ADRENOCORTICAL AND BEHAVIORAL PREDICTORS OF IMMUNE-RESPONSES TO STARTING SCHOOL
ADRENOCORTICAL AND BEHAVIORAL PREDICTORS OF IMMUNE-RESPONSES TO STARTING SCHOOL
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DOI：
10.1203/00006450-199512000-00030
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发表时间：
1995-12-01
影响因子：
3.6
通讯作者：
GUNNAR, MR
中科院分区：
文献类型：
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作者：
BOYCE, WT;ADAMS, S;GUNNAR, MR
在以前的研究中已经记录了主要心理压力和免疫功能之间的关联，但很少有研究调查免疫变化参加轻微的，规范的压力。本研究检测了39名5岁儿童开始上幼儿园时免疫反应的肾上腺皮质和行为预测因子，这些儿童在入学前1周（时间1）和入学后1周（时间2）完成了静脉穿刺实验室访视。在时间1，儿童也接种了肺炎球菌疫苗。免疫应答以T（CD 4（+）和CD 8（+））细胞、B（CD 19（+））细胞、对美洲商陆线粒体的淋巴增殖应答（PWM）和类型特异性肺炎球菌抗体应答（ABR）的变化评分来测量。肾上腺皮质反应以唾液皮质醇水平的变化来评估，行为困难与学校适应的评分采用父母对行为问题的评分，由于日常生活的改变而引起的压力，以及适应性挑战的程度。（平均值= 0.39 +/- 0.28至0.49 +/- 0.36 μ g/dL，p = 0.03），与行为困难无关。CD 4（+）细胞数量增加，而PWM下降，CD 19（+）细胞呈临界增加。唾液皮质醇的变化与CD 19（+）（Delta CD 19（+））的变化呈正相关，与ABR呈负相关。行为困难评分与Delta CD 4（+）和Delta CD 19（+）呈负相关。这些数据表明：1）入学是一种应激源，能够引起皮质醇和行为问题的升高，伴随着免疫状态的功能和计数测量的变化; 2）肾上腺皮质反应性较高的儿童B细胞数量增加，B细胞介导的抗体产生效率较低，而行为困难较多的儿童显示所有T和B细胞亚群下降。
Associations between major psychologic stressors and immune function have been documented in previous research, but few studies have investigated immune changes attending minor, normative stressors. This study examined adrenocortical and behavioral predictors of immune responses to starting kindergarten in 39 five-year-old children, who completed laboratory visits for venipunctures 1 wk before (time 1) and 1 wk after (time 2) school entry. At time 1, children were also immunized with pneumococcal vaccine. Immune responses were measured as change scores for T (CD4(+) and CD8(+)) cells, B (CD19(+)) cells, lymphoproliferative responses to pokeweed mito en (PWM), and type-specific pneumococcal coccal antibody responses (ABR). Adrenocortical response was assessed as the change in salivary cortisol level, and behavioral difficulty with school adjustment was scored using parental ratings of behavior problems, stress due to changes in routines, and degree of adaptive challenge, Salivary cortisol rose after kindergarten entry (means = 0.39 +/- 0.28 to 0.49 +/- 0.36 mu g/dL, p = 0.03) and was unrelated to behavioral difficulties. CD4(+) cells increased in number, whereas PWM declined, and CD19(+) cells showed a borderline increase. Change in salivary cortisol was positively associated with change in CD19(+) (Delta CD19(+)) and inversely related to ABR. Scores for behavioral difficulty were inversely associated with Delta CD4(+) and Delta CD19(+). These data suggest that: 1) school entry is a stressor capable of evoking elevations in cortisol and behavior problems, accompanied by shifts in functional and enumerative measures of immune status; and 2) children with greater adrenocortical reactivity have increases in B cell numbers and less effective B cell-mediated antibody production, whereas children with more behavioral difficulties show declines in all T and B cell subsets.