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Massage Benefits in HIV+ Children: Mechanisms of Action

按摩对艾滋病毒儿童的益处：作用机制

基本信息

批准号：
7230862
负责人：
Gail Shor-Posner
金额：
$ 0.27万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-09-30 至 2007-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7230862
关键词：
AIDS therapy CD4 molecule CD8 molecule alternative medicine child (0-11)clinical research cortisol human subject human therapy evaluation immune response interleukin 2 interleukin 6 massage therapy patient oriented research pediatric AIDS stress tumor necrosis factor alpha virus load

项目摘要

DESCRIPTION (provided by applicant): Despite great efforts to control the spread of HIV infection, more than 3.2 million children are living with HIV/AIDS worldwide, and 5.6 million children have died from this devastating disease. In developing countries, such as the Dominican Republic, antiretroviral medications are not yet readily available to slow disease progression. Even with access to treatment there still is no cure, side effects can be severe, and adherence is difficult, especially when it may have to be life-long. Moreover, the completeness and degree to which immune recovery occurs with antiretroviral therapy, varies among individuals. Thus, immune restoration remains a foremost priority, and identifying treatment modalities that do not require additional medications while improving clinical symptoms are of critical importance. Preliminary findings from our R21 NCCAM grant, indicate that massage therapy has a significant impact on markers of disease progression (T lymphocyte numbers) in HIV+ Dominican children without access to antiretrovirals, and may have the potential to alter the course of HIV disease. In support of this concept, increased immune capacity has been demonstrated following massage therapy in HIV+ adolescents and adults. The two-fold intent of the proposed research is to extend our preliminary findings to evaluate the impact of massage therapy on immune recovery in a larger sample size (80 vs 27) and greater age range (2-12 yrs vs 2-8 yrs) of children with HIV, and to investigate a potential neuroimmune mechanism of massage action. To achieve these goals, we are proposing a clinical trial with 80 HIV+ Dominican children randomized to receive massage, twice weekly-for 12 weeks (n=40 Group 1) or no massage treatment (n=40 Group 2). Group 2 will subsequently receive the massage intervention, which may allow confirmation of the massage-induced immune response. Group 1 will be followed at 3 months post massage to evaluate durability of the effect. Data will be gathered to assess the impact of massage on immune recovery (CD4, CDS, PHA, IL-2), stress levels (cortisol) and proinflammatory cytokines (IL-6, TNF-alpha). Disease status, antiretroviral therapy, and viral burden, will be examined and their potential utility as covariates in the analyses considered. The long-term objective is to establish rigorous scientific evidence for a feasible CAM therapy that can contribute to reducing the burden of disease for those living with compromised immune systems.

描述（由申请人提供）：尽管为控制艾滋病毒感染的传播做出了巨大努力，但全世界仍有320多万儿童感染艾滋病毒/艾滋病，560万儿童死于这一毁灭性疾病。在多米尼加共和国等发展中国家，抗逆转录病毒药物尚不容易获得，无法减缓疾病的进展。即使获得治疗，仍然无法治愈，副作用可能很严重，并且很难坚持，特别是当它可能需要终身治疗时。此外，抗逆转录病毒治疗后免疫恢复的完整性和程度因人而异。因此，免疫恢复仍然是首要任务，并且确定在改善临床症状的同时不需要额外药物的治疗方式至关重要。我们的R21 NCCAM补助金的初步研究结果表明，按摩疗法对艾滋病毒+多米尼加儿童的疾病进展标志物（T淋巴细胞数量）有显着影响，而无法获得抗逆转录病毒药物，并可能有可能改变艾滋病毒疾病的进程。为了支持这一概念，在HIV阳性青少年和成人中进行按摩治疗后，免疫能力得到了增强。拟议研究的双重目的是扩展我们的初步研究结果，以评估按摩疗法对更大样本量（80 vs 27）和更大年龄范围（2-12岁vs 2-8岁）的HIV儿童免疫恢复的影响，并调查按摩作用的潜在神经免疫机制。为了实现这些目标，我们提出了一项临床试验，80名艾滋病毒阳性多米尼加儿童随机接受按摩，每周两次，为期12周（n=40组1）或没有按摩治疗（n=40组2）。第2组随后将接受按摩干预，这可能允许确认按摩诱导的免疫应答。第1组将在按摩后3个月进行随访，以评估效果的持久性。将收集数据，以评估按摩对免疫恢复（CD 4，CDS，PHA，IL-2），应激水平（皮质醇）和促炎细胞因子（IL-6，TNF-α）的影响。将检查疾病状态、抗逆转录病毒治疗和病毒负荷，并将其作为协变量用于分析。长期目标是为可行的CAM疗法建立严格的科学证据，有助于减轻免疫系统受损患者的疾病负担。