Psychological Stress and Antibody Response to Immunization: A Critical Review of the Human Literature

Abstract

Objective: The objective of this review was to evaluate the evidence for the hypothesis that psychological stress influences antibody response to immunization in humans. Methods: A critical review of the literature was conducted. Results: The evidence supports an association between psychological stress and suppression of humoral immune (antibody) response to immunization. This association is convincing in the case of secondary immune response but weak for primary response. The lack of consistent evidence for a relation with primary response may be attributed to a failure to consider the critical points when stress needs to be elevated in the course of the production of antibody. Lower secondary antibody responses were found among patients with chronically high levels of stress (severe enduring problems or high levels of trait negative affect). These responses were found most consistently among older adults. Lower secondary responses were also found for those reporting acute stress or negative affect, but only in studies of secretory immunoglobulin A antibody in which psychological and antibody measures were linked very closely in time. Health practices did not mediate relations between stress and antibody responses; however, there were indications that elevated cortisol levels among stressed patients could play a role. Evidence also suggests the possible influences of dispositional stress-reactivity and low positive affect in the inhibition of antibody production. Conclusions: The literature supports a relationship between psychological stress and antibody responses to immunizations. The data are convincing in the case of secondary response but weak for primary response. More attention to the kinetics of stress and antibody response and their interrelations is needed in future research.

Effects of transportation, relocation, and acclimation on phenotypes and functional characteristics of peripheral blood lymphocytes in rhesus monkeys (Macaca mulatta)

“…In this study, we also observed persistent increases in circulating IL-2, IL-13, IL-b, and VEGF, mitogen-induced increases in proliferative responses and increases in IFN-γ– and perforin-producing cells on day 30 compared to baseline. Contrary to our findings, human studies have reported that chronic forms of stress were accompanied by reduced NK cell cytotoxicity, suppressed lymphocyte proliferative responses, and blunted humoral responses to immunization [ 42 – 44 ].…”

Effects of transportation, relocation, and acclimation on phenotypes and functional characteristics of peripheral blood lymphocytes in rhesus monkeys (Macaca mulatta)

“…In this study, we also observed persistent increases in circulating IL-2, IL-13, IL-b, and VEGF, mitogen-induced increases in proliferative responses and increases in IFN-γ– and perforin-producing cells on day 30 compared to baseline. Contrary to our findings, human studies have reported that chronic forms of stress were accompanied by reduced NK cell cytotoxicity, suppressed lymphocyte proliferative responses, and blunted humoral responses to immunization [ 42 – 44 ].…”

Interactions Between Caregiving and Sex and the Antibody Response to COVID-19 Vaccination

“…Our study is consistent with several other studies that have examined the influence of antibody response to several vaccination types, including exposure to novel antigens as well as primary and secondary immune responses to these vaccines (14,48–50). It also supports the recent theoretical paper suggesting that these factors may hold relevance for the antibody response to COVID-19 vaccines (45).…”

Meningococcal A Vaccination Response is Enhanced by Acute Stress in Men

“…Taken together, these findings suggest that the immunoenhancing effects of acute stress are manifest when the standard control response is less robust. This is consistent with the work by Cohen et al (2), who noted that antigens that elicit less robust responses provide greater individual variation and thus allow small-to medium-sized effects to emerge. This hypothesis must be tested using a vaccine that elicits a poor response in both sexes; we would speculate that, in this scenario, both male and female participants would demonstrate stress-induced immunoenhancement.…”

Effects of transportation, relocation, and acclimation on phenotypes and functional characteristics of peripheral blood lymphocytes in rhesus monkeys (Macaca mulatta)

“…In this study, we also observed persistent increases in circulating IL-2, IL-13, IL-b, and VEGF, mitogen-induced increases in proliferative responses and increases in IFN-γ– and perforin-producing cells on day 30 compared to baseline. Contrary to our findings, human studies have reported that chronic forms of stress were accompanied by reduced NK cell cytotoxicity, suppressed lymphocyte proliferative responses, and blunted humoral responses to immunization [ 42 – 44 ].…”

Interactions Between Caregiving and Sex and the Antibody Response to COVID-19 Vaccination

“…Our study is consistent with several other studies that have examined the influence of antibody response to several vaccination types, including exposure to novel antigens as well as primary and secondary immune responses to these vaccines (14,48–50). It also supports the recent theoretical paper suggesting that these factors may hold relevance for the antibody response to COVID-19 vaccines (45).…”

Meningococcal A Vaccination Response is Enhanced by Acute Stress in Men

“…Taken together, these findings suggest that the immunoenhancing effects of acute stress are manifest when the standard control response is less robust. This is consistent with the work by Cohen et al (2), who noted that antigens that elicit less robust responses provide greater individual variation and thus allow small-to medium-sized effects to emerge. This hypothesis must be tested using a vaccine that elicits a poor response in both sexes; we would speculate that, in this scenario, both male and female participants would demonstrate stress-induced immunoenhancement.…”

Effects of transportation, relocation, and acclimation on phenotypes and functional characteristics of peripheral blood lymphocytes in rhesus monkeys (Macaca mulatta)

“…In this study, we also observed persistent increases in circulating IL-2, IL-13, IL-b, and VEGF, mitogen-induced increases in proliferative responses and increases in IFN-γ– and perforin-producing cells on day 30 compared to baseline. Contrary to our findings, human studies have reported that chronic forms of stress were accompanied by reduced NK cell cytotoxicity, suppressed lymphocyte proliferative responses, and blunted humoral responses to immunization [ 42 – 44 ].…”

Interactions Between Caregiving and Sex and the Antibody Response to COVID-19 Vaccination

“…Our study is consistent with several other studies that have examined the influence of antibody response to several vaccination types, including exposure to novel antigens as well as primary and secondary immune responses to these vaccines (14,48–50). It also supports the recent theoretical paper suggesting that these factors may hold relevance for the antibody response to COVID-19 vaccines (45).…”

Meningococcal A Vaccination Response is Enhanced by Acute Stress in Men

“…Taken together, these findings suggest that the immunoenhancing effects of acute stress are manifest when the standard control response is less robust. This is consistent with the work by Cohen et al (2), who noted that antigens that elicit less robust responses provide greater individual variation and thus allow small-to medium-sized effects to emerge. This hypothesis must be tested using a vaccine that elicits a poor response in both sexes; we would speculate that, in this scenario, both male and female participants would demonstrate stress-induced immunoenhancement.…”