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Chronic Stress Modulates the Immune Response to a Pneumococcal Pneumonia Vaccine
Abstract
OBJECTIVE: Influenza and pneumonia account for significant morbidity and mortality, particularly in older individuals. Previous studies have shown that spousal caregivers of patients with dementia have poorer antibody and virus specific T cell responses to an influenza virus vaccine relative to noncaregiving control subjects. This study tested the hypothesis that stress can also significantly inhibit the IgG antibody response to a pneumococcal bacterial vaccine. METHOD: We measured antibody titers of current caregivers, former caregivers, and control subjects after vaccination with a pneumococcal bacterial vaccine. RESULTS: Caregivers showed deficits relative to controls and former caregivers in their antibody responses to vaccination. Although the groups did not differ before vaccination or in the rise in antibody 2 weeks or 1 month after vaccination, current caregivers had lower antibody titers 3 and 6 months after vaccination than either former caregivers or controls. CONCLUSIONS: These data, the first evidence that chronic stress can inhibit the stability of the IgG antibody response to a bacterial vaccine for pneumonia, provide additional evidence of health risks associated with dementia caregiving.
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“A growing body of evidence has implicated caregiving as a risk factor for health.”
From Chronic stress and age-related increases in the proinflammatory cytokine IL-6. (2003) · cites this paper as [3]
In the citing paper
“they have poorer immune responses to influenza virus and pneumococcal pneumonia vaccines (2-4)”
From Chronic stress and age-related increases in the proinflammatory cytokine IL-6. (2003) · cites this paper as [3]
In the citing paper
“negative emotions contribute to greater risk for infection, prolonged infection, and delayed wound healing (1-5)”
From Chronic stress and age-related increases in the proinflammatory cytokine IL-6. (2003) · cites this paper as [3]
In the citing paper
“caregivers report more infectious illness episodes, and they have poorer immune responses to influenza virus and pneumococcal pneumonia vaccines than noncaregivers (1-4).”
From Chronic stress and age-related increases in the proinflammatory cytokine IL-6. (2003) · cites this paper as [3]
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“Finally, it has been demonstrated that chronic stress may alter both cellular and humoral immune responses to vaccines (39, 40).”
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Franconi, F., Campesi, I., Occhioni, S., Antonini, P., & Murphy, M. F. (2012) · Handbook of experimental pharmacology · doi:10.1007/978-3-642-30726-3_6 · Cited by 49
“For example, elderly Alzheimer’s caregivers have an accelerated decline in antibody response to pneumococcal and influenza vaccine following immunization than age-matched (Glaser et al. 2000; Kiecolt-Glaser et al. 1996; Vedhara et al. 1999).”
BackgroundSesti‐Costa, R., Ignacchiti, M. D. C., Chedraoui-Silva, S., Marchi, L. F., & Mantovani, B. (2011) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2011.07.234 · Cited by 49
“During a stress response, the neuroendocrine system helps the body to cope with the stressor by preparing the body for a ‘‘fight or flight’’ reaction, which can enhance or inhibit some aspects of the immune system (Dhabhar, 2002; Glaser et al., 2000).”
Gao, T., Song, R., Zhu, L., & Qiu, L. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16081348 · Cited by 46
“Undue pressure can easily give rise to a suppressed immune system [9] and aggressive cancer cells [10], even leading to premature death [11].”
BackgroundVaccinate your immunocompromised patients!
Glück, T. (2005) · Lara D. Veeken · doi:10.1093/rheumatology/kei237 · Cited by 46
“Response to pneumococcal vaccination has also been studied in other immunocompromised patient groups, such as patients on chronic corticosteroid therapy for chronic obstructive pulmonary disease [8], among whom the antibody responses were not found to be compromised by corticosteroid therapy; cancer patients [9], who…”
BackgroundUnderstanding the health effects of caregiving stress: New directions in molecular aging
Christian, L. M., Wilson, S. J., Madison, A. A., Prakash, R. S., Burd, C. E., Rosko, A. E., & Kiecolt‐Glaser, J. K. (2023) · Ageing Research Reviews · doi:10.1016/j.arr.2023.102096 · Cited by 50
“…episodes (Kiecolt-Glaser et al., 1991), poorer immune responses to influenza virus and pneumococcal pneumonia vaccines (Kiecolt-Glaser et al., 1996; Glaser et al., 2000; Vedhara et al., 1999), slower wound healing (Kie-colt-Glaser et al., 1995), and greater risk for depression, hypertension,…”
BackgroundSelf-citationCaregiving alters immunity and stress hormones: a review of recent research
Whittaker, A. C., & Gallagher, S. M. (2019) · Current Opinion in Behavioral Sciences · doi:10.1016/j.cobeha.2019.02.002 · Cited by 45
“Both innate and adaptive immunity are affected, for example, in older dementia caregivers natural killer (NK) cell function [1], antibody response to vaccination [2] and wound healing [3] is impaired in caregivers when compared to age and sex -matched controls.”
BackgroundStress, Aging, and Resilience: Can Accrued Wear and Tear Be Slowed?
Hawkley, L. C., Berntson, G. G., Engeland, C. G., Marucha, P. T., Masi, C. M., & Cacioppo, J. T. (2005) · Canadian Psychology/Psychologie canadienne · doi:10.1037/h0087015 · Cited by 47
Psychosocial Factors and the Response to Influenza Vaccination in Older Adults
Moynihan, J. A., Larson, M. R., Treanor, J. J., Duberstein, P. R., Power, A., Shore, B., & Ader, R. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000140001.49208.2d · Cited by 44
“(7) had also observed that poorer social support was associated with faster decline in antibody titer to pneumococcal vaccine in Alzheimer’s caregivers.”
BackgroundInfluentialImpact of stress on aged immune system compartments: Overview from fundamental to clinical data
Fali, T., Vallet, H., & Sauce, D. (2018) · Experimental Gerontology · doi:10.1016/j.exger.2018.02.007 · Cited by 46
“…responses to infectious pathogens (reactivation of latent herpesviruses (Pariante et al., 1997; Glaser & Kiecolt-Glaser, 1997)), can limit the efficacy of immune responses to vaccination overtime (Li et al., 2007; Glaser et al., 2000), and can slow wound healing (Kiecolt-Glaser et al., 1995).”
BackgroundSocioeconomic Status and Health Across the Life Course: Progress and Prospects
George, L. K. (2005) · The Journals of Gerontology Series B · doi:10.1093/geronb/60.special_issue_2.s135 · Cited by 43
Li, J., Cowden, L. G., King, J. D., Briles, D. A., Schroeder, H. W., Stevens, A. B., Perry, R. T., Chen, Z., Simmons, M. S., Wiener, H. W., et al. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3180cc2c61 · Cited by 40
“It is important to note that, in this study, stress was assessed differently from previous ones (4,8).”
BackgroundMethodResultInfluentialFrippiat, J. (2013) · Molecular Immunology · doi:10.1016/j.molimm.2013.06.011 · Cited by 42
Neuroendocrine and viral correlates of premature immunosenescence
Bauer, M. E., Wieck, A., Petersen, L. E., & Baptista, T. S. A. (2015) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12786 · Cited by 43
Reduced immunity to measles in adults with major depressive disorder
Ford, B. N., Yolken, R. H., Dickerson, F., Teague, T. K., Irwin, M. R., Paulus, M. P., & Savitz, J. B. (2018) · Psychological Medicine · doi:10.1017/s0033291718000661 · Cited by 37
“found that, compared to controls, stressed caregivers of spouses with dementia displayed normal antibody titers 2 weeks following injection with the pneumococcal pneumonia vaccine, but that humoral antibody concentration was significantly diminished 6 months post-vaccination (Glaser et al. 2000).”
BackgroundResultGallagher, S. M., Phillips, A. C., Ferraro, A., Drayson, M. T., & Carroll, D. (2007) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2007.10.018 · Cited by 37
“For example, spousal caregivers of dementia patients have been reported to show a poorer response to the pneumococcal polysaccharide vaccine, but only six months after vaccination (Glaser et al., 2000).”
BackgroundMethodResultInfluentialThe Chronic Stress of Caregiving Accelerates the Natural Aging of the Immune System
Bennett, J. M., Fagundes, C. P., & Kiecolt‐Glaser, J. K. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4776-4_3 · Cited by 38
“…heal more slowly than controls’(Kiecolt-Glaser 1995), show more frequent latent herpesviruses reactivation (Glaser and Kiecolt-Glaser 1997; Kiecolt-Glaser et al. 1991), and poor vaccine responses (Gallagher et al. 2009a, b; Glaser et al. 2000; Kiecolt-Glaser et al. 1996; Vedhara et al. 1999).”
BackgroundInfluentialSelf-citationPosttraumatic Stress Disorder and Incident Infections
Jiang, T., Farkas, D. K., Ahern, T. P., Lash, T. L., Sørensen, H. T., & Gradus, J. L. (2019) · Epidemiology · doi:10.1097/ede.0000000000001071 · Cited by 35
Stress-associated immunomodulation and its implications for responses to vaccination
Yang, E. V., & Glaser, R. (2002) · Expert Review of Vaccines · doi:10.1586/14760584.1.4.453 · Cited by 35
Self-citationGallagher, S. M., Phillips, A. C., Ferraro, A., Drayson, M. T., & Carroll, D. (2008) · Biological Psychology · doi:10.1016/j.biopsycho.2008.01.001 · Cited by 34
“Further, life events temporally distant from vaccination have been shown to affect the IgG response to numerous vaccinations (Burns et al., 2003a; Phillips et al., 2005).”
InfluentialBehavioral Symptoms after Breast Cancer Treatment: A Biobehavioral Approach
Fagundes, C. P., LeRoy, A. S., & Karuga, M. (2015) · Journal of Personalized Medicine · doi:10.3390/jpm5030280 · Cited by 34
“infection, prolonged infectious episodes, and delayed wound healing [59–63], all processes that”
BackgroundClose Relationships and Immunity
Graham‐Engeland, J. E., Christian, L. M., & Kiecolt‐Glaser, J. K. (2007) · Elsevier eBooks · doi:10.1016/b978-012088576-3/50043-5 · Cited by 38
“For a majority of adults in the United States, the marital relationship serves as a primary source of support (Glenn and Weaver, 1981; Simmons and O’connell, 2003) and, correspondingly, a majority of research on specific close relationships has focused on marriage.”
BackgroundSelf-citationWell-Being, Aging, and Immunity
Friedman, E. M. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195394399.013.0003 · Cited by 33
Reed, P., Sejunaite, K., & Osborne, L. A. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2638-8 · Cited by 39
“…a base for the items on the questionnaire: common cold (Heikkinen and Järvinen 2003), influenza (WHO 2013), cold sores (Grout and Barber 1976), pneumonia (Glaser et al. 2000), sepsis (Hass and Schauenstein 2001), long healing injuries (Cohen et al. 2007), and skin infections (Aberg et al. 2007).”
BackgroundVitlić, A., Khanfer, R., Lord, J. M., Carroll, D., & Phillips, A. C. (2014) · Immunity & Ageing · doi:10.1186/1742-4933-11-13 · Cited by 33
“In general, there is consistent evidence of compromised immune function in older spousal caregivers for partners with dementia [34,35], whereas the results from the studies of younger caregivers are more variable [33,34] In that context, it was shown that the cortisol:DHEAS ratio was only raised in the older bereaved…”
ResultDar-Odeh, N. S., Abu-Hammad, O. A., Qasem, F., Jambi, S., Alhodhodi, A., Othman, A., Abu-Hammad, A., Al-Shorman, H. M., Ryalat, S., & Abu‐Hammad, S. (2022) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2022.2039017 · Cited by 30
“Moreover, mild depressive symptoms and chronic stress were identified as factors that prolong inflammatory responses after influenza and pneumococcal pneumonia vaccines in older adults.(20,21) Further, some vaccines contain aluminum adjuvant,(1) which was blamed for causing myalgia and fatigue Table 3.”
BackgroundBurns, V. E., & Gallagher, S. M. (2010) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.01.005 · Cited by 30
“Similarly, a study comparing pneumococcal vaccine efficacy between caregivers and controls found group differences at three and six months post-vaccination, but not at two weeks or one month (Glaser et al. 2000).”
Spousal Caregiving is Associated With an Increased Risk of Frailty: A Case-Control Study
Potier, F., Degryse, J., Aubouy, G., Henrard, S., Bihin, B., Debacq‐Chainiaux, F., Martens, H., & de Saint‐Hubert, M. (2018) · The Journal of Frailty & Aging · doi:10.14283/jfa.2018.11 · Cited by 31
Metadata
- Authors
- Glaser, R., Sheridan, J., Malarkey, W. B., MacCallum, R. C., & Kiecolt-Glaser, J. K.
- Affiliations
- The Ohio State University (US)
- Corresponding author
- Glaser, Ronald
- Venue
- Psychosomatic Medicine
- Published
- 2000-11
- Volume
- 62
- Issue
- 6
- Pages
- 804-807
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2109702099
- Cited by
- 295
- References
- 17
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 11 · 2023: 7 · 2022: 10 · 2021: 9 · 2020: 7 · 2019: 10 · 2018: 13 · 2017: 9 · 2016: 8 · 2015: 18 · 2014: 22 · 2013: 13 · 2012: 20
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh050538-05, 5k02mh001467-05, 5r37mh042096-15)
- National Institute of Mental Health (K02 MH01467, R37 MH42096, R01 MH50538)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Keywords
- chronic stress, pneumococcal vaccine, vaccine antibody response, IgG antibody titers, dementia caregivers, spousal caregiving, vaccine immunogenicity, pneumonia vaccination, older adults
- MeSH terms
- Alzheimer Disease, Antibodies, Bacterial, Female, Humans, Immune Tolerance, Male, Middle Aged, Streptococcus pneumoniae, Stress, Psychological, Caregivers, Pneumococcal Vaccines
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