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Effects of Chronic Stress and Interleukin-10 Gene Polymorphisms on Antibody Response to Tetanus Vaccine in Family Caregivers of Patients With Alzheimer’s Disease

From the Department of Epidemiology and International Health (J.L., L.G.C., R.T.P., Z.C., M.S.S., H.W.W., R.C.P.G.), School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Microbiology and Immunology (J.D.K., D.A.B.), University of Alabama at Birmingham, Birmingham, Alabama; Departments of Clinical Immunology and Medicine (H.W.S.), University of Alabama at Birmingham, Birmingham, Alabama; Department of Medicine (A.B.S.), Texas A&M University System Health Science Center, Huston, TX; Department of Biostatistics (H.K.T.), Section on Statistical Genetics, University of Alabama at Birmingham, Birmingham, Alabama; Department of Neurology (L.E.H.), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

Address correspondence and reprint requests to Jian Li, Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.

Objective: To assess the effects of psychological stress on the antibody response to tetanus vaccine adjusting for cytokine gene polymorphisms and other nongenetic factors in caregivers of patients with Alzheimer’s disease (AD).

Methods: A family-based follow-up study was conducted in 119 spouses and offspring of community-dwelling patients with AD. Psychological stress was measured by the Perceived Stress Scale (PSS) and the Center for Epidemiologic Studies Depression (CES-D) scale at baseline and 1 month after the vaccination. Nutritional status, health behaviors, comorbidity, and stress-buffering factors were assessed by self-administered questionnaires, 10 single nucleotide polymorphisms (SNP) from six selected cytokines genotyped, and anti-tetanus toxoid immunoglobulin G (IgG) concentrations tested using enzyme-linked immunosorbent assays. The effects of stress and other potential confounders were assessed by mixed models that account for familial correlations.

Results: The baseline PSS score, the baseline CES-D score, the interleukin-10–1082 A>G SNP GG genotype, and the baseline anti-tetanus IgG were inversely associated with antibody fold increase.

Conclusion: Both psychological stress and cytokine gene polymorphisms affected antibody fold increase. The study provided additional support for the detrimental effects of psychological stress on the antibody response to tetanus vaccine.

Key Words: psychological stress • cytokine genes • antibody response • vaccine

Abbreviations: AD = Alzheimer’s disease; CES-D = Center for Epidemiologic Studies Depression; PSS = Perceived Stress Scale; ELISA = enzyme-linked immunosorbent assays; SNP = single nucleotide polymorphisms.