MBSR, Stress Arousal and Immune Response in Early HIV

MBSR、早期 HIV 中的压力唤醒和免疫反应

• 批准号: 6952267
• 负责人: Susan Folkman
• 金额: $ 119.83万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6952267
• 关键词: HIV infections; alternative medicine; clinical research; meditation; neuroimmunomodulation; pathologic process; psychoneuroimmunology; psychophysiology; stress; stress management

This application for a Center for Excellence in Research on Complementary and Alternative Medicine (CERC) at the Osher Center for Integrative Medicine at the University of California - San Francisco brings together a strong multidisciplinary team of scientists to rigorously study the efficacy of a mind-body meditation-based intervention, Mindfulness Based Stress Reduction (MBSR), in people with early stage HIV disease (CD4+ T cells > 350/mu l) to slow disease progression and extend the period during which antiretroviral treatment (ART) is not indicated. Currently there are no prescribed treatments for this stage of HIV. Three closely integrated studies are planned: Project 1 is a randomized clinical trial to determine whether MBSR decreases the rate of decline of CD4+ T cells and lowers HIV RNA levels in HIV+ persons with early stage HIV disease who are not receiving ART, compared to a control group. Additional outcomes include quality of life and depression. Participants (N=330) will be followed for one year; 165 will be assigned to the MBSR group and 165 to the control group. Proiect 2 will determine the effects of MBSR on stress processes, including the appraisal of stress, negative and positive affect, and biological stress arousal, including basal anabolic (DHEA, testosterone) and catabolic (cortisol, cathecholamines) responses to the stress of daily life (Study A), and anabolic and catabolic responses and autonomic nervous system reactivity to a controlled laboratory stressor (Study B). In addition to providing findings about generic biological effects of MBSR on the stress process, Project 2 will provide information regarding neuroendocrine pathways through which MBSR might also affect immune functions that are studied in Project 3. Project 3 will test postulated immune pathways through which stress and MBSR affect HIV replication and immune functioning, including CCR5 and CXR4 density (co-receptors for HIV cell entry of CD4 T-cells), T-cell activation, levels of cytokines that are important in immune responses that may be influenced by stress, and NK and plasmacytoid dendritic cell numbers and function. Two cores will support the research projects. The Administrative Core provides scientific leadership including the Scientific Advisory Committee and the Executive Committee and. fiscal, personnel, and space administration. The Methods Core provides statistical support, data management services, and specimen banking for the CERC projects. The synergy and fertile environment provided by the CERC structure will lead to new and supplemental research on efficacy and mechanisms of actions of mind-body approaches to patient care.

该申请在加利福尼亚大学Osher综合医学中心互补和替代医学研究中心（CERC）的申请 - 旧金山召集了一个强大的多学科科学家团队基于冥想的干预措施，基于正念的压力减轻（MBSR），患有早期HIV疾病（CD4+ T细胞> 350/mu L）的患者减慢疾病进展并延长未指示抗逆转录病毒治疗（ART）的时期。目前尚无针对此艾滋病毒阶段的规定治疗方法。计划了三项密切综合的研究：项目1是一项随机临床试验，旨在确定MBSR是否降低了CD4+ T细胞的下降速度并降低HIV+患者的HIV RNA水平 与对照组相比，患有未接受ART的早期艾滋病毒疾病。其他结果包括生活质量和抑郁症。参与者（n = 330）将遵循一年； 165将分配给MBSR组，165分配给对照组。 PROIECT 2将确定MBSR对压力过程的影响，包括对压力，负面和积极影响的评估以及生物胁迫唤醒，包括基础合成代谢（DHEA，睾丸激素）和分解代谢（皮质蛋白酶，降解乙醇）对日常生活应力的反应（研究A）以及合成代谢和分解代谢的反应以及对受控实验室压力源的自主神经系统反应性（研究B）。除了提供有关MBSR对压力过程的通用生物学作用的发现，项目2还将提供有关神经内分泌途径的信息 项目3。项目3将测试应力和MBSR的假定免疫途径，其中应力和MBSR会影​​响HIV复制和免疫功能，包括CCR5和CXR4密度（用于CD4 T细胞的HIV细胞进入的共受体），T细胞激活，细胞因子的水平在可能受压力影响的免疫反应中很重要，NK和浆细胞类动物树突状细胞数量和功能。两个核心将支持研究项目。行政核心提供了科学领导，包括科学咨询委员会和执行委员会。财政，人员和太空管理。方法核心为CERC项目提供统计支持，数据管理服务和标本银行业务。 CERC结构提供的协同和肥沃的环境将导致新的和补充 研究心身治疗方法的功效和动作机制的研究。