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Immune, Endocrine, and Psychological Responses in Civilians Displaced by War

Ante Sabioncello, PhD, Dubravka Kocijan-Hercigonja, MD, PhD, Sabina Rabati, PhD, Jelka Tomai, PhD, Tatjana Jeren, MD, PhD, Ljubica Matijevi, MD, PhD, Majda Rijavec, PhD and Dragan Dekaris, MD, PhD

From the Institute of Immunology (A.S., S.R., J.T., D.D.); Dubrava University Hospital (D.K.-H., L.M.); Fran Mihaljevi University Hospital for Infectious Diseases (T.J.); and the Educational Department, Liberal Arts College (M.R.), University of Zagreb, Zagreb, Croatia.

Address reprint requests to: Ante Sabioncello, Institute of Immunology, Rockefellerova 10, 10000 Zagreb, Croatia. Email: ante.sabioncello{at}imz.tel.hr

OBJECTIVES: The objectives of this study were to assess the influence of trauma caused by forced expulsion from home in a war-ravaged region on the psychological, hormonal, and immune responses in displaced persons and to analyze the relationships between psychometric, hormonal, and immunologic variables.

METHODS: Participants were 20 displaced and 14 control women. Psychosomatic response was evaluated using the COR-NEX2 test. Serum concentrations of cortisol, prolactin, endorphin, thyroxine, and triiodothyronine were measured by radioimmunoassay. Immunophenotyping and lymphocyte proliferation were determined by flow cytometry, and phagocyte functions (ie, ingestion and antibody-dependent cytotoxicity) against ⁵¹Cr-labeled sheep red blood cells were assessed through radioactivity uptake and release, respectively.

RESULTS: In comparison with control women, displaced women had higher COR-NEX2 test scores; higher serum cortisol, prolactin, and endorphin levels; an increase in activated phenotype within all three measured cell populations (ie, B, T, and natural killer cells); as well as an enhanced proportion of proliferating lymphocytes in freshly isolated samples. However, the phytohemagglutinin-stimulated proliferative response, estimated as the stimulation index, was lower in displaced women. A complex pattern of relations between psychological, hormonal, and immune responses was observed.

CONCLUSIONS: Chronic psychological stress elicited multiple, predominantly stimulatory influences on immune functions.

Key Words: chronic stress • psychoneuroimmunology • immunophenotyping • immune functions

Abbreviations: ADCC = antibody-dependent cytotoxicity; Ig =immunoglobulin; MDD = major depressive disorder; NK = naturalkiller; PHA = phytohemagglutinin; PTSD = posttraumatic stressdisorder; RIA = radioimmunoassay; SI = stimulation index; T₃ = triiodothyronine; T₄ =thyroxine.

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