Multi-System Evaluation of Massage Therapy on HIV+ Adolescents

描述（由申请人提供）：这份经修订的以指导患者为导向的研究职业发展奖提案旨在支持Sheila Wang博士的职业发展，并提供重要的新信息，关于CAM干预，按摩疗法对艾滋病毒感染青少年，高风险，服务不足的儿科人群的多种生物学参数的影响。在所有艾滋病毒新感染病例中，多达一半发生在25岁以下的人群中。在全球范围内，有1 000万感染艾滋病毒的儿童和青少年无法获得高效抗逆转录病毒治疗，使其成为一个紧迫的国家和国际健康问题。虽然人们适当地把注意力集中在向这些人提供药物治疗的紧迫的道德和伦理困境上，但我们必须同时探索低成本、非侵入性的策略，以增强尚未获得HAART治疗的艾滋病毒感染者的免疫功能。初步研究报告了按摩疗法对感染艾滋病毒的青少年和儿童的免疫增强作用。成本相对较低的替代疗法，如按摩，可能有潜力为等待获得HAART和/或作为药物治疗的辅助手段的儿童和青少年提供安全、可持续的免疫刺激形式。提出的研究利用一种独特的、新颖的多系统评估按摩治疗干预，认识到生物系统的复杂性和疾病对多系统相互作用的影响。该研究项目是职业发展和培训的工具，包括来自国际专家Ram Yogev医学博士（儿科/青少年艾滋病毒/艾滋病和免疫学）和Iris Bell医学博士（中西医结合）的一对一指导；与伊利诺伊大学教授Sue Carter博士（神经内分泌学）合作，在伊利诺伊大学实验室Stephen Porges博士（心率变异性）进行“实践”培训；西北大学Uri Wilensky博士和Luis Amaral博士（复杂系统）的实验室；儿童纪念医院特殊传染病青少年诊所(dr。Yogev和Garofalo)。该研究计划包括两个部分：1)一项初步的随机对照试验，比较按摩疗法与放松训练对HIV+青少年免疫、自主神经、激素和行为的影响；2)比较健康青少年和HIV+青少年多系统反应谱。

DESCRIPTION (provided by applicant): This REVISED Mentored Patient-Oriented Research Career Development Award proposal is designed to support the career development of Sheila Wang, PhD, and to provide important, new information on the impact of a CAM intervention, massage therapy, on multiple biologic parameters in HIV-infected adolescents, a high risk, underserved pediatric population. As many as one-half of all new HIV infections occur in persons under 25 years of age. Globally, there are 10 million children and adolescents living with HIV infection without access to highly active antiretroviral therapy (HAART), making it a compelling national and international health problem. While much attention has appropriately been focused on the urgent moral and ethical dilemma of providing medication to these people, we must simultaneously explore low cost, non- invasive strategies to enhance immune function for HIV-infected individuals who do not yet have access to HAART. Preliminary studies report immune enhancing effects of massage therapy for adolescents and children living with HIV infection. Relatively low cost CAM therapies, like massage, may have the potential to provide a safe, sustainable form of immunostimulation to children and adolescents while they are waiting for access to HAART and/or as an adjunct to pharmacotherapy. The proposed research utilizes a unique and novel multi-system evaluation of a massage therapy intervention that recognizes the complexity of biological systems and the impact of disease on multiple system interactions. This research project is a tool for career development and training including one on one mentoring from international experts Ram Yogev, MD (Pediatric/Adolescent HIV/AIDS and Immunology) and Iris Bell, MD, PhD, (Integrative Medicine); collaboration with Univ of IL professor Sue Carter, PhD (neuroendocrinology), "hands on" training experience in the Univ of IL lab of Stephen Porges, PhD (Heart Rate Variability); in the Northwestern Univ labs of Uri Wilensky, PhD and Luis Amaral, PhD (complex systems); and in the Children's Memorial Hospital Special Infectious Diseases Adolescent Clinic (Drs. Yogev and Garofalo). The research plan involves two components: 1) a preliminary randomized controlled trial of massage therapy vs relaxation training on immune, autonomic, hormonal and behavioral measures in HIV+ adolescents and 2) a comparison between multi-system response profiles of healthy and HIV+ adolescents.