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Experimental stress in inflammatory rheumatic diseases a review of psychophysiological stress responses.doc

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Experimental stress in inflammatory rheumatic diseases a review of psychophysiological stress responses

de Brouwer et al. Arthritis Research Therapy 2010, 12:R89 /content/12/3/R89 RESEARCH ARTICLE Open Access Experimental stress in inflammatory rheumatic Research article diseases: a review of psychophysiological stress responses Sabine JM de Brouwer*1, Floris W Kraaimaat1, Fred CGJ Sweep2, Marjonne CW Creemers3, Timothy RDJ Radstake3, Antoinette IM van Laarhoven1, Piet LCM van Riel3 and Andrea WM Evers1 Abstract Introduction: Stressful events are thought to contribute to the aetiology, maintenance and exacerbation of rheumatic diseases. Given the growing interest in acute stress responses and disease, this review investigates the impact of real- life experimental psychosocial, cognitive, exercise and sensory stressors on autonomic, neuroendocrine and immune function in patients with inflammatory rheumatic diseases. Methods: Databases Medline, PsychINFO, Embase, Cinahl and Pubmed were screened for studies (1985 to 2009) investigating physiological stress responses in inflammatory rheumatic diseases. Eighteen articles met the inclusion criteria. Results: Results suggest that immune function may be altered in response to a stressor; such alterations could contribute to the maintenance or exacerbation of inflammatory rheumatic diseases during stressful events in daily life. Conclusions: This review emphasizes the need for more experimental research in rheumatic populations with controlled stress paradigms that include a follow-up with multiple evaluation points, simultaneous assessment of different physiological stress systems, and studying factors contributing to specific physiological responses, such as stress appraisal. Introduction bodys immune system [13-16]. However, little attention has been paid to whether and how different short-term experimental stressors influence the separate pathways of the physiological stress response system (ANS, HPA axis, immune system) in patients with inflammatory rheu- matic diseases. Stress is widely recognized