Table 5.

Autonomic (ANS), neuroendocrine (NE), and immune responses to different stressors in patients with systemic inflammatory rheumatic diseases

Stress paradigm	Studies	ANS		NE system		Immune system
		Measure	Response	Measure	Response	Measure	Response
Psychological stress		HR	↑ RA[29,37]	Cortisol	↓/↑ RA[30]	Leucocytes	↑ RA[36]
			↑ Arthr[32]		0 SLE[44]		↑ SLE[44]
Cognitive tasks	[38]* [29,30,44]	SC	↑ RA[29]			Lymphocytes	↑ RA[30]
	[31]** [42]*		↑ Arthr[32]				0 SLE[44]
	[32,36,37]	CO	↑ RA[37]			T	0 RA[30]
		PV	↓ RA[36]				0 SLE[44]
		SVR	↑ RA[37]			B	↑ RA[30]
		BP	↑ RA[29,36,37]				0 SLE[44]
		CA	↑ SLE[44]			NK	↑ RA[30]
							0 SLE[44]
						Th	0 SLE[44]
						Tcyt	↑ SLE[44]
						CRP	↑ RA[36]
Psychosocial	[40,41,45]	HR	↑ RA[41]	Cortisol	↑ RA[41]	Leucocytes	↑ RA[40]
tasks			↑ SLE[45]	ACTH	↑ RA[41]		↑ SLE[40,45]
		BP	↑ RA[41]			Lymphocytes	↑ RA[40]
		PEP	↓ RA[41]				↑ SLE [40,45]
		CA	↑ RA[40]			T	↑ RA[40]
			↑ SLE[40,45]				↑ SLE[40,45]
						Tcyt	↑ RA[40]
							↑ SLE[40,45]
						NK	↑ RA[40]
							↑ SLE [40,45]
						Th	↑ RA[40]
							0 SLE[40,45]
						NK toxicity	0 RA[40]
							0 SLE[40,45]
						IL-6	↓ [41]/0 [40] RA
							0 SLE[40]
						IL-4	0 RA[40]
							↑ SLE[40]
						IL-2	0 RA[40]
							0 SLE[40]
						IL-10	0 RA[40]
							0 SLE[40]
						IFN-γ	0 RA[40]
							0 SLE[40]
						TNF-α	↑ RA[41]
						β - AR	0 SLE[41]
Exercise	[38]* [34,35]			Cortisol	↓ RA[34,35]	Th	↓ RA[35]
					↓ SLE[35]		↓ SLE[35]
				ACTH	↑ RA[34]	Tcyt	0 RA[35]
				GH	↑ RA[34]		↓ SLE[35]
				IGF-I	0 RA[34]
				PRL	0 RA[35]
					0 SLE[35]
Sensory stress
Cold induction	[38]* [39]	NE	↑ JIA[46]	Cortisol	↑ RA[39]	Leucocytes	↑ SLE[43]
	[31]** [46]					Lymphocytes	0 SLE[43]
	[33]**					T	0 SLE[43]
Heat induction	[39]					Tcyt	↑ SLE[43]
Acoustic stress	[43,42]*					B	↑ SLE[43]
Pupillary light	[32]**					Th	↓ SLE[43]
						IL-6	↑ RA[39]
							↑ JIA[46]
						TNF-α	↑ RA[39]

↑ = increase in response to stressor, ↓ = decrease in response to stressor, 0 = no response to stressor. RA = rheumatoid arthritis, SLE = systemic lupus erythematosus, JIA = juvenile idiopathic arthritis, arthr = heterogeneous group of patients with inflammatory arthritis. * = study not described in Table because more than one stress paradigm was used, ** = study not described in Table due to lack of within-subject measurements. HR = heart rate, SC = skin conductance, BP = blood pressure, NE = norepinephrine, CA = catecholamines, PC = pupillary constriction, PV = plasma volume, PEP = pre-ejection period, CO = cardiac output, SVR = systemic vascular resistance, C = cortisol, ACTH = adrenocorticotropin hormone, PRL = prolactin, GH = growth hormone, β-AR = β adrenoceptor, IGF-I = insulin-like growth factor I, IFN-γ = interferon-γ, TNF-α = tumor necrosis factor α, IL = interleukin, CRP = C-reactive protein, B = B cell, T = T cell, Th = helper T cell, Tcyt = cytotoxic T cell, NK = natural killer cell.