This review focuses on studies that have examined the relation between psychosocial factors and secretory immunoglobulin A (s-IgA). Several studies have examined the relation between s-IgA and stressful circumstances ranging from major life events to minor daily events. The findings from these studies were often contradictory, since different experimenters reported different stress-related changes in s-IgA. The effects of stress reduction interventions, such as relaxation and imagery, on s-IgA levels have also been examined. Although these studies indicate that various interventions are associated with increases in s-IgA levels, methodological refinements are needed before more definitive conclusions can be made. The possibility that the relation between stress and s-IgA may be moderated by personality characteristics or mediated by psychological distress was supported in some studies. The review concludes with suggestions for future research.
References
1.
Ader R., Felten D. (1995). Psychoimmunology: interactions between the nervous system and the immune system. Lancet345:99-103.
2.
Ader R., Felten D., Cohen N. (1991). Psychoneuroimmunology. San Diego: Academic Press.
3.
Andersen BL, Kiecolt-Glaser JK, Glaser R. (1994). A biological model of cancer stress and disease course. Am Psychologist49:389-404.
4.
Basmajian JV (1989). Biofeedback; principles and practice for clinicians. Baltimore: Williams and Wilkins.
5.
Bates IF, Adams D. (1968). The influence of mental stress on low rate of saliva in man. Arch Oral Biol13:593-596.
6.
Bedovsky HD, Rey AD (1996). Immune-neuro-endocrine interactions: facts and hypotheses. Endocr Rev17:64-102
7.
Bennet KR, Reade PC (1982). Salivary immunoglobulin A levels in normal subjects, tobacco smokers, and patients with minor aphthous ulceration. Oral Surg53:461-465.
8.
Blumenthal GA, McKee DC (1987). Applications in behavioral medicine: a clinician's source book. Sarasota, FL: Professional Resource Exchange.
9.
Brandtzaeg P. (1971). Human secretory immunoglobulins. VII. Concentrations of parotid IgA and other secretory proteins in relation to the rate of flow and duration of secretory stimulus. Arch Oral Biol16:1295-1310.
10.
Carlson NR (1986). Physiology of behavior. Boston, MA: Allyn and Bacon.
11.
Cohen S., Williamson G. (1991). Stress and infectious disease in humans. Psycholog Bull109:5-24.
12.
Cohen S., Wills TA (1985). Stress, social support, and the buffering hypothesis. Psycholog Bull98:310-357.
13.
Cohen S., Kessler R., Gordon LU (1995). Measuring stress: a guide for health and social scientists. NY, NY: Oxford University Press.
14.
Derogatis LR, Lipman RS, Rickels K., Uhlenhuth EH, Covi L. ( 1974). The Hopkins Symptom Checklist (HSCL): A self report symptom inventory. Behav Sci19:1-15.
15.
Dillon KM, Minchoff B., Baker K. (1985). Positive emotional states and enhancement of the immune system. Int J Psychiatry Med15:13-18.
16.
Dillon KM, Totten MC (1989). Psychological factors, immunocompetence, and health of breast-feeding mothers and their infants. J Genet Psychol150:155-162.
17.
Dowdle WR, Coleman MT, Schoenbaum SC, Mostow SR, Kay HS, Hierholzer JC (1971). Studies of inactivated influenza vaccines: III. Effect of subcutaneous dosage on antibody levels in nasal secretions and protection against natural challenge. In: Conference on the secretory immunologic system. Dayton DH, editor. Bethesda, MD: NIH, pp. 113-127.
18.
Evans P., Bristow M., Hucklebridge F., Clow A., Walters N. (1993). The relationship between secretory immunity, mood and life-events. Br J Clin Psychol32:227-236.
19.
Evans P., Bristow M., Hucklebridge F., Clow A., Pang FY ( 1994). Stress, arousal, cortisol and secretory immunoglobulin A in students undergoing assessments. Br J Clin Psychol33:575-576.
20.
Farne MA, Boni P., Corallo A., Gnugnoli D., Sacco FL (1994) Personality variables as moderators between hassles and objective indications of distress (S-IgA). Stress Med10:15-20.
21.
Folkman S., Lazarus RS (1980). An analysis of coping in a middle-aged community sample. J Hlth Soc Behav21:219-239.
22.
Ganguly P., Ogra PL, Regas S., Waldman RH (1973). Rubella immunization of volunteers via the respiratory tract. Infect Immun8:497-502.
23.
Goldberg DP (1972). The detection of psychiatric illness by questionnaire. Oxford: Oxford University Press.
24.
Goldblum RM (1990). The role of IgA in local immune protection. J Clin Immunol10(Suppl):64-71.
25.
Graham NMH, Bartholomeusz CA, Taboonpong N., La Brooy JT (1988). Does anxiety reduce the secretion rate of secretory IgA in saliva? Med J Aust148:131-133.
26.
Green ML, Green RG, Santoro W. (1988). Daily relaxation modifies serum and salivary immunoglobulins and psychophysiologic symptom severity. Biofeedback and Self-Regulation13:187-199.
27.
Green R., Green ML (1987). Relaxation increases salivary immunoglobulin A. Psycholog Rep61:623-629.
28.
Gregory RI, Kim DE, Kindle JC, Hobbs LC, Lloyd DR (1992). Immunoglobulin-degrading enzymes in localized juvenile periodontitis. J Periodont Res27:176-183.
29.
Groer M., Mozingo J., Droppleman P., Davis M., Jolly ML, Boynton M., et al. (1994). Measures of salivary secretory immunoglobulin A and state anxiety after nursing back rub. Appl Nurs Res7:2-6.
30.
Heddle RJ, Rowley D. (1975). Dog immunoglobulins. I. The antibacterial properties of dog IgA, IgM, and IgG antibodies to Vibrio cholera. Immunology29:197-208.
31.
Herbert T., Cohen S. (1993). Stress and immunity in humans: a meta-analytic review. Psychosomatic Med55:364-379.
32.
Holmes TH, Rahe RH ( 1967). The social readjustment scale. ) Psychosomatic Med19:134-143.
33.
Irvin M., Smith TL, Gillin JC (1992). Electroencephalographic sleep and natural killer cell activity in depressed patients and control subjects. Psychosomatic Med54:10-21.
34.
jasnoski ML, Kugler J. (1987). Relaxation, imagery, and neuroimmunomodulation. Ann NY Acad Sci496:722-730.
35.
Jemmott JB, Magloire K. (1988). Academic stress, social support, and secretory immunoglobulin A. J Personality Soc Psychol55:803-810.
36.
Jemmott JB, McClelland DC (1989). Secretory IgA as a measure of resistance to infectious disease. Comments on Stone, Cox, Valdimarsdottir, and Neale. Behav Med I5:63-70.
37.
Jemmott JB, Borysenko JZ, Borysenko M., McClelland DC, Chapman R., Meyer D., et al. (1983). Academic stress, power motivation and decrease in secretory rate of salivary secretory immunoglobulin A. Lancet1:1400-1402.
38.
Kanner AD, Coyne JC, Schaeffer C., Lazarus RS (1981). ). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. J Behav Med4:l-39.
39.
Kiecolt-Glaser JK, Garner W., Speicher C., Penn SM, Holliday J., Glaser R. (1984). Psychosocial modifiers of immunocompetence in medical students. Psychosomatic Med46:7-14.
40.
Kobasa SC (1979). Stressful life events, personality and health: An inquiry into hardiness. J Personality Soc Psychol37:1-11.
41.
Kobasa SC (1982). The hardy personality: towards a social psychology of stress and health. In: Social psychology of health and illness. Suls J, Sanders G, editors. Hillsdale, NJ: Erlbaum.
42.
Kobasa SC, Maddi SR, Courington S. (1981). Personality and constitution as mediators in the stress-illness relationship. J Hlth Soc Behav22:368-378.
43.
Krantz DS, Grunberg NE, Baum A. ( 1985). Health psychology. Ann Rev Psychol36:349-383.
44.
Kubitz KA, Peavey BS, Moore BS (1986). The effect of daily hassles of humoral immunity: an interaction moderated by locus of control. Biofeedback and Self-Regulation11:115-123.
45.
Kugler J., Hess M., Haake D. (1992). Secretion of salivary immunoglobulin A in relation to age, saliva flow, mood states, secretion of albumin, cortisol, and catecholamine in saliva. J Clin Immunol12:45-49.
46.
Kugler J., Hess M., Haake D. (1993). What accounts for the interindividual variability in slgA concentration in saliva. Ann NY Acad Sci694:296-298.
47.
Labott SM, Ahleman S., Wolever ME, Martin RB (1990). The physiological and psychological effects of the expression and inhibition of emotion. Behav Med16:182-189.
48.
Lamm ME, Nedrud JG, Kaetzel CS, Mazanec MB (1995). IgA and mucosal defense. APMIS103:241-246.
49.
Lazarus RS, Folkman S. (1984). Coping and adaptation. In: Handbook of behavioral medicine. Gentry MW, editor. New York: Guilford Press, pp. 282-318.
50.
Lefcourt HM, Martin RA (1986). Humor and life stress: antidote to adversity. New York: Springer-Verlag.
51.
Lefcourt HM, Davidson-Katz K., Kueneman K. (1990). Humor and immune-system functioning. Humor3:305-321.
52.
Lehner T., Cardwell JE, Clarry ED (1967) Immunoglobulins in saliva and serum in dental caries. Lancet1:1294-1297.
53.
MacGregor RR (1986). Alcohol and immune defense. I Am Med Assoc256:1474-1479.
54.
Martin RA, Dobbin IP (1988). Sense of humor, hassles, and immunoglobulin A: Evidence for stress-moderating effect of humor. Int J Psychiatry Med18:93-105.
55.
Martin RA, Lefcourt HM (1983). Sense of humor as a moderator of the relation between stressors and moods. J Personality Soc Psychol45:1313-1324.
56.
Martin RA, Lefcourt HM (1984). The situational humor response questionnaire: a quantitative measure of the sense of humor. J Personality Soc Psychol47:145-155.
57.
Martin RB, Guthrie CA, Pitts CG (1993). Emotional crying, depressed mood, and secretory immunoglobulin A. Behav Med19:111-114.
58.
McClelland DC, Floor E., Davidson RJ, Saron C. (1980). Stressed power motivation sympathetic activation, immune function and illness. J Human Stress6:11-19.
59.
McClelland DC, Alexander C., Marks E. (1982). The need for power, stress, immune function, and illness among male prisoners. J Abnormal Psychol91:61-70.
60.
McClelland D., Ross G., Patel V. (1985). The effect of an academic examination on salivary norepinephrine and immunoglobulin levels. J Human Stress11:52-59.
61.
McNaire DM, Lorr M., Droppleman LF (1971). Profile of mood states. San Diego: Educational and Industrial Testing Service.
62.
Michel W. (1968). Personality and assessment. New York: Wiley.
63.
Michel W. (1973). Toward a cognitive social learning reconceptualization of personality. Psycholog Rev80:252-283.
64.
Mouton C., Fillion L., Tawadros E., Tessier R. (1989). Salivary IgA is a weak stress marker. Behav Med12:179-185.
65.
Muller F., Holberg-Petersen M., Rollag H., Degre M., Brandtzaeg P., Froland SS (1992). Nonspecific oral immunity in individuals with HIV infection. J AIDS5:46-51.
66.
Neale JM, Stone AA (1989). Stress, illness, and secretory immunity. In: Mechanisms of psychological influence on physical health, with special attention to the elderly. Carstensen LL, Neale JM, editors. New York: Plenum Press, pp. 81-104.
67.
Nowlis V. (1965). Research with the Mood Adjective Checklist. In: Affect, cognition and personality. Tompkins SS, Izard CE, editors. New York: Springer Publishing, pp. 352-389.
68.
Ogra PL, Kee-Grant D., Umana G., Dzierba J., Weintraub D. (1971). Antibody response in serum and nasopharynx after naturally acquired and vaccine induced infection with rubella virus. New Engl J Med285: 1333-1339.
69.
O'Leary A. (1990). Stress, emotions, and human immune function. Psycholog Bull108:363-382.
70.
Olness K., Culbert T., Uden D. ( 1989). Self-regulation of salivary immunoglobulin A by children. Pediatrics83:66-71.
71.
Rabin BS, Cohen S., Ganguli R., Lysle DT, Cunnick JE (1989). Bidirectional interaction between the central nervous system and immune system. Crit Rev Immunol9:279-312.
72.
Rider MS, Welden C. (1990). Imagery, improvisation, and immunity. The Arts in Psychotherapy17:211-216.
73.
Rider MS, Achterberg J., Lawlis GF, Goven A., Toledo R., Butler R. ( 1990). Effect of immune system imagery on secretory IgA. Biofeedback and Self-Regulation15:317-333.
74.
Schwartz GE, Weiss SM (1978). Behavioral medicine revisited: an amended definition. J Behav Med1:249-252.
75.
Spielberger CD (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press Inc.
76.
Stone AA, Neale JM (1982). Development of a methodology for assessing daily experiences. In: Advances in environmental psychology: environment and health. Baum A, Singer J, editors. Hillsdale, NJ: Erlbaum, pp. 49-83.
77.
Stone AA, Cox DS, Valdimarsdottir HB, Jandorf L., Neale JM (1987a). Evidence that secretory IgA antibody is associated with daily mood. J Personality Soc Psychol52:988-993.
78.
Stone AA, Cox DS, Valdimarsdottir HB, Neale JM (1987b). Secretory IgA as a measure of immunocompetence. J Human Stress13:136-140.
79.
Stone AA, Neale JM, Cox DS, Napoli A., Valdimarsdottir HB, Kennedy-More E. (1994). Daily events are associated with a secretory immune response to an oral antigen in men. Hlth Psychol13:440-446.
80.
Stone AA, Macro CA, Cruise CE, Cox DA, Neale JM (1996). Are stress-induced immunological changes mediated by mood? A closer look at how both desirable and undesirable daily events influence slgA antibody. Int J Behav Med3: 1-13.
81.
Taubman MA, Smith D. (1993). Significance of salivary antibody in dental diseases. Ann NY Acad Sci694:184-194.
82.
Taylor JA (1951). The relationship of anxiety to the conditioned eyelid response. J Exp Psychol41:81-92.
83.
Tomasi TB (1970). Structure and function of mucosal antibodies. Ann Rev Med21:281-289.
84.
Tomasi TB (1976). The immune system of secretions. Englewood Cliffs, NJ: Prentice-Hall.
85.
Van Rood YR, Bogaards M., Goulmy E., van Houwelingen HC (1993). The effects of stress and relaxation on the in vitro immune response in man: a meta-analytic study. J Behav Med16:163-181.
86.
Waldman RJ, Small PA, Rowe DA ( 1971). The secretory immunologic system. Washington, DC: US Government Printing Office.
87.
Wallston K., Wallston BS (1982). Who is responsible for your health? The construct of health locus of control. In: Social psychology of health and illness. Sanders GS, Suls J, editors. Hillsdale, NJ: Erlbaum, pp. 65-95.
88.
Wallston BS, Wallston KA, Kaplan GD, Maides SA (1976). Development and validation of the health locus of control (HLC) scale. J Consult Clin Psychol44:580-585.
89.
Weigent D., Blalock JE (1995). Association between the neuroendocrine and the immune systems. J Leukocyte Biol58:137-150.
90.
Zakowski S., Hall H., Baum A. ( 1989). Stress, stress management, and the immune system. Appl Prev Psychol1:1-13.
