{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T12:51:33Z","timestamp":1775739093280,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2008,1,31]],"date-time":"2008-01-31T00:00:00Z","timestamp":1201737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Psychological stress is thought to aggravate disease activity in rheumatoid arthritis (RA), although the physiologic mechanisms are unclear. Tumor necrosis factor \u03b1 (TNF\u03b1) is an inflammatory cytokine involved in the exacerbation of RA, and TNF\u03b1 antagonists have emerged as efficacious treatments. The purpose of this study was to determine whether RA patients show increased monocyte production of TNF\u03b1 following acute psychological stress and whether such responses are abrogated in RA patients taking TNF\u03b1 antagonists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A standardized stress task was administered to 3 groups of subjects: RA patients taking TNF\u03b1 antagonists, RA patients not taking such medications, and healthy controls. Lipopolysaccharide\u2010stimulated monocyte production of inflammatory cytokines was repeatedly measured using intracellular staining and flow cytometry. Subjective stress, cardiovascular responses, adrenocorticotropic hormone (ACTH) levels, and cortisol levels were also measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The stress task induced increases in subjective stress, cardiovascular activity, and levels of ACTH and cortisol, with similar responses in the 3 groups. In addition, the stress task induced a significant increase (<jats:italic>P<\/jats:italic> &lt; 0.001) in monocyte production of TNF\u03b1 among RA patients who were not taking TNF\u03b1 antagonists. However, monocyte production of TNF\u03b1 did not change following psychological stress in RA patients taking TNF\u03b1 antagonists or in healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Brief psychological stress can trigger increased stimulated monocyte production of TNF\u03b1 in RA patients. The use of TNF\u03b1 antagonists protects against stress activation of cellular markers of inflammation in RA patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.23165","type":"journal-article","created":{"date-parts":[[2008,1,31]],"date-time":"2008-01-31T19:48:42Z","timestamp":1201808922000},"page":"376-383","source":"Crossref","is-referenced-by-count":26,"title":["Stress activation of cellular markers of inflammation in rheumatoid arthritis: Protective effects of tumor necrosis factor \u03b1 antagonists"],"prefix":"10.1002","volume":"58","author":[{"given":"Sarosh J.","family":"Motivala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh","family":"Khanna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"FitzGerald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Irwin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,1,31]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20747"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.7.764"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.immunol.19.1.163"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20776"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20982"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/40.8.868"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.032151"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20678"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011303432202"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2004.12.012"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.130.3.355"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.25.6.723"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_6_15_2","first-page":"2324","article-title":"Equivalence of the acute phase reactants C\u2010reactive protein, plasma viscosity, and Westergren erythrocyte sedimentation rate when used to calculate American College of Rheumatology 20% improvement criteria or the Disease Activity Score in patients with early rheumatoid arthritis","volume":"26","author":"Paulus HE","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_16_2","unstructured":"University Medical Centre Nijmegen. 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