Stress and immune responses after surgical treatment for regional breast cancer
Stress and immune responses after surgical treatment for regional breast cancer
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DOI：
10.1093/jnci/90.1.30
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发表时间：
1998-01-07
影响因子：
10.3
通讯作者：
Glaser, R
中科院分区：
文献类型：
--
作者：
Andersen, BL;Farrar, WB;Glaser, R
背景：成人在接受慢性应激时，如乳腺癌的诊断和手术治疗，往往会经历调整困难和重要的生物效应，这种应激会影响免疫系统，可能会降低癌症患者抵抗疾病进展和转移扩散的能力，我们研究了应激是否影响乳腺癌诊断和手术后的细胞免疫反应。方法：我们研究了116例最近接受手术治疗的浸润性乳腺癌患者，在开始辅助治疗之前，所有受试者都完成了一份有效的问卷，评估了癌症患者的压力，从每个患者身上取了60毫升的血液样本进行自然杀伤(NK)细胞和T淋巴细胞检测，然后我们建立了多元回归模型来检验心理应激在预测免疫功能中的作用，所有回归方程都控制了可能对这些反应产生短期或长期影响的变量，并排除了其他潜在的混杂变量。结果：我们发现，在测试之间和测试内，结果如下：1)应激水平显著预示着NK细胞裂解能力降低，2)应激水平显著预示着NK细胞对重组干扰素γ的反应减弱，3)应激水平显著预示着外周血淋巴细胞对植物凝集素和针对T细胞受体的单抗的增殖反应减弱。结论：数据表明，应激的生理效应抑制了与癌症预后有关的细胞免疫反应，包括NK细胞毒性和T细胞反应，还需要进一步的纵向研究来确定这些影响的持续时间、对健康的影响及其生物和/或行为机制。
Background: Adults who undergo chronic stress, such as the diagnosis and surgical treatment of breast cancer, often experience adjustment difficulties and important biologic effects, This stress can affect the immune system, possibly reducing the ability of individuals with cancer to resist disease progression and metastatic spread, We examined whether stress influences cellular immune responses in patients following breast cancer diagnosis and surgery. Methods: We studied 116 patients recently treated surgically for invasive breast cancer, Before beginning their adjuvant therapy, all subjects completed a validated questionnaire assessing the stress of being cancer patients, A 60-mL blood sample taken from each patient was subjected to a panel of natural killer (NK) cell and T-lymphocyte assays, We then developed multiple regression models to test the contribution of psychologic stress in predicting immune function, All regression equations controlled for variables that might exert short- or long-term effects on these responses, and we also ruled out other potentially confounding variables, Results: We found, reproducibly between and within assays, the following: 1) Stress level significantly predicted lower NK cell lysis, 2) stress level significantly predicted diminished response of NK cells to recombinant interferon gamma, and 3) stress level significantly predicted decreased proliferative response of peripheral blood lymphocytes to plant lectins and to a monoclonal antibody directed against the T-cell receptor, Conclusions: The data show that the physiologic effects of stress inhibit cellular immune responses that are relevant to cancer prognosis, including NK cell toxicity and T-cell responses, Additional, longitudinal studies are needed to determine the duration of these effects, their health consequences, and their biologic and/or behavioral mechanisms.