Stress maladjustment in the pathoetiology of ulcerative colitis

Kuroki, Tsukasa; Ohta, Akio; Aoki, Yosuke; Kawasaki, Seiji; Sugimoto, Nozomi; Ootani, Hibiki; Tsunada, Seiji; Iwakiri, Ryuichi; Fujimoto, Kazuma

doi:10.1007/s00535-007-2042-z

Cited by 17 publications

(8 citation statements)

References 17 publications

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“…This may be due to a negative feedback mechanism caused by increased cortisol levels in the controls. In a previous study of patients with inflammatory bowel disease [2], no significant differences in CRH and ACTH levels were reported before and after the mental calculation stress test in the control group, which is consistent with the present results. The molar ratio of serum cortisol to ACTH in the patients after the stress test did not differ from that before the stress test, in contrast to the situation for the controls, who showed a significant increase after stress loading.…”

Section: Discussionsupporting

confidence: 93%

“…We have also recently reported the possibility of a deficit in the cortisol response to mental stress and the resultant exacerbation of disease in patients with inflammatory bowel diseases [2]. The present study also suggests a functional disturbance to the stress-adaptation system (low responsiveness of the HPA axis to mental stress and basal sympathetic activation) in SSc patients.…”

Section: Discussionsupporting

confidence: 71%

“…Usually, the activation of the stress-adaptation system causes a shift toward the inhibition of the cellular immune response and the production of proinflammatory cytokines such as interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-a [2]. Since these proinflammatory cytokines exert a stimulatory action on glucocorticoid secretion by promoting CRH secretion in the hypothalamus, and also by directly stimulating the adrenal gland, inhibiting these cytokines leads to the termination of the inflammatory state (neuro-endocrine-immune regulatory loop) (Fig.…”

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confidence: 99%

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

et al. 2011

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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.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 71%

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confidence: 99%

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

et al. 2011

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“…Patients with IBD are nearer reaching a consensus, with 74% believing that psychological factors have played a role in triggering the onset of disease or relapse of their illness [2]. More compellingly, recent studies in animals [3][4][5][6] and humans [7][8][9] have provided stronger evidence for plausible mechanisms by which stress effects could be transduced into gut inflammation, including stressinduced changes in intestinal permeability [10][11][12] and stress-induced changes in mucosal pro-inflammatory cytokines [7].…”

Section: Resultsmentioning

confidence: 99%

The Role of Stress in the Development and Clinical Course of Inflammatory Bowel Disease: Epidemiological Evidence

Maunder

Levenstein

2008

CMM

166

123

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“…Söderholm and Perdue [22] pointed out that various types of physical and psychological stress have an impact on several components of intestinal barrier function such as increasing intestinal permeability and stimulating secretion of ions, water, mucus, and even IgA. This increased permeability in turn reduces mucosal barrier function and alters bacteria-host interaction [12, 23]. However, based mainly on animal studies, these observations are likely to play a role in the pathophysiology of human IBD.…”

Section: Possible Mechanisms Of the Effects Of Psychological Stresmentioning

confidence: 99%

Psychological Issues in Inflammatory Bowel Disease: An Overview

Sajadinejad

Asgari

Molavi

et al. 2012

Gastroenterology Research and Practice

185

140

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Inflammatory bowel disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC) is a chronic and disabling disease with unknown etiology. There have been some controversies regarding the role of psychological factors in the course of IBD. The purpose of this paper is to review that role. First the evidence on role of stress is reviewed focusing on perceived stress and patients' beliefs about it in triggering or exacerbating the course of IBD. The possible mechanisms by which stress could be translated into IBD symptoms, including changes in motor, sensory and secretory gastrointestinal function, increase intestinal permeability, and changes in the immune system are, then reviewed. The role of patients' concerns about psychological distress and their adjustment to disease, poor coping strategies, and some personality traits that are commonly associated with these diseases are introduced. The prevalence rate, the timing of onset, and the impact of anxiety and depression on health-related quality of life are then reviewed. Finally issues about illness behavior and the necessity of integrating psychological interventions with conventional treatment protocols are explained.

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Stress maladjustment in the pathoetiology of ulcerative colitis

Abstract: These results indicate that UC patients (1) have hypersensitive nervous, endocrine, and immune systems, and (2) this hypersensitivity was augmented by the mental calculation stress test.

Cited by 17 publications

References 17 publications

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

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

The Role of Stress in the Development and Clinical Course of Inflammatory Bowel Disease: Epidemiological Evidence

Psychological Issues in Inflammatory Bowel Disease: An Overview

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