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Effects of stress hormones on the immune system. Stress hormones stimulate pro-tumorigenic immune cells to produce IL-6, IL-10, and other cytokines, and activate the COX-2/PGE2 pathway to produce VEGF, which together affect the tumor microenvironment to suppress tumor immunity. The decrease in IL-12 and the increase in IL-10 lead to selective Th1 inhibition, thereby suppressing the CTL-mediated cellular immunity and interferon production.
