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Grant Details

Grant Number: 5R01CA125069-06 Interpret this number
Primary Investigator: Fang, Carolyn
Organization: Fox Chase Cancer Center
Project Title: Effects of Mindfulness-Based Stress Reduction (MBSR) on Immune Response to HPV
Fiscal Year: 2012
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Abstract

DESCRIPTION (provided by applicant): Human papillomavirus (HPV) infection is a primary risk factor for cervical cancer. However, infection alone does not lead to cancer in all cases. Data suggest that immune factors play a central role in controlling cervical disease progression. Studies have shown that an impaired T-cell proliferative response to specific HPV16 peptides is associated with a failure to resolve HPV infection and persistent cervical disease. The relation between immune function and cervical disease is particularly relevant given the following set of observations: 1) Receipt of an abnormal Pap test result is a stressful event that can lead to increased distress and disruptions in major life areas; and 2) Psychological responses to stress are associated with immunologic changes. Over the past few years, we have been conducting preliminary studies of psychosocial and behavioral correlates of T-cell response to specific HPV16 peptides among women with cervical dysplasia. Our findings suggest that higher levels of stress are associated with an impaired T-cell response to HPV, even after controlling for key behavioral risk factors. However, any causal effects of psychosocial factors on HPV-specific immune response still remain to be demonstrated. Therefore, in a randomized trial, we plan to evaluate the biobehavioral effects of a well-established, standardized Mindfulness-Based Stress Reduction (MBSR) program in women with cervical dysplasia. MBSR is highly accessible across diverse socioeconomic and cultural groups and has demonstrated beneficial effects on psychosocial and emotional well-being in a variety of patient and healthy populations. In the proposed study, 300 women with cervical dysplasia will be randomly assigned to the MBSR program or an attention control condition. The primary aims of the study are to examine the effects of MBSR on psychosocial well-being (e.g., perceived stress, quality of life) and HPV-specific immune functioning (e.g., T-cell response to HPV16 E6, E7, and L1 peptides, intracellular cytokine expression in HPV-stimulated T cells) compared to the control condition at post-intervention and follow-up time points. It is hypothesized that MBSR participants will report lower levels of perceived stress, higher quality of life, and enhanced HPV-specific immune response (i.e. greater proliferative response to HPV16 and greater expression of Th1 cytokines) compared to control participants at post-intervention and subsequent follow-up time points. A secondary aim is to examine the extent to which changes in psychosocial well-being may mediate any effects of the intervention on HPV- specific immune response. RELEVANCE: The proposed project will be one of the first to examine whether psychosocial factors can directly influence the biological processes that are responsible for controlling cervical disease. Such findings would have clinical implications for the management of women at risk for cervical cancer.

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Publications

Enhanced psychosocial well-being following participation in a mindfulness-based stress reduction program is associated with increased natural killer cell activity.
Authors: Fang CY, Reibel DK, Longacre ML, Rosenzweig S, Campbell DE, Douglas SD
Source: J Altern Complement Med, 2010 May;16(5), p. 531-8.
PMID: 20455784
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Grant Numbers:
NCI NIH HHS - R01 CA125069-01A1 NCI NIH HHS - P30 CA006927-47 NCI NIH HHS - P30 CA000697
NCI NIH HHS - K22 CA107115-01 NCI NIH HHS - K22CA107115 NCI NIH HHS - R01CA125069

MeSH Terms:
Anxiety Humans Quality of Life
Aged Mental Health Pilot Projects
C-Reactive Protein Psychophysiology Killer Cells, Natural
Stress, Psychological Adult Health Surveys
Meditation Middle Aged Female
Male

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Behavioral correlates of HPV vaccine acceptability in the 2007 Health Information National Trends Survey (HINTS).
Authors: Fang CY, Coups EJ, Heckman CJ
Source: Cancer Epidemiol Biomarkers Prev, 2010 Feb;19(2), p. 319-26.
PMID: 20142234
Related Citations

Grant Numbers:
NCI NIH HHS - K07CA133100 NCI NIH HHS - K07 CA133100-02 NCI NIH HHS - K07 CA133100-04
NCI NIH HHS - K07CA108685 NCI NIH HHS - R01 CA125069-03 NCI NIH HHS - P30 CA006927-47
NCI NIH HHS - K07 CA108685-05 NCI NIH HHS - CA006927 NCI NIH HHS - R01CA125069

MeSH Terms:
Patient Acceptance of Health Care Humans Adult
Health Knowledge, Attitudes, Practice Health Behavior Papillomavirus Vaccines
Child Adolescent Female

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Perceived stress is associated with impaired T-cell response to HPV16 in women with cervical dysplasia.
Authors: Fang CY, Miller SM, Bovbjerg DH, Bergman C, Edelson MI, Rosenblum NG, Bove BA, Godwin AK, Campbell DE, Douglas SD
Source: Ann Behav Med, 2008 Feb;35(1), p. 87-96.
EPub date: 2008 Feb 13.
PMID: 18347908
Related Citations

Grant Numbers:
NCI NIH HHS - K22 CA107115-03 NCI NIH HHS - P30 CA006927-45 NIAID NIH HHS - P30 AI045008-049006
NCRR NIH HHS - M01 RR 00240-34 NIAID NIH HHS - P30 AI 45008-07 NCI NIH HHS - K22 CA 107115
NCI NIH HHS - R01 CA125069-01A1 NCI NIH HHS - CA 006927 NCI NIH HHS - R01 CA 125069
NCRR NIH HHS - M01 RR000240-350488

MeSH Terms:
Severity of Illness Index Reference Values Humans
Cervical Intraepithelial Neoplasia Cross-Sectional Studies Human papillomavirus 16
Adult Stress, Psychological Case-Control Studies
Middle Aged Papillomavirus Infections Uterine Cervical Dysplasia
Female T-Lymphocytes

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Last Updated: August 24, 2012
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