Systemic lupus erythematosus and rheumatoid arthritis patients differ from healthy controls in their cytokine pattern after stress exposure

Objective. To study whether patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) differ from healthy individuals in their immune responses to acute psychological stress. Methods. The phenotype and function of peripheral blood lymphocytes were analysed before and after stress exposure in patients and healthy subjects. Results. Natural killer (NK) cell numbers increased transiently in all groups under stress. NK activity. however, increased in healthy controls only. We observed a stress-induced increase in interleukin (IL)-4- producing (IL-4(+)) cells in SLE patients only, whereas interferon (IFN)gamma (+) cell numbers increased due to stress in all three groups. An analysis of supernatants from phytohaemagglutinin (PHA) cultures revealed increased IFN gamma and IL-10 levels in healthy subjects but not in SLE or RA patients after stress exposure. Conclusions. These data demonstrate that RA and SLE patients differ in their immune response to stress from healthy controls. Changes in cytokine patterns might be responsible for stress-induced exacerbation of disease activity in RA and SLE patients.