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A number of solid organs, cellular components and soluble proteins make up the immune system. These include the lymphoid tissues, lymphocytes and other immune cells, and immunoglobulins and cytokines. This chapter discusses measures of immune function, neuroendocrine function, religion and spirituality, pointing out the various strengths and weaknesses of different instruments. This chapter is key for researchers and scientists who wish to study the relationship between religion and psychoneuroimmunology. At least ten major religious dimensions require consideration: denomination/affiliation, religious belief, religious attitudes, organizational or social religious activity, non-organizational or private religious activity, religious salience or importance, religious orientation or motivation, religious coping, religious history, religious experience and religious development or maturity. Finally, there are the wider domains of spirituality and spiritual experience.

Studies in psychoneuroimmunology recently have shed light on the delicate and finely balanced interactions between the mind and physical body. Psychological stress, anxiety, depression, hopelessness, social isolation and negative health behaviors such as cigarette smoking, excessive alcohol intake and illicit drug use all have been shown to adversely affect neuroendocrine and immune system functioning. By impairing immune function, psychosocial and behavioral factors may increase susceptibility to disease or affect the course of disease once present. Religious beliefs and practices are associated with improved coping, reduced anxiety, less depression, faster recovery from depression, greater hope and optimism, greater meaning and purpose, greater social support and fewer negative health behaviors. Consequently, they are highly likely to influence neuroendocrine and immune function, thereby affecting physical health outcomes. Preliminary studies, although few in number and limited in sophistication, appear to support this hypothesis.

This chapter begins with a discussion of sex differences in death rates and disease susceptibility. It then discusses sex differences in infectious diseases, covering susceptibility to viruses, bacteria, and parasites. This is followed by discussion of sex differences in autoimmune diseases, immunological differences between the sexes, sex steroid-immune interactions, and the influence of genetic factors on sex differences in disease susceptibility. The sexes differ in their responses to infectious and autoimmune diseases. The intensity and prevalence of infectious diseases typically are higher in males than females; conversely, the prevalence and severity of autoimmune diseases are greater in females than males. Endocrine-immune interactions play a fundamental role mediating responses to diseases. Because sex steroid concentrations differ dramatically between the sexes, to date, most studies have focused on characterizing the role of sex steroids as mediators of sex differences in immune function.

This chapter discusses the immunologic factors in cancer. Topics covered include structure and function of the immune system, immune variation and cancer risk, and age-related changes in immune function. Experience with a wide range of immune deficient conditions indicates that loss of immune competence does not globally increase cancer incidence. Limited sets of malignancies are increased that are specific to the underlying immune abnormalities. A common feature is the prominent excess of non-Hodgkin lymphoma (NHL) in many of these disorders.

This chapter brings together the results of numerous scientific studies on the biology of immune function and disease. It presents the biomedical evidence that malnutrition and parasite infection contribute to greater susceptibility to any infectious disease, including those which are transmitted sexually. The conditions of poverty increase HIV susceptibility, not only to opportunist diseases after HIV infection but also to HIV transmission, just as they increase vulnerability to other infectious diseases.

Psychoneuroimmunology is the study of how social and psychological factors affect neuroendocrine and immune functioning. Religion involves beliefs about the transcendent, as well as private or communal practices and rituals that reflect devotion or commitment to those beliefs. This chapter reviews research which examines the relationships between religion, mental health, and social support. If there is an association between religious involvement, better mental health and greater social support, and if mental health and social support contribute to better immune functioning, then perhaps religious practices could also have an impact on immune function. This could help explain recent findings on the relationship between religion and physical health, particularly the rather consistent finding linking religious activity to greater longevity. While still quite preliminary, a few studies have actually documented an association between religion and immune function. The role of religion in coping with stress, as well as in mortality and overall well-being, is also discussed.

This chapter explores avenues for future research in the area of religion, spirituality and psychoneuroimmunology. Recommendations are made based in part on a recent conference at Duke University Medical Center that brought together the world's leading experts in psychoneuroimmunology to discuss the future of research on religion and immune function. This chapter describes what went on during that conference and then discusses areas of research that conference participants and chapter authors felt should have the highest priority. Because the immune response is part of the “stress response”, one recurring theme was the need to study spirituality or religion as a potential moderator of the stress response in situations of high stress. This could include populations at risk for negative outcome from stress, such as Scandinavians at high risk for suicide or Irish Catholics at high risk for alcoholism. Other specific health effects might be studied as well, such as wound healing, responses to viral illness, or immune responses following administration of vaccines.

During the past several decades, support has grown for the premise that psychological and social factors can influence physical health. This includes evidence that enduring stressful life events and prolonged negative moods (for example, depression, anxiety and anger) can increase the risk of physical illness and early death. It also includes evidence that those who participate in diverse social networks which include family, friends, workmates, neighbors and fellow members of social and religious groups live longer and healthier lives than their less socially adept counterparts. This chapter discusses research on psychosocial stress, social support and susceptibility to infection that has helped to mainstream psychoneuroimmunology into the field of medicine. It reviews how social factors may affect the immune function and disease susceptibility, and argues that religion or religious factors may influence both psychological and social functioning to a degree that health is significantly affected.

This chapter reviews the work of Janice Kiecolt-Glaser, Ron Glaser and others who have investigated the effects of psychological stress and social support on immune functioning and wound healing. This area of research is of particular importance because of its potentially wide clinical application. If either individual or group support has an impact on immune function, the public health implications would be enormous. Likewise if psychological stress affects wound healing in a clinically significant way, then stress-reducing interventions before and after surgical operations might significantly affect the speed of post-surgical recovery. This chapter also explores how such research advances may help inform future studies of the relationship between religion and health and proposes a number of research avenues to pursue. If religious involvement enhances social support and reduces stress, then investigations which explore the relationship between religion and immunity, wound healing and post-surgical recovery, may be worth pursuing.

In 2000, it was estimated that 36 million people worldwide had been infected with the human immunodeficiency virus (HIV) and that 15,000 people were being newly infected with the virus each day. In 1999 alone, 3 million people worldwide died of acquired immunodeficiency syndrome (AIDS). Because HIV is a disease characterized by immune system dysfunction and is also resisted by the immune system, it would seem that psychoneuroimmunology effects on the immune function might have an even greater impact on the course of HIV infection than on the course of other infectious diseases. This chapter deals with the pathogenesis of HIV infection, its treatment, and the various psychosocial factors known to contribute to the progression of HIV to AIDS. It also examines the impact of religion and spirituality on these psychosocial factors and the implications that this may have for the treatment of HIV/AIDS.

Concerns about marijuana's potential impact on health have generated volumes of research, numerous conferences, and considerable controversy. This chapter addresses marijuana's toxicity, as well as its impact on mental illness, the brain, the pulmonary system, reproduction, pregnancy, and immune function. In general, the drug is incapable of creating an overdose. It can exacerbate the symptoms of some mental disorders but does not appear to cause them. Data fail to show any marijuana-induced changes in brain structure, but long-term exposure to the drug alters the way the brain functions during complex tasks. People who smoke cannabis but not cigarettes have yet to show severe pulmonary problems like lung cancer or emphysema, but milder respiratory problems do appear. Large doses of cannabinoids can cause temporary changes in reproductive hormones and sperm, but these effects reverse with abstinence. The role of cannabinoids in immune function appears extremely complex, but data have yet to show that smoking marijuana increases the rates of infectious disease in humans.

Animals often face time stress because they have to reach a certain stage before a certain time horizon (e.g., the onset of winter or pond drying). Damselflies react to time stress with a shortening of their development time, and often show compensatory growth to avoid a smaller size at metamorphosis. Behaviour (increased foraging) and digestive physiology (increased growth efficiency) underlie this life history plasticity. Both ecological and physiological costs of this accelerated life history have been shown: time-stressed larvae are less responsive to predators and hence suffer higher mortality by predation, and show larger mass loss during starvation and reduced investment in immune function and in energy storage. These costs may explain why time-stressed larvae suffer a reduced lifetime mating success in the adult stage.

This chapter reviews the history of psychoneuroimmunology (PNI), highlighting the events which have transformed it to a highly respected scientific and medical discipline. The history of the development of PNI begins several thousand years ago and transcends many cultures. Indeed, long before Robert Ader first coined the term psychoneuroimmunology in 1975 to describe the study of the interrelationships among the nervous, endocrine and immune systems, ancient mystics, philosophers and healers mused about the impact of one's mental state on physical health and vice versa. Although this chapter cannot nearly do justice to all the people who have contributed to the development of this field, it does attempt to highlight some of the more critical milestones along the way. This chapter looks at holism in ancient and medieval times, the transition from holism to dualism, the role of stress in viral infections and immune function, and the relationship between mind and body.

The central nervous system (CNS) is regarded as an immunologically privileged site due to its separation from the periphery mediated by the blood-brain barrier. Despite this barrier, immunological reactions can occur within the CNS during disease and injury. Characterization of the cells, mediators and other factors participating in the immunological processes within the brain, as well as the interaction of immune-competent cells of the CNS with the systemic immune system, has been the focus of ongoing research. This chapter reviews the immune functions of glial cells, in particular their ability to produce immune mediators and to interact with their systemic counterparts in pathology and injury of the brain.

This chapter notes the differences between the sexes, particularly the fact that males are generally more prone to parasites than females, and how immune functions are affected by sex hormones. There is no evidence, however, that the regulation of testosterone, for example, is a key mechanism which is responsible for the differences between the sexes. The chapter also explores how females choose their mates pre- or post-mating; wherein evidence for pre-mating choice with respect to parasitism and immune function is rich and varied, post-mating choice is seen to be more controversial. Males might indicate their quality with respect to parasite resistance and immune function with elaborate ornamentation (secondary male sexual characters) or bodily symmetry. Females’ mating preferences are also explored, wherein female preference is for males that provide sufficiently different, but not too different, MHC-alleles.

The amphibian disease chytridiomycosis, caused by two fungal pathogens in the genus Batrachochytrium, has caused the greatest vertebrate biodiversity loss due to disease in recorded history. Both the pathogens and their amphibian hosts are impacted by biotic and abiotic conditions that are rapidly changing due to anthropogenic causes, challenging our understanding of how the host–pathogen relationship will shift in the future. By examining this problem through a physiological lens, we can elucidate the mechanisms driving increased susceptibility to disease. This chapter first examines the physiological tools that can be used by amphibian biologists to measure aspects of immune function, stress physiology, and energy expenditure, and the main environmental drivers of these physiological shifts. Then, we explore case studies that have linked environmental change, immune function, and shifts in disease susceptibility to inform amphibian conservation and management.

Massage involves the manipulation of soft tissues using a range of different techniques. The belief that a cancer diagnosis is a contra-indication to massage is largely unfounded, although adaptations of technique may be needed for individuals with cancer and it will not be appropriate in all cases. Published studies show that the benefits of massage in the cancer care setting include relief from anxiety, depression, pain, nausea, and insomnia. It may also improve measures of immune function. This chapter discusses guidelines for safe practice, myths around massage in cancer care, research relating to massage for cancer patients, use of massage in patients with haematological cancers, and assessment and contracting for massage.

Studies on model organisms have shown that individuals with lower genetic diversity are more susceptible to pathogens and suffer greater fitness costs than less inbred individuals. We investigated how genetic diversity, immune response, and parasitism by one hemosporidian parasite (Haemoproteus multipigmentatus) and two chewing lice (Columbicola macrourae and Physconelloides galapagensis) are related to the body condition of endemic Galápagos Doves (Zenaida galapagoensis) in six island populations. We hypothesized that (1) host genetic diversity would be negatively related to parasite abundance, (2) genetic diversity would be positively related to body condition of birds, (3) immune response would be positively related to blood parasite intensity but not to louse abundance, (4) alternatively, higher blood parasite intensity generates increased immunosuppression, leading to a lower white blood cell count and indirectly to a lower body condition, and (5) the abundances of the three parasite species would be positively correlated. Genetic diversity measured at eight microsatellite loci was an exogenous variable in the path analysis and explained 58% of the variation in body condition. Our results suggest that genetic diversity directly enhances body condition and indirectly depresses parasite abundance; this pattern was the same for the three parasite species, although it was not significant for C. macrourae. The best model suggested that blood parasites increase the activation of the immune system (measured as white blood cell counts), which may indicate an attempt of the host to control infection.

This chapter argues that self-efficacy works in concert with other factors to regulate lifestyle habits that directly affect health. Exposure to the same stressors without the perceived or actual ability to control them can impair immune function. Epidemiological results show that an actual or perceived lack of control over environmental stressors increases susceptibility to bacterial and viral infections, contributes to the development of physical disorders, and accelerates the progression of a disease. In addition, when one is unable to control adverse events, further complications ensue. This distress in turn affects the immune system in ways that increase the susceptibility to illness. It appears that enhanced feelings of self-efficacy actually boost the immune system's ability to ward off infections and fight disease, and a diminished sense of self-efficacy increases the body's susceptibility to disease.

The function of sleep was a longstanding mystery in neuroscience, but there is now compelling empirical evidence for several key functions of sleep. Elucidating these functions and their underlying pathways is a hot area for the field of sleep research today, and many open questions remain. What we have gleaned from recent data is that it is important to view sleep as a synthesis of processes that enable improved functioning during wakefulness. There is no single universal function of sleep, but rather a collection of synergistic functions that are each of varying importance to different species. In humans, sleep plays critical roles in consolidating memories, restoring energy stores in the brain, clearing wastes from the brain, immune function, metabolic function, and overall health.