Mills Paul J, Adler Karen A, Dimsdale Joel E, Perez Christy J, Ziegler Michael G, Ancoli-Israel Sonia, Patterson Thomas L, Grant Igor
Department of Psychiatry, University of California San Diego, 92103-0804, USA.
Am J Geriatr Psychiatry. 2004 May-Jun;12(3):281-6.
The chronic stress of caregiving may lead to sympathetic nervous system activation and immune suppression. beta(2)-adrenergic receptors are expressed on all immune cells and contribute to the stress-induced loss of immune-cell function. The authors examined the effects of being a spousal caregiver of a patient with Alzheimer disease (AD) on the lymphocyte beta(2)-adrenergic receptor.
One hundred and six women and men, spousal caregivers and non-caregivers, participated (mean age: 71.5 years). Caregivers were classified as either vulnerable or non-vulnerable on the basis of the amount of care required by the patient relative to the amount of respite the caregiver received during the previous 6 months. beta(2)-adrenergic receptor sensitivity (cyclic-AMP response to isoproterenol stimulation) and density (radioligand binding) were determined by use of whole lymphocytes.
Vulnerable caregivers had reduced beta(2)-adrenergic receptor sensitivity and density when compared with their non-vulnerable counterparts or with non-caregivers.
The findings indicate that for more vulnerable caregivers, the stress of caregiving leads to a loss of lymphocyte beta(2)-adrenergic receptors. This finding may be relevant to previous observations of clinically-relevant reduced immunity in highly stressed caregivers of AD patients.
照顾患者的慢性压力可能导致交感神经系统激活和免疫抑制。β₂ - 肾上腺素能受体在所有免疫细胞上均有表达,并导致应激引起的免疫细胞功能丧失。作者研究了作为阿尔茨海默病(AD)患者的配偶照顾者对淋巴细胞β₂ - 肾上腺素能受体的影响。
106名男女参与研究,包括配偶照顾者和非照顾者(平均年龄:71.5岁)。根据患者所需护理量相对于照顾者在前6个月所获喘息时间的量,将照顾者分为易受影响组或非易受影响组。使用全淋巴细胞测定β₂ - 肾上腺素能受体敏感性(异丙肾上腺素刺激后的环磷酸腺苷反应)和密度(放射性配体结合)。
与非易受影响的照顾者或非照顾者相比,易受影响的照顾者β₂ - 肾上腺素能受体敏感性和密度降低。
研究结果表明,对于更易受影响的照顾者,照顾压力会导致淋巴细胞β₂ - 肾上腺素能受体丧失。这一发现可能与之前在AD患者高压力照顾者中观察到的临床相关免疫降低现象有关。