Psychoneuroimmunology of Multiple Sclerosis-Changes in Endocrine and Immune Parameters after Acute Psychological Stress

By Heesen, C.; Schulz, K-H et al. | Psychologische Beiträge, January 1, 2000 | Go to article overview
Save to active project

Psychoneuroimmunology of Multiple Sclerosis-Changes in Endocrine and Immune Parameters after Acute Psychological Stress


Heesen, C., Schulz, K-H, Schulz, H., Psychologische Beiträge


Summary

Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system. An impaired hypothalamo-pituitary axis (HPA) and stress reactivity have extensively been discussed without convincing expertimental evidence. We choose a standardized acute psychological stressor to determine whether MS patients show altered endocrine and immune responses to stress. In the preliminary analysis we included 14 relapsing-remitting MS patients and 5 healthy controls. During exposure to the stress we saw a reduced ACTH response in MS patients. IL-6, IL-6 receptor did not differ between stressed and non-stressed MS patients. TNF-alpha after whole blood stimulation revealed a reduced capacity in 5 stressed versus 7 control MS patients. From these data we postulate an altered neural-- immune signaling in relapsing-remitting MS patients during acute experimental stress with an HP A hyporeactivity and a TNF hyporesponsiveness. But results have to be confirmed in a larger patient sample.

Key words: stress, multiple sclerosis, immune response, endocrine response.

Introduction

Multiple sclerosis (MS) is the most frequent disabling disease of young adults. In the beginning stages of the disease it is very difficult to predict whether the course will be rapidly progressive or relapsing-remitting. The target of the pathophysiological process is the myelin layer of nerve axons in the central nervous system (CNS). Pathomorphologically, MS is characterized by multiple demyelinating plaques with a differing extent of inflammatory cells. An autoimmune process is the generally accepted underlying etiology. Genetical, immunological and environmental factors are involved in the manifestation of the disease. Furthermore, neuroendocrinological factors are discussed, but the scientific evidence is inconsistent. As in many other chronic diseases, psychological factors are regarded important in the course of the disease, especially concerning manifestation and relapses. The evidence for a stress-mediated activation of autoimmunity nevertheless is weak.

Immunology of MS

MS is regarded a predominantly T-cell-mediated, demyelinating process in the CNS. An unknown environmental antigen is thought to elicit the inflammatory cascade (Hartung and Giovannoni, 1996). Via molecular mimicry, physiological autoaggressive T-cells might be activated through this environmental antigen, leading to the cascade of inflammatory reaction. Different authors have shown some association of MS to human leucocyte antigens (HLA) and T-cell receptor repertoires (Ransohoff et al., 1995). Sibling studies have shown an increased risk for MS when family members are already affected. Thus there is evidence for a genetic component in the disease. A quite specific humoral immune response can be detected in the cerebrospinal fluid (CSF) which suggests B-cell activation as a further pathogenetic factor (Tourtellotte, 1985). During the last 3 years, elevated levels of different cell adhesion molecules (E-selectine, intracellular-adhesion-molecules I and 3, vascular-cell adhesion-molecule 1) and cytokines (tumor-necrosis-factor-alpha and its soluble receptor, interferon-gamma, transforming growth factor beta, interleukins 2, 4, 10, 12) could be detected in tissue, CSF and serum of MS patients (Arnason et al., 1995; Hartung and Giovannoni ,1996; Rieckmann et al., 1994; Sharief et al., 1993; Trotter et al., 1991).

For many years, any attempt to establish CSF or serum activity factors for MS failed. Today there is first evidence of an association between cytokines and adhesion molecules and the disease activity (Rieckmann et al., 1994 and 1997; Sahrief et al., 1993). Perhaps these parameters have a prognostic relevance. The first approved MS therapy is itself a cytokine, interferon-Beta (The Interferon-Beta Multiple Sclerosis Study Group, 1995). A major mechanism of interferon-Beta-activity might be the modulation of interferon-gamma and tumornecrosis-factor-alpha mitigated immune alterations.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Psychoneuroimmunology of Multiple Sclerosis-Changes in Endocrine and Immune Parameters after Acute Psychological Stress
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?