Massage Benefits in HIV+ Children: Mechanisms of Action

按摩对艾滋病毒儿童的益处：作用机制

基本信息

批准号：
7230862
负责人：
Gail Shor-Posner
金额：
$ 0.27万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-09-30 至 2007-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7230862
关键词：
AIDS therapy CD4 molecule CD8 molecule alternative medicine child (0-11)clinical research cortisol human subject human therapy evaluation immune response interleukin 2 interleukin 6 massage therapy patient oriented research pediatric AIDS stress tumor necrosis factor alpha virus load

项目摘要

DESCRIPTION (provided by applicant): Despite great efforts to control the spread of HIV infection, more than 3.2 million children are living with HIV/AIDS worldwide, and 5.6 million children have died from this devastating disease. In developing countries, such as the Dominican Republic, antiretroviral medications are not yet readily available to slow disease progression. Even with access to treatment there still is no cure, side effects can be severe, and adherence is difficult, especially when it may have to be life-long. Moreover, the completeness and degree to which immune recovery occurs with antiretroviral therapy, varies among individuals. Thus, immune restoration remains a foremost priority, and identifying treatment modalities that do not require additional medications while improving clinical symptoms are of critical importance. Preliminary findings from our R21 NCCAM grant, indicate that massage therapy has a significant impact on markers of disease progression (T lymphocyte numbers) in HIV+ Dominican children without access to antiretrovirals, and may have the potential to alter the course of HIV disease. In support of this concept, increased immune capacity has been demonstrated following massage therapy in HIV+ adolescents and adults. The two-fold intent of the proposed research is to extend our preliminary findings to evaluate the impact of massage therapy on immune recovery in a larger sample size (80 vs 27) and greater age range (2-12 yrs vs 2-8 yrs) of children with HIV, and to investigate a potential neuroimmune mechanism of massage action. To achieve these goals, we are proposing a clinical trial with 80 HIV+ Dominican children randomized to receive massage, twice weekly-for 12 weeks (n=40 Group 1) or no massage treatment (n=40 Group 2). Group 2 will subsequently receive the massage intervention, which may allow confirmation of the massage-induced immune response. Group 1 will be followed at 3 months post massage to evaluate durability of the effect. Data will be gathered to assess the impact of massage on immune recovery (CD4, CDS, PHA, IL-2), stress levels (cortisol) and proinflammatory cytokines (IL-6, TNF-alpha). Disease status, antiretroviral therapy, and viral burden, will be examined and their potential utility as covariates in the analyses considered. The long-term objective is to establish rigorous scientific evidence for a feasible CAM therapy that can contribute to reducing the burden of disease for those living with compromised immune systems.

描述（由申请人提供）：尽管为控制艾滋病毒感染的传播而做出了巨大努力，但超过320万儿童在全球患有艾滋病毒/艾滋病，还有560万儿童死于这种毁灭性疾病。在多米尼加共和国等发展中国家，抗逆转录病毒药物尚不容易缓慢疾病进展。即使获得治疗方法仍然无法治愈，副作用也可能很严重，并且依从性很困难，尤其是当它必须是终身的时候。此外，抗逆转录病毒疗法发生免疫恢复的完整性和程度在个体之间各不相同。因此，免疫恢复仍然是最重要的，并且确定不需要其他药物同时改善临床症状的治疗方式至关重要。我们的R21 NCCAM赠款的初步发现表明，按摩疗法对HIV+多米尼加儿童的疾病进展标记（T淋巴细胞数）具有重大影响，而无需使用抗逆转录病毒，并且可能有可能改变HIV疾病的病程。为了支持这一概念，在HIV+青少年和成年人的按摩治疗后，已经证明了免疫能力的增加。拟议的研究的两倍意图是扩展我们的初步发现，以评估按摩疗法对较大样本量（80 vs 27）和更高的年龄范围（2-12岁vs 2 - 8年）在HIV儿童中的影响，并研究潜在的Neuromune Massage动作机制。为了实现这些目标，我们提出了一个随机进行按摩的80个HIV+多米尼加儿童的临床试验，每周两次12周（n = 40组1）或没有按摩治疗（n = 40组2）。第2组将随后接受按摩干预，这可能允许确认按摩诱导的免疫反应。按摩后3个月将遵循第1组，以评估效果的持久性。将收集数据以评估按摩对免疫恢复（CD4，CDS，PHA，IL-2），应力水平（皮质醇）和促炎细胞因子（IL-6，TNF-Alpha）的影响。疾病状况，抗逆转录病毒疗法和病毒负担将进行检查，并在所考虑的分析中作为协变量作为协变量的潜在效用。长期目标是为可行的CAM治疗建立严格的科学证据，这可能有助于减轻患有受损免疫系统的人的疾病负担。