Recent reports document a relationship between periodontal disease and stress, including the number and severity of negative life events and financial stress. The classic physiological response to stress involves both the hypothalamo-pituitary-adrenal axis as well as the sympathetic- adrenal-medullary system and results in increased levels of stress-related neuroendocrine factors including ACTH, cortisol, beta-endorphin as well as the catecholamines. The relationship between stress, neuroendocrine mediators of stress and the immune response, in particular T cells is well established. Various forms of stress management invention, including hypnosis have proven to be effective in reducing distress and improving coping. This proposal seeks to test the general hypothesis that a non- pharmacological stress management intervention can induce alterations in the psychological, neuroendocrine and T cell cytokines in periodontal patients. Therefore we have developed the following specific aims to test this hypothesis: 1) determination of the efficacy of a diseases: 2) evaluation of the effects of hypnosis intervention on the hypothalamo- pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullary (SAM) system; and 3) assessment of the effects of stress management intervention on levels of stress-related neuroendocrine mediators and T cell responses in a sample of patients with moderate adult periodontitis. Subjects are randomly assigned to a 6 week stress management protocol utilizing hypnosis or an alternative attention placebo protocol. The plasma levels of ACTH, cortisol, beta-endorphin, epinephrine will be determined. In addition, the T-cell activation responses to polyclonal stimuli and periodontal pathogens as well as the expression of T-cell specific cytokines, will be assessed. The ability to non-pharmacologically alter the neuroendocrine mediators of stress, as well as T-cell responses would be a major accomplishment. This potentially permit testing of hypotheses related to the pathogenesis of periodontitis, as well as therapeutic modalities.
| Wood, Gary J; Bughi, Stefan; Morrison, John et al. (2003) Hypnosis, differential expression of cytokines by T-cell subsets, and the hypothalamo-pituitary-adrenal axis. Am J Clin Hypn 45:179-96 |
