Stress, optimism, and social support: impact on immune responses in breast cancer

Optimism as a key factor in coping with the common cold

Objective

The optimism trait is considered one of the most important psychological factors in protecting and promoting health. This study aims to investigate whether trait optimism may help to cope better with the common cold by reducing the subjective perception of cold symptoms and affecting the immune response.

Methods

To do so, 212 volunteers from the Pittsburg Cold Study 3 within the Common Cold Project were exposed to Rhinovirus (RV39). On the 5 days following the inoculation, a daily symptoms scale, nasal wash, and blood samples were collected to assess Jackson Symptoms (nasal congestion, sneezing, runny nose, sore throat, cough, headache, chills, and malaise) and control the Immune System response to infection (concentrations of interleukin (IL)-1β, IL-6, IL-8, IL-10, tumour necrosis factor (TNF)-α, and interferon (IFN)-α).

Results

Results showed that approximately 30% of the inoculated participants were finally diagnosed with a common cold, showing higher Jackson Symptom severity and Immune System Response (IL-1β, IL-6, IL-8, IL-10, TNFα and IFNα). Importantly, moderation regression analyses showed that higher optimism scores were related to lower Jackson Symptom severity and TNFα response to infection in cold-diagnosed participants.

Conclusions

Our results provide important evidence for the protective role of optimism, a trait factor that promotes a better perception of wellbeing and less need for immune system resources to successfully cope with the common cold.

Trajectories of cancer-specific stress in cancer patients: a latent growth mixture analysis

This study aimed to examine trajectories of cancer specific stress (CSS) over the course of a year, starting at the beginning of chemotherapy, and identify psychosocial factors that predicted trajectory class membership. Growth Mixture Modeling was used to identify distinct trajectories of CSS. Multinomial regression examined potential psychosocial predictors of trajectory membership. In the 4-class solution, all four trajectories demonstrated a decrease in CSS over the year but with differing intercepts and magnitudes of slopes. These were characterized as recovery, resilience, chronic, and severely chronic. The recovery group reported significantly higher insomnia scores than the resilient group. The chronic group reported significantly higher insomnia, higher depression, lower social support, and lower optimism than the resilient group. The chronic group reported significantly lower social support and higher depression than the recovery group. The findings provide information about psychosocial risk factors for CSS that can be screened for early intervention following diagnosis.

Adult-Child Caregivers' Family Communication Experiences after an Older Parent's Blood Cancer Diagnosis: A Survey Exploring Their Openness, Avoidance, and Social Support

Adult-child caregivers of an aging parent living with a blood cancer describe struggling to communicate with one another and within the family system. They may avoid critical care conversations, which may impede care and their ability to receive social support. We examined what approaches adult-child caregivers of a parent diagnosed with a blood cancer use to enhance their family communication, the topics they find most challenging to discuss, and the roles of openness and support. We used qualitative and quantitative approaches to analyze data from a larger online survey study. In partnership with the Leukemia & Lymphoma Society, we recruited 121 adult-child caregivers. Responses to one open-ended item were analyzed to capture strategies used to enhance communication with their parent and family. They reported utilizing digital communication modalities, prioritizing frequent communication, engaging in openness, establishing boundaries, kinkeeping, and enacting support. Within the quantitative data, we further explored two of these themes (openness and support) and their relationships to other variables using t-tests and regression analysis. Adult-child caregivers and diagnosed parents avoid talking about mortality and negative feelings. Openness in the family about cancer was linked to caregivers' perceptions of receiving social support. Findings demonstrate that cultivating openness between midlife adult children and diagnosed parents may enhance opportunities to receive support.

Stress and cancer: The mechanisms of immune dysregulation and management

Advances in the understanding of psychoneuroimmunology in the past decade have emphasized the notion that stress and cancer are interlinked closely. Durable chronic stress accelerated tumorigenesis and progression, which is unfavorable for clinical outcomes of cancer patients. Available evidence has provided unprecedented knowledge about the role and mechanisms of chronic stress in carcinogenesis, the most well-known one is dysfunction of the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). With abnormal activation of neuroendocrine system, stress-related hormones contribute to increased oncogenes expression, exacerbated chronic inflammation and impaired immunologic function. In addition, accumulating studies have demonstrated that diverse stress interventions including pharmacological approaches, physical exercises and psychological relaxation have been administered to assist in mental disorders reduction and life quality improvement in cancer patients. In this review, we systematically summarize the connection and mechanisms in the stress-immune-cancer axis identified by animal and clinical studies, as well as conclude the effectiveness and deficiencies of existing stress management strategies.

Contribution of adrenergic mechanisms for the stress-induced breast cancer carcinogenesis

Breast cancer is the most common and deadliest type of cancer in women. Stress exposure has been associated with carcinogenesis and the stress released neurotransmitters, noradrenaline and adrenaline, and their cognate receptors, can participate in the carcinogenesis process, either by regulating tumor microenvironment or by promoting systemic changes. This work intends to provide an overview of the research done in this area and try to unravel the role of adrenergic ligands in the context of breast carcinogenesis. In the initiation phase, adrenergic signaling may favor neoplastic transformation of breast epithelial cells whereas, during cancer progression, may favor the metastatic potential of breast cancer cells. Additionally, adrenergic signaling can alter the function and activity of other cells present in the tumor microenvironment towards a protumor phenotype, namely macrophages, fibroblasts, and by altering adipocyte's function. Adrenergic signaling also promotes angiogenesis and lymphangiogenesis and, systemically, may induce the formation of preneoplastic niches, cancer-associated cachexia and alterations in the immune system which contribute for the loss of quality of life of breast cancer patients and their capacity to fight cancer. Most studies points to a major contribution of β₂ -adrenoceptor activated pathways on these effects. The current knowledge of the mechanistic pathways activated by β₂ -adrenoceptors in physiology and pathophysiology, the availability of selective drugs approved for clinical use and a deeper knowledge of the basic cellular and molecular pathways by which adrenergic stimulation may influence cancer initiation and progression, opens the possibility to use new therapeutic alternatives to improve efficacy of breast cancer treatments.

Stress-buffering effect of social support on immunity and infectious risk during chemotherapy for breast cancer

Objective

This study investigated the stress-buffering effect of social support on immune function and infectious risk in women with breast cancer, during and after chemotherapy.

Method

Data were collected from 50 women with breast cancer before and after their chemotherapy, as well as three months later. Stress was measured by daily hassles related to cancer and social support by marital status (MS) and perceived support from friends (Ps-fr). Blood was collected to measure innate immune markers (i.e., T cells, NK cells and neutrophils). Infections were evaluated using a semi-structured interview. Moderation, mediation and moderated mediation models were computed to test the hypotheses.

Results

Higher stress at baseline was found to significantly predict a higher occurrence of infections during chemotherapy, but not three months later. The relationship between stress and infections was not significantly explained by any of the immune markers. The interaction between stress and social support was tested using MS alone and combined with Ps-fr. A protective effect of social support on the deleterious effect of stress on infectious risk was found. Single patients reporting lower Ps-fr showed the strongest association between stress and infections, while the weakest association was found in patients in a committed relationship with a higher level of Ps-fr.

Conclusions

Women experiencing more stress before the beginning of chemotherapy would appear to be at a higher risk of developing infections during their treatment. Results of this study also suggest that this effect could be buffered by the presence of a romantic partner and by higher Ps-fr.

Optimism and telomere length among African American adults in the Jackson Heart Study

BACKGROUND

Optimism is linked with greater longevity in both White and African American populations. Optimism may enhance longevity by slowing cellular aging, for which leukocyte telomere shortening is a biomarker. However, limited studies have examined the association of optimism with leukocyte telomere length among African Americans.

METHODS

Data are from 723 men and 1244 women participating in the Jackson Heart Study (age = 21-93 years). We used multivariable linear regression models to conduct cross-sectional analyses examining whether higher optimism was associated with longer mean absolute leukocyte telomere length (assayed with Southern blot analysis). Models adjusted for sociodemographic characteristics, depressive symptomatology, health conditions, and health behavior-related factors. We also considered potential effect modification by key factors.

RESULTS

In the age-adjusted model, optimism, measured as a continuous variable, was not associated with leukocyte telomere length (β = 0.01, 95%CI: -0.02, 0.04). This association remained null in the fully-adjusted model (β = 0.02, 95%CI: -0.02, 0.05) and was also null when considering optimism as a binary measure (higher vs. lower optimism). We found no evidence of effect modification by sex, age, body mass index, income, or chronic conditions.

CONCLUSIONS

Optimism was not associated with leukocyte telomere length among African American adults. Future studies should investigate alternate biological and behavioral mechanisms that may explain the optimism-health association.

Neuroendocrine Regulation of Tumor-Associated Immune Cells

Mounting preclinical and clinical evidence continues to support a role for the neuroendocrine system in the modulation of tumor biology and progression. Several studies have shown data supporting a link between chronic stress and cancer progression. Dysregulation of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in promoting angiogenesis, tumor cell proliferation and survival, alteration of the immune response and exacerbating inflammatory networks in the tumor microenvironment. Here, we review how SNS and HPA dysregulation contributes to disturbances in immune cell populations, modifies cancer biology, and impacts immunotherapy response. We also highlight several interventions aimed at circumventing the adverse effects stress has on cancer patients.

Biobehavioral approaches to cancer progression and survival: Mechanisms and interventions

Over the last decade, there have been groundbreaking strides in our understanding of the multiple biological pathways by which psychosocial and behavioral factors can affect cancer progression. It is now clear that biobehavioral factors not only affect cellular immunity but both directly and indirectly modulate fundamental processes in cancer growth, including inflammation, angiogenesis, invasion, and metastasis. There is also an emerging understanding of how psychological and behavioral factors used in interventions can impact these physiological processes. This review outlines our current understanding of the physiological mechanisms by which psychological, social, and behavioral processes can affect cancer progression. The intervention literature is discussed, along with recommendations for future research to move the field of biobehavioral oncology forward.

Use of negative pressure wound therapy on malignant wounds - a case report and review of literature

The presence of malignancy is considered a contraindication to the use of negative pressure wound therapy (NPWT) because of concerns that it may promote tumourigenesis and expedite metastasis. This notion is extrapolated from studies evaluating NPWT in normal tissues. Despite the absence of direct evidence, the use of this technology in malignant wounds is widely considered a contraindication. We present the case of a patient with treatment-resistant metastatic colon cancer, who developed a chronic abdominal wound with positive margins. A staged reconstruction using NPWT was performed and wound closure allowed the patient to meet eligibility criteria and enrol in a clinical trial for treatment of his oncological disease. Skin closure remained intact until the patient expired 6 months after the wound closure. This case, as well as others in the literature, demonstrated that the use of NPWT should not be considered an absolute contraindication in malignancy. Individualised approaches taking into account the patient's clinical scenario, the available evidence, as well as the risks and benefits of this technology are recommended.

The Effect of Stress Management Model in Quality of Life in Breast Cancer Women

Background:

Breast cancer associates with severs severe distress and stress. Since Because of that, the stress management program can train necessary skills to cope with stress; therefore, the current study investigates the effectiveness of stress management on enhancement of quality of life.

Objectives:

The aim of the current study is to examine the effectiveness of stress management model in quality of life for breast cancer patients.

Patients and Methods:

This research is a quasi-experimental study with pre and post-tests. The 21 subjects were selected from cancer institute of Imam Khomeini in Tehran in 2014. The participants were allocated to two matched groups based on their pre-test scores. They were assigned randomly to the control and experimental groups. Stress management was conducted with the experimental group during 10 sessions. Then the questionnaire was administered at post-test. Statistical analysis was conducted by using the independent t-test and analysis of variance. The research instrument was the core quality of life questionnaire QLQ-C30.

Results:

The results of the independent t-test showed that there is a significant difference between the pretest and post-test scores in the experimental group (P < 0.05). Also, there is no significant difference between means of quality of life subscales and socio demographic of the patients such as; age, education and disease stage (P < 0.05).

Conclusions:

The results indicate that stress management can change the irrational and distortion thoughts. So, it enhances the quality of life in breast cancer patients.

Effect of Intervention Programs for Improving Maternal Adaptation in Korea: Systematic Review

PURPOSE

The purpose of this study was to review the literature on intervention for breast cancer survivors and their partners.

METHODS

The literature search was performed using MEDLINE, Pubmed, and Proquest to summarize the current state of knowledge regarding intervention for breast cancer survivors and their partners. Articles published between January 2000 and December 2011 were included.

RESULTS

A total of 14 studies were identified. Couple-base d intervention was more effective than intervention for survivors alone. Intervention to partners had also effects on their wives. Most studies were conducted in USA with Caucasian women. Sample size of intervention studies was small with most being pilot studies.

CONCLUSION

Providing couple-based intervention to breast cancer survivors could have positive impacts on physical, interpersonal, and social aspects in breast cancer survivors. Future studies with large sample and different ethnicity are needed to confirm the effects of couple-based interventions for breast cancer survivors.

Cancer-specific stress and mood disturbance: implications for symptom perception, quality of life, and immune response in women shortly after diagnosis of breast cancer

Purpose. To determine the levels of cancer-specific stress and mood disturbance in women shortly after diagnosis of breast cancer and to assess their associations with symptom perception, quality of life, and immune response. Design. Descriptive and correlational. Sample and Setting. One hundred women with newly diagnosed breast cancer were recruited from interdisciplinary breast clinics. Methods. Baseline data were collected using standardized questionnaires and established bioassay prior to the initiation of cancer adjuvant therapy. Blood samples were collected about the same time of day. Results. High cancer-specific stress was significantly correlated with high mood disturbance, which, in turn, was correlated with high symptom perception, poor quality of life, and an immune profile indicating high neutrophils and low lymphocytes. Conclusions. High cancer-specific stress and related mood disturbance show extensive negative relationships with multiple behavioral, clinical, and biological factors. Implications for Nursing. Routine screening for cancer-related stress and mood disturbance should be incorporated into nursing practice for all patients diagnosed with cancer. Given broad negative associations with other biobehavioral factors, early identification of patients at risk and provision and evaluation of stress and mood management programs may have a beneficial effect on subsequent health outcomes over time.

Associations between plasma cytokines and depressive mood in patients with breast cancer

OBJECTIVE

The few studies on the associations between cytokines and depressive mood in patients with cancer have produced conflicting results. This study investigated the associations between plasma cytokines and depressive mood in patients with breast cancer using a large panel of pro-inflammatory, anti-inflammatory, and immune-modulating cytokines.

METHODS

We recruited 273 hospitalized patients with breast cancer awaiting surgery. Preoperative plasma samples were obtained for cytokine analysis, including pro-inflammatory (interleukin [IL]-2, IL-12, interferon [IFN]-gamma, and tumor necrosis factor [TNF-alpha]), anti-inflammatory (IL-4, IL-5, IL-10, and IL-13), and immune-modulating (granulocyte/macrophage colony-stimulating factor [GM-CSF]) cytokines. Depressive mood was measured using the Montgomery-Asberg Depression Rating Scale (MADRS) at 2-5 days postoperatively, when the patients could cooperate. Covariates included various demographic and clinical characteristics. The association between the MADRS score and each cytokine level was estimated using linear regression models.

RESULTS

Cytokine levels were significantly inter-correlated. Depressive mood was associated with lower levels of pro-inflammatory (IL-2, IL-12, and TNF-alpha), anti-inflammatory (IL-5, IL-10, and IL-13), and immune-modulating (GM-CSF) cytokines independent of potential covariates such as living area or functional level.

CONCLUSIONS

The findings suggest that depressive mood is associated with a generally decreased inflammatory reaction or immune function in patients with breast cancer.

Biobehavioral influences on cancer progression

This review focuses on the contributions of stress-related behavioral factors to cancer growth and metastasis and the biobehavioral mechanisms underlying these relationships. Behavioral factors that are important in modulation of the stress response and the pivotal role of neuroendocrine regulation in the downstream alteration of physiologic pathways relevant to cancer control, including the cellular immune response, inflammation, and tumor angiogenesis, invasion, and cell signaling pathways are described. Consequences for cancer progression and metastasis, as well as quality of life, are delineated. Behavioral and pharmacologic interventions with the potential to alter these biobehavioral pathways for patients with cancer are discussed.

Biobehavioral factors and cancer progression: physiological pathways and mechanisms

Epidemiologic evidence increasingly has supported the role of biobehavioral risk factors such as social adversity, depression, and stress in cancer progression. This review describes in vitro, in vivo, and clinical studies demonstrating relationships between such processes and pathways involved in cancer progression. These include effects on the cellular immune response, angiogenesis, invasion, anoikis, and inflammation. Biobehavioral factors have been shown to contribute to the cross talk between tumor and host cells in the tumor microenvironment, and stress effects on host cells such as macrophages seem to be critical for many pathways involved in tumor progression. Some effects are bidirectional in that tumor-derived inflammation seems to affect central nervous system processes, giving rise to vegetative symptoms and contributing to dysregulation of the hypothalamic-pituitary-adrenal axis with downstream effects on inflammatory control. Findings to date are reviewed, and fruitful areas for future research are discussed.

Relationship between cytokine gene single nucleotide polymorphisms and symptom burden and quality of life in lung cancer survivors

BACKGROUND

Previous research has demonstrated that many lung cancer survivors report difficulties with symptom control and experience a poor quality of life (QOL). Although recent studies have suggested a relationship of single nucleotide polymorphisms (SNPs) in several cytokine genes with cancer susceptibility and prognosis, associations with symptom burden and QOL have not been examined. The current study was conducted to identify SNPs related to symptom burden and QOL outcomes in lung cancer survivors.

METHODS

All participants were enrolled in the Mayo Clinic Lung Cancer Cohort following diagnosis of lung cancer. A total of 1149 Caucasian lung cancer survivors completed questionnaires and had genetic samples available. The main outcome measures were symptom burden as measured by the Lung Cancer Symptom Scale and health-related QOL as measured by the Short-Form General Health Survey.

RESULTS

Twenty-one SNPs in cytokine genes were associated with symptom burden and QOL outcomes. Our results suggested both specificity and consistency of cytokine gene SNPs in predicting outcomes.

CONCLUSIONS

These results provide support for genetic predisposition to QOL and symptom burden and may aid in identification of lung cancer survivors at high risk for symptom management and QOL difficulties.

Circadian effects in cancer-relevant psychoneuroendocrine and immune pathways

Human biology is deeply integrated with the rotation of the Earth: healthy physiology is synchronized with circadian cycles, while unhealthy states are often marked by poor circadian coordination. In certain cancers including breast cancer, striking circadian rhythm dysregulation extends to endocrine, immune, metabolic, and cellular function. Disruption resulting from biological and behavioral influences has been linked with higher incidence and faster tumor progression in humans and animals. The hypothalamic SCN coordinates circadian events at the tissue and cellular level, partly via glucocorticoids that regulate genes involved in tumor growth, cell proliferation, apoptosis, immune cell trafficking, and cytotoxicity. We present a revision of our previously published model of circadian effects in cancer (Sephton and Spiegel, 2003) based on evaluation of new data from divergent lines of investigation. Human clinical studies show circadian endocrine disruption may be accompanied by suppressed functional cellular immunity and overactive inflammatory responses that could promote tumor growth, angiogenesis, and metastasis. Animal data provide strong evidence of clock gene regulation of tumor cell growth. Tissue culture research demonstrates that biologically or behaviorally mediated down-regulation of clock gene expression can accelerate tumor growth. An integrated view suggests mechanisms by which circadian effects on tumor growth may be mediated. These include psychoneuroendocrine and psychoneuroimmune pathways, the relevance of which we highlight in the context of breast cancer. Taken together, data from clinical, systemic, cellular, and molecular research suggest the circadian clock is a tumor suppressor under both biological and behavioral control.

Psychological factors in immunomodulation induced by cancer surgery: a review

The immune system's efficacy in detecting and destroying cancer cells varies considerably throughout the stages of cancer development and its role may be critical particularly during the surgical period. Although surgery causes tumor cells to shed into the blood, immune cells have the capacity to destroy these tumor cells. However, surgery also suppresses cytotoxic capacity. It is particularly during this surgical period that psychological factors can have a significant dampening or strengthening impact on surgery-related immunomodulation response, thus exerting an effect on survival. This review describes the immune changes during the peri-surgical period and the influences psychological factors have on immune function, including the immune effects caused by psychological interventions in cancer patients. We recommend that future studies exploring the role of psychological factors on immune function and survival focus more on their influence during the peri-surgical period.

A Study on the Relationship among Family Support, Stress and Quality of Life on according to the Phases of Illness in Breast Cancer Patients

PURPOSE

The purpose of this study was to investigate the relationship among family support, stress and quality of life according to the phases of illness in breast cancer patients.

METHODS

A descriptive correlational study was employed with 121 breast cancer patients. The data was collected by using self reported questionnaire. Self reported data was collected by using the Family support scale, Perceived Stress Scale (PSS), and EORTC QLQ-BR23. Phases of illness consisted 1st phase, 2nd phase, 3rd phase.

RESULTS

The score of family supporting, stress and quality of life showed a statically differences according to the phase of illness. Family supporting and stress had negative relation in the first, second and third phase. Family supporting and quality of life in function area had positive relation in the first, second phase. There was no relation between family supporting and quality of life in symptom area. Stress, quality of life in symptom area and quality of life in function area had correlation in the first, third phase.

CONCLUSION

This study suggest that the new nursing implementation should be considered according to the phase of illness in order to improve the family supporting and quality of life and reduce the stress in breast cancer patients through this study results.

Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology?

BACKGROUND

: It long has been recognized that married patients have improved cancer survival when compared with unmarried patients. This has been postulated as being due to increased support, potentially leading to better compliance with therapy. Conversely, some data exist pointing to a relationship between marital discord and decreased immunity. We examined whether unmarried patients have a different prognosis by whether they are 1) never married, 2) divorced, 3) widowed, or 4) separated at time of diagnosis.

METHODS

: The public access data of the Surveillance, Epidemiology and End Results (SEER) registry were queried for cancer survival across all 17 registries between 1973 and 2004. SEER last updated data in April 2007. Records of 3.79 million patients were included in the analysis. We specifically analyzed 5-year and 10-year relative survival (RS; 5yRS, 10yRS), defined as observed survival divided by observed survival of an age-matched, race-matched, and gender-matched population without disease, for all cancer patients by marital status, with specific subset analyses as indicated.

RESULTS

: Among unmarried patients, those separated at time of diagnosis had the lowest survival, followed by widowed, divorced, and never married patients. 5-year and 10-year RS of separated patients was 72% and 64% than that of married patients, respectively. This relationship persists when data are analyzed by gender.

CONCLUSIONS

: Separated marital status is associated with a significant decrement in cancer survival, even in comparison with other unmarried groups. While other socioeconomic variables could contribute to this phenomenon, further research into the immunologic correlates of the acutely stressful condition of marital separation should be conducted. Cancer 2009. (c) 2009 American Cancer Society.

Optimism and physical health: a meta-analytic review

BACKGROUND

Prior research links optimism to physical health, but the strength of the association has not been systematically evaluated.

PURPOSE

The purpose of this study is to conduct a meta-analytic review to determine the strength of the association between optimism and physical health.

METHODS

The findings from 83 studies, with 108 effect sizes (ESs), were included in the analyses, using random-effects models.

RESULTS

Overall, the mean ES characterizing the relationship between optimism and physical health outcomes was 0.17, p < .001. ESs were larger for studies using subjective (versus objective) measures of physical health. Subsidiary analyses were also conducted grouping studies into those that focused solely on mortality, survival, cardiovascular outcomes, physiological markers (including immune function), immune function only, cancer outcomes, outcomes related to pregnancy, physical symptoms, or pain. In each case, optimism was a significant predictor of health outcomes or markers, all p < .001.

CONCLUSIONS

Optimism is a significant predictor of positive physical health outcomes.

Dispositional optimism and stress-induced changes in immunity and negative mood

Evidence suggests that optimism may be protective for health during times of heightened stress, yet the mechanisms involved remain unclear. In a double-blind placebo-controlled study, we recently showed that acute psychological stress and an immune stimulus (Typhim-Vi typhoid vaccine) synergistically increased serum levels of interleukin-6 (IL-6) and negative mood in 59 healthy men. Here we carried out further analysis of this sample to investigate the relationship between dispositional optimism and stress-induced changes in immunity and mood. Volunteers were randomly assigned to one of four experimental conditions in which they received either typhoid vaccine or saline placebo, and then rested or completed two mental tasks. In the stress condition, optimism was inversely related to IL-6 responses, independent of age, BMI, trait CES-D depression and baseline IL-6. This relationship was present across both stress groups (combining vaccine and placebo) and was not present in the vaccine/stress group alone, suggesting that optimism protects against the inflammatory effects of stress rather than vaccine per se. Typhoid vaccine induced a significant increase in participants' circulating anti-Vi antibody levels. Stress had no effect on antibody responses overall. However, in the vaccine/stress group, there was a strong positive association between optimism and antibody responses, indicating that stress accentuated the antibody response to vaccine in optimists. Across the complete sample, more optimistic individuals had smaller increases in negative mood and less reduction in mental vigour. Together these findings suggest that optimism may promote health, by counteracting stress-induced increases in inflammation and boosting the adjuvant effects of acute stress.

Beta-endorphin neuronal cell transplant reduces corticotropin releasing hormone hyperresponse to lipopolysaccharide and eliminates natural killer cell functional deficiencies in fetal alcohol exposed rats

BACKGROUND

Natural killer (NK) cell dysfunction is associated with hyperresponse of corticotropin releasing hormone (CRH) to immune challenge and with a loss of beta-endorphin (BEP) neurons in fetal alcohol exposed animals. Recently, we established a method to differentiate neural stem cells into BEP neurons using cyclic adenosine monophosphate (cAMP)-elevating agents in cultures. Hence, we determined whether in vitro differentiated BEP neurons could be used for reversing the compromised stress response and immune function in fetal alcohol exposed rats.

METHODS

To determine the effect of BEP neuron transplants on NK cell function, we implanted in vitro differentiated BEP neurons into the paraventricular nucleus of pubertal and adult male rats exposed to ethanol or control in utero. The functionality of transplanted BEP neurons was determined by measuring proopiomelanocortin (POMC) gene expression in these cells and their effects on CRH gene expression under basal and after lipopolysaccaride (LPS) challenge. In addition, the effectiveness of BEP neurons in activating NK cell functions is determined by measuring NK cell cytolytic activity and interferon-gamma (IFN-gamma) production in the spleen and in the peripheral blood mononuclear cell (PBMC) following cell transplantation.

RESULTS

We showed here that when these in vitro differentiated BEP neurons were transplanted into the hypothalamus, they maintain biological functions by producing POMC and reducing the CRH neuronal response to the LPS challenge. BEP neuronal transplants significantly increased NK cell cytolytic activity in the spleen and in the PBMC and increased plasma levels of IFN-gamma in control and fetal alcohol exposed rats.

CONCLUSIONS

These data further establish the BEP neuronal regulatory role in the control of CRH and NK cell cytolytic function and identify a possible novel therapy to treat stress hyperresponse and immune deficiency in fetal alcohol exposed subjects.

Cyclic adenosine monophosphate differentiated beta-endorphin neurons promote immune function and prevent prostate cancer growth

Pituitary adenylate cyclase-activating peptide (PACAP), a cAMP-activating agent, is highly expressed in the hypothalamus during the period when many neuroendocrine cells become differentiated from the neural stem cells (NSCs). Activation of the cAMP system in rat hypothalamic NSCs differentiated these cells into beta-endorphin (BEP)-producing neurons in culture. When these in vitro differentiated neurons were transplanted into the paraventricular nucleus (PVN) of the hypothalamus of an adult rat, they integrated well with the surrounding cells and produced BEP and its precursor gene product, proopiomelanocortin (POMC). Animals with BEP cell transplants demonstrated remarkable protection against carcinogen induction of prostate cancer. Unlike carcinogen-treated animals with control cell transplants, rats with BEP cell transplants showed rare development of glandular hyperplasia, prostatic intraepithelial neoplasia (PIN), or well differentiated adenocarcinoma with invasion after N-methyl-N-nitrosourea (MNU) and testosterone treatments. Rats with the BEP neuron transplants showed increased natural killer (NK) cell cytolytic function in the spleens and peripheral blood mononuclear cells (PBMCs), elevated levels of antiinflammatory cytokine IFN-gamma, and decreased levels of inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) in plasma. These results identified a critical role for cAMP in the differentiation of BEP neurons and revealed a previously undescribed role of these neurons in combating the growth and progression of neoplastic conditions like prostate cancer, possibly by increasing the innate immune function and reducing the inflammatory milieu.

Predictors of cancer-related fatigue in women with breast cancer before, during, and after adjuvant therapy

The purpose of this longitudinal study was to examine potential predictors of cancer-related fatigue (CRF) before, during, and after adjuvant therapy in women with breast cancer. A convenience sample of 44 women postsurgery (M = 18) aged 38 to 77 years (M = 52) were recruited from a Southern breast clinic. Based on Piper's Integrated Fatigue Model, the women (1) completed questionnaires assessing innate host factors (age, income, and education level), disease and treatment patterns (disease stage, surgery type, and adjuvant therapy), psychological patterns (perceived stress, mood disturbance, and optimism), social patterns (type and satisfaction with social support) and (2) provided a blood sample to examine regulation patterns (morning cortisol levels, interleukin-1 beta, tumor necrosis factor alpha, and natural killer cell activity) before adjuvant therapy. The Piper Fatigue Scale-Revised was completed at all 3 time points. Mood disturbance was the most significant predictor of CRF at all time points. Interleukin-1 beta predicted CRF levels before adjuvant therapy and morning cortisol before adjuvant therapy predicted CRF during and after adjuvant therapy. These findings suggest that interventions to reduce mood disturbances might be effective in decreasing CRF. Further research regarding the physiological mechanisms underlying the relationships between CRF, mood disturbance, interleukin-1 beta, and cortisol is needed.

Psychobiologische Mechanismen sozialer Unterstützung

Zusammenfassung. Epidemiologische Studien können eindrucksvoll nachweisen, dass Personen, die in stabile soziale Netzwerke eingebunden sind, zufriedener, gesünder und auch länger leben als sozial isolierte Personen. Einerseits wird vermutet, dass dieser gesundheitsfördernde Effekt sozialer Unterstützung durch Verhaltensänderungen vermittelt wird, welche auf nahestehende Personen zurückführbar sind. Auf der anderen Seite wird ein direkter protektiver Effekt sozialer Unterstützung auf die körperliche Stressreaktivität angenommen, der unterschiedliche salutogenetische Wirkungen haben könnte. Die möglichen vermittelnden biologischen Mechanismen dieses Effekts werden zunehmend in Labor- und Feldstudien untersucht. In diesem Artikel geben wir einen Überblick über die Ergebnisse psychobiologischer Untersuchungen zu den Einflüssen sozialer Unterstützung auf der Ebene des Herz-Kreislauf-Systems, des endokrinen Systems und des Immunsystems. Abschließend gehen wir auf erste Studien ein, in denen die zentralnervösen Mechanismen sozialer Unterstützung experimentell untersucht wurden, und fassen die Ergebnisse in einem Modell zusammen.