Stress and psoriasis: psychoendocrine and metabolic reactions in psoriatic patients during standardized stressor exposure.

Abstract

Psychoendocrine and metabolic reactions during standardized stressor exposure (color-word conflict test and forced mental arithmetics) were studied in ten psoriatic and ten matched healthy subjects. During resting conditions, the groups were similar with regard to psychologic and biochemical variables, except for plasma glucose, which was slightly elevated in the psoriatic group. During stressor exposure, the psoriatic group reported significantly higher strain levels. Blood pressure, pulse rate, plasma glucose, and urinary adrenaline excretion increased in both groups during exposure, with more pronounced increases of the latter two in the psoriatic group. Serum cortisol, prolactin, progesterone and urinary cortisol decreased in both groups during stressor exposure. The decrease in serum cortisol was more pronounced in the psoriatic group. Thus, no psychoendocrine differences were found between the healthy and psoriatic subjects during resting conditions. In contrast, during a standardized stressor exposure, psoriatic subjects reported higher levels of strain, which was accompanied by higher levels of urinary adrenaline and lower levels of plasma cortisol. These results fit the hypothesis that psoriatic patients perceive certain challenging situations as more stressful than do nonpsoriatic controls, and react accordingly in their differential psychoendocrine reaction pattern. Possible pathophysiologic implications of the different pituitary-adrenocortical and sympatho-adrenomedullary reactions in psoriatics submitted to stressor exposure are discussed.

Stress-induced enhancement of leukocyte trafficking into sites of surgery or immune activation

“…Acute stress is defined as stress that lasts for minutes to hours, and chronic stress is defined as stress that lasts for months to years (3). The psychophysiological stress response is an important modulator of skin immunobiology in health and disease (4)(5)(6)(7). Whereas chronic stress is immunosuppressive (8), studies have shown that acute stress enhances cutaneous immune function (6).…”

Psychological and biological background of the interaction between psoriasis and stress

“…A kilenc, alapkortizolszintet vizsgáló tanulmányból öt alacsonyabb plazma-vagy nyálhormon-koncentrációt mutatott ki [16,53,54,55,56,57,58,59,60]. Tudva, hogy a HPA-tengely működését és így a kortizoltermelést fokozó IFN-γ, TNF-α, IL-10, IL-12 és IL-18 plazmaszintjei emelkedettek pikkelysömörben, a megfi gyelt alacsony stresszhormon-koncentráció diszfunkcionális HPA-tengely-működést sejtet [61].…”

“…Az alapszintmérések eredményei azonban ellentmondóak: míg Ionescu és mtsai (1991) emelkedett [64], addig Arnetz és mtsai (1985) [53] és Weigl (2000) normális hormonkoncentrációkról számolt be [60].…”

Psoriasis and lasting implications

“…Chronic relapses of these plaques are known to occur and cause significant psychological distress upon these individuals [18]. Notably, the stress produced is connected to the inflammatory cascade by the neuroendocrine system, which shows a mechanism by which plaque psoriasis can progress [19]. Psoriatic patients experience episodes of intense stress that leads to changes in the serum cortisol levels and the pituitary-adrenocortical axis; such changes affect the regulatory mechanisms within the neuroendocrine system that leads to further progression of plaque psoriasis [19].…”