Sympathoimmune anomalies underlying the response to stressful challenge in human immunodeficiency virus spectrum disease

Psychosom Med. 2005 Sep-Oct;67(5):798-806. doi: 10.1097/01.psy.0000181279.06164.6e.

Abstract

Objective: This study examined immune, endocrine, and cardiovascular reactivity during stressful behavioral challenge in human immunodeficiency virus (HIV) seropositive (HIV+) and seronegative (HIV-) men and women and assessed whether immunocellular reactivity was differentially associated with concomitant alterations in sympathetic response.

Methods: The 133 HIV+ [84 asymptomatic, 49 symptomatic] and 92 HIV- subjects completed a speech stress reactivity protocol.

Results: Immunocellular reactivity to the speech stressor did not differ among asymptomatic and symptomatic HIV+ groups; however, relative to seronegatives, reactivity differences were present. Specifically, HIV+ subjects exhibited greater increases in total number of T cells, as well as in cytotoxic/suppressor T cells, activated T cells, and activated cytotoxic/suppressor T cells, and less increase in natural killer (NK) cell numbers. In addition, less stress-induced increase in NK cell cytotoxicity was observed along with greater suppression of the lymphoproliferative response to mitogen stimulation in the HIV+ group. Although no group differences in catecholamine reactivity were observed, the association of immunoreactivity with catecholamine responsiveness differed between serostatus groups. Specifically, the HIV+ subjects compared with HIV- subjects displayed greater lymphocytosis per unit change in norepinephrine; whereas NK cell reactivity was positively related to epinephrine responsiveness, but only in the HIV- group. These findings were present even after controlling for age and body mass, as well as other potential influences on immunocellular migration, such as cortisol levels and prevailing cardiac output.

Conclusion: Early in HIV spectrum disease, functional abnormalities in the stress-induced migratory ability of specific immunocellular subsets are present that may reflect an underlying pathophysiological alteration in sympathoimmune communication.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Cardiac Output / physiology
  • Cardiac Output / radiation effects
  • Disease Progression
  • Epinephrine / pharmacology
  • Female
  • HIV Seronegativity / immunology
  • HIV Seronegativity / physiology
  • HIV Seropositivity / diagnosis*
  • HIV Seropositivity / immunology*
  • HIV Seropositivity / physiopathology
  • Humans
  • Hydrocortisone / blood
  • Killer Cells, Natural / cytology
  • Killer Cells, Natural / drug effects
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Norepinephrine / pharmacology
  • Speech*
  • Stress, Psychological / diagnosis
  • Stress, Psychological / immunology*
  • Stress, Psychological / physiopathology*
  • Sympathetic Nervous System / physiopathology*
  • T-Lymphocytes / cytology
  • T-Lymphocytes / drug effects

Substances

  • Hydrocortisone
  • Norepinephrine
  • Epinephrine