The relation between stress and disease activity in rheumatoid arthritis

Thomason, Bradley T.; Brantley, Phillip J.; Jones, Glenn N.; Dyer, Herbert R.; Morris, J

doi:10.1007/bf00848326

Cited by 96 publications

(54 citation statements)

References 14 publications

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“…However, a stress-induced enhancement of immune function could also be detrimental if the immune response were directed against an innocuous (e.g., poison ivy, nickel in jewelry, or latex) or autoimmunogenic antigen. This hypothesis could explain the well known stress-induced exacerbation of autoimmune diseases (38)(39)(40). Moreover, we have shown that chronic stress (1) and hormonal conditions that mimic chronic stress suppress immune function.…”

Section: Discussionmentioning

confidence: 65%

“…Another paradoxical observation is that, on the one hand, stress is thought to suppress immunity and increase susceptibility to infections and cancer (8,10,(35)(36)(37). On the other, it is thought to exacerbate inflammatory diseases (38)(39)(40), like psoriasis, asthma, and arthritis, which should be ameliorated by a suppression of immune function. Keeping these considerations in mind and based on our initial observations on the effects of stress and of the circadian corticosterone rhythm on leukocyte redistribution in the body (12,13), we showed that stress has bidirectional effects on immune function, such that acute stress is immunoenhancing, whereas chronic stress is immunosuppressive (1, 13, 15).…”

Section: Discussionmentioning

confidence: 99%

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Enhancing versus suppressive effects of stress hormones on skin immune function

Dhabhar

McEwen

1999

Proc. Natl. Acad. Sci. U.S.A.

571

414

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Delayed-type hypersensitivity (DTH) reactions are antigen-specific cell-mediated immune responses that, depending on the antigen, mediate beneficial (e.g., resistance to viruses, bacteria, and fungi) or harmful (e.g., allergic dermatitis and autoimmunity) aspects of immune function. Contrary to the idea that stress suppresses immunity, we have reported that short-duration stressors significantly enhance skin DTH and that a stress-induced trafficking of leukocytes to the skin may mediate this immunoenhancement. Here, we identify the hormonal mediators of a stressinduced enhancement of skin immunity. Adrenalectomy, which eliminates the glucocorticoid and epinephrine stress response, eliminated the stress-induced enhancement of skin DTH. Low-dose corticosterone or epinephrine administration significantly enhanced skin DTH and produced a significant increase in the number of T cells in lymph nodes draining the site of the DTH reaction. In contrast, high-dose corticosterone, chronic corticosterone, or low-dose dexamethasone administration significantly suppressed skin DTH. These results suggest a role for adrenal stress hormones as endogenous immunoenhancing agents. These results also show that hormones released during an acute stress response may help prepare the immune system for potential challenges (e.g., wounding or infection) for which stress perception by the brain may serve as an early warning signal.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Enhancing versus suppressive effects of stress hormones on skin immune function

Dhabhar

McEwen

1999

Proc. Natl. Acad. Sci. U.S.A.

571

414

View full text Add to dashboard Cite

show abstract

“…Second, on the one hand, stress is thought to suppress immunity and increase susceptibility to infections and cancer (7,9,(64)(65)(66), while on the other, it is thought to exacerbate inflammatory diseases like psoriasis, asthma, and arthritis (which should be ameliorated by a suppression of immune function) (67)(68)(69)(70)(71). The finding that depending on specific physiologic conditions stress can either enhance or suppress immune function may help reconcile these paradoxical observations (1,2).…”

Section: Dhabhar Et Almentioning

confidence: 99%

Stress-induced enhancement of skin immune function: A role for γ interferon

Dhabhar

Satoskar

Bluethmann

et al. 2000

Proc. Natl. Acad. Sci. U.S.A.

143

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Contrary to the widespread belief that stress is necessarily immunosuppressive, recent studies have shown that, under certain conditions, stress can induce a significant enhancement of a skin cellmediated immune response [delayed-type hypersensitivity (DTH) or contact hypersensitivity]. Adrenal stress hormones and a stressinduced trafficking of leukocytes from the blood to the skin have been identified as systemic mediators of this immunoenhancement. Because ␥ interferon (IFN␥) is an important cytokine mediator of DTH, the studies described here were designed to examine its role as a local mediator of the stress-induced enhancement of skin DTH. The effect of acute stress on skin DTH was examined in wild-type and IFN␥ receptor-deficient (IFN␥R؊͞؊) mice that had previously been sensitized with 2,4-dinitro-1-fluorobenzene. Acutely stressed wild-type mice showed a significantly larger DTH response than nonstressed mice. In contrast, IFN␥R؊͞؊ mice failed to show a stress-induced enhancement of skin DTH. Immunoneutralization of IFN␥ in wild-type mice significantly reduced the stress-induced enhancement of skin DTH. In addition, an inflammatory response induced by direct IFN␥ administration to the skin was significantly enhanced by acute stress. Our results suggest that IFN␥ is an important local mediator of a stress-induced enhancement of skin DTH. These studies are clinically relevant because, depending on the nature of the antigen, DTH reactions mediate numerous protective (e.g., resistance to viral, bacterial, parasitic, and fungal infections) or pathological (e.g., autoimmune reactions and contact sensitivity reactions such as that to poison ivy) immune responses.

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“…FMS is more prevalent in women than in men (7:1) [3]. FMS patients report high levels of stressful life events [4] and daily nuisance [5,6] and frequently attribute the onset of their illness to stress, emotions, or trauma [7]. A recent study [8] on healthy subjects has also shown that psychological stress of their living state and work-associated stress persuade them toward high levels of stress.…”

Section: Introductionmentioning

confidence: 99%

Is Fibromyalgia a Syndrome of Hormonal Imbalance?

Tanwar

Mattoo

Kumar

et al. 2018

Asian J Pharm Clin Res

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Objectives: The present study was conducted to estimate cortisol and thyroid-stimulating hormone (TSH) levels in patients with fibromyalgia syndrome (FMS) and to find correlation if any between hormone levels and pain duration in FMS.Methods: Plasma cortisol and TSH concentration were determined by electro chemiluminescence immunoassay in 89 female patients with FMS and 74 age-matched healthy women.Results: No significant difference in TSH level was observed between FMS and healthy subjects. Ten patients had higher cortisol levels than the standard reference range, 48 patients with reduced cortisol and 31 patients with normal cortisol levels. No significant correlation was observed between pain duration and levels of cortisol. Conclusion:The study has confirmed the equivocal data regarding cortisol/hypothalamic-pituitary-adrenal axis related dysfunction in FMS. To the best of our knowledge, it is the first Indian study on FMS which assessed the cortisol and TSH levels and their correlation with pain duration if any.

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The relation between stress and disease activity in rheumatoid arthritis

Cited by 96 publications

References 14 publications

Enhancing versus suppressive effects of stress hormones on skin immune function

Enhancing versus suppressive effects of stress hormones on skin immune function

Stress-induced enhancement of skin immune function: A role for γ interferon

Is Fibromyalgia a Syndrome of Hormonal Imbalance?

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