Researchers Study Whether Psychosocial Interventions Ease Psoriasis

November 11, 2009

The National Center for Complementary and Alternative Medicine has awarded University of Rochester Medical Center researchers $2.5 million to investigate the impact of psychological interventions on attacks of psoriasis and the intensity of the disease.

Researchers will measure and track the biological markers of the disease in the skin lesions that are the hallmark of psoriasis and also in the blood of volunteers who have participated in programs designed to improve daily living.

Psoriasis appears to have a strong psychoneuroimmunological component to it, such that signals from the brain may exacerbate the disease, and the disease itself may induce psychological distress, said Jan Moynihan, Ph.D., director of the Rochester Center for Mind-Body Research and principal investigator for the study.

“We want to determine whether increasing psychological well-being results in measurable decreases in inflammation,” said Moynihan, a professor of Psychiatry. “We want to see if positive changes in psychological well-being affect actual psoriatic lesions and which immune mechanisms are the targets.”

Researchers plan to recruit 200 Rochester-area residents with psoriasis to take part in the study, which will test the effects of two interventions, Mindfulness Based Stress Reduction and Living Well.

Psoriasis is a chronic inflammatory disease of the skin that affects about 7.5 million people in the United States. The disease causes silvery scales and red patches that are sites of inflammation and excessive production of skin cells.

In many people with psoriasis, psychological or life stress precedes flare-ups of the disease, according to Moynihan. Research also suggests that stress is associated with increased production of many of the proinflammatory proteins called cytokines that are involved in psoriasis, including interleukin-6 and tumor necrosis factor-alpha. Researchers will test skin lesions and blood for these cytokines and other markers.

Participants in the study will take part in one of two interventions. Mindfulness Based Stress Reduction, a program developed at the University of Massachusetts Medical Center, uses meditation and yoga to develop a calm, non-judgmental awareness and acceptance of the present moment. Living Well is a didactic intervention that includes seminars on relevant topics, including sleep, nutrition and the importance of exercise. It will be led by a team of wellness educators and researchers.

Psoriasis patients could benefit from these low-cost, adjunctive psychological interventions that are intended to decrease psychological distress, but which may also ameliorate the skin disease and inflammatory processes by interrupting the connection between the stress response and flare-ups of psoriasis.

“We have the opportunity to use new technology to look at the molecular biology of this disease. We hope to elucidate new ways that the brain can direct our immune responses,” Moynihan said.

The study supported by the five-year grant will be a collaborative effort involving researchers from several Medical Center departments. In addition to Moynihan, the research team includes: Lisa Beck, M.D., associate professor of Dermatology; Francisco A. Tausk, M.D., professor of Dermatology; Christopher Ritchlin, M.D., M.P.H., professor of Medicine; Nancy L. Talbot, Ph.D., associate professor of Psychiatry; and Michael Krasner, M.D., assistant professor of Medicine.

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