Overall, the inability to demonstrate clinical effects of stress-induced alterations in immune activity on health appears to be the major limitation of research in behavioral neuroimmunology. Research has consistently demonstrated stress effects on health and stress effects on immunity; however, immune changes have not been shown to mediate the effects of stress on health. This may be due to methodological difficulties. As mentioned previously, the immune system is very complex and its components may respond differently to stress. Perhaps measuring activity or the number of one or a few immune cells is not a realistic representation of in vivo immune responses to stress or illness. Recent results showing stress-induced immune alterations and poorer health are suggestive, but research examining multiple immune indices and testing med-iational models is necessary before we can conclude with any certainty that immune changes in response to stress play a role in disease progression.

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