Increases in a marker of immune system reconstitution are predated by decreases in 24-h urinary cortisol output and depressed mood during a 10-week stress management intervention in symptomatic HIV-infected men.

Abstract

BACKGROUND:

Stress management interventions reduce distress symptoms and hypothalamic-pituitary-adrenal (HPA) axis hormones such as cortisol, which has been related to a down-regulation of immune system components relevant to the human immunodeficiency virus (HIV) infection. We previously showed that HIV+ men assigned to a 10-week cognitive behavioral stress management (CBSM) intervention showed more CD4+CD45RA+CD29+ lymphocytes, an indicator of immune system reconstitution, at a 6- to 12-month follow-up compared with controls. Here, we tested whether reductions in urinary cortisol output and depressed mood during the 10-week CBSM intervention period mediated its effects on this immune system reconstitution marker at follow-up.

METHODS:

Twenty-five HIV-infected men randomized to either a 10-week CBSM intervention or a wait-list control provided 24-h urine samples and psychological responses pre- to postintervention, which were related to changes in immune status over a 6- to 12-month follow-up period.

RESULTS:

Greater reductions in cortisol output and depressed mood during CBSM appeared to mediate the effects of this intervention on this indicator of immune system reconstitution over the 6- to 12-month follow-up period. Changes in mood were maintained over the follow-up period, although these did not add explanatory information beyond the cortisol and mood changes that were observed during the 10-week intervention period. These findings were not explained by the changes in medications or health behaviors during follow-up.

CONCLUSION:

A time-limited CBSM intervention may affect the rate of immune system reconstitution in HIV-infected men by modifying the stress of symptomatic disease. This intervention may work by decreasing depressed mood and normalizing HPA axis functioning.

• Authors: Michael H Antoni, Dean G Cruess, Nancy Klimas, Adam W Carrico, Kevin Maher, Stacy Cruess, Suzanne C Lechner, Mahendra Kumar, Susan Lutgendorf, Gail Ironson, Mary Ann Fletcher, Neil Schneiderman
• Journal: Journal of psychosomatic research (J Psychosom Res) Vol. 58 Issue 1 Pg. 3-13 (Jan 2005) ISSN: 0022-3999 [Print] England
• PMID: 15771864 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Biomarkers
• CD3 Complex
• CD4 Antigens
• Integrin beta1
• Leukocyte Common Antigens
• Hydrocortisone

Topics

• Adolescent
• Adult
• Biomarkers
• CD3 Complex (immunology)
• CD4 Antigens (immunology)
• Cognitive Behavioral Therapy (methods)
• Depression (etiology, immunology, urine)
• Follow-Up Studies
• HIV Seropositivity (psychology)
• Humans
• Hydrocortisone (metabolism, urine)
• Hypothalamo-Hypophyseal System (metabolism)
• Integrin beta1 (immunology)
• Leukocyte Common Antigens (immunology)
• Male
• Middle Aged
• Monitoring, Ambulatory
• Pituitary-Adrenal System (metabolism)
• Stress, Psychological (etiology, therapy)