Document Detail

Stress-induced endocrine and immunological changes in psoriasis patients and healthy controls. A preliminary study.
MedLine Citation:
PMID:  9491439     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Clinical observations suggest that psychological stress can induce exacerbation of psoriasis. It is hypothesized that these stress effects on the course and outcome of psoriasis are caused by neuroendocrine modulation of immune functions. Therefore we investigated the cardiovascular, endocrine and immunological response to a laboratory stressor in psoriasis patients and healthy controls. METHODS: Untreated (n = 7) and PUVA-treated (n = 4) psoriatics and healthy controls (n = 7) were exposed to a brief laboratory stressor (public speaking and mental arithmetic). Heart rate and blood pressure, catecholamine, cortisol, and DHEA plasma concentration, as well as distribution of T and NK lymphocytes were analyzed before, immediately after and 1 h after stress exposure. RESULTS: Heart rate and blood pressure increased in all three groups during stress exposure with the most pronounced changes in PUVA-treated patients. Psoriasis patients displayed higher adrenaline values but diminished cortisol and DHEA plasma concentrations compared to controls. NK cell numbers (CD16+, CD56+), but not T lymphocyte subsets, increased immediately after stress exposure in untreated patients and controls. This effect was significantly diminished in PUVA-treated patients. CONCLUSIONS: The data of this pilot study indicate an enhanced stress-induced autonomic response and diminished pituitary-adrenal activity in psoriasis patients. PUVA treatment seems to interfere with the cardiovascular and NK cell response to acute psychological stress. Future studies will analyze the stress-induced neuroimmunological mechanisms in psoriatics in more detail.
G Schmid-Ott; R Jacobs; B Jäger; S Klages; J Wolf; T Werfel; A Kapp; T Schürmeyer; F Lamprecht; R E Schmidt; M Schedlowski
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Psychotherapy and psychosomatics     Volume:  67     ISSN:  0033-3190     ISO Abbreviation:  Psychother Psychosom     Publication Date:  1998  
Date Detail:
Created Date:  1998-04-02     Completed Date:  1998-04-02     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0024046     Medline TA:  Psychother Psychosom     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  37-42     Citation Subset:  IM    
Department of Psychosomatic Medicine, Hannover Medical School, Germany.
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MeSH Terms
Blood Pressure
Heart Rate
Immunity, Cellular
Killer Cells, Natural
Lymphocyte Subsets
Neurosecretory Systems / physiology*
PUVA Therapy*
Pilot Projects
Pituitary-Adrenal System / immunology*
Psoriasis / immunology*,  psychology*,  therapy
Stress, Psychological*

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