Perceived stress and ineffective coping related to the uncertain course of disease in Multiple Sclerosis (MS) may contribute to both disease progression and rate of exacerbation. MS is characterized by an imbalance of pro- and anti-inflammatory cytokines that contribute to the pathogenic process. Because there are clear neuroendocrine links with the immune system, it is likely that stress can influence the clinical course of MS cytokine balance. Therefore, the overall aim of this study is to determine, in MS patients, the relationships among psychological stress, illness uncertainty, cytokine profile and clinical status. Additionally, the modulating effect of coping behavior will be examined. The study will examine individuals with MS in an outpatient setting, collecting data at three time points. Self report measures will be used to assess psychological variables while cytokine profiles will be determined by measuring immune cell production of interferon gamma (IFN-gamma), interleukin six (IL-6), tumor necrosis factor (TNF), interleukin four (IL-4) and interleukin ten (IL-10). Understanding the stress-immune relationship and its impact on the clinical status of MS patients could allow for the development of nursing interventions targets at both stress appraisal and coping behavior, with an aim toward amelioration of disease course.
