The DOI matches its Crossref record; 119 of the 122 references it cites were found in a registry or an index.
Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer
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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“alterations in T cell characteristics have been reported in patients with major depression (15–18)”
From Inflammatory T helper 17 cells promote depression-like behavior in mice (2013) · cites this paper as [15]
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The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267
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
Cytokines in cancer pathogenesis and cancer therapy
Dranoff, G. (2004) · Nature reviews. Cancer · doi:10.1038/nrc1252 · Cited by 1,660
Liyanage, U. K., Moore, T. T., Joo, H., Tanaka, Y., Herrmann, V. M., Doherty, G. M., Drebin, J. A., Strasberg, S. M., Eberlein, T. J., Goedegebuure, P. S., et al. (2002) · The Journal of Immunology · doi:10.4049/jimmunol.169.5.2756 · Cited by 1,466
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
Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma
Thaker, P. H., Han, L. Y., Kamat, A. A., Arevalo, J. M., Takahashi, R., Lu, C., Jennings, N. B., Armaiz-Pena, G., Bankson, J. A., Ravoori, M., et al. (2006) · Nature Medicine · doi:10.1038/nm1447 · Cited by 1,320
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
The cortisol awakening response (CAR): Facts and future directions
Fries, E., Dettenborn, L., & Kirschbaum, C. (2009) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2008.03.014 · Cited by 1,188
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Self-citationImmune system to brain signaling: Neuropsychopharmacological implications
Capuron, L., & Miller, A. H. (2011) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2011.01.014 · Cited by 1,195
Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.05.018 · Cited by 905
Impact of Stress on Cancer Metastasis
Moreno‐Smith, M., Lutgendorf, S. K., & Sood, A. K. (2010) · Future Oncology · doi:10.2217/fon.10.142 · Cited by 522
Giese-Davis, J., Collie, K., Rancourt, K. M. S., Neri, E., Kraemer, H. C., & Spiegel, D. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2010.28.4455 · Cited by 458
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Metadata
- 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
- 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
- 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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