron evaluados mediante las herramientas del Joanna Briggs Institute (JBI).
Resultados: Tras la aplicación de los criterios de elegibilidad, se incluyeron 16 estudios. Los resultados evidenciaron que la ansiedad ejerce una influencia negativa sobre parámetros inmunológicos y hormonales. Se observó un aumento de citocinas inflamatorias, elevación de linfocitos circulantes y un incremento en los niveles de cortisol y ACTH, indicando la activación del eje hipotálamo-hipófisis-adrenal (HPA). Asimismo, se identificó una asociación entre ansiedad y niveles elevados de proteína C reactiva (PCR), sugiriendo una relación con procesos inflamatorios crónicos. La mayoría de los estudios presentó un riesgo de sesgo moderado.
Conclusión: Los hallazgos indican que los trastornos de ansiedad tienen un impacto significativo sobre el sistema inmunológico. Estos resultados refuerzan la importancia de implementar estrategias eficaces para el manejo de la ansiedad con el fin de promover la salud inmunológica y mejorar la calidad de vida.
Citas
Abbas, A. K., Lichtman, A. H., & Pillai, S. (2021). Cellular and molecular immunology (10th ed.). Elsevier.
American Psychiatric Association. (2026). Anxiety disorders. https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
Auer, B. J., Calvi, J. L., Jordan, N. M., et al. (2018). Communication and social interaction anxiety enhance interleukin-1 beta and cortisol reactivity during high-stakes public speaking. Psychoneuroendocrinology, 94, 83–90. https://doi.org/10.1016/j.psyneuen.2018.04.017
Bower, J. E., & Kuhlman, K. R. (2023). Psychoneuroimmunology: An introduction to immune-to-brain communication and its implications for clinical psychology. Annual Review of Clinical Psychology, 19, 331–359. https://doi.org/10.1146/annurev-clinpsy-081219-092602
Carneiro, É. M., et al. (2020). Effects of the laying on of hands on anxiety, stress and autonomic response of employees in a hospital: A double-blind randomized controlled trial. Complementary Therapies in Medicine, 52, 102475. https://doi.org/10.1016/j.ctim.2020.102475
Costa, C. O., Branco, J. C., Vieira, I. S., Souza, L. D. M., & Silva, R. A. (2019). Prevalência de ansiedade e fatores associados em adultos. Jornal Brasileiro de Psiquiatria, 68(2), 92–100. https://doi.org/10.1590/0047-2085000000232
Costello, H., Gould, R. L., Abrol, E., & Howard, R. (2019). Systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalised anxiety disorder. BMJ Open, 9(7), e027925. https://doi.org/10.1136/bmjopen-2018-027925
D’Elia, A. T. D., Juruena, M. F., Coimbra, B. M., et al. (2022). Increased immuno-inflammatory mediators in women with post-traumatic stress disorder after sexual assault: 1-year follow-up. Journal of Psychiatric Research, 155, 241–251. https://doi.org/10.1016/j.jpsychires.2022.09.012
Fernández-Serrano, A. B., Moya-Faz, F. J., Giner Alegría, C. A., & Fernández Rodríguez, J. C. (2022). Negative correlation between IL-1β, IL-12 and TNF-γ, and cortisol levels in patients with panic disorder. Brain and Behavior, 12(6), e2624. https://doi.org/10.1002/brb3.2624
Gandarela, L., Sampaio, T. P. D. A., Marçal, L., et al. (2024). Inflammatory marker changes following acceptance-based behavioral psychotherapy in generalized anxiety disorder patients: Evidence from a randomized controlled trial. Brain, Behavior, & Immunity – Health, 38, 100779. https://doi.org/10.1016/j.bbih.2024.100779
Hanstock, H. G., Edwards, J. P., Roberts, R., & Walsh, N. P. (2018). High heart rate reactors display greater decreases in tear SIgA concentration following a novel acute stressor. Biological Psychology, 133, 85–88. https://doi.org/10.1016/j.biopsycho.2018.01.009
Haroon, E., Raison, C. L., & Miller, A. H. (2012). Psychoneuroimmunology meets neuropsychopharmacology: Translational implications of the impact of inflammation on behavior. Neuropsychopharmacology, 37(1), 137–162. https://doi.org/10.1038/npp.2011.205
Hou, R., Garner, M., Holmes, C., & Baldwin, D. S. (2017). Peripheral inflammatory cytokines and immune balance in generalised anxiety disorder: Case-controlled study. Brain, Behavior, and Immunity, 62, 212–218. https://doi.org/10.1016/j.bbi.2017.01.021
Irwin, M. R., Cole, S., & Olmstead, R. (2019). Moderators for depressed mood and systemic and transcriptional inflammatory responses: A randomized controlled trial of endotoxin. Neuropsychopharmacology, 44(3), 635–641. https://doi.org/10.1038/s41386-018-0297-2
Joanna Briggs Institute. (2017). The Joanna Briggs Institute critical appraisal tools for use in JBI systematic reviews. JBI.
Landau, E. R., Raniti, M. B., & Blake, M. (2021). The ratio of morning cortisol to CRP prospectively predicts first-onset depression in at-risk adolescents. Social Science & Medicine, 281, 114098. https://doi.org/10.1016/j.socscimed.2021.114098
Michopoulos, V., Powers, A., Gillespie, C. F., & Ressler, K. J. (2017). Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond. Neuropsychopharmacology, 42, 254–270. https://doi.org/10.1038/npp.2016.146
Page, M. J., McKenzie, J. E., Bossuyt, P. M., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Rhein, C., Apelt, I., Werner, F., et al. (2024). Paradoxical effect of anti-inflammatory drugs on IL-6 mRNA expression in patients with PTSD during treatment. Journal of Neural Transmission, 131(7), 813–821. https://doi.org/10.1007/s00702-024-02623-0
Rohleder, N. (2019). Stress and inflammation: The need to address the gap in the transition between acute and chronic stress effects. Psychoneuroendocrinology, 105, 164–171. https://doi.org/10.1016/j.psyneuen.2019.03.011
Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychological Bulletin, 130(4), 601–630. https://doi.org/10.1037/0033-2909.130.4.601
Sundquist, K., Memon, A. A., Palmér, K., et al. (2021). Inflammatory proteins and miRNA-144-5p in patients with depression, anxiety, or stress- and adjustment disorders after psychological treatment. Cytokine, 146, 155646. https://doi.org/10.1016/j.cyto.2021.155646
Szuhany, K. L., & Simon, N. M. (2022). Anxiety disorders: A review. JAMA, 328(24), 2431–2445. https://doi.org/10.1001/jama.2022.22744
Tang, Z., Ye, G., Chen, X., et al. (2018). Peripheral proinflammatory cytokines in Chinese patients with generalised anxiety disorder. Journal of Affective Disorders, 225, 593–598. https://doi.org/10.1016/j.jad.2017.09.012
Uy, J. P., Dieffenbach, M., & Leschak, C. J. (2022). Sleep duration moderates the associations between immune markers and corticolimbic function during stress in adolescents. Neuropsychologia, 176, 108374. https://doi.org/10.1016/j.neuropsychologia.2022.108374
Viljoen, M., Benecke, R. M., & Martin, L. (2020). Anxiety: An overlooked confounder in the characterisation of chronic stress-related conditions? PLoS ONE, 15(4), e0230053. https://doi.org/10.1371/journal.pone.0230053
Wegner, A., Elsenbruch, S., & Maluck, J. (2014). Inflammation-induced hyperalgesia: Effects of timing, dosage, and negative affect on somatic pain sensitivity in human experimental endotoxemia. Brain, Behavior, and Immunity, 41, 46–54. https://doi.org/10.1016/j.bbi.2014.04.010
World Health Organization. (2025). Anxiety disorders. https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders