Aspirin, but not propranolol, attenuates the acute stress-induced increase in circulating levels of interleukin-6: a randomized, double-blind, placebo-controlled study.
Psychosocial stress might increase the risk of atherothrombotic events by setting off an elevation in circulating levels of the proinflammatory cytokine interleukin (IL)-6. We investigated the effect of aspirin and propranolol on the responsiveness of plasma IL-6 levels to acute psychosocial stress. For 5 days, 64 healthy subjects were randomized, double-blind, to daily oral aspirin 100mg plus long-acting propranolol 80 mg, aspirin 100mg plus placebo, long-acting propranolol 80 mg plus placebo, or placebo plus placebo. Thereafter, all subjects underwent the 13-min Trier Social Stress Test, which combines a preparation phase, a job interview, and a mental arithmetic task. Plasma IL-6 levels were measured in blood samples collected immediately pre- and post-stress, and 45 min and 105 min thereafter. The change in IL-6 from pre-stress to 105 min post-stress differed between subjects with aspirin medication and those without (p =0.033; eta p2=0.059). IL-6 levels increased less from pre-stress to 105 min post-stress (p <0.027) and were lower (p =0.010) at 105 min post-stress in subjects with aspirin than in subjects without aspirin. The significance of these results was maintained when controlling for gender, age, waist-to-hip ratio, mean arterial blood pressure, and smoking status. Medication with propranolol was not significantly associated with the stress-induced change in IL-6 levels. Also, aspirin and propranolol did not significantly interact in determining the IL-6 stress response. Aspirin but not propranolol attenuated the stress-induced increase in plasma IL-6 levels. This suggests one mechanism by which aspirin treatment might reduce the risk of atherothrombotic events triggered by acute mental stress.
von Känel
Roland
R
Department of General Internal Medicine, University Hospital Bern, CH-3010 Bern, Switzerland. roland.vonkaenel@insel.ch
Kudielka
Brigitte M
BM
Metzenthin
Petra
P
Helfricht
Susanne
S
Preckel
Daniel
D
Haeberli
André
A
Stutz
Monika
M
Fischer
Joachim E
JE
D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000276:immunology / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015213:Neuroimmunomodulation / Q000187:drug effects / Q000276:immunology; D010919:Placebos; D011433:Propranolol / Q000008:administration & dosage*; D012146:Rest; D013315:Stress, Psychological / Q000188:drug therapy* / Q000276:immunology
D000319:Adrenergic beta-Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D015850:Interleukin-6; D010919:Placebos; D011433:Propranolol; D001241:Aspirin; D006854:Hydrocortisone