PNI-BASED STRESS MANAGEMENT IN EARLY BREAST CANCER

基于 PNI 的早期乳腺癌压力管理

• 批准号: 6838838
• 负责人: Nancy L McCain
• 金额: $ 58.11万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-21 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6838838
• 关键词: alternative medicine; behavioral /social science research tag; biomarker; breast neoplasms; cell proliferation; clinical research; clinical trials; coping; cytotoxicity; human subject; immunology; immunosuppression; lymphocyte; natural killer cells; neoplasm /cancer chemotherapy; neuroendocrine system; patient oriented research; perception; psychological aspect of cancer; psychological tests; psychoneuroimmunology; quality of life; religion; social psychology; stress management

DESCRIPTION (provided by applicant): A growing body of research with persons having chronic and potentially fatal illnesses such as cancer indicates that a variety of complementary "mind-body" interventions, including strategies for stress management, can not only mitigate psychological distress and improve coping skills, but also can enhance immune function through neuroendocrine-immune system modulation. Psychoneuroimmunology (PNI), the theoretical framework within which this proposal is grounded, is concerned with the mechanisms of multidimensional psychobehavioral-neuroendocrine-immune system interactions, including the influence of psychosocial, spiritual, and behavioral factors on health outcomes. To date, the majority of psycho behavioral studies in persons with cancer have not examined PNI-based biological indicators. While PNI-based research among persons with cancer is clearly indicated, the multiplicity and complexity of diseases and treatments render such research difficult, particularly in relation to the selection and measurement of appropriate biological markers. The customary immunological measures of lymphocyte proliferative function and natural killer cell cytotoxicity need to be augmented by investigations that may elucidate underlying mechanisms of immunosuppression, using measures such as patterns of cellular cytokine production. Additionally, the timing of such measures in relation to disease and treatment parameters must be carefully controlled and evaluated. This proposal directly addresses these issues by precisely controlling sample inclusion criteria, including medical treatment protocols, and by measuring multiple psycho behavioral, neuroendocrine, immunological, and health status variables over time. The proposed study is a randomized clinical trial involving 240 women receiving adjuvant chemotherapy for early breast cancer. The study is designed to test two psycho behavioral interventions, which we view holistically as mind-body-spirit interventions, and to evaluate multiple biological markers that may shed light on cancer- and treatment-specific mechanisms. The overarching hypothesis is that both tai chi training and spiritual growth group interventions will reduce perceived stress, enhance coping patterns, normalize levels of stress-related neuroendocrine mediators, attenuate immunosuppression, and enhance the adaptational outcomes of psychosocial functioning, quality of life, and physical health.

描述(申请人提供)：越来越多对患有慢性和潜在致命疾病(如癌症)的人的研究表明，包括压力管理策略在内的各种补充的“身心”干预措施不仅可以缓解心理痛苦和改善应对技能，而且还可以通过神经内分泌-免疫系统调节来增强免疫功能。心理神经免疫学(PNI)是这一建议的理论基础，它涉及多维心理行为-神经内分泌-免疫系统相互作用的机制，包括心理社会、精神和行为因素对健康结果的影响。到目前为止，大多数癌症患者的心理行为研究还没有检查基于PNI的生物学指标。虽然明确指出了癌症患者中基于PNI的研究，但疾病和治疗的多样性和复杂性使这种研究变得困难，特别是在选择和测量适当的生物标记物方面。淋巴细胞增殖功能和自然杀伤细胞细胞毒性的常规免疫学指标需要通过调查来加强，这些调查可能利用细胞细胞因子产生的模式等指标来阐明免疫抑制的潜在机制。此外，必须仔细控制和评估与疾病和治疗参数有关的此类措施的时机。这项建议通过精确控制样本纳入标准，包括医疗方案，并通过测量随时间推移的多个心理行为、神经内分泌、免疫学和健康状态变量，直接解决了这些问题。这项拟议的研究是一项随机临床试验，涉及240名接受早期乳腺癌辅助化疗的妇女。这项研究旨在测试两种心理行为干预，我们将其整体视为精神-身体-精神干预，并评估可能揭示癌症和治疗特定机制的多个生物标记物。最重要的假设是，太极训练和精神成长团体干预都将减少感知到的压力，增强应对模式，使与压力相关的神经内分泌介质水平正常化，减轻免疫抑制，并增强心理社会功能、生活质量和身体健康的适应结果。