Psychoimmunology and Rheumatoid Arthritis: Concepts and Methodologies

Abstract

The recent growth of knowledge about the immune-neuroendocrine network has important implications for future research into psychosomatic hypotheses about the aetiology of rheumatoid arthritis. The available evidence suggests that three phases of the aetiological process in rheumatoid arthritis need to be considered separately because of the different role that psychological and social variables may play at different points of the disease. These are the loss of immunological tolerance, the onset of joint inflammation and the long-term disease course. It is suggested that future studies will need to be prospective, include multiple sampling techniques and comparisons within patient groups if they are to elucidate the precise role of psychoneuroimmunological factors in rheumatoid arthritis.

Stressful life events' effects on rheumatoid arthritis disease activity.

“…Joint examinations and ARIMA time series analyses provided empirical support for this interpretation. Such a rapid and dramatic unfolding of events implied physiological changes, specifically an altered state of immunity that would alleviate symptoms of RA (McFarlane & Brooks, 1990).…”

“…Because of the large and immediate clinical changes, as well as the potential to identify mechanisms, her case was earmarked for intense study. Consistent with McFarlane and Brooks (1990), major events were hypothesized to correlate inversely with disease activity. Small life events were investigated for their unique effects on symptoms, as well as for their mediating properties.…”

“…As mentioned previously, everyday stressors seem to exacerbate arthritis symptoms by enhancing immune reactions in RA populations (Zautra et al, 1994). Conversely, reduced immune activity after major life events has been hypothesized to decrease RA clinical symptoms (McFarlane & Brooks, 1990), because significantly stressful times, such as bereavement periods, are met with a suppressed immune response in humans (Schleifer, Keller, Camerino, Thornton, & Stein, 1983). Until now, the theoretical impact of major events on RA clinical presentations has not been tested properly.…”

Susceptibility to adjuvant arthritis: relative importance of adrenal activity and bacterial flora

“…Similarly, we observed that stress, induced by daily injection ofa vehicle substance, may result in almost complete prevention of murine type II collagen arthritis ( [15], manuscript in preparation). In addition, studies in patients with rheumatoid arthritis (RA) also demonstrated immunosuppressive effects of stress [16,17]. In contrast, other investigators emphasize that stress may selectively affect the T suppressor cell system in RA patients [I8j.…”