Abstract

Loneliness has been defined as an agonizing encounter, experienced when the need for human intimacy is not met adequately, or when a person’s social network does not match their preference, either in number or attributes. This definition helps us realize that the cause of loneliness is not merely being alone, but rather not being in the company we desire. With loneliness being introduced as a measurable, distinct psychological experience, it has been found to be associated with poor health behaviors, heightened stress response, and inadequate physiological repairing activity. With these three major pathways of pathogenesis, loneliness can do much harm; as it impacts both immune and metabolic regulation, altering the levels of inflammatory cytokines, growth factors, acute-phase reactants, chemokines, immunoglobulins, antibody response against viruses and vaccines, and immune cell activity; and affecting stress circuitry, glycemic control, lipid metabolism, body composition, metabolic syndrome, cardiovascular function, cognitive function and mental health, respectively. Taken together, there are too many immunologic and metabolic manifestations associated with the construct of loneliness, and with previous literature showcasing loneliness as a distinct psychological experience and a health determinant, we propose that loneliness, in and of itself, is not just a psychosocial phenomenon. It is also an all-encompassing complex of systemic alterations that occur with it, expanding it into a syndrome of events, linked through a shared network of immunometabolic pathology. This review aims to portray a detailed picture of loneliness as an “immunometabolic syndrome”, with its multifaceted pathology.

Highlights

  • As social creatures, our need for social interaction, social support, and social stimuli should be met adequately in order for us to feel well and live a healthy life [1,2,3,4]

  • granulocyte-macrophage colony-stimulating factor (GM-CSF) levels have been found associated with loneliness [80], and this association can be explained by the distinct way that conserved transcriptional response to adversity (CTRA) acts in the face of adversity, which is manifested through the sympathetic nervous system (SNS)

  • In the articles we found on this topic, the animal studies mostly observed the effects of social isolation [141,142,143,144], or loss of a bonded partner [145] on the corticotropin-releasing hormone (CRH) system, endogenous opioids or oxytocin, and not the effect of the perceived entity of “loneliness” [146], and the human studies were mostly on the effect of depression on endogenous opioids, and further human studies aimed at loneliness are suggested in this area

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Summary

Introduction

Our need for social interaction, social support, and social stimuli should be met adequately in order for us to feel well and live a healthy life [1,2,3,4]. We believe there are too many immunologic and metabolic manifestations associated with the construct of loneliness, and with the previous research showcasing loneliness as a distinct psychological experience [15,16,19], and a health determinant [21,52,53,54,55], we propose that loneliness, in and of itself, is not just a psychosocial phenomenon It is an all-encompassing complex of systemic alterations that occur with it, expanding it into a syndrome of events, concurrent with each other [56], and linked through a shared network of immunometabolic pathology.

Measures of cortisol in loneliness
Immunologic Factors
Inflammatory Cytokines
Endotoxin Trials
IL-2 and IL-10
Growth Factors
GM-CSF
Acute-Phase Reactants
Fibrinogen
Ferritin
Chemokines
Immunoglobulins
Antiviral Immunity
Interferons
Antibody Response against Viral Infection
Antibody Response against Vaccines
Behavioral Immunity against Viruses of Social Stigma
Immune Cells’ Number and Activity
Genetic Correlates of Immune Regulation
Regulation of Glucocorticoids in Loneliness
Counter-Regulation of the Stress Circuitry in Loneliness
Measures of Cortisol in Loneliness
Markers of Glycemic Control
Markers of Lipid Metabolism
Indices of Weight Control and Body Composition
Meeting the Criteria for Metabolic Syndrome
Elements of Cardiovascular Function
Markers of Cognitive Function
Elements of Mental Health
Genetic Correlates of Metabolic Regulation
Findings
Conclusions

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