Running head: CRITICAL REVIEW OF KISSING REDUCING ALLERGIC RESPONSE 1

A Critical Review of Kimata, H. (2003). Kissing reduces allergic skin wheal responses

and plasma neurotrophin levels. Physiology & Behavior, 80(2-3), 395-398.

Introduction

Dr. Hajime Kimata, 62, won the Ig Nobel Prize for the record ninth time in 2015. Hailing

from Osaka, Japan, the doctor is specialist in allergology (Hongo, 2017). The award was in

recognition for his study conducted in 2003 that demonstrated a reduction of allergic skin wheal

responses and plasma neurotrophin levels as a result of kissing (Kimata, 2003), obviously it

made people laugh, and but it also provoked science into the right direction; hence, the Ig Nobel

Prize.

Based on his prior studies Kimata suggested that positive stressors such as the one

involving emotions of happiness and humour appeared to reduce the symptoms of allergic

reactions. He did so by conducting skin prick tests which resulted in wheal formation on the skin.

Kimata analyzed and compared the relative wheal sizes and neurotrophins levels in plasma to

adduce his correlations. Being an allergy specialist, he has been in the forefront of conducting

various studies of similar nature, experimenting with laughter (Kimata, 2004), music (Kimata,

2003), computer-induced stress (Kimata, 2003), humour (Kimata, 2009), and sexual intercourse

(Kimata, 2004). His objective was to find more natural methods in order to alleviate symptoms

of allergy in his patients without using prescriptive medications or steroids (Hongo, 2017).

In this paper, I would summarize the findings of his study involving kissing’s effect on

allergic reactions, offer my view on limitations of the study and identify improvements to be

made which I consider appropriate in the next step towards future studies.
CRITICAL REVIEW OF KISSING REDUCING ALLERGIC RESPONSE 2

Summary of Current Study

In pursuit to further consolidate his findings Kimata conducted an experiment in 2003

using a cross-over design which involves kissing (love) which acted as the independent variable.

The research question here was on whether kissing would have an effect in skin wheal sizes

(dependent variable) formed and in the levels of plasma neurotrophin (dependent variable)

(Kimata, 2003). He hypothesized that kissing would cause a reduction in skin wheal sizes and

plasma neurotrophin.

He recruited 90 participants which included, 30 normal subjects (N), 30 patients of

allergic rhinitis (AR) and 30 patients of atopic dermatitis (AD). Patients with AR and AD were

already predetermined to be allergic to house dust mite (HDM) and Japanese cedar pollen (JCP)

(Kimata, 2003). All the participants were Japanese and did not practice the act of kissing their

partners on a habitual basis. The participants were placed in a room, alone with doors closed for

a 30 minutes duration during which they kissed their lover or spouse. The act of kissing was

done while listening to soft music which was of romantic in nature (Kimata, 2003). Skin prick

tests were performed both before and after the kissing using commercially obtainable HDM and

JCP allergen, histamine and a control solution were also used. A control study was performed

two weeks later wherein the same participants were asked to embrace their lover or spouse for 30

minutes while listening to the same music (Kimata, 2003). Similar prick tests were performed on

them as well. In both situations pretest and posttest measurements of skin wheal size and plasma

levels of neurotrophins; NGF, BDNF, NT-3 and NT-4 were assayed using ELISA. In his paper,

Kimata does mention that plasma cortisol levels were also measured in each group, both pretest

and posttest. Measurements showed kissing did not affect cortisol levels. The overall data

gathered was then analyzed using Wilcoxon’s t test (Kimata, 2003) for interpretation.
CRITICAL REVIEW OF KISSING REDUCING ALLERGIC RESPONSE 3

As anticipated by Kimata, the results obtained demonstrated a significant reduction in

skin wheal size and plasma levels of neurotrophins in patients with AR and AD. Kimata cross

referenced this result which was similar to others as mentioned earlier in my introduction. He

suggests the results indicate that a direct action reflecting that of love may prove to be positive in

alleviating allergic responses and find relevance in further neuroimmunology studies.

Limitations of Current Study

Kimata’s paper on this kissing experiment was indeed interesting to read as he laid out

the facts in a simplistic manner; nonetheless, there appears to be various concerns which needs to

be addressed. This would provide greater clarity, accuracy, consistency and validity to his

findings and conclusions.

Although Kimata’s study was conducted using 90 participants, not all were equal in terms

of conditions; 30 were of normal condition, 30 had AR and another 30 had AD. The small

sample size used to represent the 3 groups can contribute to sampling error. Smaller sample size

can also result in lower reproducibility and lower statistical power, reducing the ability to detect

true effect (Button et al., 2013).

Kimata’s sampling methodology should be improved for better validity (Lucas, 2003).

Although he states participants from each group were random subdivided into two groups, the

total number of 90 participants were recruited based on an advertisement posted in Ujitakeda

Hospital. Thus, he was deliberately seeking participants from the populace visiting the hospital

of whom he chose persons with specific conditions suited for his experiment. He also does not

account for the effect of the participants sex in his study.

It is understandable that all his participants were Japanese, but this again affects the

external validity hence bringing into question the application of the conclusion he made to the
CRITICAL REVIEW OF KISSING REDUCING ALLERGIC RESPONSE 4

wider population of the world. As the participants chosen did not kiss habitually could this fact

have affected the measurements of the dependent variables. This is a variable that has not been

taken into full consideration. The participants were also pretested for allergy and measured for

serum allergen-specific IgE. They were also treated in his hospital. There may be a possibility

that these actions may have acted as priming effect and in addition reduced the stress levels in

participants. He should have also used participants who suffer from other allergic conditions.

This may again have affected the final outcome.

Kimata experiment only involved kissing and did not use other forms of intimacy or

display of affection to demonstrate love and its consequent effect on the measurements he took.

The component of music was restricted to one particular genre only leaving us to guess the other

types of music that would have possibly made an impact on the results, after all music taste

differs from person to person. The participants were kept in rooms with doors closed and alone

during their act of kissing their respective partners. This arrangement though suitable to avoid

“Hawthorne’s effect”, it does not guarantee that the participants actually kissed for the entire 30

minutes duration given the fact that they were already conservative to begin with. Such factors

can affect the final measurements.

He also did not account for other biochemical parameters such as oxytocin and

endorphins as kissing has been proven cause an increase of these two (Science, 2017). Although

Kimata stated that cortisol levels measured remained unaffected due to the act of kissing, I find

this hardly convincing as there are numerous studies showing quite the contrary (Floyd &

Riforgiate, 2008).

Wilcoxon’s t test, a non-parametric statistical test was used to analyse the date he

obtained. The disadvantage of using a non-parametric test is, it may lack power compared to the
CRITICAL REVIEW OF KISSING REDUCING ALLERGIC RESPONSE 5

parametric approach especially when the sample size is small (Elise Whitley, 2017). Non-

parametric tests are more suited towards hypothesis testing compared to estimation of effects. In

addition to this we do not have any information on effect size. Using P value alone to interpret

the outcome of the experiment is insufficient (Sullivan & Feinn, 2012)

Improvements & Next Steps / Future

Based on the limitations which I have opined above, Kimata or future experimenters

following his footstep may want to consider improving similar experiments. Participants could

be recruited from various other hospitals through cluster sampling or simple random sampling

from the public by advertising the necessary criteria. This includes samples from various other

geographical locations and cultures. We need to find out if the same effect is found in those

societies where display and act of affection is viewed liberally. Future studies should also

involve larger sample size and an analysis of difference between males and females which could

provide for a better external validity. Instead of testing patients for allergy, one could randomly

select individuals who have been confirmed to have such allergies. It is also necessary to expand

the study to include other forms of allergy and not merely restricted to AR and AD. A similar

finding across other allergies may lend more qualitative credence to the study.

Contrary to how it was done in Kimata’s experiment, participants can be observed

through a one-way mirror in order to ensure the condition for the study is met. Different types of

music can also be applied to experiment to study possible effects on the final measurement. In

addition to this, effect of environment can also be studies by introducing stimuli such for the

olfaction and ambient lighting. The dietary consumption of the participants can also be analysed

for possible affects in allergic reactions. Future studies also need to include different types of

personality traits. It would be interesting to study how types of personality traits can affect the
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outcome of allergic reactions. The biochemical measurements being measured need to be

expanded beyond neutrophins. Being neuromodulators as such, it is important that stress and

stress related hormones such as cortisol is studied with greater depth.

Future researchers or even Kimata himself should utilize more powerful statistical tests

such as analysis of variance with pretest and posttest analysis. This would provide greater

credibility. Findings of this experiment should also spur studies into stress hormones and mast

cells relationship including IgE. Such researches can help understand such interactions on a

larger scale. It also opens avenues for therapeutic applications and marketing purposes.

Though Ig Nobel Prize appears laughable for the uninitiated and his experiments can be

conducted in a much more effective manner, I believe Dr. Hajime Kimata has stumbled upon

another key evidence linking stress and environment with and physiological response to it and

how stress itself compounds the body’s natural defences against offending factors as exemplified

in allergic responses (Kimata, 2003). In short, there is insufficient attention in the mainstream

media on direct and indirect stress that increasingly envelopes each human being in this 21st

century world. Its impact equally reverberates negatively into our psychology affecting our

quality of life.
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References

Button, K., Ioannidis, J., Mokrysz, C., Nosek, B., Flint, J., Robinson, E., & Munafó, M. (2013).

Power failure: why small sample size undermines the reliability of neuroscience. Nature

Reviews Neuroscience, 14(6), 442-442.

Elise Whitley, J. (2017). Statistics review 6: Nonparametric methods. PubMed Central (PMC).

Retrieved 10 November 2017, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC153434/

Floyd, K., & Riforgiate, S. (2008). Affectionate Communication Received from Spouses Predicts

Stress Hormone Levels in Healthy Adults. Communication Monographs, 75(4), 351-368.

Hongo, J. (2017). Japanese Doctor Wins Ig Nobel for Research on Kissing. WSJ. Retrieved 8

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wins-ig-nobel-for-research-on-kissing/

Kimata, H. (2003). Enhancement of allergic skin wheal responses and in vitro allergen-specific

IgE production by computer-induced stress in patients with atopic dermatitis. Brain,

Behavior, And Immunity, 17(2), 134-138.

Kimata, H. (2003). Kissing reduces allergic skin wheal responses and plasma neurotrophin

levels. Physiology & Behavior, 80(2-3), 395-398.

Kimata, H. (2003). Listening to Mozart Reduces Allergic Skin Wheal Responses and in Vitro

Allergen-specific IgE Production in Atopic Dermatitis Patients with Latex

Allergy. Behavioral Medicine, 29(1), 15-19.

Kimata, H. (2004). Laughter Counteracts Enhancement of Plasma Neurotrophin Levels and

Allergic Skin Wheal Responses by Mobile Phone—Mediated Stress. Behavioral

Medicine, 29(4), 149-154.

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Kimata, H. (2004). Reduction of allergic skin weal responses by sexual intercourse in allergic

patients. Sexual And Relationship Therapy, 19(2), 151-154.

Kimata, H. (2009). Viewing a humorous film decreases IgE production by seminal B cells from

patients with atopic eczema. Journal Of Psychosomatic Research, 66(2), 173-175.

Lucas, J. (2003). Theory-Testing, Generalization, and the Problem of External

Validity. Sociological Theory, 21(3), 236-253

Science, L. (2017). Saliva: Secret Ingredient in the Best Kisses. Live Science. Retrieved 10

November 2017, from https://www.livescience.com/3328-saliva-secret-ingredient-

kisses.html

Sullivan, G., & Feinn, R. (2012). Using Effect Size—or Why thePValue Is Not Enough. Journal

Of Graduate Medical Education, 4(3), 279-282.