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

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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

DOI 10.1016/j.bbi.2009.07.007

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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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Auphan, N., DiDonato, J. A., Rosette, C., Helmberg, A., & Karin, M. (1995) · Science · doi:10.1126/science.270.5234.286 · Cited by 2,390
Role of Transcriptional Activation of IκBα in Mediation of Immunosuppression by Glucocorticoids
Scheinman, R. I., Cogswell, P. C., Lofquist, A. K., & Baldwin, A. S. (1995) · Science · doi:10.1126/science.270.5234.283 · Cited by 1,676
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Depression and anxiety in women with early breast cancer: five year observational cohort study
Burgess, C. C., Cornelius, V. R., Love, S., Graham, J., Richards, M. A., & Ramirez, A. J. (2005) · BMJ · doi:10.1136/bmj.38343.670868.d3 · Cited by 1,336
Cancer despite immunosurveillance: immunoselection and immunosubversion
Zitvogel, L., Tesniere, A., & Kroemer, G. (2006) · Nature reviews. Immunology · doi:10.1038/nri1936 · Cited by 1,324
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Depression and cortisol responses to psychological stress: A meta-analysis
Burke, H. M., Davis, M. C., Otte, C., & Mohr, D. C. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.02.010 · Cited by 1,194
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dos Santos, J. C. (2020) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.17.2020.tde-20112018-110709
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Straub, R. H., & Schedlowski, M. (2022) · Springer Reference Medizin · doi:10.1007/978-3-662-46764-0_57-1
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Breitenbach, M., Kapferer, E., & Sedmak, C. (2023) · Springer eBooks · doi:10.1007/978-3-031-23697-6_4
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Saw, P. E., & Song, E. (2023) · Springer eBooks · doi:10.1007/978-981-99-1183-7_18
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Buiting, H. M., & Sonke, G. S. (2024) · The Yale Journal of Biology and Medicine · doi:10.59249/fqvx3500
Retracted
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Hall, J. M. F. (2013) · Digital Commons @ UNT Health Science Center
Psychoendokrinologie und Psychoimmunologie in der Onkologie
Antoni, M. H., & Lutgendorf, S. K. (2010) · Springer eBooks · doi:10.1007/978-3-642-16964-9_15

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.
ORCID: Sephton, Sandra E.
Dhabhar, Firdaus S.
Keuroghlian, Alex S.
McEwen, Bruce S.
Ionan, Alexei C.
Spiegel, David
Venue: Brain, Behavior, and Immunity
Publisher: Elsevier BV
Published: 2009-11
Volume: 23
Issue: 8
Pages: 1148-1155
ISSN: 0889-1591 (ISSN-L)
DOI: 10.1016/j.bbi.2009.07.007
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
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: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › 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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Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer

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