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My citation abstract, explained.
Dec. 7th, 2005 12:10 pmThis is the first major finding from our big five-year study of stress, coping, and immune function in HIV. In a previous study, we found that a specific coping pattern - suppression or even total non-recognition of negative emotions, a focus on others' needs rather than one's own, and an outward appearance of being Just Fine - was associated with a decreased immune response to HIV. Now we're trying to (a) replicate that finding with a larger and more carefully-selected sample of patients, and (b) figure out how it works. A major hypothesis is that people with the coping style in question (known as Type C coping) have an abnormal physiological response to stress.
So, as part of our research protocol, we bring patients into the lab and stress them out while we monitor their physiological responses - blood pressure, heart rate, maximal arterial pressure. First, we ask them to tell about a recent situation that made them angry. We help rev up the emotions with our reactions ("My God, I can't believe she said that - that's totally unfair!"). Then we tell them to stop thinking about the angry situation and "make yourself relaxed and calm."
The second half of the stress procedure is a role play. We tell patients to pretend that the experimenter is their doctor, and has prescribed a medicine that's causing terrible side effects. They are to complain about the side effects, amd the experimenter plays the role of the doctor. What we don't tell them: the "doctor" is rude, dismissive, and insulting. ("Oh, for heaven's sake, what is it now? ...You think another medicine would be better for you? Well, when did you go to medical school?") After the role play, again, they're supposed to make themselves relaxed and calm.
What we're finding is that patients who have greater increases in heart rate and blood pressure during the test periods and/or lesser ability to reduce their heart rate and blood pressure in the "make yourself relaxed and calm" recovery period, have a poorer immune response to HIV.
We take samples of the patients' blood and expose it to different antigens - things the immune system ought to defend against. Then we measure the amount of various immune products that are produced in response to the antigen. We're specifically interested in beta-chemokines, which bind to the same receptors on CD4+ (T-helper) cells that HIV needs to bond to, therefore blocking HIV from entering the cell. So when we challenged patients' blood with the core protein of HIV, the ones who had greater cardiovascular reactivity on the stress tests and poorer recovery afterward produced lower amounts of beta-chemokines. this was specific to the HIV antigen - it didn't apply to either of the standard research antigens we used in addition to the core HIV protein.
We still need to work out how this relates to coping, especially the Type C coping style, but it's a fascinating piece of evidence for how stress affects the immune system in people with HIV.
So, as part of our research protocol, we bring patients into the lab and stress them out while we monitor their physiological responses - blood pressure, heart rate, maximal arterial pressure. First, we ask them to tell about a recent situation that made them angry. We help rev up the emotions with our reactions ("My God, I can't believe she said that - that's totally unfair!"). Then we tell them to stop thinking about the angry situation and "make yourself relaxed and calm."
The second half of the stress procedure is a role play. We tell patients to pretend that the experimenter is their doctor, and has prescribed a medicine that's causing terrible side effects. They are to complain about the side effects, amd the experimenter plays the role of the doctor. What we don't tell them: the "doctor" is rude, dismissive, and insulting. ("Oh, for heaven's sake, what is it now? ...You think another medicine would be better for you? Well, when did you go to medical school?") After the role play, again, they're supposed to make themselves relaxed and calm.
What we're finding is that patients who have greater increases in heart rate and blood pressure during the test periods and/or lesser ability to reduce their heart rate and blood pressure in the "make yourself relaxed and calm" recovery period, have a poorer immune response to HIV.
We take samples of the patients' blood and expose it to different antigens - things the immune system ought to defend against. Then we measure the amount of various immune products that are produced in response to the antigen. We're specifically interested in beta-chemokines, which bind to the same receptors on CD4+ (T-helper) cells that HIV needs to bond to, therefore blocking HIV from entering the cell. So when we challenged patients' blood with the core protein of HIV, the ones who had greater cardiovascular reactivity on the stress tests and poorer recovery afterward produced lower amounts of beta-chemokines. this was specific to the HIV antigen - it didn't apply to either of the standard research antigens we used in addition to the core HIV protein.
We still need to work out how this relates to coping, especially the Type C coping style, but it's a fascinating piece of evidence for how stress affects the immune system in people with HIV.
