Type C coping, alexithymia, and heart rate reactivity are associated independently and differentially with specific immune mechanisms linked to HIV progression.
Type C coping, alexithymia, and heart rate reactivity are associated independently and differentially with specific immune mechanisms linked to HIV progression.
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C 型应对、述情障碍和心率反应性与 HIV 进展相关的特定免疫机制独立且有区别地相关。
DOI：
10.1016/j.bbi.2008.02.003
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Wiley,JamesA
中科院分区：
文献类型：
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作者：
Temoshok,LydiaR;Waldstein,ShariR;Wald,RebeccaL;Garzino-Demo,Alfredo;Synowski,StephenJ;Sun,Lingling;Wiley,JamesA
适应不良的C型应对方式与艾滋病毒和其他免疫介导疾病的疾病进展有关。我们假设，强C型应对，较高水平的述情障碍，以及更大的心血管（特别是心率）反应和长期恢复与以前与HIV发病和进展相关的免疫参数功能较差有关：（1）抗原刺激的β（β）-趋化因子MIP-1α和MIP-1β的产生，其结合HIV辅助受体CCR 5并阻断HIV进入CD 4+淋巴细胞;和（2）抗原刺激的促炎细胞因子白细胞介素-6（IL-6）的产生，其协同与HIV复制相关的免疫激活。我们在巴尔的摩市中心一家HIV初级保健诊所就诊的200名HIV感染者（主要是非洲裔美国人）的基线样本中，研究了心理、心血管和免疫变量之间的关系。在校正了CD 4+计数和年龄的回归分析中，正如预测的那样，强C型应对与显著较高的IL-6产生相关。理论上与述情障碍相关的结构与显著较低的抑制HIV的MIP-1α的刺激产生相关。独立于述情障碍，对实验应激反应的心率反应性更高和心率恢复较差也与MIP-1α的产生较低显著相关，调整了心血管药物、美沙酮使用、CD 4+计数和年龄。这些研究结果支持我们的主要假设，即适应不良的C型应对，述情障碍，心率反应性/恢复与干扰在两个关键的免疫参数涉及艾滋病毒的发病机制。我们的次要假设，即心率反应性失调可能介导C型应对和/或述情障碍与IL-6/ MIP-1α之间的联系，但未得到证实。C型应对、述情障碍和心率反应性/恢复与相关免疫功能的特定方面独立和差异相关，这一发现可能反映了导致HIV进展的不同生物行为途径。
The maladaptive Type C coping style has been linked to disease progression in HIV and other immunologically mediated disorders. We hypothesized that strong Type C coping, higher levels of alexithymia, and greater cardiovascular (particularly heart rate) responses to, and prolonged recovery from stress would be associated with poorer functioning of immune parameters previously linked to HIV pathogenesis and progression: (1) antigen-stimulated production of the beta (β)-chemokines MIP-1α and MIP-1β, which bind to the HIV co-receptor CCR5 and block HIV entry into CD4+lymphocytes; and (2) antigen-stimulated production of the proinflammatory cytokine interleukin-6 (IL-6), which synergizes immune activation associated with HIV replication. We examined relations among psychological, cardiovascular, and immune variables in a baseline sample of 200 HIV-infected, predominantly African American outpatients attending an HIV primary care clinic in inner-city Baltimore. In regression analyses adjusted for CD4+count and age, strong Type C coping was associated with significantly higher IL-6 production, as predicted. The theoretically related construct of alexithymia was correlated with significantly lower stimulated production of HIV-inhibiting MIP-1α. Independent of alexithymia, greater heart rate reactivity, and poorer heart rate recovery in response to experimental stressors were also significantly associated with lower production of MIP-1α, adjusted for cardiovascular medications, methadone use, CD4+count, and age. These findings support our primary set of hypotheses that maladaptive Type C coping, alexithymia, and heart rate reactivity/recovery are associated with disturbances in two key immune parameters implicated in HIV pathogenesis. Our secondary hypothesis, that dysregulated heart rate reactivity may mediate the connections between Type C coping and/or alexithymia and IL-6/ MIP-1α was not confirmed. The finding that Type C coping, alexithymia, and heart rate reactivity/recovery are associated independently and differentially with specific aspects of relevant immune functioning may reflect distinct biobehavioral pathways that contribute to HIV progression.