title: Immune responses to stress after stress management training in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Psychological stress may alter immune function by activating physiological stress pathways. Building on our previous study, in which we report that stress management training led to an altered self-reported and cortisol response to psychological stress in patients with rheumatoid arthritis (RA), we explored the effects of this stress management intervention on the immune response to a psychological stress task in patients with RA.
  
  
  METHODS
  In this study, 74 patients with RA, who were randomly assigned to either a control group or a group that received short stress management training, performed the Trier Social Stress Test (TSST) 1 week after the intervention and at a 9-week follow-up. Stress-induced changes in levels of key cytokines involved in stress and inflammatory processes (for example, interleukin (IL)-6 and IL-8) were assessed.
  
  
  RESULTS
  Basal and stress-induced cytokine levels were not significantly different in patients in the intervention and control groups one week after treatment, but stress-induced IL-8 levels were lower in patients in the intervention group than in the control group at the follow-up assessment.
  
  
  CONCLUSIONS
  In line with our previous findings of lower stress-induced cortisol levels at the follow-up of stress management intervention, this is the first study to show that relatively short stress management training might also alter stress-induced IL-8 levels in patients with RA. These results might help to determine the role of immunological mediators in stress and disease.
  
  
  BACKGROUND
  The Netherlands National Trial Register (NTR1193)
authors.forename: Sabine J M
authors.initials: SJ
authors.lastname: de Brouwer
authors.forename: Henriët
authors.initials: H
authors.lastname: van Middendorp
authors.forename: Floris W
authors.initials: FW
authors.lastname: Kraaimaat
authors.forename: Timothy R D J
authors.initials: TR
authors.lastname: Radstake
authors.forename: Irma
authors.initials: I
authors.lastname: Joosten
authors.forename: A Rogier T
authors.initials: AR
authors.lastname: Donders
authors.forename: Agnes
authors.initials: A
authors.lastname: Eijsbouts
authors.forename: Saskia
authors.initials: S
authors.lastname: Spillekom-van Koulil
authors.forename: Piet L C M
authors.initials: PL
authors.lastname: van Riel
authors.forename: Andrea W M
authors.initials: AW
authors.lastname: Evers
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000276:immunology* / Q000523:psychology*; D016207:Cytokines / Q000032:analysis / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D013315:Stress, Psychological / Q000276:immunology*
chemical_list: D016207:Cytokines