Stress management and vaccine response among women at risk for breast cancer

描述(申请人提供)：癌症疫苗正在成为癌症治疗和预防的重要工具。不幸的是，最终将从疫苗中受益最大的人群，即癌症风险较高的人群，可能会受到压力。慢性压力会损害免疫功能，包括对疫苗的免疫反应。对疫苗的反应不充分会削弱疫苗的保护作用。患乳腺癌风险较高的女性可能会经历严重的痛苦，并伴有相关的免疫功能下降。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；然而，到目前为止，研究结果喜忧参半。这项拟议的调查将进行一项探索性随机临床试验，以收集认知行为压力管理(CBSM)小组干预对因家族病史而患乳腺癌风险增加且报告痛苦程度增加的女性的有效性的初步数据。研究结果将包括甲型肝炎疫苗的抗体和细胞免疫反应以及自我报告的痛苦。公共卫生相关性：目前的基本生物行为研究提案将调查心理社会和生物机制之间的相互作用。特别是，本研究将收集试点数据，以研究减轻心理压力如何提高乳腺癌风险女性对疫苗的免疫反应。这项研究的最终目标是支持使用压力管理干预来提高癌症高危人群对癌症疫苗的免疫反应。

DESCRIPTION (provided by applicant): Cancer vaccines are emerging as important tools for cancer treatment and prevention. Unfortunately, the cohorts that ultimately will benefit most from the vaccines, those at elevated risk for cancer, are likely to be stressed. Chronic stress can impair immune function, including immune response to vaccines. An inadequate response to vaccines can weaken their protective effect. Women at elevated risk for breast cancer can experience significant levels of distress and have associated 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; however, the findings to date are mixed. The proposed investigation will conduct an exploratory randomized clinical trial to collect preliminary data on the efficacy of a cognitive behavioral stress management (CBSM) group intervention among women who are at elevated risk for breast cancer because of family history and who are reporting elevated levels of distress. Study outcomes will include antibody and cellular immune response to hepatitis A vaccine and self-reported distress. PUBLIC HEALTH RELEVANCE: The present basic biobehavioral research proposal will investigate the interaction between psychosocial and biological mechanisms. In particular, the present study will collect pilot data for examining how reducing psychological stress may improve immune response to vaccines among women at risk for breast cancer. The goal of this research is ultimately to support using stress management intervention to improve immune response to cancer vaccines among those at risk for cancer.