Exhaled nitric oxide and vascular endothelial growth factor as predictors of cold symptoms after stress

•Exhaled nitric oxide (FENO) is linked to mucosal immunity.•Vascular endothelial growth factor (VEGF) also determines mucosal integrity.•Academic stress impacts airway NO and VEGF.•Lower FENO and higher airway and salivary VEGF predict cold symptoms after stress.•FENO and VEGF add to salivary cortis...

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Bibliographic Details
Published in:	Biological psychology 2018-02, Vol.132, p.116-124
Main Authors:	Ritz, Thomas, Trueba, Ana F., Vogel, Pia. D., Auchus, Richard J., Rosenfield, David
Format:	Article
Language:	eng
Subjects:	Academic stress Adolescent Biomarkers - metabolism Breath Tests Cold symptoms Common Cold - psychology Exhalation Exhaled breath condensate Exhaled nitric oxide Female Humans Hydrocortisone - metabolism Male Mucosal immunity Nitric Oxide - metabolism Predictive Value of Tests Proof of Concept Study Saliva - metabolism Stress, Psychological - complications Stress, Psychological - metabolism Students - psychology Vascular endothelial growth factor Vascular Endothelial Growth Factor A - metabolism Young Adult
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Summary:	•Exhaled nitric oxide (FENO) is linked to mucosal immunity.•Vascular endothelial growth factor (VEGF) also determines mucosal integrity.•Academic stress impacts airway NO and VEGF.•Lower FENO and higher airway and salivary VEGF predict cold symptoms after stress.•FENO and VEGF add to salivary cortisol and perceived stress in predicting symptoms. Prior research has demonstrated that psychosocial stress is associated with respiratory infections. Immunologic, endocrine, and cardiovascular predictors of such infections have been explored with varying success. We therefore sought to study the unexplored role of airway mucosal immunity factors, nitric oxide (NO) and vascular endothelial growth factor (VEGF). NO is secreted by airway epithelial cells as part of the first line of defense against bacteria, viruses, and fungi. VEGF is expressed by mast cells in respiratory infections and recruits immune cells to infected sites, but in excess lead to vulnerability of the airway epithelium. In this proof-of-concept study we measured exhaled NO, exhaled breath condensate (EBC) VEGF, salivary VEGF, and salivary cortisol in 36 students undergoing final academic examinations at three occasions: a low-stress baseline during the term, an early phase of finals, and a late phase of finals. Participants also reported on cold symptoms at these time points and approximately 5 and 10days after their last academic examination. Higher baseline NO was associated with fewer cold symptoms after stress, whereas higher baseline VEGF in EBC and saliva were associated with more cold symptoms after stress. Perceived stress at baseline as well as salivary VEGF and cortisol late in the finals also contributed to the prediction of later cold symptoms. Basal levels of NO and VEGF may inform about mucosal immunocompetence and add to preventative treatments against airway infections from periods of stress in daily life.
ISSN:	0301-0511 1873-6246