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Immune responses to stress in rheumatoid arthritis and psoriasis
Sabine J M de Brouwer1, Henriët van Middendorp2, Claudia Stormink3
1Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Department of Rheumatology and Clinical Immunology & Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Department of Dermatology, Radboud University Medical Center, Department for Health Evidence, Radboud University Medical Center, Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands. Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Department of Rheumatology and Clinical Immunology & Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Department of Dermatology, Radboud University Medical Center, Department for Health Evidence, Radboud University Medical Center, Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands. sabine.debrouwer@radboudumc.nl.
Objective:
Stress is one of the factors that may exacerbate the progression of chronic inflammatory diseases such as RA and psoriasis. We exploratively compared the effects of acute stress on levels of circulating cytokines involved in disease progression and/or the stress response in patients with RA, patients with psoriasis and healthy subjects.
Methods:
Patients with RA, patients with psoriasis and healthy controls underwent a standardized psychosocial stress test (Trier Social Stress Test). Levels of circulating cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IFN-γ and TNF-α) were measured before and after the stress test.
Results:
The baseline levels of all cytokines, except IL-8, were significantly higher in patients with RA. After correction for baseline levels, patients with RA showed higher stress-induced levels of IL-1β and IL-2 than patients with psoriasis and healthy controls.
Conclusion:
The results suggest that patients with RA have a different immune response to stress than patients with psoriasis or healthy controls. More needs to be learned about the complex interaction between stress, immune parameters and chronic inflammation.
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