Stress can inhibit the inflammatory responses that are critical to early wound healing through the release of hormones which suppress immune function. Thus, stress as encountered by Alzheimer's caregivers and students taking examinations can serve as an important determinant in individual variance in wound healing rates. Preliminary suggest that experimental skin wounds heal 25 percent slower in chronically stressed, older adults caring for Alzheimer's disease patients. The stress of taking examinations delayed healing of oral wounds 40 percent as compared to non-stress conditions. In both of these studies, the proinflammatory cytokine interleukin-1beta was significantly reduced in leukocytes from individuals in the stressed groups. An individual's beliefs, attitudes and values will alter their response to a stressor such that lonely individuals will have lower IL-1 responses and a greater delay in wound healing than socially embedded individuals who have lower levels of stress. Thus, analyses of the stressors as well a s personality attributes that affect the appraisal of events as stressors is essential to understanding patterns in wound healing. The proposed studies will investigate the dysregulation of neuroendocrine pathways by psychosocial factors and the impact this has on gene expression during the early inflammatory process in a rapidly healing non-scarring standardized oral wound.
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