Stress as a Risk Factor in the Pathogenesis of Rheumatoid Arthritis

Cutolo, Maurizio; Straub, Rainer H.

doi:10.1159/000104855

Cited by 106 publications

(86 citation statements)

References 61 publications

(31 reference statements)

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“…However, during the course of the disease, minor stress could aggravate SLE and RA (Herrmann et al, 2000). In contrast, strong major stress, which is likely accompanied by a large and long-lived release of stress axes mediators, was associated with a decrease in disease activity (Cutolo & Straub, 2006).…”

Section: Stress As Pathogenetic Factor Of Autoimmune Diseasesmentioning

confidence: 99%

“…and hormones (cortisol etc.) which serve to send an efferent message from the brain to the periphery in order to modulate the stressful event (Cutolo & Straub, 2006).…”

Section: Definition Of Stressmentioning

confidence: 99%

“…These somatic signals typically start off in the highest centres of the autonomic nervous system (ANS) and the endocrine system within the hypothalamus (Cutolo & Straub, 2006). Selye was the first to describe the system by which the body copes with stress: the hypothalamus-pituitaryadrenal system (HPA) (Stojanovich & Marisavljevich, 2008).…”

Section: Definition Of Stressmentioning

confidence: 99%

“…Therefore, it is suggested that neurotransmitters such as norepinephrine or stress hormones such as cortisol might have different effects on immune/inflammatory responses at high and low concentrations present during short or extended periods of time, respectively. Long-lasting (chronic) stress may lead to pro-inflammatory effects since no adequate long-term responses of stress axes (anti-inflammatory) are to be expected (Cutolo & Straub, 2006). Furthermore, major life events and chronic minor stress seem to be important factors in juvenile chronic arthritis and are significantly associated with the onset of the rheumatic disease.…”

Section: Stress As Pathogenetic Factor Of Autoimmune Diseasesmentioning

confidence: 99%

“…Stress has been studied in several autoimmune rheumatic diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) (Cutolo & Straub, 2006). Growing evidence supports the hypothesis that alterations of the stress response and interactions between the neuroendocrine and immune systems contribute to the pathogenesis of rheumatic diseases .…”

mentioning

confidence: 99%

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The Pathogenetic Link Between Stress and Rheumatic Diseases

Malysheva¹,

Baerwald²

2012

Insights and Perspectives in Rheumatology

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Section: Stress As Pathogenetic Factor Of Autoimmune Diseasesmentioning

confidence: 99%

“…and hormones (cortisol etc.) which serve to send an efferent message from the brain to the periphery in order to modulate the stressful event (Cutolo & Straub, 2006).…”

Section: Definition Of Stressmentioning

confidence: 99%

Section: Definition Of Stressmentioning

confidence: 99%

Section: Stress As Pathogenetic Factor Of Autoimmune Diseasesmentioning

confidence: 99%

mentioning

confidence: 99%

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The Pathogenetic Link Between Stress and Rheumatic Diseases

Malysheva¹,

Baerwald²

2012

Insights and Perspectives in Rheumatology

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Association Between Noninfectious Uveitis and Psychological Stress

et al. 2019

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IMPORTANCE Uveitis involves dysregulation of the ocular immune system. Stress has been shown to affect immune function, but it is unclear whether there is an association between stress and uveitis.OBJECTIVE To determine whether having uveitis is associated with psychological stress. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional, case-control study including a self-administered survey, medical records review, and diurnal salivary cortisol test was conducted at a university-based uveitis clinic and comprehensive eye clinic. Participants included 146 consecutive adults with noninfectious uveitis and age-matched controls with no eye disease. The study was conducted from December 1, 2017, to March 14, 2018. MAIN OUTCOMES AND MEASURESParticipants completed the self-administered, Cohen 10-item Perceived Stress Scale (PSS-10), a demographics questionnaire. Responses to each question were categorized on a 5-point Likert scale, with total scores ranging from 0 (no stress) to 40 (high stress). In addition, participants submitted 3 salivary cortisol samples. Those with uveitis were classified as having recently active or controlled disease through medical records review. The prespecified primary analysis was a linear regression of PSS-10 score and uveitis correcting for age, sex, educational level, employment, and median income. Secondary analyses included comparing PSS-10 scores in patients with recently active and controlled uveitis, determining predictors of stress, and comparing diurnal salivary cortisol between uveitis and control groups. RESULTSOf 146 eligible patients, 17 declined participation and 9 consented but were excluded because they did not complete both questionnaires, resulting in 120 patients (80 uveitis; 40 controls) in the final analysis. Eighty participants (66.7%) were women, and 70 (58.3%) were white. Median age was 40 years (interquartile range, 29-59 years). Having uveitis was associated with a 4.3-point increase in PSS-10 score (95% CI, 1.8 to 6.9; P = .002). There was no significant difference in PSS-10 scores between patients with recently active and controlled uveitis (1.0 point greater for patients with active uveitis; 95% CI, −2.0 to 3.9; P = .52). Factors associated with increased PSS-10 score in patients with uveitis included female sex (coefficient, 4.0; 95% CI, 1.6 to 6.5; P = .002), current immunomodulatory therapy (coefficient, 2.5; 95% CI, −0.3 to 5.2; P = .08), history of depression (coefficient, 3.8; 95% CI, 0.8 to 6.8; P = .02), and having posterior or panuveitis (coefficient, 2.6; 95% CI, 0.8 to 4.4; P = .006). Of the 70 participants (58.3%) who had testable samples for cortisol analysis, diurnal salivary cortisol levels did not significantly differ between uveitis and nonuveitis groups.CONCLUSIONS AND RELEVANCE These findings suggest that patients with uveitis have higher levels of psychological stress compared with controls, yet no significant difference was identified in the stress of patients with active vs controlled uveitis. Consequently, comprehensive treatment for noninf...

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Stress and Resilience in Women With Rheumatic Disease

Danoff‐Burg

2013

Women's Health Psychology

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Stress as a Risk Factor in the Pathogenesis of Rheumatoid Arthritis

Cited by 106 publications

References 61 publications

The Pathogenetic Link Between Stress and Rheumatic Diseases

The Pathogenetic Link Between Stress and Rheumatic Diseases

Association Between Noninfectious Uveitis and Psychological Stress

Stress and Resilience in Women With Rheumatic Disease

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