TY - JOUR T1 - Evaluating the effects of stress on asthma: a paradoxical challenge JF - European Respiratory Journal JO - Eur Respir J SP - 574 LP - 575 DO - 10.1183/09031936.03.00067903 VL - 22 IS - 4 AU - M.D. Klinnert Y1 - 2003/10/01 UR - http://erj.ersjournals.com/content/22/4/574.abstract N2 - Investigations into the relationship between emotional stress and asthma have a long and complicated history. Stemming from patient reports and clinician observations that asthma exacerbations were sometimes preceded by emotional reactions or severe stress, a series of empirical investigations was initiated in the 1960s. Study results were inconsistent, with some apparently methodologically rigorous studies showing relationships between emotional arousal and lung function changes, while others were unable to demonstrate such effects 1. In the face of this confusing picture, a number of reviews have attempted to integrate data from the field, and in so doing have proposed pathways and mechanisms to explain how emotions or stress could affect asthma 1–4. From the beginning, this area of research has been plagued by the paradox wherein the typical physiological reaction to emotional arousal was the opposite of physiological events associated with bronchoconstriction. The paper by Laube et al. 5 in the current issue of the European Respiratory Journal, which describes careful testing of a hypothesis generated by a theoretical model, represents another step forward in this tortuous process of investigation. Although the authors' hypothesis was not supported, the specifics of the unexpected results of the study provide another piece of the puzzle, and so contribute to a revision and refinement of the working model for investigating the interaction of stress and asthma. The most important aspect of the results reported by laube et al. 5 was the failure of the data to support the hypothesis; in fact, the results were the opposite of what was expected. The authors hypothesised that the pulmonary response toallergen exposure in individuals with allergic asthma would be potentiated by emotional arousal elicited by a stress interview. Instead, lung function testing showed less airway … ER -