Cognitive-behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men

Antoni, Michael H.; Cruess, Stacy; Cruess, Dean G.; Kumar, Mahendra; Lutgendorf, Susan K.; Ironson, Gail; Dettmer, Elizabeth; Williams, J. B. W.; Klimas, Nancy G.; Fletcher, Mary A; Schneiderman, Neil

doi:10.1007/bf02895165

Cited by 125 publications

(70 citation statements)

References 52 publications

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“…Although it has been known that biobehavioral processes modulate the activity of many hormones by the central nervous system (50,51), and those processes in turn can module tumor cell biology (52,53), specific interventions targeting the pathways involved in neuroendocrine function may represent novel strategies for helping individuals fight the effects of stress on tumor progression.…”

Section: Discussionmentioning

confidence: 99%

Stress Effects on FosB- and Interleukin-8 (IL8)-driven Ovarian Cancer Growth and Metastasis

Shahzad

Arevalo

Armaiz-Pena

et al. 2010

Journal of Biological Chemistry

149

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A growing number of studies indicate that chronic stress can accelerate tumor growth due to sustained sympathetic nervous system activation. Our recent findings suggest that chronic stress is associated with increased IL8 levels. Here, we examined the molecular and biological significance of IL8 in stress-induced tumor growth. Norepinephrine (NE) treatment of ovarian cancer cells resulted in a 250 -300% increase in IL8 protein and 240 -320% increase in its mRNA levels. Epinephrine treatment resulted in similar increases. Moreover, NE treatment resulted in a 3.5-4-fold increase in IL8 promoter activity. These effects were blocked by propranolol. Promoter deletion analyses suggested that AP1 transcription factors might mediate catecholamine-stimulated up-regulation of IL8. siRNA inhibition studies identified FosB as the pivotal component responsible for IL8 regulation by NE. In vivo chronic stress resulted in increased tumor growth (by 221 and 235%; p < 0.01) in orthotopic xenograft models involving SKOV3ip1 and HeyA8 ovarian carcinoma cells. This enhanced tumor growth was completely blocked by IL8 or FosB gene silencing using 1,2-dioleoyl-snglycero-3-phosphatidylcholine nanoliposomes. IL8 and FosB silencing reduced microvessel density (based on CD31 staining) by 2.5-and 3.5-fold, respectively (p < 0.001). Our findings indicate that neurobehavioral stress leads to FosB-driven increases in IL8, which is associated with increased tumor growth and metastases. These findings may have implications for ovarian cancer management.

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Section: Discussionmentioning

confidence: 99%

Stress Effects on FosB- and Interleukin-8 (IL8)-driven Ovarian Cancer Growth and Metastasis

Shahzad

Arevalo

Armaiz-Pena

et al. 2010

Journal of Biological Chemistry

149

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“…The effect of CBSM on HSV-2 IgG titers was partially mediated by reductions in depressive symptoms as well as increases in social support (42,54), while CBSM effects on EBV IgG titers paralleled sustained increases in social support (55). CBSM also buffered against declines in cytotoxic-suppressor (CD8+) T-cells at 1-year follow-up, and this was mediated by greater reductions in NE during the intervention (50). Finally, men in CBSM displayed increases in transitional naïve T-cells through 1-year follow-up (56), an effect mediated by decreases in depressive symptoms and 24-hour cortisol during the intervention (54).…”

Section: Managing the Emerging Symptoms Of Hiv Infectionmentioning

confidence: 93%

“…The psychoneuroimmunologic framework underlying the RCTs of CBSM proposes that mood improvements are related to potentially immunomodulatory hormonal changes (12). This appeared to be the case with men in these CBSM groups showing decreases in 24-hour cortisol and norepinephrine (NE), reductions in the plasma cortisol/dehydroepiandrosterone-sulfate (DHEA-S) ratio, and increased plasma testosterone (49)(50)(51)(52)(53). Reductions in NE paralleled decreases in anxiety (49).…”

Section: Managing the Emerging Symptoms Of Hiv Infectionmentioning

confidence: 99%

Effects of Psychological Interventions on Neuroendocrine Hormone Regulation and Immune Status in HIV-Positive Persons: A Review of Randomized Controlled Trials

Carrico

Antoni

2008

Psychosomatic Medicine

Self Cite

131

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We reviewed randomized controlled trials (RCTs) that examined the effects of psychological interventions on HIV disease markers including neuroendocrine hormone regulation and immune status. Utilizing both PubMed and PsycINFO, we searched for RCTs published over the past 20 years . Of the 31 RCTs identified, 14 tested effects of psychological interventions on neuroendocrine regulation or immune status. Despite the fact that there are significant methodological limitations of RCTs that have been conducted to date, psychological interventions for HIV-positive persons have been shown to be efficacious in improving psychological adjustment compared with wait-list or treatment as usual control conditions. However, there is little support for differential efficacy of group-based interventions that have been tested to date, even in comparison with semistructured social support groups. Irrespective of the treatment modality, it seems that interventions that are successful in improving psychological adjustment are more likely to have salutary effects on neuroendocrine regulation and immune status. Psychological interventions represent a viable adjuvant treatment that can assist patients with improving psychological adjustment and potentially enhancing immune status. To inform the development of innovative treatments with potentially superior efficacy, deconstruction trials are necessary to examine the effects of distinct components of multimodal psychological interventions compared with nonspecific social support effects. Effectiveness trials of promising psychological interventions with more representative samples of HIV-positive persons are also needed to provide more definitive information on the clinical utility and potential cost-effectiveness of treatments that have been developed to date.

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“…To the extent that behavioral and central nervous system processes modulate the activity of multiple hormones [45][46][47][48] and those processes are linked to angiogenic parameters in human clinical studies 37,49 interventions targeting neuroendocrine function at the CNS level might also represent novel strategies for protecting cancer patients from the detrimental effects of stress biology on the progression of malignant disease. Such interventions may include behavioral interventions alone or in combination with pharmacological approaches.…”

Section: Clinical Opportunities and Challengesmentioning

confidence: 99%

The Neuroendocrine Impact of Chronic Stress on Cancer

Thaker¹,

Lutgendorf²,

Sood³

2007

Cell Cycle

129

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Behavioral processes have long been suspected to influence many health processes including effects on cancer. However, mechanisms underlying these observations are not fully understood. Recent work has demonstrated that chronic behavioral stress results in higher levels of tissue catecholamines, greater tumor burden, and a more invasive pattern of ovarian cancer growth in an orthotopic mouse model. These effects are mediated primarily through the b 2 adrenergic receptor (ADRB2) activation of the tumor cell cyclic AMP (cAMP)-protein kinase A (PKA) signaling pathway. Additionally, tumors in stressed animals have increased vascularization and enhanced expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) -2 and -9. In this review, we highlight the importance of the neuroendocrine stress response in tumor biology and discuss mechanisms by which the b-adrenergic receptors on ovarian cancer cells enhance angiogenesis and tumor growth.

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Cognitive-behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men

Cited by 125 publications

References 52 publications

Stress Effects on FosB- and Interleukin-8 (IL8)-driven Ovarian Cancer Growth and Metastasis

Stress Effects on FosB- and Interleukin-8 (IL8)-driven Ovarian Cancer Growth and Metastasis

Effects of Psychological Interventions on Neuroendocrine Hormone Regulation and Immune Status in HIV-Positive Persons: A Review of Randomized Controlled Trials

The Neuroendocrine Impact of Chronic Stress on Cancer

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