Stress Reduction as a Means to Enhance Oral Immunity in HIV-Infected Individuals

The primary diseases that currently plague the industrialized world are those resulting from cumulative damage over many years, such as cerebrovascular diseases, heart disease, and cancer. These diseases would have been unrecognizable to past generations of Americans, who dealt with acute conditions related primarily to infectious diseases and malnutrition. Diseases of the late 20th and early 21st century are brought on by decades of wear-and-tear, poor lifestyle choices, and a condition commonly referred to as “stress.” In fact, the programmed physiological response to our everyday stressors, the stress response, has allowed animals to survive extreme and dangerous acute conditions. However, overwhelming evidence during the past few decades indicates that chronic activation of this biological stress response to nonlife-threatening situations such as traffic jams and work pressures affects physiological systems like immunity and is believed to cause or exacerbate many contemporary physical and psychological ailments. The study of the relationship among the neural, endocrine, and immune systems, called psychoneuroimmunology, is an important piece in understanding and treating the effects of stress (Ader & Cohen, 1993; Solomon, 1969). Understanding this relationship is especially relevant for the immunocompromised population infected with HIV. Stressrelated conditions are prominent clinical problems in HIV-infected individuals and are associated with acute as well as chronic conditions. It seems that stress can have a detrimental effect on oral as well as general health. Oral immunity and health becomes an important area of study with regard to the HIVinfected population, because these individuals are disproportionately affected with opportunistic oral and esophageal infections.