Immunologische Imbalancen bei Stress

Zusammenfassung

Chronische Belastungsstörungen finden derzeit in Klinik und Forschung eine vermehrte Aufmerksamkeit. Die psychoneuroimmunologische Forschung untersucht in diesem Zusammenhang die biologische Stressantwort sowie den „Cross-talk” zwischen neuroendokrinen Zellen und Immunzellen. Bei der Frage nach der Interaktion von psychischem Stress, Stressmediatoren und psychischen wie somatischen Erkrankungen kann nicht von einem unmittelbaren linearen Zusammenhang ausgegangen werden. Stattdessen ist das grundlegende Paradigma, dass insbesondere chronischer psychischer Stress zu Veränderungen in Regulationsgleichgewichten führt, die wiederum die Vulnerabilität für pathologische Folgeprozesse erhöhen. Da eine Dysregulation eben dieser Mediatoren in der Pathogenese von Infektions-, Autoimmun- und allergischen Erkrankungen eine bedeutende Rolle spielt, sind die pathologischen Folgeprozesse von Patienten mit chronischem psychischen Stress, besonders im Hinblick auf chronische Belastungsstörungen, zu prüfen. Um die Interaktion zwischen Psyche und Soma näher zu erforschen, erscheinen hier die Stressmediatoren vielversprechend, speziell die Zytokine Interleukin-10 und Interleukin-12 sowie die Th-1/Th-2-Ratio.

Summary

There is a growing interest in chronic stress reactions. Psychoneuroimmunological research examines the biological stress response and the “cross-talk” between neuroendocrine cells and immune cells. The interaction of psychological stress, stress mediators and psychiatric and/or somatic illnesses cannot be an immediate linear connection. Instead, the basic paradigm is that chronic psychological stress leads to changes in the allostatic ability of the organism which raises the vulnerability of pathological processes. Because a dysregulation of these mediators plays an important role in the pathogenesis of infections or autoimmune and allergic diseases, the pathological adaptation processes of patients with chronic psychological stress are of high interest. Promising indicators of these processes are the cytokines Interleukin-10, Interleukin-12 and the Th-1/Th-2-Ratio.

Schlüsselwörter

Psychischer Stress - Belastungsstörung - Zytokine - IL-10/12-Ratio

Keywords

Psychological stress - stress dysfunction - cytokines - IL-10/12-Ratio

• Literatur

• 1 Aloe L, Alleva E, Fiore M. Stress and nerve growth factor: findings in animal models and humans. Pharmacol Biochem Behav 2002; 73: 159-166.
• 2 Altare F. et al. Impairment of mycobacterial immunity in human interleukin-12 receptor deficiency. Sience 1998; 280: 1432-1435.
• 3 Arck PC, Slominzki A, Theoharides TC, Peters EMJ, Paus R. Neuroimmunology of Stress: Skin takes center stage. Journal of Investigative Dermatology 2006; 126: 1697-1704.
• 4 Arolt V, Rothermundt M. The immunology of Psychiatric Disorders. Psychother Psych Med 2005; 55: 36-48.
• 5 Bartolomucci A, Palanza P, Gaspani L, Limiroli E, Panerai AE, Ceresini G. et al. Social status in mice: behavioral, endocrine and immune changes are context dependent. Psychol Behav 2001; 73: 401-410.
• 6 Bartolomucci A, Sacerdote P, Panerai AE, Pederzani T, Palanza P, Parmigiani S. Chronic psychosocial stress induced down-regulation of immunity depends upon individual factors. J Neuroimmunol 2003; 151: 58-64.
• 7 Bartolomucci A, Palanza P, Dacerdote P, Panerai AE, Sgoifo A, Dantzer R, Parmigiani S. Social factors and individual vulnerability to chronic stress exposure. Neuroscience biobehavior Rev 2005; 29: 67-81.
• 8 Besedovsky HO, Sorkin E. Network of immuneendocrine interactions. Clin Exp Immunol 1977; 27: 1-12.
• 9 Blotta MH, DeKruyff RH, Umetu DT. Corticocosteroids inhibit IL-12 production in human monocytes and enhance their capacity to induce IL-4 synthesis in CD4+ lymphocytes. J Immunol 1997; 158: 5589-5595.
• 10 Boscarino JA, Chang J. Higher abnormal leukocyte and lymphocyte counts 20 years after exposure to severe stress: research and clinical implications. Psychosomatic Medicine 1999; 61: 378-386.
• 11 Bresnitz S. et al. Experimental induction of acutepsychological stress in human volunteers, effects on immunological, neuroendocrine, cardio vascular and psychological parameters. Brain, Behavior and Immunity 1998; 12: 34-55.
• 12 Cacioppo JT, Berntson GG, Malarkey WB, Kiecolt-Glaser JK, Sheridan JF, Poehlmann KM. et al. Autonomic, neuroendocrine, and immune responses to psychological stress: the reactivity hypothesis. Ann NY Acad Sci 1998; 840: 664-673.
• 13 Cash JM, Crofford LJ, Gallucci WT, Sternberg EM, Gold PW, Chrousos GP, Wilder RL. Pituitaryadrenal axis responsivemness to ovine corticotropin releasing hormone in patients with rheumatoid arthritis treated with low dose prednisone. J Rheumatol 1992; 19: 1692-1696.
• 14 Chrousos GP. The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. New Engl J Med 1995; 332: 1351-1362.
• 15 Cohn S, Tyrrell DA, Smith AT. Psychological stress and susceptibility to common cold. New Engl J Med 1991; 325: 606-612.
• 16 Cohen S, William JD, David PS. Psychological stress, cytokine production, and severity of upper respiratory illness. Psychosomatik Medicine 1999; 61: 175-180.
• 17 Dhabhar FS. Stress-induced enhancement of cellmediated immunity. Ann NY Acad Sci 1998; 840: 359-372.
• 18 Dhabar FS, McEwen BS. Bidirectional effects of stress and glucocorticoid hormones on immune function: possible explainations for paradoxical observations. In: Ader R, Felten DL, Cohen N. (Hrsg): Psychoneuroimmunology. 3rd ed. Vol. 1. San Diego: Academic Press; 2001
• 19 DeKruyff RH, Fang Y, Umetsu DT. Corticosteroids enhance the capacity of macrophages to induce Th2 cytokine synthesis in CD4+ lymphocytes by inhibiting IL-12 production. J Immunol 1998; 160: 2231-2237.
• 20 Elenkov IJ, Papanicolaou DA, Wilder RL, Chrousos GP. Modulatory effects of glucocorticoids and catecholamines on human interleukin-12 and interleukin-10 production: clinical implications. Proc Assoc Am Physicians 1996; 108: 374-381.
• 21 Elenkov IJ, Chrousos GP. Stress hormones, Th1/ Th2 patterns, pro/anti-inflammatory cytokines and susceptibility to disease. TEM 1999; 09: 359-368.
• 22 Elenkov IJ, Iezzoni DG, Daly A, Harris AG, Chrousos GP. Cytokine dysregulation, inflammation and well-being. Neuroimmunomodul 2005; 12: 255-269.
• 23 Fearon DT, Lockslay RM. The instruktive role of innate immunity in the acquired immune responce. Science 1996; 272: 50-53.
• 24 Gilioli R, Campanini P, Fichera GP, Punzi S, Cassitto MG. Emerging aspects of psychosocial risks: violence and harassment at work. Med Lav 2006; 97: 160-164.
• 25 Glaser R, Kiecolt-Glaser JK. Stress-induced immune dysfunction: implications for helth. Nat Rev Immunol 2005; 05: 243-251.
• 26 Haraguchi S, Good RA, James-Yarish M, Cianciolo GJ, Day NK. Induction of intracellular cAMP by syntetic retroviral envelope peptide: a possible mechanism of immunopathogemesis in retroviral infections. Proc Natl Acad Sci USA 1995; 92: 5568-5571.
• 27 Hasko G, Szabo C, Nemeth ZH, Salzman AL, Vizi ES. Stimmulation of beta-adrenoceptors inhibits endotoxin-induced IL-12 production in normal and IL-10 deficient mice. J Neuroimmunol 1998; 88: 57-61.
• 28 Kersting A, Fischer S, Suslow T, Ohrmann P, Arolt V. Messinstrument zur Erfassung von Trauer – Ein kritischer Überblick. Psychotherapie, Psychosomatik Medizinische Psychologie 2003; 53: 475-484.
• 29 Kincy-Cain T, Bost KL. Substanz P-induced IL-12 production by murine macrophages. J Immunol 1997; 158: 2334-2339.
• 30 Knackstedt MK, Arck PC. Geschlechtsspezifische Unterschiede bei Asthma bronchiale. Klinikarzt 2006; 35 (01) 359-365.
• 31 Lazarus RS. (Hrsg) Psychological stress and coping process. New York: McGraw-Hill; 1966
• 32 Lerner BH. Can stress cause disease? Revisiting the tuberculosis reseach of Thomas Holmes, 1949–1961. Ann Intern Med 1996; 124: 673-680.
• 33 Levi-Montalcini R, Skaper SD, Dal Toso R, Petrelli L, Leon A. Nerve groth factor: from neurotrophin to neurokin. Trends Neurosci 1996; 19: 514-520.
• 34 Linden M. The Posttraumatic Embitterment Disorder. Psychotherapy and Psychosomatics 2003; 72: 195-202.
• 35 Linden M, Schippan B, Baumann K, Spielberg R. Die posttraumatische Verbitterungsstörung. Nervenarzt 2004; 75: 51-57.
• 36 Liu J, Chen M, Wang X. Calcitonin gene-related peptide inhibits lipopolysaccharide-induced interleukin-12 release from mouse peritoneal macrophages, mediated by the cAMP pathway. Immunology 2000; 101: 61-67.
• 37 Maes M, Lin AH, Delmeire L. et al. Elevated serum interleukin-6 (IL-6) an IL-6 receptor concentrations in posttraumatic stress disorder following accidental man-made traumatic events. Biol Psychiatry 1999; 45: 833-839.
• 38 Marshall JS. et al. Nerve groth factor modifies the expression of inflammatory cytokines by mast cells via a prostanoid-dependent mechanism. J Immunol 1999; 162: 4271-4276.
• 39 Mason JW. A review of psychoendocrine research on the sympathetic-adrenal medullary system. Psychosomatic Medicine 1968; 30: 631-653.
• 40 McEvoy AN, Bresnihan B, FitzGerald O, Murphy EP. Corticotropin-releasing hormone signalling in synovial tissue from patients with early inflammatory arthritis is mediated by the type 1a corticotrophin-realising hormonenreceptor. Arthritis Rheum 2001; 44: 1761-1767.
• 41 McEwen BS, Wingfield JC. The concept of allostasis in biology and biomedicine. Hormones and Behavior 2003; 43: 2-15.
• 42 Michelson D, Stone L, Magiakou MA, Chrousos GP, Sternberg EM, Gold PW. Multiple Sclerosis is associated with alterations in hypothalamic-pituitary-adrenal axis function. J Clin Endocrionol Metab 1994; 79: 848-853.
• 43 Mommersteeg PM, Heijnen CJ, Kavelaars A, van Dornen LJ. Immune and endocrine function in burnout syndrome. Psychosomatic Medicine. 2006
• 44 Mosmann TR, Sad S. The expanding universe of T-cell subsets: Th1, Th2 and more. Immunolo Today 1996; 17: 138-146.
• 45 Olff M. Stress, depression and immunity: the role of defence and coping styles. Rsychiatry Res 1999; 85: 7-15.
• 46 Paik IH, Toh KY, Lee C, Kim JJ, Lee SJ. Psychological stress may induce increased humoral and dereased cellular immunity. Behav Med 2000; 26 (03) 139-141.
• 47 Panina-Bordignon P. et al. Beta2-agonists prevent Th1 development by selective inhibition of interleukin12. J Clin Invest 1997; 100: 1513-1519.
• 48 Powell LH, Eagleston JR. The assessment of chronic stress in college students. In Altmeier EM. (Hrsg). Helping students manage stress– new directions for students services. San Francisco: Jossey-Bass; 1983
• 49 Pranjic N, Males-Bilic L, Beganlic A, Mustajbegovic J. Mobbing, stress, and work ability index among physicans in Bosnia and Herzegovina: survey study. Croat Med J 2006; 47: 750-758.
• 50 Prigerson HG, Shear MK, Jacobs SC, Reynolds 3^rd CF, Maciejewski PK, Davidson JR, Rosenheck R, Pilkonis PA, Wortman CB, Williams JB, Widiger TA, Frank E, Kupfer DJ, Zisook S. Consensus criteria for traumatic grief. A preliminary empirical test. Br J Psychiatry 1999; 174: 67-73.
• 51 Raychaudhuri SP, Raychaudhuri SK. Role of NGF and neurogenic inflammation in the pathogenesesis of psoriasis. Prog Brain Res 2004; 146: 433-437.
• 52 Reck C. (Hrsg). Kritische Lebensereignisse und Depression. Berlin: Lengerich; 2001
• 53 Reinecker H. Forschung in der Klinischen Psychologie. In: Reinecker H. (Hrsg). Lehrbuch der klinischen Psychologie und Psychotherapie. Modelle psychischer Störungen. Göttingen: Hogrefe; 2003
• 54 Rogers MP, Fozdar M. Psychoneuroimmunology of autoimmune disorders. Adv Neuroimmunol 1996; 06: 169-177.
• 55 Sanders VM, Baker RA, Ramer-Quinn DS, Kasprowics DJ, Fuchs BA, Street NE. Differential expression of the beta2-adrenergic receptor by Th1 and Th2 clones: implications for cytokine production and B cell help. J Immunol 1997; 158: 4200-4210.
• 56 Sapolski RM. Neoroendocrinology of the stressresponce. In: Becker JB, Breedlove SM, Crews D. (Hrsg). Behavioral endocrinology. Cambridge: The Mit Press; 1992
• 57 Sapolsky RM. Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry 2000; 57: 925-935.
• 58 Schulz H, Schulz KH. Kurzfristige psychische Belastung und Immunfunktionen- eine metaanalytische Übersicht. In: Schulz KH, Kugler J, Schedlowski M. (Hrsg). Psychoneuroimmunologie. Bern, Göttingen, Toronto, Seattle: Verlag Hans Huber; 1997
• 59 Segal BM, Dwyer BK, Shevach EM. An interleukin (IL)-10/IL-12 immunregulatory circuit controls susceptibility to autoimmune disease. J Exp Med 1998; 187: 537-546.
• 60 Segestrom SC, Kemeny ME, Laundslager ML. Individual difference factors in psychoneuroimmunolgy. In: Ader R, Felten DL, Cohen N. (Hrsg). Psychoneuroimmunology. 3rd ed. San Diego: Academic Press; 2001
• 61 Selye H. The general adaption syndrome and the diseases of adaption. J Clin Endocrinol 1946; 06: 117-230.
• 62 Selye H. (Hrsg). Stress. Montreal, Quebec, Canada: Acta Medical Publisher; 1950
• 63 Steinman L. Elaborate interactions between the immune and nervous system. Nat Immunol 2004; 05: 575-581.
• 64 Stiglitz Rolf-Dieter. Anpassungs- und Belastungsstörungen in der ICD-10. Psychoneuro 2005; 31: 16-20.
• 65 Trinchieri G. Interleukin-12: a proinflammatory cytokine with immunoregulatory functions that bridge innate resistance and antigenspecific adaptive immunity. Annu Rev Immunol 1995; 13: 251-276.
• 66 Wannacott KM, Bonneau RH. The effect of stress on memory cytotoxic T lymphocyte-mediated protection against herpes simplex virus at mucosal sites. Brain Behav Immun 2002; 16: 104-117.
• 67 Webster JL, Tonelli L, Sternberg EM. Neuroendocrine regulation of immunity. Annu Rev Immunol 2002; 20: 125-163.
• 68 Wills-Karp M. IL-12/IL-13 axis in allergic asthma. J Allergy Clin Immunol 2001; 107: 9-18.
• 69 Yehuda R, Boissoneau D, Lowy MT, Giller EL. Dose-response changes in plasma cortisol and lyphmphocyte glucocorticoid reseptors following dexamethasone administration in combat veterans with and without posttraumatic stress disorder. Arch Gen Psychiatry 1995; 150: 583-593.
• 70 Yehuda R. Sensitization on the hypothalamic-pituitary-adrenal-axis in posttraumatic stress disorder. Ann NY Acad Sci 1997; 821: 57-75.
• 71 Yehuda R. Psychoneuroendocrinology of posttraumatic stress disorder. Psychiatr Clinics North America 1998; 21: 359-379.
• 72 Yehuda R, Golier JA, Halligan SL, Meaney M, Bierer LM. The ACTH responce to dexamethasone in PTSD. Am J Psychiatry 2004; 161: 1397-1403.
• 73 Zabel P, Horst JH, Krüger JM. Circadian rhythm of interleukin-1 production of monozytes and the influence of endogenous glucocorticoids in man. Klin Wochenschr 1990; 68: 1217-1221.
• 74 Zabel P, Linnemann K, Schaak M. Zirkadiane Rhythmik von Zytokinen. Immun Infekt 1993; 21: 38-40.
• 75 Zdrenghea D, Poanta L, Gaita D. Cardiovascular risk factors and risk behaviors in railway workers. Professional stress and cardiovascular risk. Rom J Intern Med 2005; 43 (1–2): 49-59.
• 76 Zimbardo PG. (Hrsg). Psychologie. Berlin, Heidelberg, New York: Springer-Verlag; 1992