title: Stress-induced endocrine and immunological changes in psoriasis patients and healthy controls. A preliminary study.
abstract: BACKGROUND
  Clinical observations suggest that psychological stress can induce exacerbation of psoriasis. It is hypothesized that these stress effects on the course and outcome of psoriasis are caused by neuroendocrine modulation of immune functions. Therefore we investigated the cardiovascular, endocrine and immunological response to a laboratory stressor in psoriasis patients and healthy controls.
  
  
  METHODS
  Untreated (n = 7) and PUVA-treated (n = 4) psoriatics and healthy controls (n = 7) were exposed to a brief laboratory stressor (public speaking and mental arithmetic). Heart rate and blood pressure, catecholamine, cortisol, and DHEA plasma concentration, as well as distribution of T and NK lymphocytes were analyzed before, immediately after and 1 h after stress exposure.
  
  
  RESULTS
  Heart rate and blood pressure increased in all three groups during stress exposure with the most pronounced changes in PUVA-treated patients. Psoriasis patients displayed higher adrenaline values but diminished cortisol and DHEA plasma concentrations compared to controls. NK cell numbers (CD16+, CD56+), but not T lymphocyte subsets, increased immediately after stress exposure in untreated patients and controls. This effect was significantly diminished in PUVA-treated patients.
  
  
  CONCLUSIONS
  The data of this pilot study indicate an enhanced stress-induced autonomic response and diminished pituitary-adrenal activity in psoriasis patients. PUVA treatment seems to interfere with the cardiovascular and NK cell response to acute psychological stress. Future studies will analyze the stress-induced neuroimmunological mechanisms in psoriatics in more detail.
authors.affiliation: Department of Psychosomatic Medicine, Hannover Medical School, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schmid-Ott
authors.forename: R
authors.initials: R
authors.lastname: Jacobs
authors.forename: B
authors.initials: B
authors.lastname: Jäger
authors.forename: S
authors.initials: S
authors.lastname: Klages
authors.forename: J
authors.initials: J
authors.lastname: Wolf
authors.forename: T
authors.initials: T
authors.lastname: Werfel
authors.forename: A
authors.initials: A
authors.lastname: Kapp
authors.forename: T
authors.initials: T
authors.lastname: Schürmeyer
authors.forename: F
authors.initials: F
authors.lastname: Lamprecht
authors.forename: R E
authors.initials: RE
authors.lastname: Schmidt
authors.forename: M
authors.initials: M
authors.lastname: Schedlowski
mesh_terms: D000328:Adult; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D007111:Immunity, Cellular; D007694:Killer Cells, Natural; D016131:Lymphocyte Subsets; D008297:Male; D009490:Neurosecretory Systems / Q000502:physiology*; D011701:PUVA Therapy; D010865:Pilot Projects; D010913:Pituitary-Adrenal System / Q000276:immunology*; D011565:Psoriasis / Q000276:immunology* / Q000523:psychology* / Q000628:therapy; D013315:Stress, Psychological