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Am J Psychiatry 1995; 152:543-550
Copyright © 1995 by American Psychiatric Association
Stress-associated reductions of cytotoxic T lymphocytes and natural killer cells in asymptomatic HIV infection
DL Evans, J Leserman, DO Perkins, RA Stern, C Murphy, K Tamul, D Liao, CM van der Horst, CD Hall and JD Folds
Department of Psychiatry, University of Florida College of Medicine, Gainesville 32610-0256.
OBJECTIVE: Previous research has documented a possible relation of stress
and depression to cell-mediated immunity. The authors examined how
stressful events and depression may affect key parameters of cellular
immunity in subjects with and without HIV infection. METHOD: Data were
collected on 99 asymptomatic HIV-positive and 65 HIV-negative homosexual
men as part of an ongoing, longitudinal study. Criticisms of previous
studies of psychoimmunity were addressed by 1) using a comprehensive,
semistructured interview to measure the objective context of stressful
events, 2) double labeling of lymphocytes with monoclonal antibodies to
measure subsets of cytotoxic/suppressor T lymphocytes and natural killer
(NK) cells, and 3) controlling for circadian effects and methodological
factors. RESULTS: In the HIV- positive men, severe stress was significantly
associated with reductions in NK cell populations and a subset of T cells
thought to represent cytotoxic T effector cells, particularly the CD8+ T
cells expressing the CD57 antigen. In the HIV-negative men, no clear and
consistent relation between stress and immune system measures was found.
Depression was not correlated with any variables in either of the groups,
perhaps due to the low levels of depressive symptoms. CONCLUSIONS: The
findings suggest that stress is associated with reductions in killer
lymphocytes (decreased NK cell and cytotoxic T lymphocyte phenotypes). The
data provide evidence that stress may alter cell populations that provide
cytotoxic defense against infection in HIV-positive men and indicate that
the clinical significance of stress- related changes in cytotoxic T
lymphocytes and NK cells in HIV infection warrants further study.
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