Kollagenosen und Psychoneuroimmunologie – Beispiel systemischer Lupus erythematodes

Zusammenfassung

Die Kollagenosen einschließlich des systemischen Lupus erythematodes (SLE) sind chronische Autoimmunkrankheiten, für deren Pathogenese die derzeitige Biomedizin keine Erklärung und damit auch keine kausale Therapie bereithält. Die Psychoneuroimmunologie (PNI) als empirische Realisierung des biopsychosozialen Modells ermöglicht durch die Hereinnahme nichtstofflicher, insbesondere psychischer und psychosozialer Entitäten in die wissenschaftliche Auseinandersetzung mit diesen chronischen, teils lebensbedrohlichen Entzündungserkrankungen einen neuen Zugang zu Diagnostik und Therapie. Dies wird in der vorliegenden Arbeit mithilfe von Ergebnissen aus integrativen Einzelfallstudien, einem speziell zur Erfassung psychoneuroimmunologischer Komplexität entwickelten Forschungsdesign, an Patientinnen mit SLE dargelegt.

Keywords

Psychoneuroimmunologie - Kollagenosen - Lupus - Stress - Entzündung - integrative Einzelfallstudie

• Literatur

• 1 Herrick AL. General approach to the assessment of patients with a suspected connective tissue disease. In Gordon C, Gross WL. Hsrg Connective Tissue Disorders. Oxford: Atlas Medical Publishing; 2011: 1-16
• 2 Jose J, Naidu RM, Sunil PM. et al Pathogenesis of autoimmune diseases: A short review. Oral Maxillofac Pathol J 2014; 5: 434-436
• 3 Engel GL. The need for a new medical model: A challenge for biomedicine. Science 1977; 196: 129-136
• 4 Sharif K, Watad A, Coplan L. et al The role of stress in the mosaic of autoimmunity: An overlooked association. Autoimmun Rev 2018; 17: 967-983
• 5 Blalock JE. The immune system as a sensory organ. J Immunol 1984; 132: 1067-1070
• 6 Besedovsky HO, del Rey A. Physiological implications of the immune-neuroendocrine network. In Ader R, Felten DL, Cohen N. Hsrg Psychoneuroimmunology. San Diego, CA: Academic Press; 1991: 589-608
• 7 Schubert C. Soziopsychoneuroimmunologie – Integration von Dynamik und subjektiver Bedeutung in die Psychoneuroimmunologie. In Schubert C. Hsrg Psychoneuroimmunologie und Psychotherapie. Stuttgart: Schattauer; 2015: 374-405
• 8 Schubert C. Bewusstwerdung als Heilung – die Wirkung künstlerischen Tuns auf das Immunsystem. In Von Spreti F, Martius P, Steger F. Hsrg KunstTherapie. Stuttgart: Schattauer; 2017: 43-128
• 9 Solomon GF. Whither psychoneuroimmunology? A new era of immunology, of psychosomatic medicine, and of neuroscience. Brain Behav Immun 1993; 7: 352-366
• 10 Hannemann J, Ott M, Singer M. et al Psychoneuroimmunologie und Autoimmunerkrankungen – eine paradigmatische Herausforderung. zkm 2017; 5: 48-55
• 11 Spinnler P. Glaubensbekenntnisse: Komplementärmedizin – Wissenschaft – Schulmedizin. Bulletin des médecins suisses 2010; 91: 462-465
• 12 Bertsias G, Cervera R, Boumpas D. Systemic lupus erythematosus: pathogenesis and clinical features. In Bijlsma J. Hsrg EULAR textbook on rheumatic diseases. London: BMJ Group; 2012: 476-505
• 13 Choi J, Kim ST, Craft J. The pathogenesis of systemic lupus erythematosus-an update. Curr Opin Immunol 2012; 24: 651-657
• 14 Bierhaus A, Wolf J, Andrassy M. et al A mechanism converting psychosocial stress into mononuclear cell activation. Proc Natl Acad Sci U S A 2003; 100: 1920-1925
• 15 Marsland AL, Walsh C, Lockwood K. et al The effects of acute psychological stress on circulating and stimulated inflammatory markers: A systematic review and meta-analysis. Brain Behav Immun 2017; 64: 208-219
• 16 Straub RH, Cutolo M. Psychoneuroimmunology-developments in stress research. Wien Med Wochenschr 2018; 168: 76-84
• 17 Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res 2002; 53: 865-871
• 18 Dragoş D, Tănăsescu MD. The effect of stress on the defense systems. J Med Life 2010; 3: 10-8
• 19 Kobrzycka A, Napora P, Pearson BL. et al Peripheral and central compensatory mechanisms for impaired vagus nerve function during peripheral immune activation. J Neuroinflammation 2019; 16: 150
• 20 Harbuz MS, Jessop DS. Is there a defect in cortisol production in rheumatoid arthritis?. Rheumatology (Oxford) 1999; 38: 298-302
• 21 Heim C, Ehlert U, Hellhammer DH. The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology 2000; 25: 1-35
• 22 Zietz B, Reber T, Oertel M. et al Altered function of the hypothalamic stress axes in patients with moderately active systemic lupus erythematosus. II. Dissociation between androstenedione, cortisol, or dehydroepiandrosterone and interleukin 6 or tumor necrosis factor. J Rheumatol 2000; 27: 911-918
• 23 Ripley BJ, Goncalves B, Isenberg DA. et al Raised levels of interleukin 6 in systemic lupus. Ann Rheum Dis 2005; 64: 849-853
• 24 Tsai CY, Shen CY, Liao HT. et al Molecular and cellular bases of immunosenescence, inflammation, and cardiovascular complications mimicking "inflammaging" in patients with systemic lupus erythematosus. Int J Mol Sci 2019; 20: E3878
• 25 Montoya-Ortiz G. Immunosenescence, aging, and systemic lupus erythematous. Autoimmune Dis 2013; 2013: 267078
• 26 Morris G, Berk M, Walder K. et al Central pathways causing fatigue in neuro-inflammatory and autoimmune illnesses. BMC Med 2015; 13: 28
• 27 Santoro TJ, Tomita M, Larson SJ. The potential impact of sickness-motivated behavior on the expression of neuropsychiatric disturbances in systemic lupus erythematosus. Med Hypotheses 2007; 69: 502-507
• 28 Dantzer R, O’Connor JC, Freund GG. et al From inflammation to sickness and depression: When the immune system subjugates the brain. Nat Rev Neurosci 2008; 9: 46-56
• 29 Schubert C. Effektive und effiziente Forschung in der Psychoneuroimmunologie. In Trautmann-Voigt S, Voigt B. Hrsg Effizienz und Effektivität in der Psychotherapie. Gießen: Psychosozial-Verlag; im Druck;
• 30 Hinrichsen H, Barth J, Rückemann M. et al Influence of prolonged neuropsychological testing on immunoregulatory cells and hormonal parameters in patients with systemic lupus erythematosus. Rheumatol Int 1992; 12: 47-51
• 31 Pawlak CR, Jacobs R, Mikeska E. et al Patients with systemic lupus erythematosus differ from healthy controls in their immunological response to acute psychological stress. Brain Behav Immun 1999; 13: 287-302
• 32 Jacobs R, Pawlak CR, Mikeska E. et al Systemic lupus erythematosus and rheumatoid arthritis patients differ from healthy controls in their cytokine pattern after stress exposure. Rheumatology (Oxford) 2001; 40: 868-875
• 33 Hinrichsen H, Barth J, Ferstl R. et al Changes of immunoregulatory cells induced by acoustic stress in patients with systemic lupus erythematosus, sarcoidosis, and in healthy controls. Eur J Clin Invest 1989; 19: 372-377
• 34 Schubert C, Lampe A, Rumpold G. et al Daily psychosocial stressors interfere with the dynamics of urine neopterin in a patient with systemic lupus erythematosus: An integrative single-case study. Psychosom Med 1999; 61: 876-882
• 35 Brown GW, Harris TO. Life events and illness. New York: Guilford Press; 1989
• 36 Box GEP, Jenkins GM. Time-series analysis: forecasting and control. San Francisco: Holden-Day; 1976
• 37 Fuchs D, Weiss G, Wachter H. Neopterin, biochemistry and clinical use as a marker for cellular immune reactions. Int Arch Allergy Immunol 1993; 101: 1-6
• 38 Lim KL, Muir K, Powell RJ. Urine neopterin: a new parameter for serial monitoring of disease activity in patients with systemic lupus erythematosus. Ann Rheum Dis 1994; 53: 743-748
• 39 Schubert C, Geser W, Noisternig B. et al Stressful life events and skin diseases: an additional perspective from research on psychosomatic dynamics in systemic lupus erythematosus. Psychother Psychosom 2002; 71: 123-124
• 40 Schubert C, Lampe A, Geser W. et al Daily psychosocial stressors and cyclic response patterns in urine cortisol and neopterin in a patient with systemic lupus erythematosus. Psychoneuroendocrinology 2003; 28: 459-473
• 41 Schubert C, Noisternig B, Fuchs D. et al Multifaceted effects of positive incidents on urine cortisol and urine neopterin dynamics in a patient with systemic lupus erythematosus. Stress Health 2006; 22: 215-227
• 42 Schubert C, Geser W, Noisternig B. et al Stress system dynamics during „life as it is lived“: an integrative single-case study on a healthy woman. PLoS One 2012; 7: e29415
• 43 Davas EM, Tsirogianni A, Kappou I. et al Serum IL-6, TNFalpha, p55 srTNFalpha, p75srTNFalpha, srIL-2alpha levels and disease activity in systemic lupus erythematosus. Clin Rheumatol 1999; 18: 17-22
• 44 Schubert C, Haberkorn J, Ocaña-Peinado FM. et al Cause-effect relations between 55 kD soluble TNF receptor concentrations and specific and unspecific symptoms in a patient with mild SLE disease activity: an exploratory time series analysis study. BMC Res Notes 2015; 8: 465 Erratum in: BMC Res Notes 2017; 10: 100
• 45 Schiepek G, Strunk G. The identification of critical fluctuations and phase transitions in short term and coarse-grained time series-a method for the real-time monitoring of human change processes. Biol Cybern 2010; 102: 197-207
• 46 Schubert C, Schiepek G. Psychoneuroimmunologie und Psychotherapie: Psychosozial induzierte Veränderungen der dynamischen Komplexität von Immunprozessen bei einer Patientin mit systemischem Lupus erythematodes. In Schiepek G. Hsrg Neurobiologie der Psychotherapie. Stuttgart: Schattauer; 2003: 485-508
• 47 Schubert C, Fuchs D, Lambertz M. et al Psychoneuroimmunologie. In Haken H, Schiepek G. Hsrg Synergetik in der Psychologie. Göttingen: Hogrefe; 2006: 221-243
• 48 McClary AR, Meyer E, Weitzman EL. Observations on the role of the mechanism of depression in some patients with disseminated lupus erythematosus. Psychosom Med 1955; 17: 311-321
• 49 Otto R, Mackay IR. Psycho-social and emotional disturbance in systemic lupus erythematosus. Med J Aust 1967; 2: 488-493
• 50 Freud A. Die Schriften der Anna Freud. Band I. München: Kindler Verlag; 1980: 233-243
• 51 Schröder M, Schröder H. Sprache und Kommunikation als Therapeutikum – Plädoyer für den Vale(b)o-Effekt in der Heilkunde. Erfahrungsheilkunde 2019; 4: 217-224