Can Stress Management Improve Vaccine Immune Response

职位描述(申请人提供)：本申请的目的是为了让自己成为癌症预防和控制领域的一名独立调查员。我将通过出色的多学科指导、有针对性的教育计划以及完成一项创新的研究项目来实现这一目标，该研究项目旨在测试集体心理干预对乳腺癌高危女性免疫功能和心理功能的影响。 慢性压力会损害免疫功能，包括对疫苗的免疫反应。这对癌症控制和预防具有重要影响，因为肿瘤疫苗正在成为癌症治疗和预防的工具，而将从疫苗中受益的队列可能会受到强调。患乳腺癌风险较高的女性会经历与免疫功能下降相关的严重痛苦。需要对这些妇女中与痛苦相关的免疫功能减退进行干预，因为这些妇女将是乳腺癌疫苗的首批候选对象之一。从理论上讲，压力管理干预应该会改善免疫功能和对疫苗的反应，但到目前为止，研究结果喜忧参半，部分原因是大多数干预研究都是针对天生免疫混乱的内科患者进行的。因此，目前尚不清楚压力管理干预如何影响有压力但其他方面健康的人的免疫功能，例如乳腺癌风险增加的妇女。 为了弥补这一差距，拟议的研究将进行一项随机的临床试验，以测试认知行为应激管理(CBSM)小组干预对乳腺癌高危女性对疫苗和痛苦的免疫反应的有效性。

DESCRIPTION (provided by applicant): The goal of this application is to distinguish myself as an independent investigator in cancer prevention and control. I will accomplish this goal through excellent multidisciplinary mentorship, a targeted education plan, and the completion of an innovative research project testing the effects of a group psychological intervention on immune function and psychological function among women at elevated risk for breast cancer. Chronic stress can impair immune function, including immune response to vaccines. This has important implications for cancer control and prevention because tumor vaccines are emerging as tools for cancer treatment and prevention, and the cohort that would benefit from the vaccines is likely to be stressed. Women at elevated risk for breast cancer experience significant levels of distress that have been associated with immune function decrements. Interventions to treat distress-related immune decrements among these women are needed because these women will be among the first candidates for breast cancer vaccines. In theory, stress-management interventions should improve immune function and response to vaccines, but the findings to date are mixed, in part because most intervention studies have been done with medical patients who by nature have immune confounds. Thus, it is unknown how stress management interventions effect immune function in stressed but otherwise healthy people, such as women at elevated risk for breast cancer. To address this gap, the proposed investigation will conduct a randomized, clinical trial to test the efficacy of a cognitive behavioral stress management (CBSM) group intervention on immune response to vaccine and distress among women at elevated risk for breast cancer.