2014 Immune Risk Standing Review Panel: Status Review

No abstract availabl

Sensitivity of PCR Assays for Murine Gammaretroviruses and Mouse Contamination in Human Blood Samples

Gammaretroviruses related to murine leukemia virus (MLV) have variously been reported to be present or absent in blood from chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) patients and healthy controls. Using subjects from New York State, we have investigated by PCR methods whether MLV-related sequences can be identified in nucleic acids isolated from whole blood or from peripheral blood mononuclear cells (PBMCs) or following PBMC culture. We have also passaged the prostate cancer cell line LNCaP following incubation with plasma from patients and controls and assayed nucleic acids for viral sequences. We have used 15 sets of primers that can effectively amplify conserved regions of murine endogenous and exogenous retrovirus sequences. We demonstrate that our PCR assays for MLV-related gag sequences and for mouse DNA contamination are extremely sensitive. While we have identified MLV-like gag sequences following PCR on human DNA preparations, we are unable to conclude that these sequences originated in the blood samples

Insights into myalgic encephalomyelitis/chronic fatigue syndrome phenotypes through comprehensive metabolomics

The pathogenesis of ME/CFS, a disease characterized by fatigue, cognitive dysfunction, sleep disturbances, orthostatic intolerance, fever, irritable bowel syndrome (IBS), and lymphadenopathy, is poorly understood. We report biomarker discovery and topological analysis of plasma metabolomic, fecal bacterial metagenomic, and clinical data from 50 ME/CFS patients and 50 healthy controls. We confirm reports of altered plasma levels of choline, carnitine and complex lipid metabolites and demonstrate that patients with ME/CFS and IBS have increased plasma levels of ceramide. Integration of fecal metagenomic and plasma metabolomic data resulted in a stronger predictive model of ME/CFS (cross-validated AUC = 0.836) than either metagenomic (cross-validated AUC = 0.745) or metabolomic (cross-validated AUC = 0.820) analysis alone. Our findings may provide insights into the pathogenesis of ME/CFS and its subtypes and suggest pathways for the development of diagnostic and therapeutic strategies

Cognitive Processing Style, Mood, and Immune Function Following HIV Seropositivity Notification

The relations among cognitive processing of stressful emotional material, mood, and immune functioning were examined in 30 asymptomatic gay men during the stress of HIV-1 seropositivity notification. We administered the Impact of Event Scale, and immunological and mood data were collected 5 weeks before, 1 week after, and 5 weeks after notification of HIV-1 seropositivity. Consistent elevations of avoidance or intrusion levels during the study period did not predict distress at 5 weeks postdiagnosis; rather, increased levels of both avoidance and intrusion over the study period were related to significantly greater anxiety, depression, and total mood disturbance by the end of the study. Increased intrusion, but not avoidance, during the period from study entry to 1-week postdiagnosis was related to higher levels of distress 1 week after HIV serostatus notification. In contrast, in the weeks following serostatus notification, increased avoidance predicted worse mood outcomes. Increased avoidance over the 10-week study period significantly predicted poorer proliferative response to pokeweed mitogen as well as trends toward lower T-helper-inducer lymphocyte (CD4+) percentages. Increased intrusion over this time period significantly predicted lower CD4+ percentages, controlling statistically for baselines. Mood change during the 10-week study did not mediate effects of cognitive processing on immune function. Mood changes may work jointly with cognitive processing to influence some immune outcomes. As increases in avoidant and intrusion processing may reflect difficulties in working through the trauma of HIV seropositivity notification, the current findings suggest the importance of thorough cognitive processing of traumatic medical information in this population for subsequent adjustment and immune functioning

Relationships of Cognitive Difficulties to Immune Measures, Depression and Illness Burden in Chronic Fatigue Syndrome

Objective. We related the subjective assessment of cognitive difficulties with lymphocyte phenotypes, cellmediated immunity (CMI), cytokine and neopterin levels in patients with chronic fatigue syndrome (CFS), in order to determine if CFS patients complaining of greater cognitive difficulties would show greater impairments in cell-mediated immunity and a greater degree of immune system dysregulation, and to determine if these cognitive difficulties would correlate with the other non-affective measures of CFS associated illness burden. We also assessed whether these relationships would hold independent of depression in two ways, by statistically covarying depression severity scores and by comparing subsets of CFS patients with and without a concurrent diagnosis of major depressive disorder. Design. A case series of CFS patients. Setting. Outpatient tertiary referral clinic at the University of Miami School of Medicine, Miami, FL. Patienrs. Consecutive sample of 65 patients who were referred as CFS to the University of Miami Diagnostic Immunology Clinic, who met the Centers for Disease Control and Prevention (CDC) criteria for diagnosis of CFS and consented to participate. Main Measures. Self-assessment of cognitive difficulties, depression and illness burden, clinician-assessed depression and CFS symptoms, lymphocyte phenotype, proliferative response to mitogens, serum levels of cytokines and neopterin. Results. Among CFS patients, high Cognitive Difficulty Scale (CDS) scores were significantly related to lower lymphocyte proliferative responses to mitogens, higher neopterin levels, and higher CD4 and lower CD8 lymphocyte counts. These relationships, with the exception of T cell subset percentages, were maintained when depression severity was used as a co-variate. High CDS scores were also significantly related to lower Karnofsky scores, and greater illness burden as measured by the Sickness Impact Profile. Conclusions. Evidence is presented that CFS patients with higher cognitive difficulty scores have more immune and clinical dysfunction than those patients with less cognitive difficulty, and that these relationships are independent of depression. These observations provide support for the concept that although both cognitive difficulties and immunologic abnormalities, such as immune activation and impaired cell-mediated immunity, may represent secondary sequence to the same event(s), they are not likely to be secondary sequence to depression

Psychoneuroimmunology and HIV/AIDS

https://nsuworks.nova.edu/hpd_com_facbooks/1027/thumbnail.jp

Cognitive-behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men

Stress management interventions can reduce symptoms of distress as well as modulate certain immune system components in persons infected with human immunodeficiency virus (HIV). These effects may occur in parallel with reductions in hypothalamic-pituitary-adrenal (HPA) axis hormones such as cortisol, which has been related in other work to a down-regulation of immune system components relevant to HIV infection. The present study tested the effects of a multimodal cognitive-behavioral stress management (CBSM) intervention on 24-hour urinary free cortisol levels and distressed mood in symptomatic HIV+ gay men.Symptomatic HIV-infected gay men who were randomized to either a 10-week group-based CBSM intervention or a 10-week wait-list period provided psychological responses and urine samples pre-post intervention.Of the 59 participants providing matched questionnaire data, men assigned to CBSM (n=40) showed significantly lower posttreatment levels of self-reported depressed affect, anxiety, anger, and confusion than those in the wait-list control group (n=19). Among the 47 men providing urine samples (34 CBSM, 13 controls), those assigned to CBSM revealed significantly less cortisol output as compared to controls. At the individual level, depressed mood decreases paralleled cortisol reductions over this period across the entire sample.A time-limited CBSM intervention reduced distress symptoms and urinary free cortisol output in symptomatic HIV+ gay men and greater reductions in some aspects of distress, especially depressed mood, paralleled greater decreases in cortisol over the intervention period. If persisting stressors and depressed mood contribute to chronic HPA axis activation in HIV-infected persons, then interventions such as CBSM, which teaches them to relax, alter cognitive appraisals, use new coping strategies, and access social support resources, may decrease distress and depressed mood and normalize HPA axis functioning

Coping: Interventions for optimal disease management

Individuals with HIV spectrum disease including AIDS face a multitude of stressors. It is reasonable to ask whether stress management may have a buffering or beneficial effect on quality of life and health status. This chapter reviews evidence in this area. First, the authors review some of the stressors faced by people who are HIV positive. Next, the authors review intervention studies (including cognitive-behavioral, relaxation, exercise, and massage). These studies encompass the authors' own work during the past 15 years and the work of others dealing with individuals at different stages of HIV infection and include psychoneuroimmunology studies demonstrating changes in endocrine and immune system components that occur with these interventions. (PsycINFO Database Record (c) 2009 APA, all rights reserved