Arthritis Research & Therapy

Table 5 Autonomic (ANS), neuroendocrine (NE), and immune responses to different stressors in patients with systemic inflammatory rheumatic diseases

From: Experimental stress in inflammatory rheumatic diseases: a review of psychophysiological stress responses

Stress paradigm	Studies	ANS		NE system		Immune system
		*Measure*	*Response*	*Measure*	*Response*	*Measure*	*Response*
Psychological stress		HR	↑ RA[29, 37]	Cortisol	↓/↑ RA[30]	Leucocytes	↑ RA[36]
			↑ Arthr[32]		0 SLE[44]		↑ SLE[44]
Cognitive tasks	[38]* [29, 30, 44]	SC	↑ RA[29]			Lymphocytes	↑ RA[30]
	[31]** [42]*		↑ Arthr[32]				0 SLE[44]
	[32, 36, 37]	CO	↑ RA[37]			T	0 RA[30]
		PV	↓ RA[36]				0 SLE[44]
		SVR	↑ RA[37]			B	↑ RA[30]
		BP	↑ RA[29, 36, 37]				0 SLE[44]
		CA	↑ SLE[44]			NK	↑ RA[30]
							0 SLE[44]
						Th	0 SLE[44]
						Tcyt	↑ SLE[44]
						CRP	↑ RA[36]
Psychosocial	[40, 41, 45]	HR	↑ RA[41]	Cortisol	↑ RA[41]	Leucocytes	↑ RA[40]
tasks			↑ SLE[45]	ACTH	↑ RA[41]		↑ SLE[40, 45]
		BP	↑ RA[41]			Lymphocytes	↑ RA[40]
		PEP	↓ RA[41]				↑ SLE [40, 45]
		CA	↑ RA[40]			T	↑ RA[40]
			↑ SLE[40, 45]				↑ SLE[40, 45]
						Tcyt	↑ RA[40]
							↑ SLE[40, 45]
						NK	↑ RA[40]
							↑ SLE [40, 45]
						Th	↑ RA[40]
							0 SLE[40, 45]
						NK toxicity	0 RA[40]
							0 SLE[40, 45]
						IL-6	↓ [41]/0 [40] RA
							0 SLE[40]
						IL-4	0 RA[40]
							↑ SLE[40]
						IL-2	0 RA[40]
							0 SLE[40]
						IL-10	0 RA[40]
							0 SLE[40]
						IFN-γ	0 RA[40]
							0 SLE[40]
						TNF-α	↑ RA[41]
						β - AR	0 SLE[41]
Exercise	[38]* [34, 35]			Cortisol	↓ RA[34, 35]	Th	↓ RA[35]
					↓ SLE[35]		↓ SLE[35]
				ACTH	↑ RA[34]	Tcyt	0 RA[35]
				GH	↑ RA[34]		↓ SLE[35]
				IGF-I	0 RA[34]
				PRL	0 RA[35]
					0 SLE[35]
Sensory stress
Cold induction	[38]* [39]	NE	↑ JIA[46]	Cortisol	↑ RA[39]	Leucocytes	↑ SLE[43]
	[31]** [46]					Lymphocytes	0 SLE[43]
	[33]**					T	0 SLE[43]
Heat induction	[39]					Tcyt	↑ SLE[43]
Acoustic stress	[43, 42]*					B	↑ SLE[43]
Pupillary light	[32]**					Th	↓ SLE[43]
						IL-6	↑ RA[39]
							↑ JIA[46]
						TNF-α	↑ RA[39]

↑ = increase in response to stressor, ↓ = decrease in response to stressor, 0 = no response to stressor. RA = rheumatoid arthritis, SLE = systemic lupus erythematosus, JIA = juvenile idiopathic arthritis, arthr = heterogeneous group of patients with inflammatory arthritis. * = study not described in Table because more than one stress paradigm was used, ** = study not described in Table due to lack of within-subject measurements. HR = heart rate, SC = skin conductance, BP = blood pressure, NE = norepinephrine, CA = catecholamines, PC = pupillary constriction, PV = plasma volume, PEP = pre-ejection period, CO = cardiac output, SVR = systemic vascular resistance, C = cortisol, ACTH = adrenocorticotropin hormone, PRL = prolactin, GH = growth hormone, β-AR = β adrenoceptor, IGF-I = insulin-like growth factor I, IFN-γ = interferon-γ, TNF-α = tumor necrosis factor α, IL = interleukin, CRP = C-reactive protein, B = B cell, T = T cell, Th = helper T cell, Tcyt = cytotoxic T cell, NK = natural killer cell.

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