Effect of Hypnotherapy on Immune Response and Standard Therapy in Psychogenic Asthma Patients

Objective: Asthma is a complex inflammatory disease. The therapy for asthma is usually pharmacotherapy but it can increase the side effects in the long run. Hypnosis has been used to clinically treat asthma. This study aimed to investigate the efficacy of hypnotherapy which will increase the standard of therapy in psychogenic asthma patients on immune response, stress mediators, and asthma control level. Materials and Methods: This research is a double-blind experimental randomized control trial group study with a crossover design conducted in the outpatient clinic of Dr. Moewardi Hospital, Surakarta, Indonesia. The Friedman test followed by the marginal homogeneity statistic test was used to assess variations in the levels of asthma control. The study subjects were 30 respondents who were divided randomly into groups A and B. Both groups had standard asthma therapy and hypnotherapy with a different sequence. Results: Hypnotherapy made a significant decrease in SCL 90 score within each group as follows: Group A (A1 vs A2; p=0.004) and Group B (B2 vs B3; p=0.001). Levels of asthma control improved significantly in both groups (A1 vs A2; p=0.001 and B2 vs B3; p=0.004). Hypnotherapy significantly improved the norepinephrine levels in both groups as well (A1 vs A2; p=0.001 and B2 vs B3; p=0.073). Hypnotherapy insignificantly reduced IL-13 (p=0.132) and IL-17 (p=0.149) levels. Conclusion: This study concluded that hypnotherapy applied to psychogenic asthma patients can improve their standard therapy response. This improved standard therapy response will affect the treatment, prevention, and management of uncontrolled asthma.

Flow Cytometric Analysis of T Cell Vβ Repertoire in Common Variable Immunodeficiency Patients with TACI Mutations

Objective: TCR (T Cell Receptor) which is expressed on T cells is responsible for recognizing antigens presented by HLA molecules of the APCs (Antigen Presenting Cells) and initiation of the immune response. It has been reported that TACI (Transmembrane activator and calcium modulating cyclophilin ligand interactor) mediates the interaction of B cells and dendritic cells which are both responsible for the processing of T cells. Materials and Methods: In this study, 24 TCRVβ clones were analyzed by using multiparametric flow cytometry in seven patients with TACI mutation [two homozygous (c.310T> C) five heterozygous (c.310T> C, c.226G> C, c.260T> A)], four CVID (Common Variable Immunodeficiency) patients who had not TACI defect (non-TACI) and five healthy controls. In this study group, serum Ig levels and infection history, CD4+ and CD8+ cell percentages, and HLA profiles were investigated. Results: Increased TCRVβ13.2 clone was observed in patients with TACI defects unlike control individuals and non-TACI-CVID patients (p=0.02). We found that there was a statistically significant decrease in TCRVβ8 clone (p=0.012) in TACI deficient CVID patients and non-TACI-CVID patients compared to control individuals. TCRVβ20 clones in non-TACI-CVID patients were decreased compared to TACI-CVID patients and control individuals (p=0.009). Decreased TCRVβ8 was also associated with TACI deficient CVID patients. Conclusion: Further studies and large cohorts are needed to understand the relationship between TCRVβ8, TCRVβ13.2, and CVID with TACI mutations.