HCC Psychoneuroimmunology Basics 3 — Questions and Answers
Question 1: A coaching client reports that their chronic loneliness is making them sick more often. Which PNI mechanism best explains this?
- Loneliness increases dopamine, suppressing NK cell activity
- Social isolation activates conserved transcriptional responses that upregulate inflammatory gene expression (Correct answer)
- Loneliness reduces cortisol, causing immune overactivation
- Social isolation decreases vagal tone, raising NK cell count
Correct answer: Social isolation activates conserved transcriptional responses that upregulate inflammatory gene expression
CTRA (conserved transcriptional response to adversity) research shows loneliness upregulates pro-inflammatory genes and downregulates antiviral genes.
Question 2: Which practice has been shown in PNI studies to increase telomerase activity, potentially slowing cellular aging of immune cells?
- High-intensity interval training only
- Mindfulness-based stress reduction (MBSR) (Correct answer)
- Intermittent fasting
- Cold exposure therapy
Correct answer: Mindfulness-based stress reduction (MBSR)
MBSR has been associated with increased telomerase activity in immune cells, suggesting a slowing of stress-related cellular aging.
Question 3: What role do 'Th1' and 'Th2' helper T-cell pathways play in PNI discussions of stress and immunity?
- Chronic stress shifts the balance toward Th1, increasing autoimmune risk
- Chronic stress shifts the balance toward Th2, promoting allergic and anti-parasitic responses over cell-mediated immunity (Correct answer)
- Stress eliminates both Th1 and Th2 pathways equally
- Stress has no documented effect on Th1/Th2 balance
Correct answer: Chronic stress shifts the balance toward Th2, promoting allergic and anti-parasitic responses over cell-mediated immunity
Cortisol from chronic stress suppresses Th1 cell-mediated immunity while relatively sparing Th2, shifting the immune profile toward allergic-type responses.
Question 4: Which cytokine is often called a 'master regulator' of systemic inflammation and is elevated in both depression and chronic stress?
- IL-10
- IL-4
- IL-6 (Correct answer)
- IFN-gamma
Correct answer: IL-6
IL-6 is a pleiotropic pro-inflammatory cytokine consistently elevated in chronic stress and depression, promoting systemic inflammation and sickness behavior.
Question 5: How does the vagus nerve contribute to immune regulation in the cholinergic anti-inflammatory pathway?
- It stimulates the adrenal medulla to release cortisol
- It releases acetylcholine in the spleen, inhibiting macrophage production of TNF-alpha (Correct answer)
- It increases sympathetic tone to recruit neutrophils
- It directly produces IL-10 to suppress inflammation
Correct answer: It releases acetylcholine in the spleen, inhibiting macrophage production of TNF-alpha
Vagal efferent fibers release acetylcholine in the spleen, where it binds alpha-7 nicotinic receptors on macrophages, inhibiting TNF-alpha release.
Question 6: A client experiences 'sickness behavior' — fatigue, social withdrawal, and low mood — during an infection. What PNI mechanism drives this?
- Elevated serotonin acting on the hypothalamus
- Pro-inflammatory cytokines signaling the brain via neural and humoral routes (Correct answer)
- Increased cortisol suppressing dopamine pathways
- NK cell infiltration of the prefrontal cortex
Correct answer: Pro-inflammatory cytokines signaling the brain via neural and humoral routes
Pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) signal the brain through the vagus nerve and circumventricular organs, producing adaptive sickness behavior.
Question 7: Which technique, commonly used in holistic coaching, has been shown to increase heart rate variability (HRV) and thereby enhance vagal anti-inflammatory activity?
- Rapid shallow breathing
- Coherent or slow diaphragmatic breathing (~5-6 breaths/min) (Correct answer)
- Breath holding (Valsalva maneuver)
- Mouth breathing during exercise
Correct answer: Coherent or slow diaphragmatic breathing (~5-6 breaths/min)
Slow diaphragmatic breathing at approximately 5-6 breaths per minute maximizes respiratory sinus arrhythmia and vagal tone, enhancing the cholinergic anti-inflammatory pathway.
HCC Psychoneuroimmunology Basics 3
A coaching client reports that their chronic loneliness is making them sick more often.
Which PNI mechanism best explains this?