A
long admission in the hospital and the change of own life-style are defined
as a “stressful event” according to the “Social Readjustment Rating Scale”
(SRRS) of Holmes and Rahe (1987).
It is possible that HIV-infected
individuals, in particular, in the course of a prolonged admission in the
hospital can show a syndrome characterised by psychological reactions such
as disorders of the behaviour related to anxiety, feeling of danger for
the own health.
The anxiety can have strict
rapports with the reactions of surveillance and alarm, because psychologically
related to both loss of the own health and changes of life-style.
After this first phase,
it appears a depression characterised by a disorder of the temporal organisation
that is related to a loss of psychosocial reactions.
Therefore, the prolonged
admission in the hospital determines a background characterised by loss
of the psychosocial stimulus, depression and stress.
Our research, in collaboration
with Perrella's group, has a precise endpoint: the analysis of the molecular
basis of the interaction between the prolonged admission in the hospital,
defined as stressor event, and the immunodepression.
Study design is based on
the evaluation of:
a. phenotypic expression
of immune response;
b. polarisation of Th1/Th2
switch;
c. expression of IL-2 receptor;
d. glucorticoids and pituitary
hormones serum levels.
In this study some population,
sex and age matched, with same type of disease will be enrolled: HIV-infected
individuals in hospital and in domiciliary therapy will be two main groups
of the study.
The following laboratory
variables will be examined:
a. mRNA and proteins of
IL-2, gamma-ifn, il-4 and IL-10.
b. Flow cytometry expression
of IL-2 receptor, CD69 and CD30 on T-lymphocytes.
c. Markers of activation
such as CD8+CD30+;
CD4+CD45RO+;
CD8+CD38+.
It is known that stress
and a variety of psychiatric illnesses are increasingly reported to be
associated with immunodepression.
In particular stress can
induce a variety of disorders such as:
- Stimulation of glucocorticoids
hormones;
- Serum increase of catecolamines;
- Activation of the sympathetic
system.
There is a growing body
of evidence that between immune system and nervous system it is possible
a regulatory loop.
This interaction is bi-directional
and is also a consequence of the interaction of these systems with endocrine
system (Fig. 1).
Clelia Toscano
Psicologa
Osp. “D. Cotugno” - Napoli
|
Curriculum 
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Italian
Mensile di scienza medica e attualita`
