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The effect of a transient immune activation on subjective health perception in two placebo controlled randomised experiments
Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.ORCID iD: 0000-0003-0203-7977
Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
Stockholm University, Faculty of Social Sciences, Stress Research Institute.
Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
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Number of Authors: 82019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 3, article id e0212313Article in journal (Refereed) Published
Abstract [en]

Background Patient-reported outcomes predict mortality and play increasingly important roles in care, but factors that modify central measures such as health ratings have been little investigated. Building on designated immune-to-brain pathways, we aimed to determine how a short-term induced inflammation response impacts self-reported health status. Methods Lipopolysaccharide injections were used to provoke acute systemic inflammatory responses in healthy men and women and were compared to placebo in two double-blind randomized experiments. In Experiment 1, 8 individuals (mean 24 years; SD = 3.7) received lipopolysaccharide 0.8 ng/kg once and placebo once in a cross-over design, and in Experiment 2, 52 individuals received either lipopolysaccharide 0.6 ng/kg or placebo once (28.6 years; SD = 7.1). Main outcomes were perceived health (general and current), sickness behaviour (like fatigue, pain and negative affect), and plasma interleukin-6, interleukin-8 and tumour necrosis factor-alpha, before and after injection. Results Compared to placebo, lipopolysaccharide lead to a deterioration in both self-rated general (Experiment 1, b = 1.88 for 0.8 ng/kg) and current health (Experiment 1 b = -3.00; and Experiment 2 b = -1.79) 1.5h after injection (p's<0.01), effects that remained after 4.5 to 5 hours (p's<0.05). The effect on current health in Experiment 2 was mediated by increased inflammation and sickness behaviour in response to lipopolysaccharide injection (beta = -0.28, p = 0.01). Conclusion Health is drastically re-evaluated during inflammatory activation. The findings are consistent with notions that inflammation forms part of health-relevant interoceptive computations of bodily state, and hint at one mechanism as to why subjective health predicts longevity.

Place, publisher, year, edition, pages
2019. Vol. 14, no 3, article id e0212313
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Public Health, Global Health, Social Medicine and Epidemiology
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URN: urn:nbn:se:su:diva-167495DOI: 10.1371/journal.pone.0212313ISI: 000460372100026PubMedID: 30840633OAI: oai:DiVA.org:su-167495DiVA, id: diva2:1301199
Available from: 2019-04-01 Created: 2019-04-01 Last updated: 2019-04-01Bibliographically approved

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Andreasson, AnnaÅkerstedt, TorbjörnAxelsson, JohnLekander, Mats
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