MBSR, Stress Arousal and Immune Response in Early HIV

MBSR、早期 HIV 中的压力唤醒和免疫反应

基本信息

批准号：
7340364
负责人：
Susan Folkman
金额：
$ 4.07万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
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 2009-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7340364
关键词：
Advisory Committees Affect Anti-Retroviral Agents Arousal Autonomic nervous system Biological CCR5 gene CD4 Positive T Lymphocytes California Cell Count Cells Complementary and alternative medicine Control Groups Daily Dendritic Cells Disease Disease Progression Environment Generic Drugs HIV HIV Receptors Human Resources Hydrocortisone Immune Immune response Integrative Medicine Intervention Laboratories Lead Leadership Life Meditation Mental Depression Methods Mind-Body Intervention Neurosecretory Systems Outcome Participant Pathway interactions Patient Care Persons Process Quality of life RNA Randomized Clinical Trials Rate Research Research Project Grants San Francisco Scientist Services Specimen Staging Stress Structure Support of Research T-Cell Activation Testing Testosterone Universities base body-mind cytokine data management dehydroepiandrosterone density immune function mindfulness-based stress reduction multidisciplinary response stressor

项目摘要

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/pl) 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: Proiect 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.

补充和替代医学研究卓越中心的申请加州大学旧金山分校奥舍整合医学中心 (CERC) 带来了汇集强大的多学科科学家团队，严格研究身心功效针对早期艾滋病毒患者的基于冥想的干预，基于正念的减压（MBSR）疾病（CD4+ T 细胞 > 350/pl），以减缓疾病进展并延长疾病持续时间没有表明抗逆转录病毒治疗（ART）。目前尚无针对此阶段的规定治疗方法艾滋病病毒。计划进行三项紧密结合的研究：项目 1 是一项随机临床试验，旨在确定 MBSR 是否可以降低 HIV + 患者中 CD4+ T 细胞的下降速度并降低 HIV RNA 水平与对照组相比，患有早期艾滋病毒且未接受抗逆转录病毒治疗的患者。额外成果包括生活质量和抑郁症。参与者（N=330）将被跟踪一年； 165 将是分配给 MBSR 组，165 分配给对照组。项目 2 将确定 MBSR 对压力过程，包括压力、消极和积极情感以及生物压力的评估唤醒，包括基础合成代谢（DHEA、睾酮）和分解代谢（皮质醇、儿茶酚胺）反应日常生活压力（研究 A）、合成代谢和分解代谢反应以及自主神经系统对受控实验室压力源的反应（研究 B）。除了提供有关通用的发现之外 MBSR 对应激过程的生物效应，项目 2 将提供有关以下方面的信息 MBSR 还可能通过神经内分泌途径影响免疫功能，这些研究已在项目 3。项目 3 将测试压力和 MBSR 影响 HIV 的假定免疫途径复制和免疫功能，包括 CCR5 和 CXR4 密度（HIV 细胞进入的共同受体） CD4 T 细胞）、T 细胞激活、对免疫反应很重要的细胞因子水平受应激、NK 和浆细胞样树突细胞数量和功能的影响。两个核心将支持研究项目。行政核心提供科学领导，包括科学咨询委员会和执行委员会及。财政、人事和空间管理。方法 Core 为 CERC 项目提供统计支持、数据管理服务和样本库。 CERC 结构提供的协同作用和肥沃环境将带来新的补充研究身心方法对患者护理的功效和作用机制。