Abstract
IntroductionPsychological 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.MethodsIn 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.ResultsBasal 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.ConclusionsIn 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.Trial registrationThe Netherlands National Trial Register (NTR1193)
Highlights
Psychological stress may alter immune function by activating physiological stress pathways
We explored the effects of the intervention on stress-induced levels of key cytokines involved in disease progression in patients with rheumatoid arthritis (RA), with stress being elicited by the Trier Social Stress Test
Post-treatment stress-induced cytokine levels Immediately after the intervention, stress-induced cytokine levels were similar in the intervention and control groups, indicating that patients in the intervention group did not have an altered immune response to stress compared with patients in the control group
Summary
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. Stress could have negative effects on health, in populations with immune dysfunction, such as patients with rheumatoid arthritis (RA). In an extensive meta-analysis by Miller and Cohen there was only modest evidence that different types of stress management interventions change basal immune function in healthy and clinical populations, with most consistent changes being found in basal total leukocyte counts and secretory immunoglobulin A levels [6]. The benefits of stress management training can become evident because patients are challenged to cope with a stressful situation
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