title: Anxiety accelerates T-helper 2-tilted immune responses in patients with atopic dermatitis.
abstract: BACKGROUND
  Stress, which mediates anxiety, worsens skin symptoms in patients with atopic dermatitis (AD). The contribution of anxiety to immune dysfunction, which plays a critical role in the pathogenesis of AD, requires clarification.
  
  
  OBJECTIVE
  To examine the relationship between anxiety and atopy-relevant immune function in AD.
  
  
  METHODS
  Eighty-five patients with AD and 58 normal individuals without a history of allergic disorders were enrolled in this study. To assess anxiety, the state-trait anxiety inventory was completed for both groups. In the AD group, measurements were made of SCORAD scores, serum IgE levels, itching (visual analogue scale), blood eosinophil count and T-helper (Th) 1/Th2 ratio in the peripheral blood.
  
  
  RESULTS
  Anxiety was significantly higher among the subjects with AD than the normal subjects, and trait anxiety (TA) was higher than state anxiety (SA) in the AD group. Serum total IgE levels were correlated positively with TA and the TA/SA ratio and inversely with SA, and the Th1/Th2 ratio was correlated inversely with TA and the TA/SA ratio.
  
  
  CONCLUSIONS
  The patients with AD had higher anxiety levels than normal individuals, and those with a stronger perception of TA than SA showed enhanced serum IgE synthesis and Th2 shifting.
authors.affiliation: Department of Dermatology, Hamamatsu University School of Medicine, 1-20-1 Handa-yama, Hamamatsu, Japan. hihashiz@hama-med.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Hashizume
authors.forename: T
authors.initials: T
authors.lastname: Horibe
authors.forename: A
authors.initials: A
authors.lastname: Ohshima
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: H
authors.initials: H
authors.lastname: Yagi
authors.forename: M
authors.initials: M
authors.lastname: Takigawa
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000276:immunology; D001008:Anxiety Disorders / Q000276:immunology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003876:Dermatitis, Atopic / Q000276:immunology* / Q000523:psychology*; D004802:Eosinophilia; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology*; D014581:Urticaria / Q000276:immunology
chemical_list: D007073:Immunoglobulin E