Immune responses to stress in rheumatoid arthritis and psoriasis.
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.


CONCLUSIONS
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.
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. 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.
Sabine J M
SJ
de Brouwer
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. 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.
Henriët
H
van Middendorp
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.
Claudia
C
Stormink
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.
Floris W
FW
Kraaimaat
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.
Irma
I
Joosten
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.
Timothy R D J
TR
Radstake
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.
Elke M G J
EM
de Jong
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.
Joost
J
Schalkwijk
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.
A Rogier T
AR
Donders
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.
Agnes
A
Eijsbouts
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.
Peter C M
PC
van de Kerkhof
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.
Piet L C M
PL
van Riel
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. 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.
Andrea W M
AW
Evers
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000276:immunology* / Q000523:psychology; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000097:blood / Q000150:complications / Q000276:immunology*; D013315:Stress, Psychological / Q000097:blood / Q000276:immunology* / Q000523:psychology
D016207:Cytokines
cytokines; immune system; psoriasis; rheumatoid arthritis; stress