Rheumatology Advance Access originally published online on November 30, 2005
Rheumatology 2006 45(2):182-186; doi:10.1093/rheumatology/kei081
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Mirthful laughter differentially affects serum pro- and anti-inflammatory cytokine levels depending on the level of disease activity in patients with rheumatoid arthritis
Department of Joint Disease and Rheumatism, Nippon Medical School, Tokyo, Japan.
Correspondence to: T. Matsuzaki. E-mail: matsuzaki{at}nms.ac.jp
Objectives. To examine the effect of mirthful laughter in rheumatoid arthritis (RA), we evaluated the levels of serum cytokines before and after patients experienced mirthful laughter.
Methods. Forty-one patients with RA and 23 healthy subjects were enrolled. They listened to ‘Rakugo’, a traditional Japanese comic story, to induce mirthful laughter. We measured serum IL-6, IL-1ß, TNF-
, IL-4 and IL-1 receptor antagonist (IL-1Ra) concentrations before and after patients listened to the story. The RA subjects were divided into two groups. One was designated the ‘difficult-to-control RA’ group (CRP 
1.0 mg/dl); The other group was regarded as the ‘easily controlled RA’ group (CRP <1.0 mg/dl).
Results. The basal levels of serum IL-6 and TNF- in the RA patients were significantly higher than those in the healthy group. After experiencing mirthful laughter, the levels of serum IL-6 decreased significantly in the RA group but not in the healthy subjects. Interestingly, the level of serum TNF- decreased only in the easily controlled RA group. Serum IL-4 concentration in the RA group was significantly higher than that in healthy subjects before the story. After the story, the level of serum IL-4 significantly decreased in the RA group, especially in the difficult-to-control RA group. In contrast, serum IL-1Ra concentration was statistically higher in the RA group than that in healthy subjects before the story, and a further increase was observed after the story, especially in the easily controlled RA group.
Conclusions. Our findings suggest that mirthful laughter affects the levels of serum pro- and anti-inflammatory cytokines differentially, depending on the RA disease activity.
KEY WORDS: Rheumatoid arthritis, Cytokines, Mental condition, Stress, Mirthful laughter
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