Functional disturbance of the stress-adaptation system in patients with scleroderma
Functional disturbance of the stress-adaptation system in patients with scleroderma
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DOI：
10.3109/s10165-010-0412-5
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发表时间：
2011-01
影响因子：
2.2
通讯作者：
E. Matsuura;A. Ohta;R. Suematsu;H. Inoue;S. Koarada;Y. Tada;Ryoko Sherriff-Tadano;Tsukasa Kuroki;Daisaku Ikeda;K. Nagasawa
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文献类型：
--
作者：
E. Matsuura;A. Ohta;R. Suematsu;H. Inoue;S. Koarada;Y. Tada;Ryoko Sherriff-Tadano;Tsukasa Kuroki;Daisaku Ikeda;K. Nagasawa
有几份报告表明，最近的压力经验和风湿性疾病的发作或恶化之间的关联，虽然很少有这样的报告存在于硬皮病（SSc）患者。本研究旨在阐明SSc患者在应激时神经内分泌免疫系统作为一个稳态系统是否存在任何功能紊乱。在17名SSc患者和38名健康志愿者中，在心算应激试验前后检测了各种应激相关激素和细胞因子的血清水平，并进行了一致性感（SOC，与科普应激的能力有关）、近期应激经历和生活质量（QOL）的基础问卷研究。患者的身体QOL状态受损，但患者和对照组之间的近期应激经历和SOC评分无差异。基础血清皮质醇水平相似的患者和对照组，但增加的促炎细胞因子和去甲肾上腺素的水平被认为是在SSc患者。典型的，相反的对照组，其皮质醇水平显着增加后的心算压力测试，没有显着增加时，观察到的患者测试后的皮质醇水平相比，测试前的水平，这表明在正常的皮质醇反应的缺陷后，压力在SSc患者。目前的结果表明，有可能是受损的神经内分泌免疫系统的功能，在应力的SSc患者。
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.