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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.

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  • Authors+Show Affiliations

    ,

    Department of Psychology, University of Miami, Coral Gables, FL 33146, USA. mantoni@miami.edu

    , , , , , , , , , ,

    Source

    Journal of psychosomatic research 58:1 2005 Jan pg 3-13

    MeSH

    Adolescent
    Adult
    Biomarkers
    CD3 Complex
    CD4 Antigens
    Cognitive Behavioral Therapy
    Depression
    Follow-Up Studies
    HIV Seropositivity
    Humans
    Hydrocortisone
    Hypothalamo-Hypophyseal System
    Integrin beta1
    Leukocyte Common Antigens
    Male
    Middle Aged
    Monitoring, Ambulatory
    Pituitary-Adrenal System
    Stress, Psychological

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15771864

    Citation

    Antoni, Michael H., et al. "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." Journal of Psychosomatic Research, vol. 58, no. 1, 2005, pp. 3-13.
    Antoni MH, Cruess DG, Klimas N, et al. 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. J Psychosom Res. 2005;58(1):3-13.
    Antoni, M. H., Cruess, D. G., Klimas, N., Carrico, A. W., Maher, K., Cruess, S., ... Schneiderman, N. (2005). 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. Journal of Psychosomatic Research, 58(1), pp. 3-13.
    Antoni MH, et al. 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. J Psychosom Res. 2005;58(1):3-13. PubMed PMID: 15771864.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - 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. AU - Antoni,Michael H, AU - Cruess,Dean G, AU - Klimas,Nancy, AU - Carrico,Adam W, AU - Maher,Kevin, AU - Cruess,Stacy, AU - Lechner,Suzanne C, AU - Kumar,Mahendra, AU - Lutgendorf,Susan, AU - Ironson,Gail, AU - Fletcher,Mary Ann, AU - Schneiderman,Neil, PY - 2002/10/07/received PY - 2004/05/18/accepted PY - 2005/3/18/pubmed PY - 2005/7/29/medline PY - 2005/3/18/entrez SP - 3 EP - 13 JF - Journal of psychosomatic research JO - J Psychosom Res VL - 58 IS - 1 N2 - 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. SN - 0022-3999 UR - https://www.unboundmedicine.com/medline/citation/15771864/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3999(04)00525-2 DB - PRIME DP - Unbound Medicine ER -