Goodkin K, Feaster D J, Tuttle R, Blaney N T, Kumar M, Baum M K, Shapshak P, Fletcher M A
Department of Psychiatry, University of Miami School of Medicine, Florida 33136-1045, USA.
Clin Diagn Lab Immunol. 1996 Jan;3(1):109-18. doi: 10.1128/cdli.3.1.109-118.1996.
Seventy-nine human immunodeficiency virus type 1 (HIV-1)-seropositive homosexual men participating in a longitudinal study of HIV-1 infection were assessed twice, 6 months apart, to investigate associations between bereavement and cellular immune function. Subjects were assessed by using a theory-driven model comprising life stressors, social support and coping style, and control variables. Natural killer cell cytotoxicity was decreased among the bereaved at both times. Lymphocyte proliferative response to phytohemagglutinin was decreased among the bereaved at the second time point but not at the first. These functional immune decrements are associated with increased neuroendocrine responses of the sympathetic adrenomeduallary system as well as the limbic-hypothalamic-pituitary-adrenal axis. Implications for differential neuroendocrine responses over time are discussed. Active coping style was independently and positively related to both immune measures. The results imply that a bereavement support group intervention merits investigation for an effect on immunological measures and clinical progression of HIV-1 infection as well as grief resolution.
79名参与人类免疫缺陷病毒1型(HIV-1)感染纵向研究的HIV-1血清反应阳性同性恋男性,每隔6个月接受两次评估,以调查丧亲之痛与细胞免疫功能之间的关联。通过使用一个由生活应激源、社会支持和应对方式以及控制变量组成的理论驱动模型对受试者进行评估。两次评估时,丧亲者的自然杀伤细胞细胞毒性均降低。在第二个时间点,丧亲者对植物血凝素的淋巴细胞增殖反应降低,但在第一个时间点未降低。这些功能性免疫下降与交感肾上腺髓质系统以及边缘-下丘脑-垂体-肾上腺轴的神经内分泌反应增加有关。讨论了随着时间推移不同神经内分泌反应的影响。积极的应对方式与两种免疫指标均独立且呈正相关。结果表明,丧亲支持小组干预对于影响免疫指标、HIV-1感染的临床进展以及悲伤情绪的缓解值得进行研究。