Psychological Stress and Antibody Response to Immunization: A Critical Review of the Human Literature (original) (raw)
Related papers
Association between chronic stress and immune response to influenza vaccine in healthcare workers
Revista Portuguesa de Saúde Pública, 2014
Introduction: Chronic stress can influence immune response to vaccines. Healthcare workers are exposed to stressors and biological hazards, the health effects of which may be prevented through vaccination. Objectives: This study aims to evaluate the association between stress in nurses and: (1) insufficient response to influenza vaccine, assessed one month after vaccination (T 1); (2) the drop in haemagglutination-inhibition (HAI) antibodies (ab) six months after vaccination (T 6). Methods: A nested case-control study was carried out with 136 healthy hospital nurses. Individual interviews, the General Health Questionnaire (GHQ 12) and Maslach Burnout Inventory (MBI-HSS) were applied in order to determine the presence of stress, using the triangulation method at the beginning of the study (T 0). Influenza vaccine was administered and titres of HAI above each strain composing influenza vaccine before vaccination (T 0), at T 1 and T 6 were assessed. Results: There was no statistically relevant (5%) relationship between stress and the insufficient immune response to the vaccine at T 1. Nevertheless, there was an association between stress and the drop in HAI ab AH 1 at T 6 , when we assessed stress by the triangulation method using an interview (p = 0.006), GHQ 12 (p = 0.045) and combination of criteria (p = 0.001), even after multivariate analysis (respectively, p = 0.01, p < 0.05 and p = 0.002). The odds ratios were, respectively, 3.64, 2.73 and 5.22. Conclusions: The association we found, between chronic stress and the drop in HAI ab at T 6 , corroborates the hypothesis that stress can negatively influence immune response. Therefore, it seems reasonable to consider this issue when we implement vaccination programmes for healthcare workers.
Acute stress exposure prior to influenza vaccination enhances antibody response in women
Brain, Behavior, and Immunity, 2006
Animal studies have shown that an acute stressor in close temporal proximity to immune challenge can enhance the response to delayed-type hypersensitivity and antibody response to vaccination. The current study examined the eVects of acute exercise or mental stress prior to inXuenza vaccination on the subsequent antibody response to each of the three viral strains. Sixty young healthy adults (31 men, 29 women) were randomly allocated to one of three task conditions: dynamic exercise, mental stress, or control. After an initial baseline, participants completed their allocated 45 min task and then received the inXuenza vaccine. Plasma cortisol and interleukin-6 were determined at the end of baseline, after the task, and after 60 min recovery. Antibody titres were measured prevaccination and at 4 weeks and 20 weeks post-vaccination follow-ups. For the A/Panama strain, women in both the exercise and mental stress conditions showed higher antibody titres at both 4 and 20 weeks than those in the control condition, while men responded similarly in all conditions. Interleukin-6 at +60 min recovery was found to be a signiWcant predictor of subsequent A/Panama antibody response in women. In line with animal research, the current study provides preliminary evidence that acute stress can enhance the antibody response to vaccination in humans.
Antibody response to vaccination and psychosocial stress in humans: relationships and mechanisms
Vaccine, 2003
The purpose of this review is to determine the effects of psychosocial stress on antibody response to vaccination in humans, consider possible mechanisms, and identify agenda for future research. Studies of the association between stress and vaccination response in humans were reviewed. There is evidence of a negative association between stress and antibody response to vaccination, which is most apparent with thymus-dependent vaccines and when measured at extended times after vaccination. Preliminary findings implicate the hypothalamic-pituitary-adrenal axis and sympathetic nervous system as potential mechanisms, although a role for unhealthy behaviours cannot be discounted at this stage. Results to date are sufficiently indicative to direct future research to untangling their theoretical ramifications, as well as realising their clinical implications.
Chronic stress alters the immune response to influenza virus vaccine in older adults
Proceedings of the National Academy of Sciences, 1996
To determine whether a chronic stressor (caregiving for a spouse with a progressive dementia) is associated with an impaired immune response to influenza virus vaccination, we compared 32 caregivers' vaccine responses with those of 32 sex-, age-, and socioeconomically matched control subjects. Caregivers showed a poorer antibody response following vaccination relative to control sub-
Effect of stress and other biopsychosocial factors on primary antibody response
Journal of Adolescent Health Care, 1990
There is growing evidence that life stress is associated with altered cellular immune function, but only a few studies have examined the effect of stress on humoral immune response. We immunized 89 healthy women (16-24 years) with a novel antigen, keyhole limpet hemocyanin (KLH), to study the impact of stressful events and psychosocial and biologic factors on primary antibody response to immunization. Antibodies to KLH were measured preimmunization and 3 and 8 weeks after immunixation. Previously validated scales were used to measure (11 recent major stress (both "good" and "bad," as defined by the subjects) and minor stressful events, and i2) psychological status and social support. Subjects were also asked about personal medical history, sociodemographics, and side effects of immunization. Subjects with more stressful events (of any type) tended to have lower baseline and 3-week postimmunization IgG levels. Those reporting more "good" events tended to have higher IgG levels at 8 weeks postimmunization. Psychological Distress scores correlated negatively and Psychological Wellbeing scores corp:lated positively with each IgG level, subjects with a recent infection (preimmunixation> or a local reaction to immunization had signi6cantly higher IgG levels at all three points compared to those without these factors. These data and exploratory analysis suggest that recent stress and psychological status (perhaps representing the cumulative effects of stress and response to stress) may influence immune response to immunization. However, predisposing biological fac-412 tars must also be assessed for possible confounding in the stress-immune response relationship.
Stress, immune reactivity and susceptibility to infectious disease
2002
Psychological stress is known to affect immune function and to predict infectious disease susceptibility. However, not all individuals who are stressed develop disease. In the present article, we report on a series of studies from our laboratory describing interindividual variability of immune responses to psychological stress. In our initial series of experimental investigations, we demonstrated that acute laboratory stress alters both quantitative and functional components of cellular immunity.
Effect of Perceived Stress on Cytokine Production in Healthy College Students
Western Journal of Nursing Research, 2014
Chronic psychological stress impairs antibody synthesis following influenza vaccination. Chronic stress also increases circulating levels of proinflammatory cytokines and glucocorticoids in elders and caregivers, which can impair antibody synthesis. The purpose of this study was to determine whether psychological stress increases ex vivo cytokine production or decreases glucocorticoid sensitivity (GCS) of peripheral blood leukocytes from healthy college students. A convenience sample of Reserve Officer Training Corps (ROTC) students completed the Perceived Stress Scale (PSS). Whole blood was incubated in the presence of influenza vaccine and dexamethasone to evaluate production of interleukin-6 (IL-6), interleukin-1-beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ). Multiple regression models controlling for age, gender, and grade point average revealed a negative relationship between PSS and GCS for vaccine-stimulated production of IL-1β, IL-6, and TNF...
Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry
Psychological Bulletin, 2004
The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.
This study examined whether neuroticism was related to the antibody response to influenza vaccination and whether the relationship was mediated by cortisol reactions to acute laboratory mental stress. Antibody status was assessed at baseline and to a trivalent influenza vaccination in 57 students at 5-week and 5-month follow-up. Neuroticism was also measured at baseline. Cortisol was measured at rest and in response to a pressurized mental arithmetic task. At both follow-ups, higher neuroticism scores were associated with poorer A/Panama antibody response, following adjustment for baseline antibody titer. Higher neuroticism scores were also associated with blunted cortisol reactivity, and blunted cortisol reactivity was associated with poorer A/Panama antibody response, but only at 5 months. However, there was no conclusive evidence that cortisol reactivity mediated the association between neuroticism and antibody response.