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Rheumatology 2001; 40: 868-875
© 2001 British Society for Rheumatology

Original Papers

Systemic lupus erythematosus and rheumatoid arthritis patients differ from healthy controls in their cytokine pattern after stress exposure

R. Jacobs, C. R. Pawlak1, E. Mikeska1, D. Meyer-Olson, M. Martin2, C. J. Heijnen3, M. Schedlowski4 and R. E. Schmidt

Division of Clinical Immunology,
1 Division of Medical Psychology,
2 Division of Clinical Molecular Pharmacology, Hannover Medical School, 30623 Hannover, Germany,
3 Division of Immunology, University Hospital for Children and Youth, 3501 CA Utrecht, The Netherlands and
4 Division of Medical Psychology, University of Essen, 45122 Essen, Germany

Objective. To study whether patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) differ from healthy individuals in their immune responses to acute psychological stress.

Methods. The phenotype and function of peripheral blood lymphocytes were analysed before and after stress exposure in patients and healthy subjects.

Results. Natural killer (NK) cell numbers increased transiently in all groups under stress. NK activity, however, increased in healthy controls only. We observed a stress-induced increase in interleukin (IL)-4-producing (IL-4+) cells in SLE patients only, whereas interferon (IFN) {gamma}+ cell numbers increased due to stress in all three groups. An analysis of supernatants from phytohaemagglutinin (PHA) cultures revealed increased IFN{gamma} and IL-10 levels in healthy subjects but not in SLE or RA patients after stress exposure.

Conclusions. These data demonstrate that RA and SLE patients differ in their immune response to stress from healthy controls. Changes in cytokine patterns might be responsible for stress-induced exacerbation of disease activity in RA and SLE patients.

KEY WORDS: Rheumatoid arthritis, Systemic lupus erythematosus, Stress, Natural killer cells, Cytokines.

Correspondence to: R. Jacobs


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