Longitudinal Change in Telomere Length and the Chronic Stress Response in a Randomized Pilot Biobehavioral Clinical Study: Implications for Cancer Prevention
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Abstract
Shortened telomere length is associated with increased cancer incidence and mortality. Populations experiencing chronic stress have accelerated telomere shortening. In this exploratory study, we examined associations between longitudinal changes in patient reported outcomes (PRO) of psychologic distress and peripheral blood mononuclear cell (PBMC) telomere length to test the hypothesis that modulation of the chronic stress response would also modulate telomere dynamics. Archived PBMC specimens (N = 22) were analyzed from a completed and reported randomized, longitudinal trial that showed a psychosocial telephone counseling intervention improved quality of life (QOL) and modulated stress-associated biomarkers in cervical cancer survivors. PROs and biospecimens were collected at baseline and 4 months postenrollment. Telomere length of archived PBMCs was evaluated using the flow-FISH assay. Longitudinal changes in psychologic distress, measured by the Brief Symptom Inventory-18, were significantly associated with increased telomere length within the CD14(+) (monocyte) population (r = -0.46, P = 0.043); a similar trend was observed for the CD14(-) population. Longitudinal changes in telomere length of the CD14(-) subset, primarily T lymphocytes, were associated with longitudinal increases in the naive T-cell population (r = 0.49, P = 0.052). Alterations in the chronic stress response were associated with modulation of telomere length in PBMCs, with evidence for mobilization of "younger" cells from progenitor populations. These data provide preliminary support for the (i) capacity to modulate the chronic stress response and the associated accelerated telomere shortening, (ii) inclusion of telomere length in the biobehavioral paradigm, and (iii) potential link between the chronic stress response and biologic mechanisms responsible for genomic integrity and carcinogenesis.
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In women with breast cancer, telomerase activity increased by approximately 17% over 12 weeks in the BSRP group, compared to negligible changes in the control group.
“Furthermore, in women with breast cancer, telomerase activity—a key enzyme in maintaining telomere length—increased by approximately 17% over 12 weeks in the BSRP group, compared to negligible changes in the control group [75,76].”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [76]
Telomeres are highly sensitive to chronic stress.
“Telomeres, the protective caps at the ends of chromosomes, are highly sensitive to chronic stress.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [76]
BSRPs have shown promise in mitigating accelerated telomere shortening.
“BSRPs have shown promise in mitigating this effect.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [76]
A shortened telomere length is linked to increased cancer incidence and mortality, and populations under chronic stress exhibit accelerated telomere shortening.
“A shortened telomere length is linked to increased cancer incidence and mortality, and populations under chronic stress exhibit accelerated telomere shortening.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [76]
In one study, BSRPs were significantly associated with increased telomere length in CD14(+) monocytes, with similar trends observed in CD14(-) T lymphocytes.
“In one study, BSRPs were significantly associated with increased telomere length in CD14(+) monocytes, with similar trends observed in CD14(-) T lymphocytes.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [76]
Longitudinal increases in the naive T-cell population were noted in BSRP studies, suggesting a rejuvenating effect on immune cells.
“Longitudinal increases in the naive T-cell population were also noted, suggesting a rejuvenating effect on immune cells.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [76]
Biegler et al. (2012) found no significant overall change in LTL following four months of telephone-based psychological stress-reduction counseling in 22 women with cervical cancer, but changes in distress ratings over that time period were inversely correlated with changes in LTL.
“One additional small-scale study involving telephone-based psychological stress-reduction counseling in 22 women with cervical cancer (Biegler et al., 2012), found no significant overall change in LTL following four months of counseling, but did find that changes in distress ratings over that time period were inversely correlated with changes in LTL (Biegler et al., 2012).”
From Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging (2015) · cites this paper as Biegler et al., 2012
Biegler et al. (2012) had no control group, and four months may be too short to discern significant changes in LTL.
“This study, however, had no control group, and four months may be too short to discern significant changes in LTL.”
From Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging (2015) · cites this paper as Biegler et al., 2012
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- Authors
- Biegler, K. A., Anderson, A. K. L., Wenzel, L. B., Osann, K., & Nelson, E. L.
- Affiliations
- University of California, Irvine (US)
- Corresponding author
- Nelson, Edward L.
- Venue
- Cancer Prevention Research
- Published
- 2012-10-01
- Volume
- 5
- Issue
- 10
- Pages
- 1173-1182
- ISSN
- 1940-6207 (ISSN-L)
- 1940-6215
- PMC
- PMC4479406
- OpenAlex
- W2129577566
- Cited by
- 48
- References
- 56
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2022: 3 · 2021: 1 · 2020: 4 · 2019: 7 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 9 · 2013: 9 · 2012: 1
- FWCI
- 4.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Prevention Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- National Cancer Institute (R01CA118136, R21CA098794, R01CA11836, 5T32 CA09054-32, P30CA062203, T32CA009054)
- Topics
- Health Sciences › Medicine › Physiology › Telomeres, Telomerase, and Senescence
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- telomere length, chronic stress, psychological distress, peripheral blood mononuclear cells, cervical cancer survivors, CD14+ monocytes, naive T cells, telomere shortening, cancer prevention, genome stability, carcinogenesis, biobehavioral research
- MeSH terms
- Uterine Cervical Neoplasms, Female, Flow Cytometry, Humans, Leukocytes, Mononuclear, Longitudinal Studies, Middle Aged, Monocytes, Pilot Projects, Quality of Life, Stress, Psychological, T-Lymphocytes, Immunophenotyping, In Situ Hybridization, Fluorescence, Telomere Homeostasis
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