Cited by 170Cancer, Stress, Anesthesia, and Immune ResponseStress Responses and CortisolTryptophan and brain disorders

Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer

Sephton, Sandra E., Dhabhar, Firdaus S., Keuroghlian, Alex S., Giese-Davis, Janine, McEwen, Bruce S., Ionan, Alexei C., Spiegel, David·2009·Brain, Behavior, and Immunity

Abstract

Cancer treatment is known to have significant immuno-suppressive/dysregulatory effects. Psychological distress and depression, which often accompany cancer diagnosis and treatment, can also suppress or dysregulate endocrine and immune function. Cell-mediated immunity (CMI) is critical for protection against a host of pathogens to which cancer patients may be particularly susceptible. CMI is also important for defense against some tumors. This study explored relationships among depressive symptoms, cortisol secretion, and CMI responses in 72 women with metastatic breast cancer. Depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Scale (CES-D). Saliva was sampled throughout the day over a 3-day period to obtain a physiologic index of diurnal cortisol concentrations and rhythmicity, which is associated with breast cancer survival time. CMI for specific antigens was measured following intradermal administration of seven commonly encountered antigens (tuberculin, tetanus, diphtheria, Streptococcus, Candida, Trichophyton, and Proteus). Analyses adjusting for relevant medical and treatment variables indicated that women reporting more depressive symptoms showed suppressed immunity as measured by lower average induration size. Women with higher mean diurnal cortisol concentrations also showed suppressed immunity as indicated by a decreased number of antigens to which positive reactions were measured. This study highlights the relationships among depression, stress, and immune function in the context of advanced breast cancer.

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Crossref · 10.1016/j.bbi.2009.07.007

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Authors
Sephton, S. E., Dhabhar, F. S., Keuroghlian, A. S., Giese-Davis, J., McEwen, B. S., Ionan, A. C., & Spiegel, D.
Affiliations
  • University of Louisville (US)
  • Stanford Medicine (US)
  • Rockefeller University (US)
  • Wayne State University (US)
Corresponding author
  • Sephton, Sandra E.
  • Dhabhar, Firdaus S.
Venue
Brain, Behavior, and Immunity
Publisher
Elsevier BV
Published
2009-11
Volume
23
Issue
8
Pages
1148-1155
ISSN
0889-1591 (ISSN-L)
OpenAlex
W1975040297
Cited by
170
References
122
Citations by year
2026: 4 · 2025: 8 · 2024: 11 · 2023: 10 · 2022: 13 · 2021: 10 · 2020: 10 · 2019: 8 · 2018: 8 · 2017: 9 · 2016: 11 · 2015: 8 · 2014: 13 · 2013: 10 · 2012: 15
FWCI
7.63
Type
journal article
Language
en
Open access
closed
Locations
  • Brain Behavior and Immunity (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • John D. and Catherine T. MacArthur Foundation
  • National Institute on Aging (P01AG018784)
  • National Institute of Mental Health
  • National Cancer Institute (2R001 1 MH/CA47226-06)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Keywords
depression, cortisol, cell-mediated immunity, metastatic breast cancer, immunosuppression, psychological distress, diurnal cortisol rhythm, stress and immunity, induration
MeSH terms
Breast Neoplasms, Circadian Rhythm, Depression, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Immunity, Cellular, Middle Aged, Neoplasm Metastasis, Pituitary-Adrenal System, Psychiatric Status Rating Scales, Saliva, Stress, Psychological, Linear Models, Patient Selection

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