Front Cover 1
Handbook of Human Stress and Immunity 3
Copyright Page 4
Table of Contens 5
CONTRIBUTORS 17
PREFACE 21
Chapter 1. Stress-Induced Modulation of Immune Function in Mice 23
I. INTRODUCTION 23
II. THE EFFECTS OF HANDLING ON IMMUNE FUNCTION AND ON TUMOR METASTASES 25
III. HANDLING RESULTS IN HABITATION OF THE STRESS RESPONSE 28
IV. THE EFFECTS OF STRESS ON VIRAL INFECTION AND IMMUNITY 31
V. THE CENTRAL NERVOUS SYSTEM RESPONSE OF A RECIPIENT MOUSE TO THE ODORS EMITTED BY A STRESSED CONSPECIHC ALTERS CELL-MEDIATED AND HUMORAL IMMUNE FUNCTION 
31 
VI. DIFFERENT STRESSORS CAN AFFECT IMMUNE FUNCTION DIFFERENTLY 34
VII. DIFFERENT STRAINS OF MICE RESPOND DIFFERENTLY TO THE SAME STRESSOR 35
VIII. STRESS EFFECTS ON ANTIBODY RESPONSES MAY DEPEND ON THE CONCENTRATION 
36 
IX. STRESS AND AUTOIMMUNE DISEASE 36
X. CONCLUSIONS 39
ACKNOWLEDGMENTS 40
REFERENCES 40
Chapter 2. Mechanistic Aspects of Stressor-lnduced 
45 
I. INTRODUCTION 45
II. ABNORMALITIES OF IMMUNE FUNCTION: LESSONS FOR THE 
46 
III. ACTIVATION OF THE SYMPATHETIC NERVOUS SYSTEM 48
IV. THE EFFECT OF ADRENERGIC AGONISTS AND ANTAGONISTS 
52 
V. ADRENERGIC RECEPTORS ON LYMPHOCYTES 55
VI. CELL INTERACTIONS IN IMMUNE ALTERATION 57
VII. CORTISOL 58
VIII. LIMITATIONS ASSOCIATED WITH THE STUDY OF STRESSOR-INDUCED IMMUNE 
59 
IX. INTRACEREBRAL REGULATION OF STRESSOR-INDUCED IMMUNE ALTERATIONS 61
X. WHICH 
63 
XI. NONIMMUNE-RELATED EFFECTS OF STRESS ON HOST DEFENSES 65
XII. STRESSOR-INDUCED ENHANCEMENT OF IMMUNE RESPONSE 65
XIII. DEVELOPMENTAL MODIFICATION OF IMMUNE ALTERATIONS TO STRESS 66
XIV. CYTOKINE INTERACTIONS IN THE BRAIN 67
XV. CONCLUSIONS 68
ACKNOWLEDGMENT 69
REFERENCES 70
Chapter 3. Neuroìmmunomodubfion of Moaophoge Function 75
I. THE ROLE OF MONONUCLEAR PHAGOCÏÏES IN RESISTANCE AND IMMUNITY 75
II. HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND MACROPHAGE FUNCTION 76
III. THE SYMPATHETIC NERVOUS SYSTEM 82
IV. THE EFFECT OF NEUROPEPTIDES ON MACROPHAGE FUNCTION 83
V. MACROPHAGE-DERIVED CYTOKINES AFFECT NERVOUS SYSTEM FUNCTION 86
VI. SUMMARY AND CONCLUSIONS 88
ACKNOWLEDGMENTS 89
REFERENCES 89
Chapter 4. The Effects of Stress 
99 
I. STRESS EFFECTS ON HUMAN AUTOIMMUNE DISEASE 99
II. Communication Links between the Neuroendocrine and Immune Systems 103
III. 
104 
IV. EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS 110
V. SUMMARY 115
REFERENCES 115
Chapter 5. Stress, Viral Pathogenesis, and Immunity 123
I. INTRODUCTION 123
II. NEUROENDOCRINE RESPONSES TO STRESS DURING VIRAL INFECTION 124
III. ANTIVIRAL IMMUNITY AND RESPONSE TO STRESS 126
IV. MECHANISMS OF NEUROENDOCRINE IMMUNE INTERACTIONS DURING VIRAL INFECTION 136
V. SUMMARY AND FUTURE DIRECTIONS 140
ACKNOWLEDGMENTS 141
REFERENCES 141
Chapter 6. Experimental Approaches to Identify Mechanisms of Stress-Induced Modulation of Immunity to Herpes Simplex 
147 
I. INTRODUCTION 147
II. STRESS-INDUCED MODULATION OF IMMUNE FUNCTION 149
III. HERPES SIMPLEX VIRUS INFECTION—AN OVERVIEW 149
IV. EVIDENCE OF PSYCHOSOCIAL FACTORS AFFECTING HERPESVIRUS INFECTIONS 151
V. DESIGN OF AN EXPERIMENTAL MODEL SYSTEM 152
VI. STRESS-ASSOCIATED EFFECTS ON THE CELLULAR IMMUNE RESPONSE 
156 
VII. STRESS-ASSOCIATED EFFECTS ON OTHER COMPONENTS OF HERPES SIMPLEX 
173 
VIII. SUMMARY 175
ACKNOWLEDGMENTS 175
REFERENCES 175
Chapter 7. Stress and Immunity: Of Mice,Monkeys, Models, and Mechanisms 183
I. INTRODUCTION 183
II. ANIMAL MODELS 184
III. RELATIONSHIPS BETWEEN BEHAVIOR AND IMMUNITY AS STUDIED 
185 
IV. MURINE MODELS FOR INVESTIGATING BIOLOGICAL MECHANISMS OF STRESS-INDUCED 
190 
V. CONCLUSIONS 200
ACKNOWLEDGMENTS 200
REFERENCES 200
Chapter 8. Stress and Immunity in Humans: 
205 
I. INTRODUCTION 205
II. REPRESSION 206
III. SOCIAL SUPPORT 210
IV. GUIDED IMAGERY 213
V. EXERCISE 216
VI. PLACEBOS 218
VII. IMMUNOLOGA AND VIRAL MODULATION OF THE STRESS RESPONSE 220
VIII. SUMMARY 222
IX. Appendix I: Potential Confounding Variables in Studies of Stress and Immunity: A Partial 
223 
ACKNOWLEDGMENTS 224
REFERENCES 224
Chapter 9. Stress, Immunity, and Health 239
I. INTRODUCTION 239
II. HISTORICAL PERSPECTIVES: CONTROVERSIES INVOLVING NEW PARADIGMS 240
III. METHODOLOGICAL, CONCEPTUAL, AND STATISTICAL ISSUES 241
IV. CONCEPTUAL AND OPERATIONAL DEFINITION OF MODEL COMPONENTS 246
V. EVIDENCE FOR PARTIAL S-I-H MODELS 251
VI. EVIDENCE 
I => H
VII. CONCLUSIONS 261
ACKNOWLEDGMENT 262
REFERENCES 262
Chapter 10. Stressful Events, Psychological Responses, and Progression of HIV Infection 267
I. INTRODUCTION 267
II. THE PATHOGENESIS Of HIV INFECTION 268
III. COFACTORS IN HIV PROGRESSION 270
IV. POTENTIAL PHYSIOLOGICAL PATHWAYS 277
V. CONCLUSION AND METHODOLOGICAL ISSUES 280
ACKNOWLEDGMENTS 283
REFERENCES 283
Chapter 11. HIV-I, Immunity, and 
289 
I. INTRODUCTION 289
II. STRESS, ENDOCRINES, AND IMMUNITY 291
III. BEHAVIORAL STRESSORS, STRESS HORMONES, IMMUNE STATUS, AND HIV 293
IV. PSYCHOSOCIAL PREDICTORS OF HIV-1 DISEASE PROGRESSION 297
V. BEHAVIORAL INTERVENTIONS IN HIV-1 SPECTRUM DISEASE 300
V. SUMMARY AND CONCLUSIONS 312
ACKNOWLEDGMENTS 314
REFERENCES 314
Chapter 12. Psychosocial Influences on Immunity and Infectious Disease in Humans 323
I. INTRODUCTION 323
II. CURRENT STATE OF KNOWLEDGE 324
III. THE COMMON COLD STUDIES 329
IV. FUTURE PROSPECTS 336
V. SUMMARY 338
ACKNOWLEDGMENTS 338
REFERENCES 338
Chapter 13. Stressful Personal Relationships: 
343 
I. OVERVIEW 343
II. MARITAL INTERACTION 345
III. SPOUSAL CAREGIVERS OF ALZHEIMER'S DISEASE PATIENTS 352
IV. THE SEQUELAE OF CHRONIC STRESS: INTERACTIONS AMONG SYMPATHETIC NERVOUS 
354 
ACKNOWLEDGMENTS 357
REFERENCES 357
Chapter 14. Psychoneuroimmunologic Aspects of 
363 
I. IMMUNITY AND AGING 363
II. PSYCHOIMMUNOLOGIC 
371 
III. EXERCISE AND IMMUNITY 372
IV. DEPRESSION, BEREAVEMENT, LIFE STRESS, ALCOHOLISM, AND IMMUNITY IN THE ELDERLY 373
V. INTERVENTIONS 376
VI. CONCLUSIONS 377
REFERENCES 378
Chapter 15. Psychoeducational Interventions and 
387 
I. INTRODUCTION 387
II. PSYCHOSOCIAL INTERVENTIONS: EFFECTS ON GENERAL HEALTH OUTCOMES 388
III. PSYCHOSOCIAL INTERVENTIONS FOR NONCANCER SUBJECTS: 
389 
IV. PSYCHOSOCIAL INTERVENTIONS FOR CANCER SUBJECTS: EFFECTS ON THE IMMUNE 
390 
V. EFFECTS OF THE MODEL INTERVENTION ON PSYCHOLOGICAL AND IMMUNOLOGICAL PARAMETERS 
398 
VI. EFFECTS OF THE MODEL INTERVENTION ON RECURRENCEAND SURVIVAL FIVE YEARS POSTINTERVENTION 410
VII. ANALYSIS OF TOTAL SAMPLE AT BASELINE AND AT SIX MONTHS FOR COPING, POMS 
415 
VIII. THE ROLE OF BASELINE SCORES AND CHANGE OVER TIME IN COPING, AFFECTIVE 
419 
IX. SIGNIFICANCE OF PSYCHOLOGICAL AND IMMUNOLOGIA FINDINGS 420
REFERENCES 422
INDEX 425