PSYCHOIMMUNOLOGY

-an emotion to immunity

Dr.M.KANNAN, M.Sc., M.Phil., Ph.D.

Assistant Professor,
Department of Microbiology,
V.H.N.S.N.College,
Virudhunagar – 626 001
 PSYCHOIMMUNOLOGY

• THE CONCEPT of an inter-relationship between

immune status and psychologic states can be traced
to ancient history. Basic writings of Indian medicine
that date back two millennia contain concepts of
natural and acquired immunity.
• Over the past two decades increasing evidence has
supported the hypothesis that psychologic factors play a
role in health and the development of illness. Stress,
bereavement, affective disorders, and schizophre­nia
have all been reported to be associated with immune
alterations.
 Stress and Illness
• Stress also seems to be linked to physical illness including
cardiovascular disorders.
• Stress is linked to: headaches; infectious illness (e.g. ‘flu);
cardiovascular disease; diabetes, asthma and rheumatoid
arthritis.
• High stressed individuals are more than twice as likely to
catch a common cold as low stressed individuals.
Overview of Immunology
We all get sick
sometimes...but then
we get better.

What happens when

we get sick?

Why do we get better?

 YOUR ACTIVE IMMUNE DEFENSES

Innate Immunity
- invariant (generalized)
- early, limited specificity
- the first line of defense
5
Adaptive Immunity
- variable (custom)
- later, highly specific
- ‘‘remembers’’ infection
INNATE IMMUNITY
When you were born, you brought with you several
mechanisms to prevent illness. This type of immunity
is also called nonspecific immunity.

Innate immunity consists of:

• Barriers

• Cellular response
• phagocytosis
• inflammatory reaction
• NK (natural killer) and mast cells

6
• Soluble factors
INNATE IMMUNITY
Barriers
• Physical • Chemical

• skin • sweat

7
• hair • tears
• mucous • saliva
• stomach acid
• urine
INNATE IMMUNITY
Cellular response

• nonspecific - the same response works against many

pathogens

8
• this type of response is the same no matter how often it is triggered

• the types of cells involved are macrophages, neutrophils, natural

killer cells, and mast cells

• a soluble factor, complement, is also involved

INNATE IMMUNITY –
Soluble factors

• Interferon
• a chemical (cytokine) produced by virus-infected
cells that contributes to their death by apoptosis

9
• Acute phase proteins
• proteins in the plasma that increase during
infection and inflammation
• can be used diagnostically to give an indication of
acute inflammation
 PASSIVE IMMUNITY
While your immune system was developing, you were
protected by immune defenses called antibodies. These
antibodies traveled across the placenta from the maternal
blood to the fetal blood.

Antibodies (Y) are also found

in breast milk.

The antibodies received

through passive immunity
last only several weeks.
10
Cells of the immune system
Hematopoiesis
• All blood cells arise from a type of cell called the
hematopoiesis stem cell(HSC).
• Stem cells are cells that can differentiate into other
cell types, they are self-renewing- they maintain
their population level by cell division.
• In humans, hematopoiesis, the formation and
development of red blood cells, begins in the
embryonic yolk sac during the first weeks of
development.
11
Hematopoiesis

12
Lymphoid cells
• Lymphocytes constitute 20% - 40% of the
body’s white blood cells and 99% of the cells
in the lymph.
• There are approxiamately 1011 (range
depending on body size and age: ~1010 – 1012)
lymphocytes in the human body.
• The lymphocytes can be broadly subdivided
into three populations-B-cells, T-cells and null
cells-on the basis of function and cell
membrane components.
16
Lymphocytes

• B-cells mature in bone marrow then

concentrate in lymph nodes and spleen
• T-cells mature in thymus
• B and T cells mature then circulate in the
blood and lymph
• Circulation ensures they come into contact
with pathogens and each other
B -Lymphocytes
Macrophages
• Larger than neutrophils.
• Found in the organs, not the blood.
• Made in bone marrow as monocytes,
called macrophages once they reach
organs.
• Long lived
• Initiate immune responses as they display
antigens from the pathogens to the
lymphocytes.
 NK cells
• In recent years a population of non-B, non-T
lymphocytes has been identified. These cells,
also known as null or natural killer (NK) cells,
attack and destroy tumor cells and virus-infected
cells.
• In contrast to cytotoxic T cells, which require
recognition of specific antigens before activation,
NK cell activity does not require prior antigen
interaction.
• NK cell activity has recently been widely studied
as a measure of psychoimmune response.
 Organs of the immune system
• A number of morphologically and functionally diverse organs
and tissues have various functions in the development of
immune responses.
• These can be distinguished by function as the primary and
secondary lymphoid organs.
• The thymus and bone marrow are the primary(or central)
lymphoid organs, where maturation of lymphocytes takes
place.
• The lymph nodes, spleen, and various mucosal-associated
lymphoid tissues (MALT) such as gut-associated lymphoid
tissue (GALT) are the secondary (or peripheral) lymphoid
organs, which trap antigen and provide sites for mature
lymphocytes to interact with that antigen.
27
 ANATOMY OF THE IMMUNE SYSTEM
• Thymus – glandular organ near the heart – where T cells learn
their jobs
• Bone marrow – blood-producing tissue located inside certain
bones

28
• blood stem cells give rise to all of the different types of blood cells
• Spleen – serves as a filter for the blood
• removes old and damaged red blood cells
• removes infectious agents and uses them to activate cells called
lymphocytes
• Lymph nodes – small organs that filter out dead cells, antigens,
and other “stuff” to present to lymphocytes
• Lymphatic vessels – collect fluid (lymph) that has “leaked” out
from the blood into the tissues and returns it to circulation
Organs of the
immune system

29
How Does Stress Make Us Vulnerable
to Disease?
• Stress Diverts energy from the immune
system.
• It inhibits activities of its B and T
lymphocytes and macrophages.
• Stress does not cause diseases such as
cancer.
• It may influence the cancer’s progression.
31
LABORATORY STUDIES OF IMMUNE
RESPONSE
• In the early literature, peripheral blood
smears were examined for abnormalities.
• Quantitative studies that have assessed
numbers of the various white blood cells or
quantitative assessments of immunoglobulin
levels were assessed.
• Although some attention has been given to
measurement of humoral immunity in
psychiatric patients, research in recent years
has focused predominantly on cell-mediated
immunity
• An in vitro lymphocyte stimulation assay was used to
measures the proliferative response of either T or B cells
to a variety of stimulants.
• Lymphocytes are isolated from the blood of subjects and
are cultured with these stimulants, or mitogens, to
measure levels of activation.
• Three mitogens (all plant lectins) are widely used:
phytohemagglutinin (PHA) and con- canavalin A
(ConA) are predominantly T cell mitogens
pokeweed mitogen (PWM) stimu­lates primarily B
lymphocytes.
• More recently, NK cell activity has been used as a
measure of immune response by cytotoxicity assay.
Assessment of Immune-response
 Psychological stress and Immunity
Changes in the immune system have been found
to accompany
• pressure to perform at work, at school or in sports
• threats of physical violence
• money worries
• arguments
• family conflicts
• divorce
• bereavement
• unemployment
• moving house
• alcohol or drug abuse.
• Sometimes, there is no particular reason for developing
stress, or it arises out of a series of minor irritations.
 Immunological status of medical
students during final exams
• Compared to test-free periods, students
undergoing exams have showed
 Decrements in lymphocyte response to
mitogenic stimulation.
 Reduced NK cell activity.
 Alterations in T-cell populations.
 Increased plasma levels of circulating
antibodies and
 Decreased cytokine production
 loss of an intimate relationship from either death or
divorce was also been associated with altered immunity
• Including suppression of lymphocyte responses to
mitogenic stimulation.
• Reduced NK cell activity and changes in T-cell
subpopulations.
• Early investi­gations found lowered mitogenic
lymphocyte proliferation in bereaved subjects following
the loss of a spouse, as compared to both non-bereaved
controls and the pre- bereavement period
• Subsequent findings indicated that the degree of
immune change among bereaved per­sons was related
to the severity of depressive response before and after
the loss.
• Separation and divorce have similarly been
associated with immune alterations
• Immunological changes accompany other
prolonged stressors, like long-term
unemployment and occupational stress.
• There are now several studies demonstrating
immunological alterations following exposure to
standardized laboratory stressors, including
challenging computer tasks, mental arithmetic,
electrical shocks, loud noise, unsolvable puzzles,
graphic films depicting combat surgery, marital
discussions involving conflict, and inter­views
eliciting the recollection of positive and negative
experiences and mood states
 Stress and Immunity
• The preponderance of the findings appears to suggest that
when the individual is confronted with stressful situations,
immune cells in the peripheral circulation tend to increase,
especially NK cells and CD8 cells.
• If the stress is sustained, there may be a decrease in all types
of lymphocytes and an associated increase in phagocytes.
Generally, the trend is for leukocytes to be functionally less
active under stress.
• Thus, even though there are more NK cells, they appear to be
less cytotoxic, making it possible that the changes (i.e.,
increased number of cells with decreased activity) simply
maintain the prestress competence while mobilizing the
leukocyte population.
 Research studies have shown that continue
exposure to stressors and a chronically activated stress
response can have the effect of lowering the immune
defense of the human body.

This effect is mediated by the response to those

stressors of the autonomous nervous system, which causes
the endocrine system to secrete hormones such as cortisol
and the catecholamines.
The individual whose immune system is impaired is
more sensitive to the effect of stressful stimuli and is more
susceptible to disease.
Health Problems Linked to Stress
• Heart attack
• Hypertension
• Stroke
• Cancer
• Diabetes
• Depression
• Obesity
• Eating disorders
• Substance abuse
• Ulcers
• Irritable bowel syndrome
• Memory loss
• Autoimmune diseases (e.g. lupus)
• Insomnia
• Thyroid problems
• Infertility
 Stress - Relax

• Exercise and eat regularly

• Avoid excess caffeine intake which can increase
feelings of anxiety and agitation
• Avoid illegal drugs, alcohol and tobacco
• Learn relaxation exercises (abdominal breathing and
muscle relaxation techniques)
• Learn practical coping skills. For example, break a
large task into smaller, more attainable tasks
• Decrease negative self talk: challenge negative
thoughts about yourself with alternative neutral or
positive thoughts. "My life will never get better” can
be transformed into "I may
• Relax - Each person has her own way to relax. Some ways
include deep breathing, yoga, meditation, and massage
therapy. If you can’t do these things, take a few minutes to
sit, listen to soothing music, or read a book.
• Make time for yourself. It’s important to care for yourself.
Think of this as an order from your doctor, so you don’t feel
guilty! No matter how busy you are, you can try to set aside
at least 15 minutes each day in your schedule to do
something for yourself, like taking a bubble bath, going for a
walk, or calling a friend.
• Sleep. Sleeping is a great way to help both your body and
mind. Your stress could get worse if you don’t get enough
sleep. You also can’t fight off sickness as well when you
sleep poorly. With enough sleep, you can tackle your
problems better and lower your risk for illness. Try to get
seven to nine hours of sleep every night.
• Eat right. Try to fuel up with fruits, vegetables, and proteins.
Good sources of protein can be peanut butter, chicken, or
tuna salad. Eat whole-grains, such as wheat breads and
wheat crackers.
What activities or things could help people to relax?
• Listening to music
• Playing with a pet
• Laughing or crying
• Going out with a friend (shopping, movie,
dining)
• Taking a bath or shower
• Writing, painting, or other creative activity
• Praying or going to church
• Exercising or getting outdoors to enjoy nature
• Discussing situations with a spouse or close
friend
• Gardening or making home repairs
• Practicing deep breathing, meditation, or
muscle relaxation
A Truth for Health

“Peoples’ health should be no

worse at the end of a working day
than it was at the start”
M.J. Harrington
(1997)
A Truth for Health

“People who work sitting down

get paid more than people who
work standing up”
Ogden Nash
(1902 - 1971)
Discussion
Thank You