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Stress and prednisone

Stress impairs the body's response to steroids

The long held belief held by many pemphigus and pemphigoid patients that stress triggers and exacerbates their disease was supported by the results of a study released in Washington, D.C. November 2002.

"Chronic stress seems to impair the immune system's capacity to respond to glucocortico hormones that normally are responsible for terminating an inflammatory response following infection and/or injury." This is one of the conclusions of the study which appeared in the November issue of "Health Psychology" the journal of the American Psychological Association.

To study people under stress, Gregory E. Miller, Ph. D, of Washington University and colleagues, studied 25 parents with children undergoing treatment for pediatric cancer. Blood and saliva samples were taken from the parents several times over the course of two days. When compared to a control group of 25 parents of healthy children, the study showed that the parents of cancer patients were under more psychological stress and suffered a diminished sensitivity to steroids.

Steroids produced by the body are called hormones and steroids produced by man are called drugs. In pemphigus and pemphigoid large doses of prednisone, a man-made steroid mimics the body's natural hormones, and anti-inflammatory medications such as CellCept and Imuran, are used to control the formation of sometimes life-threatening lesions.

"These findings suggest a novel mechanism through which psychological stress could influence the onset and/or progression of conditions that involve excessive inflammation, like allergic, autoimmune, cardiovascular, infectious and rheumatologic illnesses," states Dr. Miller.

The study also showed that the "consequences were lessened" by a social support network. It is theorized that assistance with financial concerns, workload and family disruptions, as well as emotional support, may reduce stress levels. Further, the study finds that the parents of cancer patients showed more signs of depression than the control group and that the depression did "not seem to operate as a mediator." This indicates that feeling depressed does not help the body's capacity to heal itself in stressful situations.

Further studies will be needed to prove what pemphigus and pemphigoid patients have suspected for some time; that stress is a major factor in their disease. The concept is not new, but this innovative study is another important step in proving the theory.