Answer to Question 1
In a normal immune system Th1 and Th2 immunity are in proper balance. However, in eczema, there is too much Th2 relative to Th1 . Upon reviewing the allergy literature, Hashizume and Takigawa concluded that acute stressors that chronically and repeatedly raise the anxiety levels of patients with atopic dermatitis lead to a worsening of allergic symptoms by dysregulating the immune system through enhancing Th2 responses. This model of stress-induced dysregulation toward Th2 immunity can be applied to all the atopic disorders. In a review by Marshall and Agarwal, the authors suggested that chronic stress does not simply suppress the immune system, but induces a shift in the type-1/type-2 cytokine balance toward a predominant type-2 cytokine response. Such a change would favor the inflammatory milieu characteristic of asthma and allergic diseases.
Answer to Question 2
Fumal and Schoenen reviewed the research on TTH and concluded that preventive therapy is generally not effective. However, acute behavioral treatment for specific episodes of TTH can be effective. In fact, there is good empirical evidence for the effectiveness of electromyography (EMG) biofeedback combined with relaxation. Overall, the authors recommended the combination of drug therapies (e.g., Ibuprofen or aspirin) and non-pharmacological approaches (e.g., stress management relaxation or physical therapies) for the treatment of TTH.
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