Hormonal stress and susceptibility to hematological diseases: impact of cortisol and catecholamines
Keywords:
Chronic stress, Cortisol/catecolaminas, Enfermedades hematológicasAbstract
Chronic stress, through hormonal dysregulation of cortisol and catecholamines (adrenaline/noradrenaline), increases susceptibility to hematological diseases such as anemia, leukemia, and lymphoma. Cortisol, released by the hypothalamic-pituitary-adrenal (HPA) axis, suppresses immunity by reducing B/T lymphocytes and erythropoiesis, and is linked to anemia and myelodysplasia. Catecholamines, mediators of the adrenergic response, promote oxidative stress in the bone marrow and leukemic cell proliferation, in addition to creating a proinflammatory microenvironment (IL-6, TNF-α) favorable to malignancy. Studies show that these mechanisms compromise the response to therapies, such as monoclonal antibodies in lymphomas, and increase relapses in leukemias. To counteract these effects, multidisciplinary strategies are proposed: stress management (mindfulness, exercise) to reduce cortisol, and beta-blockers (propranolol) as antitumor adjuvants. The inclusion of psychological and endocrine assessments in clinical management is essential to address the psychobiological impact of stress in hematology.
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