Psychosocial factors and hematopoietic stem cell transplantation: potential biobehavioral pathways.

Psychosocial factors and hematopoietic stem cell transplantation: potential biobehavioral pathways.
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DOI:
10.1016/j.psyneuen.2013.06.016
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发表时间:
2013-11
影响因子:
3.7
通讯作者:
Moynihan, Jan A.
Moynihan, Jan A.
中科院分区:
医学2区
文献类型:
--
作者:
Knight, Jennifer M.;Lyness, Jeffrey M.;Sahler, E. Jane Z.;Liesveld, Jane L.;Moynihan, Jan A.

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虽然已知心理社会因素在许多患者群体中通过生物行为途径影响癌症进展,但这些关系在造血干细胞移植(HCT)患者中仍基本未被探索。本文的目的是批判性地回顾文献的心理和内分泌/免疫方面的HCT,重点探索的途径,可能介导的社会心理因素和疾病的结果之间的关联。这些包括儿茶酚胺、糖皮质激素、炎症、血管内皮生长因子(VEGF)、免疫重建和感染易感性的作用,以及基因组学研究中的新机会。我们还讨论了潜在的免疫调节心理社会干预的影响。阐明解释心理社会因素与临床病程之间关联的生物学途径,最终可能会改善这一心理和免疫脆弱人群的结局。
While psychosocial factors are known to affect cancer progression via biobehavioral pathways in many patient populations, these relationships remain largely unexplored in hematopoietic stem cell transplant (HCT) patients. The purpose of this paper is to critically review the literature regarding psychosocial and endocrine/immune aspects of HCT, with an emphasis on exploring pathways that may mediate the associations between psychosocial factors and disease outcomes. These include the roles of catecholamines, glucocorticoids, inflammation, vascular endothelial growth factor (VEGF), immune reconstitution and infectious susceptibility, as well as the new opportunities available in genomics research. We also discuss the implications for potential immunomodulating psychosocial interventions. Elucidating the biological pathways that account for the associations between psychosocial factors and clinical course could ultimately lead to improved outcomes for this psychologically and immunologically vulnerable population.
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