Multi-System Evaluation of Massage Therapy on HIV+ Adolescents

描述（由申请人提供）：此修订的指导以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，并提供关于CAM干预，按摩疗法对HIV感染青少年多个生物参数影响的重要新信息，高风险，服务不足的儿科人群。在所有新的艾滋病毒感染病例中，多达一半发生在25岁以下的人身上。在全球范围内，有1 000万儿童和青少年感染艾滋病毒，但无法获得高效抗逆转录病毒疗法，使其成为一个紧迫的国家和国际卫生问题。虽然很多注意力已经适当地集中在向这些人提供药物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的HIV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CAM疗法，如按摩，可能有潜力为儿童和青少年提供一种安全，可持续的免疫刺激形式，同时他们正在等待获得HAART和/或作为药物治疗的辅助手段。这项研究利用了一种独特而新颖的多系统评估按摩疗法干预，该疗法认识到生物系统的复杂性以及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，包括国际专家Ram Yogev博士的一对一指导（儿科/青少年艾滋病毒/艾滋病和免疫学）和Iris Bell，MD，PhD，（中西医结合）;与伊利诺伊大学教授Sue Carter博士合作（神经内分泌学），在伊利诺伊大学Stephen Porges博士实验室的“动手”培训经验（心率变异性）; Uri Wilensky博士和Luis Amaral博士的西北大学实验室（复杂系统）;以及儿童纪念医院特殊传染病青少年诊所（Yogev和Garofalo博士）。该研究计划包括两个部分：1）按摩疗法与放松训练对HIV+青少年免疫，自主神经，激素和行为措施的初步随机对照试验; 2）健康和HIV+青少年多系统反应特征的比较。

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.