Cognitive-behavioral stress management reverses anxiety-related leukocyte transcriptional dynamics

Department of Psychology, University of Miami, Coral Gables, 5665 Ponce DeLeon Boulevard, Coral Gables, FL 33124-0751, USA.
Biological psychiatry (Impact Factor: 9.47). 11/2011; 71(4):366-72. DOI: 10.1016/j.biopsych.2011.10.007
Source: PubMed

ABSTRACT Chronic threat and anxiety are associated with pro-inflammatory transcriptional profiles in circulating leukocytes, but the causal direction of that relationship has not been established. This study tested whether a cognitive-behavioral stress management (CBSM) intervention targeting negative affect and cognition might counteract anxiety-related transcriptional alterations in people confronting a major medical threat.
One hundred ninety-nine women undergoing primary treatment of stage 0-III breast cancer were randomized to a 10-week CBSM protocol or an active control condition. Seventy-nine provided peripheral blood leukocyte samples for genome-wide transcriptional profiling and bioinformatic analyses at baseline, 6-month, and 12-month follow-ups.
Baseline negative affect was associated with >50% differential expression of 201 leukocyte transcripts, including upregulated expression of pro-inflammatory and metastasis-related genes. CBSM altered leukocyte expression of 91 genes by >50% at follow-up (group × time interaction), including downregulation of pro-inflammatory and metastasis-related genes and upregulation of type I interferon response genes. Promoter-based bioinformatic analyses implicated decreased activity of NF-κB/Rel and GATA family transcription factors and increased activity of interferon response factors and the glucocorticoid receptor as potential mediators of CBSM-induced transcriptional alterations.
In early-stage breast cancer patients, a 10-week CBSM intervention can reverse anxiety-related upregulation of pro-inflammatory gene expression in circulating leukocytes. These findings clarify the molecular signaling pathways by which behavioral interventions can influence physical health and alter peripheral inflammatory processes that may reciprocally affect brain affective and cognitive processes.

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Available from: Michael Antoni, Jul 22, 2015
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    • "Moreover, a pure psychosocial treatment of inflammatory diseases with behavioral disturbances (myalgic encephalomyelitis/chronic fatigue syndrome ) received a severe criticism regarding its effectiveness and even safety (Twisk and Maes, 2009; but see also White et al., 2011). Together with the results of other studies (Antoni et al., 2012; Bhasin et al., 2013; Kovács et al., 2008), our data suggest that psychosocial intervention is associated with altered gene expression in peripheral immune cells, with a special reference to ''hubs'' of pro-inflammatory pathways (e.g., NF-jb). "
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    • "ty - related affective and behavioral processes or an active control condition . Consistent with the other two studies just described , this intervention counteracted the effects of stress - related transcriptional skewing by reducing expression of proin - flammatory and metastasis - related genes and by increasing expres - sion of IFN - ␣ genes ( Antoni et al . , 2012 ) . Considered together , these studies suggest that psychotherapeu - tic and meditative interventions that are already in our clinical toolbox may be helpful for reducing inflammation . None of the studies just reviewed , though , sampled depressed individuals . As such , additional research is needed to examine whether these cognitive"
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    • "This is certainly not the case, though, and in the long run, the most impactful human social genomics studies may well be those that identify the types of positive experiences that influence gene expression. In one recent study, for example, a 10-week cognitive-behavior intervention designed to target anxietyrelated affective and behavioral processes counteracted the effects of stress-related CTRA transcriptional skewing by reducing expression of proinflammatory and metastasisrelated genes and by increasing expression of interferonrelated genes in early-stage breast cancer patients who were randomly assigned to receive the intervention (Antoni et al., 2012). Similar genome-regulating effects have been found for Kirtan Kriya meditation (Black et al., in press) and for a mindfulness-based stress reduction program (Creswell et al., 2012). "
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