Vol.21 No.4

Original Article

Functional disturbance of the stress-adaptation system in patients with scleroderma

Authors

Emi Matsuura1,2 , Akihide Ohta3 , Rie Suematsu4 , Hisako Inoue4 , Syuichi Koarada4 , Yoshifumi Tada4 , Ryoko Sherriff-Tadano5 , Tsukasa Kuroki6 , Daisaku Ikeda7 , Kohei Nagasawa4

  • Graduate School of Medical Science, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
  • Present address: Faculty of Nursing, Kwassui Women’s University, 2-1246-3 Kubara, Omura Nagasaki, 856-0835, Japan
  • Department of Adult and Gerontological Nursing, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
  • Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
  • Department of Comprehensive Support in Nursing, International University of Health and Welfare, 1-3-1 Nagahama, Chuo-ku, Fukuoka 810-0072, Japan
  • Department of Nursing Science, Hiroshima University Graduate School of Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
  • Department of Nursing, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
Received:

1 October 2010

Accepted:

18 December 2010

Published online:

21 January 2011

Full Text

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Abstract

There have been several reports indicating the association between recent stress experiences and the onset or the exacerbation of rheumatic diseases, although few such reports exist in patients with scleroderma (SSc). The present study was performed to elucidate whether there were any functional disturbances in the neuro-endocrine-immune system as a homeostatic system upon stress in SSc patients. Various serum levels of stress-related hormones and cytokines were examined before and after a mental calculation stress test, and a basal questionnaire study of sense of coherence (SOC, which is related to the ability to cope with stress), recent stress experiences, and quality of life (QOL) was performed in 17 SSc patients and in 38 healthy volunteers. Physical QOL state was impaired in patients, but there were no differences in recent stress experiences and SOC scores between patients and controls. Basal serum cortisol levels were similar in patients and controls, but increased levels of proinflammatory cytokine and noradrenalin were seen in SSc patients. Characteristically, contrary to the control group, whose cortisol levels increased significantly following the mental calculation stress test, no significant increase was observed in the patients when post-test cortisol levels were compared to pre-test levels, suggesting a defect in the normal cortisol response upon stress in SSc patients. The present results suggest that there may be impaired function of the neuro-endocrine-immune system upon stress in SSc patients.

Key words

Stress - Hypothalamic-pituitary-adrenal axis - Neuro-endocrine-immune system - Scleroderma