title: Perceived stress is associated with impaired T-cell response to HPV16 in women with cervical dysplasia.
abstract: BACKGROUND
  Infection with high-risk subtypes of human papillomavirus (HPV) is a central factor in the development of cervical neoplasia. Cell-mediated immunity against HPV16 plays an important role in the resolution of HPV infection and in controlling cervical disease progression. Research suggests that stress is associated with cervical disease progression, but few studies have examined the biological mechanisms that may be driving this association.
  
  
  OBJECTIVE
  This study examines whether stress is associated with immune response to HPV16 among women with cervical dysplasia.
  
  
  METHODS
  Seventy-four women presenting for colposcopy completed measures of health behaviors, stressful life events and perceived stress. A blood sample was obtained to evaluate proliferative T-cell response to HPV16, and a cervical sample was obtained during gynecologic exam for HPV-typing.
  
  
  RESULTS
  More than 55% tested positive for one or more HPV subtypes. Women who did not show proliferative responses to HPV (i.e. non-responders) were more likely to be HPV(+) compared to women who had a response (i.e. responders). Consistent with study hypotheses, logistic regression revealed that higher levels of perceived stress were associated with a non-response to HPV16, controlling for relevant covariates. Stressful life events were not associated with T-cell response to HPV.
  
  
  CONCLUSIONS
  Higher levels of perceived stress are associated with impaired HPV-specific immune response in women with cervical dysplasia, suggesting a potential mechanism by which stress may influence cervical disease progression.
authors.affiliation: Division of Population Science, Fox Chase Cancer Center, Cheltenham, PA 19012, USA. carolyn.fang@fccc.edu
authors.forename: Carolyn Y
authors.initials: CY
authors.lastname: Fang
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Miller
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.forename: Cynthia
authors.initials: C
authors.lastname: Bergman
authors.forename: Mitchell I
authors.initials: MI
authors.lastname: Edelson
authors.forename: Norman G
authors.initials: NG
authors.lastname: Rosenblum
authors.forename: Betsy A
authors.initials: BA
authors.lastname: Bove
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Godwin
authors.forename: Donald E
authors.initials: DE
authors.lastname: Campbell
authors.forename: Steven D
authors.initials: SD
authors.lastname: Douglas
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D052162:Human papillomavirus 16 / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000276:immunology / Q000523:psychology*; D012016:Reference Values; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000276:immunology / Q000523:psychology* / Q000821:virology