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90 Cards in this Set
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psychoneuroimmunology |
= interactions among behavioural, neuroendocrine and immunological processes of adaption |
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3 main disorders related to immune system functioning |
AIDS, cancer, arthritis |
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indicators of immune functioning |
1) measure number of cells in the immune system - amount of T, B and NK cells - amount of lymphokines or antibody levels 2) assessing the functioning of immune cells --> the activation, proliferation, transformation and cytotoxicity of cells |
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functioning of cells examples |
lymphocyte cytotoxicity (ability of lymphocytes to kill invading cells) lymphocyte reproduction ability when stimulated by mitogen phagocytotic activity (ability of some white blood cells to ingest foreign particles) |
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Antibody titer |
is a laboratory test that measures the level of antibodies in a blood sample. |
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Proliferation |
is a rapid multiplication of parts or the increase in the number of something. |
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Mitogen |
A mitogen is any substance that triggers the process of mitosis, or cell division. In immunology, mitogens can be used to stimulate mitosis of lymphocytes, or white blood cells — cells that protect the host organism from invading bacteria or viruses. The mitotic ability of lymphocytes can be used as a test to determine whether the immune system is functioning correctly. If a mitogen is introduced and the lymphocytes fail to respond by dividing, the immune system is considered to be impaired. |
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lymphocyte |
A lymphocyte is a type of white blood cell in one's immune system. They include natural killer cells (NK cells) (which function in cell-mediated, cytotoxic innate immunity: = critical to the innate immune system. NK cells provide rapid responses to viral-infected cells, acting at around 3 days after infection, and respond to tumorformation. ) T cells (for cell-mediated, cytotoxicadaptive immunity), and B cells (for humoral, antibody-driven adaptive immunity: They function in the humoral immunity component of the adaptive immune system by secreting antibodies). |
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Lymphokines |
Lymphokines are a subset of cytokines that are produced by a type of immune cell known as a lymphocyte Types include: interleukin 2, interleukin 3 They are typically produced by T cells to direct the immune system response by signalling between its cells Lymphokines aid B cells to produce antibodies. |
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Cytokines |
are a broad and loose category of small proteins that are important in cell signaling. |
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Cytotoxicity |
is the quality of being toxic to cells. |
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3rd type of measure of immune system functioning |
levels of antibodies in produced to a latent virus (i.e. Epstein-Barr, Herpes Simplex) If body starts to produce antibodies to the inactive virus = a sign that immune system is not functioning properly |
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4th type of measure of immune system functioning |
levels of antibodies produced in response to a vaccine = sign of good functioning poor T cell proliferation & negative affect predicted lower antibody response higher stress after getting a vaccine --> inadequate antibody titre |
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immunocompetence |
immune system is working effectively |
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immunocompromise |
immune functioning = disrupted or reduced |
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another way of studying effects of stress on immune system |
wound healing psychological distress impairs inflammatory response that initiates wound repair |
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more than _____ studies look at stress and the immune system |
more than 300 studies look at stress and the immune system |
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short term response to stress |
fight&flight, wound repair, infection prevention --> increase in NK cells acutely stressful events cause immune cells to redistribute but specific immunity decreases in acutely stressful event. --> upregulation if natural immunity --> downregulation of specific immunity |
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specific immunity |
= slow to develop, thus not used to deal with short-term stressors |
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stressors of a couple days duration |
mobilizes immune system to fight off invaders esp. changes in cytokine production = shift from cellular immunity to humoral immunity |
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chronic psychosocial stressors |
i.e. chronic illness, low SES linked to adverse effects on almost ALL measures of immune functioning, incl. inflammation. chronic stress often leads to chronic inflammation, which is linked to heart disease. |
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1) intense, short-term stressors (acute) 2) acute stressors of several days duration 3) chronic stress |
1) recruit cells that defend against wounds and infection 2) upregulate immune functioning to defend against pathogends 3) affect most measures of immune functioning |
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stress system |
sympathetic NS (immediate increase in immune activity) and HPA (immunosuppressive effects) activation of HPA: release of cortisol, which reduces white blood cells, lymphocytes and cytokines which reduces ability of immune system to communicate internally |
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cortisol can trigger ______ of white blood cells |
apoptosis (cell death) |
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levels of ________ are related to ppl's perception of their own health |
cytokines |
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space flight and immune functioning |
space flight was associated with: - increase in white blood cells - decrease in NK cells - decerased T cell immunity - activation of latent viruses at landing: - increase in catecholamines (epinephrine and norepinephrine) - increase in white blood cells (but those on longer trips: effects were attenuated) space flight and landing produces sympathetic NS response, but this may ne attenuated by long mission. |
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self blame --> shame, guilt |
increased pro-inflammatory cytokine activity thus: self-related emotions can cause changes in inflammatory processes |
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anticipatory stress and immune functioning |
number of stressful events and number of anticipated stressors both related to decreased percentage of Th cells |
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study on academic stress |
elevated cortisol level right before exam but not weeks before however, other markers were changed 6-8 weeks before the exam SO: anticipation of academic stressors linked to alterations in immune functioning, while immediate stressors are linked to alterations in endocrine functioning. |
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can effects of stress be delayed? |
yes! antibody responses to a vaccine may occur only days after the vaccination (these results may have been affected by sleep loss) |
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immune changes related to stress = also related to health? |
yes! colds, flu, herpes infections, chicken pox, epstein-barr virus |
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autoimmune disorders |
immune system attacks body's own tissues, falsely identifying them as invaders incl. more than 80 conditions, i.e. - graves disease (excessive production of thyroid hormone) - chronic active hepatitis (chronic inflammation of liver) - lupus (chronic inflammation of connective tissue) - multiple sclerosis (myelin sheath) - rheumatoid arthritis (inflamed tissue lining the joints) - inflammatpry bowel disease (crohn's, colitis) - type 1 diabetes |
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80% of ppl who have autoimmune disorders are _____ |
women maybe hormonal changes? most develop a disorder in their 20s, when estrogen is high also: testosterone might be protective |
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depression and immunity |
depression was linked to alterations in cellular immunity - lower proliferative response of lymphocytes to mitogens - less NK cell activity - changes in numbers of white blood cells depression also linked to prolonged inflammation, which may explain links to disease sleep loss may be a confound |
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stress, immune system and interpersonal relationships |
bereaved ppl: less responsiveness to mitogenic challenge (more recent research says this effect is related to the depression of the bereaved, not the bereavement itself!) Loneliness: more immunocompromise Insecure attachment: lower NK cell cytotoxicity Marital disruption and conflict = adverse effects, even with short-term marital conflict Caregiving: higher epstein-barr antibodies, less T cells and Th cells. |
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coping resources for stress-immune functioning relationship |
optimism: MORE NK cytotoxicity and fewer numbers of T cells self-efficacy: - controllable vs. uncontrollable things - finding benefits of the situation (= associated with increased NK cell cytotoxicty) active coping = best for high levels of stress avoidant coping = best for low levels of stress |
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interventions to enhance immunocompetence |
stress management emotional disclosure (led to faster wound healing!) relaxation (dose-dependant response) - mindfulness mediation: increased antibodies in response to influenza vaccine massage therapy enhanced cellular immunity increased leukocytes and decreased cortisol --> for inflammatory and autoimmune issues? |
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The Immune System |
Guardsagainst infection, allergies, cancer, and autoimmune disorders Primary Function: Distinguish between “self” and foreign and then attack andrid the body of that which is foreign Primary Organs: Lymphoid organs: Thymus,lymph nodes, spleen, tonsils, appendix, Peyer’s patches (small intestine), and bonemarrow |
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Natural Immunity |
The defense against many pathogens More rapid reaction Involves granulocytes, NK cells |
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Specific Immunity |
Slower, fit with one and only one antigen receptor Cells divide when activated to create a population to attack specific antigen This is because some of the activated T and B cells had become memory cells. Memory cells ensure that the next time a person meets up with the same antigen, the immune system is already set to demolish it. |
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Humoral-Mediated Immunity Cell-Mediated Immunity |
Mediated by B lymphocytes (antibodies) Mediated by T lymphocytes (cytokines) |
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Lymphocyte Phagocyte |
Lympho: Small white blood cells that bear the major responsibility for carrying out the activities of the immune system; they number about 1 trillion. Phago: A type of cell within the body capable of engulfing and absorbing bacteria and other small cells and particles. |
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Aids |
Firstdiagnosed in 1981 but it appears that it existed prior to that (1970s, Central Africa) Route seems to have been from Africa,Europe, Haiti, United States. |
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Aids in Canada |
Canada in 1982… •By 2000, over 16,000 Canadians had AIDS, > 45,000 positive for HIV •2006… > 20,000 cases of AIDS, 60,000 HIV positive •13,000 Canadians have died from AIDS |
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what facilitated the spread of aids? |
high rate of extramarital sex little condom use high rate of gonorrhea |
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viral agent of AIDS |
The viral agent ( = HIV; humanimmunodeficiency virus) = a retrovirus that attacks the immune system withvariable rates of time between contracting the virus and developing AIDS attacks T cells and macrophages of immune system exchanged by bodily fluids, esp. semen and blood someone may be HIV-seropositive but free of AIDS and still pass on the virus |
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how many ppl live with HIV/AIDS worldwide? |
34 million |
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patient zero |
Geatan Dugas - airline steward - connected to 9 out of the first 19 cases in LA but recent research suggests, patient zero was actually an immigrant from Haiti, 1969 |
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how many canadians may be unaware of their HIV infection? |
18 000 |
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number of new HIV infections in the last decade aids related deaths dropped by ____% between 2004 and 2009 |
declined by 19% dropped by 19% |
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risk of death |
2008: 6th leading cause of death worldwide 2030: 3rd leading cause |
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process of HIV infection |
first few weeks: virus grows rapidly and spreads throughout the body Mild early symptoms: swollen glands, flu-like 3-6 weeks: infection may abate, long asymptomatic period viral growth = slow and controlled eventually virus starts killing T cells and makes body vulnerable to opportunistic infections --> abnormalities in their neuroendocrine and cardiovascular responses to stress --> neurological impairment (similar symptoms as depression) |
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opportunistic infections |
i.e. kaposi's sarcoma (rare skin cancer) or non-Hodgkin’s lymphoma chronic diarrhea, wasting, skeletalpain, blindness, gynecological infection in women; under-diagnosed = what ppl with AIDS/HIV eventually die from |
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Antiretroviral therapy |
= highly active antiretroviral therapy (HAART) = combination of antiretroviral medications that has dramatically improved health of HIV patients adherence is extremely important, but difficult |
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who gets AIDS? |
early in the epidemic, 2 risk groups: 1) men who have sex with men 2) intravenous drug users increasing risk: 1) aboriginal people & minorities most at risk: 1) adolescents and young adults (from sexual activity and multiplepartners) |
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are AIDS infections climbing again? |
yes especially among women esp. minority women |
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multiple risk factors contribute to increased risk |
rates of HIV seroconverion were 7X higher in men who a) had sex with other men, plus who b) also were intravenous drug users (compared to men who just had sex with men) |
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psychosocial impact of HIV |
major threatening event (being HIV positive) plus uncertainty & fear depression is common, but majority make positive lifestyle changes disclosure of HIV status: positive benefits |
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Balfour Ottawa team … |
Developed and tested program to increase readiness for taking HAART no long-term data using theory of planned behaviour, health belief model and transtheoretical model |
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1) Not disclosing that you are HIV positiveis associated with ___? 2) Disclosure associated with better ___? |
1) less likely hood to use condoms 2) immunocomptence |
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how successful are educational interventions to reduce spread of AIDS? |
effective for secondary prevention for HIV+ individuals (reducing behaviour that might infect others) but not as effective as a primary prevention strategy for uninfected individuals culturally sensitive interventions for specific target groups may fare better! |
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health beliefs and AIDS |
self-efficacy: more likely to use condoms, less sexual partners health belief model: modest ability to predict condom use and numbers of sexual partners theory of planned behaviour: more informative! social norms are very important regarding AIDS! |
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is AIDS chronic or acute disease? |
chronic! |
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psychosocial factors that affect course of AIDS |
stress: more rapid course of illness, more aggressive symptoms negative beliefs about self and future: T cell decline and onset of AIDS in HIV+ individuals negative expectations about illness: more rapid course of illness depression: T cell decline hope, compassion, optimism, positive affect = beneficial effects, aid adjustment |
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all cancers result from ___? |
dysfunction of DNA (which controls cell growth) this malfunctioning DNA causes excessive, rapid cell growth cancer cells provide no benefits for the body |
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Leadingcause of death in Canada (2009) |
cancer |
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cancer prevalence |
Canceron a general decline but on the rise in women in lung cancer (smoking) |
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___% of canadians will die from cancer ___% of canadians will develop cancer |
25% around 44% |
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why are cancers hard to study? |
1) species specific, some species more vulnerable than others 2) 1 cancer in 1 species may develop in different ways 3) long, irregular growth cycles 4) high within-species variability |
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who gets cancer? |
family history, genetics (but also lifestyle factors)! lifestyle/risk factors: smoking, obesity, not enough fruits/veggies, alcohol, HPV diet: fat, food additives marriage: protective factor, esp. for men |
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psychosocial factors and cancer |
1) depression: - elevated neuroendocrine responses (like cortisol or norepinephrine) - psyc. distress --> colectoral cancer mortality - less depression --> longer survival 2) stress - evidence for uncontrollable stress & cancer progression 3) avoidant/passive coping |
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mechanisms linking stress and cancer |
immune and neuroendocrine systems NK cells: tumor surveillance & whether or not a carcinogen takes hold stress adversely affects NK's ability to destroy tumours |
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TYPE C, Cancer Prone Personality |
This person is •Inhibited •Over socialized •Conforming •Compulsive •Depressive |
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____/3 families will have a family memberwith cancer 60% of cancer patients live on average ___ years afterdiagnosis |
2/3 5 |
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5 patterns of coping (Dunkel-Schetter et al) |
1) Seekingand using social support 2) Focusingon the positive 3) Distancing 4) Cognitiveescape-avoidance 5) Behavioural escape-avoidance 4 & 5 -->more emotional distress |
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when partners use ____ and ____ forms of coping, adjustment to cancer is maximized |
congruent and adaptive forms of coping |
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interventions: cognitive behavioural |
stress management: reduced cortisol mindfulness based stress reduction: shift from depressive markers on immune system to more normal immune system relaxation training: more T and NK cells exercise |
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interventions: psychotherapeutic interventions |
individual therapy: crisis intervention format, focus on specific issues faced by patient group/family therapy, cancer support goups: i.e. reach to recovery, can-surmount |
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most prevalent autoimmune disease |
arthritis body falsely identifies own tissue as foreign and attacks it = inflammation of a joint includes over 100 diseases that attack joints ot connective tissues |
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prevalence of arthritis in canada |
4.4 million people affected (1 in 6) 2 thirds of the ones affected are women in past decade rates have increased by 50% costs 33 billion CAD a year |
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5 major forms of arthritis |
1) rheumatoid arthritis 2) osteoarthritis 3) gout 4) lupus 5) ankylosing spondilitis (spine arthritis) |
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____ people cannot work due to arthritis 3/5 of arthritis patients are under ____ years, high in ____ population |
600,000 65 years aboriginal |
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Rheumatoid Arthritis |
Affects300,000 Canadians, 3 x more common in women, strikes between 25-50 years andchildren also Usuallyaffects small joints of the hands and feet, may also involve inflammation ofthe heart, may be product of autoimmune response Over50% of RA patients recover, 50% remainarthritic, 10% severely disabled |
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treatment of Rheumatoid Arthritis |
•Aspirin (NSAIDs) •Rest •Supervisedexercise --> adherence = low •Increasinglyused are CBT Interventions•Biofeedback •Relaxation training •Problem solving skills •Cognitive pain-coping skills |
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juvenile RA starts betwen ___ and ___ years and periodically flares up until ___ |
2-5 years puberty 4X more likely to affect girls |
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most common form of arthritis |
osteoarthritis women and men = equally affected onset = after 45 years ELDERLY and ATHLETES at increased risk only modifiable risk factor = obesity |
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osteoarthritis |
Develops when the smooth lining of ajoint, known as the articular cartilage, begins to crack or wear away becauseof overuse, injury, or other causes. Typically occurs in the weight-bearingjoints like the knees, hips, and spine |
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osteoarthritis treatments |
weight control, aspirin and exercise (may initially aggravate symptoms) |
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Gout |
Affects 500,000 Canadians = 3% Men are 4x more likely than women! = a build up of uric acid in the body due to the kidney’s inability to excrete the acid in the urine |
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Lupus |
Affects 15,000 Canadians, most common in women of child-bearing age (15-45) LUPUS is name of group of autoimmune diseases (common is lupus erythematosus) Can affect various tissues for different people and life-threatening when attacks vital organs antibodies attack health tissue, inflaming it |
