Williams Edith M, Hyer J Madison, Viswanathan Ramakrishnan, Faith Trevor D, Egede Leonard, Oates Jim C, Marshall Gailen D
Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite CS303, Charleston, SC 29425, USA.
Department of Medicine, Medical College of Wisconsin, Clinical Cancer Center Building, 5th Floor, Suite C5400, 9200 W Wisconsin Ave, Milwaukee, WI 53226, USA.
Hum Immunol. 2017 Sep;78(9):574-581. doi: 10.1016/j.humimm.2017.07.005. Epub 2017 Jul 14.
The Peer Approaches to Lupus Self-Management program sought to address the disparate impact of systemic lupus erythematosus (SLE) on African American women through a peer mentoring intervention with aims of reducing stress, anxiety, and depression. Given the association between psychological health and immune function this study examines the relationship between patient reported outcomes (PROs) in these domains and immunologic indicators of disease activity. Twenty-three African American women with SLE served as mentees in the intervention from whom PRO measures were collected at the outset, midpoint, and end of the 12week pilot study. Blood samples were collected pre- and post-intervention. Plasma was collected from the samples and cryopreserved for subsequent analyses. The strongest correlations were between the Generalized Anxiety Disorder measure and Th1/Th2 cytokine balance. Weaker correlations existed between depression and the Th1/Th2 cytokine balance. Assessment of fresh versus cryopreserved samples revealed that changes in Th1/Th2 cytokine balance within the intervention were generally equivalent, regardless of sample type. The PALS intervention resulted in significant improvements to anxiety and depression levels which were significantly associated with positive changes in Th1/Th2 cytokine balance indicating a possible underlying mechanism of action. The nature of this relationship warrants further study.
狼疮自我管理同伴计划旨在通过同伴指导干预来解决系统性红斑狼疮（SLE）对非裔美国女性的不同影响，目标是减轻压力、焦虑和抑郁。鉴于心理健康与免疫功能之间的关联，本研究考察了这些领域中患者报告结局（PROs）与疾病活动免疫指标之间的关系。23名患有SLE的非裔美国女性在干预中担任受指导者，在为期12周的初步研究开始、中期和结束时收集她们的PRO测量数据。在干预前后采集血样。从样本中采集血浆并冷冻保存以供后续分析。广义焦虑症测量值与Th1/Th2细胞因子平衡之间的相关性最强。抑郁症与Th1/Th2细胞因子平衡之间的相关性较弱。对新鲜样本与冷冻保存样本的评估表明，无论样本类型如何，干预期间Th1/Th2细胞因子平衡的变化总体上是相当的。同伴指导干预显著改善了焦虑和抑郁水平，这与Th1/Th2细胞因子平衡的积极变化显著相关，表明可能存在潜在的作用机制。这种关系的本质值得进一步研究。
