Stress Inflammation Mechanisms of Survivorship Disparities Experienced by Hispanic Women After Breast Cancer

西班牙裔女性乳腺癌后生存差异的应激炎症机制

• 批准号: 9296607
• 负责人: THADDEUS PACE
• 金额: $ 20.03万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-25 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9296607
• 关键词: Acculturation; Biology; Brain; Breast Cancer survivor; Cancer Survivor; Clinic Visits; Communities; Diagnosis; Distress; Emotional; Exhibits; Fatigue; Functional disorder; Goals; Health; Health Sciences; Hispanics; Immigration; Impairment; Individual; Inflammation; Inflammation Mediators; Inflammatory; Inflammatory Response; Interleukin-10; Interleukin-6; Intervention; Laboratories; Lead; Link; Measures; Mental Depression; Methodology; Moods; Not Hispanic or Latino; Nuclear; Outcome; Perception; Physical Function; Procedures; Psychological Stress; Quality of life; Race; Reporting; Rest; Risk; Severities; Signal Transduction; Social Functioning; Social status; Social support; Socioeconomic Factors; Stigmatization; Stress; Testing; Time; Treatment Factor; Trier Social Stress Test; Woman; Work; base; cancer therapy; contextual factors; depressive symptoms; experience; health disparity; health related quality of life; improved; inflammatory marker; innovation; insight; low socioeconomic status; malignant breast neoplasm; neurotransmitter metabolism; novel; response; screening; social; stressor; survivorship; theories

SUMMARY Multiple studies using different methodologies have found that compared to non-Hispanic whites (NHWs), Hispanic women who are survivors of breast cancer are more likely to report impairments in health-related quality of life (hr-QOL) attributable to emotional functioning (increased depression and distress), physical functioning (fatigue), and social functioning. This increased "survivorship burden" or the combination of different hr-QOL domains has been found to exist even when controlling for cancer treatment factors. Evidence suggests that socioeconomic factors, socio-cultural factors, and inflammation may be involved in the survivorship burden. With respect to the latter, the PI and others have shown that inflammation is associated with the severity of depression and fatigue in NHW breast cancer survivors. Stress-based theories of health suggest that in addition to socioeconomic factors, socio-cultural factors are also important for understanding the survivorship burden. These include acculturation and acculturation stress, social status, stigmatization, social support, and familism. Low acculturation has been associated with poor emotional functioning in Hispanic breast cancer survivors. Interestingly, acculturation stress has also been linked to increased inflammation in other racial groups, suggesting that stress related to socio-cultural factors may impact the biology of hr-QOL impairments in Hispanic breast cancer survivors. Connections between stress and inflammation involved with the survivorship burden have been studied using short-term psychological stress challenges in the laboratory. Specifically, exaggerated inflammation responsiveness to short-term laboratory stress has been found in individuals of low socioeconomic status, suggesting that stress in the laboratory may reveal unique aspects of the pathophysiology of hr-QOL impairments not otherwise apparent at rest. The PI and others have used similar procedures (the Trier Social Stress Test [TSST]), to reveal increased inflammation in individuals with depression. The overarching goal of this proposal is to determine if hr- QOL impairments experienced by Hispanic breast cancer survivors are associated with stress- associated inflammation in a manner that involves socio-cultural factors. Accordingly, the current proposal features two specific aims. First, the study will work to determine if inflammation in response to short- term psychological stress challenge in the laboratory with the TSST predicts hr-QOL disparities experienced by Hispanic compared to non-Hispanic white breast cancer survivors. And second, the study will explore the relationships among stress-related inflammation and socio-cultural factors to predict hr-QOL disparities experienced by Hispanic breast cancer survivors. Accomplishment of these aims will provide critical insight into the likely stress pathophysiological mechanisms of inflammation and socio-cultural factors involved in the survivorship burden experienced by Hispanic breast cancer survivors, and may eventually result in novel risk screening strategies and interventions for this important and underserved group.

概括 使用不同方法的多项研究发现，与非西班牙裔白人 (NHW) 相比， 乳腺癌幸存者的西班牙裔女性更有可能报告与健康相关的损害 生活质量 (hr-QOL) 可归因于情绪功能（抑郁和痛苦增加）、身体 功能（疲劳）和社会功能。这增加了“生存负担”或结合 即使在控制癌症治疗因素的情况下，也发现存在不同的 hr-QOL 域。证据 表明社会经济因素、社会文化因素和炎症可能与 生存负担。对于后者，PI 和其他人已经表明炎症与 NHW 乳腺癌幸存者抑郁和疲劳的严重程度。基于压力的健康理论 表明除了社会经济因素外，社会文化因素对于理解也很重要 生存负担。这些包括文化适应和文化适应压力、社会地位、污名化、 社会支持和家庭主义。文化程度低与情绪功能差有关 西班牙裔乳腺癌幸存者。有趣的是，文化适应压力也与增加 其他种族群体的炎症，表明与社会文化因素相关的压力可能会影响 西班牙裔乳腺癌幸存者 hr-QOL 损伤的生物学。压力与压力之间的联系 使用短期心理压力研究了与生存负担有关的炎症 实验室中的挑战。具体来说，对短期实验室的炎症反应过度 在社会经济地位较低的个体中发现了压力，这表明实验室中的压力 可能揭示 hr-QOL 损伤的病理生理学的独特方面，这些方面在其他方面并不明显 休息。 PI 和其他人使用了类似的程序（特里尔社会压力测试 [TSST]），以揭示增加的 抑郁症患者的炎症。该提案的总体目标是确定人力资源是否 西班牙裔乳腺癌幸存者的生活质量受损与压力有关 相关炎症涉及社会文化因素。据此，当前 该提案有两个具体目标。首先，该研究将致力于确定炎症是否是对短期反应的反应。 在实验室中使用 TSST 进行术语心理压力挑战可以预测以下人群所经历的 hr-QOL 差异： 西班牙裔与非西班牙裔白人乳腺癌幸存者的比较。其次，该研究将探讨 压力相关炎症和社会文化因素之间的关系来预测 hr-QOL 差异 西班牙裔乳腺癌幸存者经历过。这些目标的实现将为我们提供重要的见解 炎症可能的应激病理生理机制和参与炎症的社会文化因素 西班牙裔乳腺癌幸存者经历的生存负担，最终可能导致新的风险 针对这一重要且服务不足的群体的筛查策略和干预措施。