W. Kuis et al., THE AUTONOMIC NERVOUS-SYSTEM AND THE IMMUNE-SYSTEM IN JUVENILE RHEUMATOID-ARTHRITIS, Brain, behavior, and immunity, 10(4), 1996, pp. 387-398
This study demonstrates that juvenile rheumatoid arthritis is associat
ed with a dysregulation of the autonomic nervous system as well as wit
h disturbances in the capacity of the immune system to respond to medi
ators of the autonomic nervous system. In patients with active disease
heart rate at rest is higher than in healthy controls. In addition, 3
-hydroxy-4-phenoxyphenylglycol levels in urine are higher in all patie
nts than in the control group. Cardiovascular responses to an orthosta
tic stress test (tilt up) are reduced in patients with active and nona
ctive disease. Plasma norepinephrine responses to tilt up are reduced
in subjects with active juvenile rheumatoid arthritis. In summary, our
data show that patients with juvenile rheumatoid arthritis have an al
tered function of the autonomic nervous system associated with increas
ed central noradrenergic outflow, presumably leading to increased vaso
constriction, resulting in a decreased response to an orthostatic stre
ssor. The altered function of the autonomic nervous system is associat
ed with changes in the response of leukocytes to mediators of the auto
nomic nervous system via beta(2)-adrenergic receptors. Leukocytes of p
atients with active juvenile rheumatoid arthritis have a lower cAMP re
sponse to a beta 2-adrenergic agonist, presumably due to increased cAM
P-phosphodiesterase activity in these cells. (C) 1996 Academic Press.