研究正念干预、抑郁、炎症和癌症生存率之间的相互关系

SCI

3 July 2022

Examining the interrelationships between mindfulness- based interventions, depression, inflammation, and cancer survival

 (CA Cancer J Clin, IF:508.702)

Marinovic Debra A,Hunter Rebecca L,Examining the interrelationships between mindfulness-based interventions, depression, inflammation, and cancer survival.[J] .CA Cancer J Clin, 2022, undefined: undefined.

Depression is highly prevalent in those diagnosed with cancer and is also associated with poorer prognostic outcomes. Mindfulness-based interventions are effective in reducing depressive symptoms and improving quality of life in patients with cancer. The objective of this review was to investigate whether mindfulness practices can improve survival and, if so, what mechanisms of action may contribute to these outcomes. Although no long-term studies have investigated this hypothesis, the current literature supports an inflammatory basis for depression, implicating proinflammatory cytokines and hypothalamic-pituitary-adrenal axis dysfunction as contributing factors. Markers of inflammation, such as interleukin-6, tumor necrosis factor-α, and cortisol, are all found at elevated concentrations in many depressed individuals. These exact mechanisms are associated with higher mortality in patients with cancer. Mindfulness has been studied for its effects on cytokine and cortisol levels, and there are promising data to support that the intervention can measurably decrease inflammation. Therefore, it is conceivable that mindfulness programs can affect survival in this population. There are limited data on the long-term effects of mindfulness on depression and inflammatory markers in patients with cancer, and there are potential barriers to the implementation of mindfulness-based interventions as part of a comprehensive treatment plan. Therefore, it is necessary to further explore these questions through longitudinal studies to establish a survival correlation.

抑郁症在被诊断为癌症的患者中非常普遍，并且与较差的预后结果有关。以正念为基础的干预措施在减少癌症患者的抑郁症状和提高生活质量方面是有效的。这篇综述的目的是调查正念练习是否可以提高存活率，如果可以，什么行动机制可能会导致这些结果。虽然没有对这一假设进行长期研究，但目前的文献支持抑郁症的炎症基础，提示促炎细胞因子和下丘脑-垂体-肾上腺轴功能障碍是相关因素。炎症标志物，如白细胞介素-6、肿瘤坏死因子-α和皮质醇，在许多抑郁症患者体内的浓度都较高。这些确切的机制与癌症患者较高的死亡率有关。正念对细胞因子和皮质醇水平的影响已经被研究过，有很有希望的数据支持这种干预可以显著减少炎症。因此，可以想象正念项目可以影响这一人群的生存。关于正念对癌症患者抑郁症和炎症标志物的长期影响的数据有限，将正念干预作为综合治疗计划的一部分实施还存在潜在的障碍。因此，有必要通过纵向研究进一步探讨这些问题，以建立生存相关性。

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