Circulating cytokine signatures in healthy medical students exposed to academic examination stress

Psychophysiology. 2012 Jul;49(7):991-7. doi: 10.1111/j.1469-8986.2012.01371.x. Epub 2012 Apr 3.


Stress-induced production of proinflammatory cytokines in the brain and periphery is associated with mental distress. In this study, we measured changes in levels of salivary cortisol and 50 circulating immune mediators in 28 4th-grade medical students (19 males and 9 females) 7 weeks before, 1 day before, immediately after, and 1 week after an authorized nationwide examination for promotion. Repeated measures ANOVA with multiple testing correction and post hoc tests revealed that the examination significantly increased levels of proinflammatory cytokines (granulocyte colony-stimulating factor, interferon-γ, interleukin (IL)-1β, and tumor necrosis factor-α), Th2 cytokines (IL-4, IL-5, and IL-13), and β-nerve growth factor in association with significant decreases in salivary cortisol levels and anxiety after the examination. These mediators may have a negative impact on the mental state of healthy young adults exposed to naturalistic stressors.

MeSH terms

  • Adult
  • Anxiety / blood
  • Anxiety / metabolism*
  • Cytokines / blood*
  • Cytokines / metabolism
  • Educational Measurement*
  • Female
  • Humans
  • Hydrocortisone / metabolism*
  • Inflammation Mediators / blood
  • Inflammation Mediators / metabolism*
  • Male
  • Saliva / metabolism*
  • Stress, Psychological / blood
  • Stress, Psychological / metabolism*
  • Students, Medical*


  • Cytokines
  • Inflammation Mediators
  • Hydrocortisone