随机试验中简短形式的压力管理对行初级治疗的乳腺癌患者中与 RAGE 相关的 S100A8/A9 的影响。
The effects of a randomized trial of brief forms of stress management on RAGE-associated S100A8/A9 in patients with breast cancer undergoing primary treatment.
机构信息
Department of Psychology, University of Miami, Coral Gables, Florida.
Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
出版信息
Cancer. 2019 May 15;125(10):1717-1725. doi: 10.1002/cncr.31965. Epub 2019 Jan 11.
BACKGROUND
Women with breast cancer (BCa) experience heightened distress, which is related to greater inflammation and poorer outcomes. The s100 protein family facilitates the inflammatory response by regulating myeloid cell function through the binding of Toll-like receptor 4 and the receptor for advanced glycation end products (RAGE). The heterodimer s100A8/A9 RAGE ligand is associated with hastened tumor development and metastasis. Previously, a 10-week stress-management intervention using cognitive behavioral therapy (CBT) and relaxation training (RT) was associated with less leukocyte inflammatory gene expression in patients with BCa; however, its impact on s100A8/A9 was not examined. Because a 10-week intervention may be impractical during primary treatment for BCa, the authors developed briefer forms of CBT and RT and demonstrated their efficacy in reducing distress over 12 months of primary treatment. Here, the effects of these briefer interventions were tested effects on s100A8/A9 levels over the initial 12 months of BCa treatment.
METHODS
Postsurgical patients with BCa (stage 0-IIIB) were randomized to a 5-week, group-based condition: CBT, RT, or health education control (HE). At baseline and at 12 months, women provided sera from which s100A8/A9 levels were determined using any enzyme-linked immunosorbent assay.
RESULTS
Participants (mean age ± standard deviation, 54.81 ± 9.63 years) who were assigned to either CBT (n = 41) or RT (n = 38) had significant s100A8/A9 decreases over 12 months compared with those who were assigned to HE (n = 44; F = 4.500; P = .036) controlling for age, stage, time since surgery, and receipt of chemotherapy or radiation. Greater increases in stress-management skills from preintervention to postintervention predicted greater reductions in s100A8/A9 levels over 12 months (β = -0.379; t = -4.056; P < .001).
CONCLUSIONS
Brief, postsurgical, group-based stress management reduces RAGE-associated s100A8/A9 ligand levels during primary treatment for BCa.
背景
患有乳腺癌（BCa）的女性会经历更高程度的痛苦，这与更大的炎症和更差的结果有关。S100 蛋白家族通过结合 Toll 样受体 4 和晚期糖基化终产物受体（RAGE）调节髓样细胞功能，促进炎症反应。S100A8/A9-RAGE 配体异二聚体与肿瘤发展和转移的加速有关。先前，一项为期 10 周的使用认知行为疗法（CBT）和放松训练（RT）的应激管理干预与 BCa 患者白细胞炎症基因表达减少有关；然而，其对 S100A8/A9 的影响并未被检测到。由于在 BCa 的主要治疗期间，为期 10 周的干预可能不切实际，因此作者开发了更简短的 CBT 和 RT 形式，并证明了它们在 12 个月的主要治疗期间减轻痛苦的效果。在这里，测试了这些更简短的干预措施对 BCa 治疗最初 12 个月内 S100A8/A9 水平的影响。
方法
接受手术后的 BCa（0-IIIb 期）患者被随机分配到一个为期 5 周的小组条件：CBT、RT 或健康教育对照（HE）。在基线和 12 个月时，女性提供血清，使用任何酶联免疫吸附测定法测定 S100A8/A9 水平。
结果
与被分配到 HE（n=44）的女性相比，被分配到 CBT（n=41）或 RT（n=38）的参与者（平均年龄±标准差，54.81±9.63 岁）在 12 个月内 S100A8/A9 水平显著降低；F=4.500；P=.036），控制年龄、分期、手术时间、化疗或放疗的接受情况。从干预前到干预后的应激管理技能的更大增加预示着 12 个月内 S100A8/A9 水平的更大降低（β=-0.379；t=-4.056；P<.001）。
结论
简短的、术后、基于小组的应激管理在 BCa 的主要治疗期间降低了与 RAGE 相关的 S100A8/A9 配体水平。
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