Tai Chi, Cellular Inflammation, and Transcriptome Dynamics in Breast Cancer Survivors With Insomnia: A Randomized Controlled Trial
Tai Chi, Cellular Inflammation, and Transcriptome Dynamics in Breast Cancer Survivors With Insomnia: A Randomized Controlled Trial
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DOI：
10.1093/jncimonographs/lgu028
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发表时间：
2014-11-01
期刊：
影响因子：
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通讯作者：
Cole, Steve
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文献类型：
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作者：
Irwin, Michael R.;Olmstead, Richard;Cole, Steve
乳腺癌幸存者广泛使用太极等身心疗法，但对炎症的影响尚不清楚。本研究假设，太极拳（TCC）将减少全身，细胞和基因组炎症标志物相比，认知行为疗法治疗失眠症（CBT-I）。方法在这个随机试验治疗失眠，90乳腺癌幸存者失眠被分配到TCC或CBT-I每周2小时的会议3个月。在基线和干预后，获得血液样本的测量C-反应蛋白和Toll样受体-4激活的单核细胞产生的白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF），与一个随机子样本（n = 48）分析全基因组转录profiling.Results水平的C-反应蛋白并没有改变TCC和CBT-I组。Toll样受体-4激活的单核细胞产生IL-6和TNF的水平显示TCC与CBT-I相比总体降低（P <0.02），单独使用IL-6（P = 0.07）和TNF（P <0.05）具有相似的效果。对于循环外周血单核细胞的全基因组转录谱，编码促炎介质的基因表达显示TCC与CBT-I相比总体减少（P = .001）。TELiS启动子为基础的生物信息学分析牵连的促炎性转录因子，核因子-κ B，在结构这些differentiation.Conclusions乳腺癌幸存者失眠，3个月的TCC减少细胞炎症反应，并减少编码促炎介质的基因的表达。鉴于炎症和癌症之间的联系，这些发现提供了一个基于证据的分子框架，以了解TCC对癌症生存率的潜在有益影响。
Background Mind-body therapies such as Tai Chi are widely used by breast cancer survivors, yet effects on inflammation are not known. This study hypothesized that Tai Chi Chih (TCC) would reduce systemic, cellular, and genomic markers of inflammation as compared with cognitive behavioral therapy for insomnia (CBT-I).Methods In this randomized trial for the treatment of insomnia, 90 breast cancer survivors with insomnia were assigned to TCC or CBT-I for 2-hour sessions weekly for 3 months. At baseline and postintervention, blood samples were obtained for measurement of C-reactive protein and toll-like receptor-4-activated monocyte production of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF), with a random subsample (n = 48) analyzed by genome-wide transcriptional profiling.Results Levels of C-reactive protein did not change in the TCC and CBT-I groups. Levels of toll-like receptor-4-activated monocyte production of IL-6 and TNF combined showed an overall reduction in TCC versus CBT-I (P < .02), with similar effects for IL-6 (P = .07) and TNF (P < .05) alone. For genome-wide transcriptional profiling of circulating peripheral blood mononuclear cells, expression of genes encoding proinflammatory mediators showed an overall reduction in TCC versus CBT-I (P = .001). TELiS promoter-based bioinformatics analyses implicated a reduction of activity of the proinflammatory transcription factor, nuclear factor-kappa B, in structuring these differences.Conclusions Among breast cancer survivors with insomnia, 3 months of TCC reduced cellular inflammatory responses, and reduced expression of genes encoding proinflammatory mediators. Given the link between inflammation and cancer, these findings provide an evidence-based molecular framework to understand the potential salutary effects of TCC on cancer survivorship.