Dataset Information

Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis.

ABSTRACT:

Background

Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA).

Methods

Seventy-four patients with RA, who were randomly assigned to either a control group or a group that received short-term stress management training, performed a standardized psychosocial stress task (Trier Social Stress Test; TSST) 1 week after the stress management training and at a 9-week follow-up. Psychological and physical functioning, and the acute psychophysiological response to the stress test were assessed.

Results

Patients in the intervention group showed significantly lower psychological distress levels of anxiety after the training than did the controls. While there were no between-group differences in stress-induced tension levels, and autonomic (?-amylase) or endocrine (cortisol) responses to the stress test 1 week after the intervention, levels of stress-induced tension and cortisol were significantly lower in the intervention group at the 9-week follow-up. Overall, the response to the intervention was particularly evident in a subgroup of patients with a psychological risk profile.

Conclusion

A relatively short stress management intervention can improve psychological functioning and influences the psychophysiological response to stress in patients with RA, particularly those psychologically at risk. These findings might help understand how stress can affect health and the role of individual differences in stress responsiveness.

Trial registration

TrialRegister.nl NTR1193.

SUBMITTER: de Brouwer SJ

PROVIDER: S-EPMC3232221 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Publications

Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis.

de Brouwer Sabine J M SJ Kraaimaat Floris W FW Sweep Fred C G J FC Donders Rogier T RT Eijsbouts Agnes A van Koulil Saskia S van Riel Piet L C M PL Evers Andrea W M AW

PloS one 20111206 12

<h4>Background</h4>Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA).<h4>Methods</h4>Seventy-four patients with RA, who were randomly assigned to either a control group or a group that received short-term stress management training, performed a standardized psychosocial stress task (T ...[more]

PMID: 22162990

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Project description:Accumulating data implicate the CD4+ T cell subset (Th17 cells) in rheumatoid arthritis (RA). IL-17 is an inflammatory cytokine that induces tumor necrosis factor (TNF)?, IL-1? and IL-6, all of which are targets of biologic therapies used to treat RA. RA patients are well documented to experience more infections than age-matched controls, and biologic therapies further increase the risk of infection. The Th17/IL-17 axis is vital for immunity to fungi, especially the commensal fungus Candida albicans. Therefore, we were prompted to examine the relationship between RA and susceptibility to C. albicans because of the increasing interest in Th17 cells and IL-17 in driving autoimmunity, and the advent of new biologics that target this pathway.We analyzed peripheral blood and saliva from 48 RA and 33 healthy control subjects. To assess C. albicans-specific Th17 responses, PBMCs were co-cultured with heat-killed C. albicans extract, and IL-17A levels in conditioned supernatants were measured by ELISA. The frequency of Th17 and Th1 cells was determined by flow cytometry. As a measure of IL-17A-mediated effector responses, we evaluated C. albicans colonization rates in the oral cavity, salivary fungicidal activity and levels of the antimicrobial peptide ?-defensin 2 (BD2) in saliva.Compared to controls, PBMCs from RA subjects exhibited elevated baseline production of IL-17A (P?=?0.004), although they had similar capacity to produce IL-17A in response to Th17 cell differentiating cytokines (P?=?0.91). However RA PBMCs secreted less IL-17A in response to C. albicans antigens (P?=?0.006). Significantly more RA patients were colonized with C. albicans in the oral cavity than healthy subjects (P?=?0.02). Concomitantly, RA saliva had reduced concentrations of salivary BD2 (P?=?0.02). Nonetheless, salivary fungicidal activity was preserved in RA subjects (P?=?0.70).RA subjects exhibit detectable impairments in oral immune responses to C. albicans, a strongly Th17-dependent opportunistic pathogen, despite an overall elevated baseline production of IL-17A.

Dataset Information

Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis.

Background

Methods

Results

Conclusion

Trial registration

Publications

Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis.

Similar Datasets

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