Psychological stress, endocrine and immune response in patients with lichen planus

BACKGROUND: Lichen planus still remains a disease of unclear etiology. Inconclusive reports exist on the role of stress the pathophysiological mechanisms involved in this disease. The objective of this study was to find associations between levels of stress and indices of the endocrine and immune response in patients with lichen planus. METHODS: A total of 57 patients with lichen planus and 27 healthy control volunteers took part in the study. All participants completed questionnaires measuring the frequency of stressful life events. Blood samples were collected and analyzed for levels of endocrine and immune parameters: neopterin, cortisol, interleukin (IL)-2, IL-6, IL-18, soluble IL-2 receptor (sIL-2R), sIL-6R, sFasL, T lymphocyte antigens CD3, CD4, CD8, CD25, CD69, HLA-DR, CD16/56, CD45RO and CD45RA. RESULTS: Patients differed significantly from the controls in the levels of neopterin (but not cortisol), expression of CD25, CD16, CD8, and CD45RA antigens on T lymphocytes. Patients had also significantly higher levels of sIL-2R, sFasL, sIL-6R and IL-18 than healthy controls. Patients and controls did not differ in the overall frequency of stressful life events experienced over 1 year prior to the study. However, two subgroups of patients with various stress levels differed significantly in the expression of CD25, HLA-DR, CD45RO, and CD45RA on T lymphocytes. CONCLUSIONS: Our findings suggest that stress may alter numerous parameters of endocrine and immune response in lichen planus, which provides support for its role in the etiopathogenesis of this disease.