The aims of this study were (1) to measure levels of cytokines and stress hormones in ulcerative colitis (UC) patients and determine whether there were any disturbances in the nervous, endocrine, or immune systems, and (2) to measure the ability of UC patients to cope with stress (using a sense of coherence, SOC, test) and their perceived self-efficacy, and to elucidate their response to a stress load.
We administered questionnaires to and took blood samples from 42 outpatients and eight inpatients whose UC was in remission, and 21 healthy volunteers. In addition, we evaluated blood samples from the inpatients and healthy volunteers following a mental calculation stress test.
The questionnaire results revealed that self-efficacy was significantly decreased in the patient groups. Levels of adrenocorticotropic hormone, β-endorphin and interleukin (IL)-6 were significantly higher in the outpatient than in the control group. IL-6 levels significantly increased following the mental calculation stress test in UC patients compared with in the volunteers.
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.
cytokines hypothalamic–pituitary–adrenal axis mental calculation stress test self-efficacy stress hormone
Drossman, DA, Leserman, J, Li, Z, Mitchell, M, Zagami, EA, Patrick, DL 1991The rating form of IBD patient concerns: a new measure of health statusPsychosom Med5370112PubMedGoogle Scholar
Moser, G, Tillinger, W, Sachs, G, Genser, D, Maier-Dobersberger, T, Spiess, K, et al. 1995Disease-related worries and concerns: a study on out patients with inflammatory diseaseEur J Gastroenterol Hepatol78538PubMedGoogle Scholar
Mawdsley, JE, Rampton, DS 2005Psychological stress in IBD: new insights into pathogenic and therapeutic implicationsGut54148191PubMedCrossRefGoogle Scholar
Kojima, K, Naruse, Y, Iijima, N, Wakabayashi, N, Mitsufuji, S, Ibata, Y, et al. 2002HPA-axis responses during experimental colitis in the ratAm J Physiol Regul Integr Comp Physiol282R134855PubMedGoogle Scholar
Kresse, AE, Million, M, Saperas, E, Tache, Y 2001Colitis induces CRF expression in hypothalamic magnocellular neurons and blunts CRF gene response to stress in ratsAm J Physiol Gastrointest Liver Physiol281G1023213Google Scholar
Straub, RH, Vogl, D, Gross, V, Lang, B, Scholmerich, J, Andus, T 1998Association of humoral markers of inflammation and dehydroepiandrosterone sulfate or cortisol serum levels in patients with chronic inflammatory bowel diseaseAm J Gastroenterol932197202PubMedCrossRefGoogle Scholar
Myren, J, Bouchier, IA, Watkinson, G, Softley, A, Clamp, SE, de Dombal, FT 1984The O.M.G.E. Multinational Inflammatory Bowel Disease Survey 1976–1982. A further report on 2657 casesScand J Gastroenterol Suppl95127PubMedGoogle Scholar
Sherer, M, Maddux, J, Mercandante, B, Prentice-Dunn, S, Jacobs, B, Rogers, RW 1982The self-efficacy scale: construction and validationPsychol Rep5166371Google Scholar
Sakano, Y, Tohjoh, M 1986The general self-efficacy scale (GSES): scale development and validation (in Japanese with English abstract)Jpn J Behav Ther127382Google Scholar
Antonovsky, A 1996The salutogenic model as a theory to guide health promotionHealth Promot Int11118CrossRefGoogle Scholar
Callahan, LF, Pincus, T 1995The sense of coherence scale in patients with rheumatoid arthritisArthritis Care Res82835PubMedCrossRefGoogle Scholar
Togari, T, Yamazaki, Y 2005Examination of the reliability and factor validity of 13-item five-point version sense of coherence scale (in Japanese with English abstract)Minzoku Eisei7116882Google Scholar
Iwahashi, S, Tanaka, Y, Fukudo, S, Hongo, M 2002The development of the Japanese version of the perceived stress scale (in Japanese with English abstract)Jpn J Psychosom Med4245966Google Scholar
Okano, Y, Utsunomiya, T, Yano, K 1998Effect of mental stress on hemodynamics and left ventricular diastolic function in patients with ischemic heart diseaseJpn Circ J621737PubMedCrossRefGoogle Scholar
deanfield, JE, Shea, M, Kensett, M, Horlock, P, Wilson, RA, De Landsheere, CM, et al. 1984Silent myocardial ischaemia due to mental stressLancet210015PubMedCrossRefGoogle Scholar
Kmiec, Z 1998Cytokines in inflammatory bowel diseaseArch Immunol Ther Exp (Warsz)4614355Google Scholar
Hyams, JS, Fitzgerald, JE, Wyzga, N, Treem, WR, Justinich, CJ, Kreutzer, DL 1994Characterization of circulating interleukin 1 receptor antagonist expression in children with inflammatory bowel diseaseDig Sci3918939CrossRefGoogle Scholar
Hirano, D, Nagashima, M, Ogawa, R, Yoshino, S 2001Serum levels of interleukin 6 and stress related substances indicate mental stress condition in patients with rheumatoid arthritisJ Rheumatol284905PubMedGoogle Scholar