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. 2019 Aug:28:44-50.
doi: 10.1016/j.cobeha.2019.01.009. Epub 2019 Feb 26.

The interplay among psychological distress, the immune system, and brain tumor patient outcomes

Sebastian Otto-Meyer  1 , Jan Lumibao  1 , Eugene Kim  1 , Erik Ladomersky  1 , Lijie Zhai  1 , Kristen L Lauing  1 , Denise M Scholtens  2 , Frank Penedo  3 , Christina Amidei  1 , Rimas V Lukas  4   5 , Derek A Wainwright  1
Affiliations

The interplay among psychological distress, the immune system, and brain tumor patient outcomes

Sebastian Otto-Meyer et al. Curr Opin Behav Sci. 2019 Aug.

Abstract

A malignant brain tumor diagnosis is often accompanied with intense feelings and can be associated with psychosocial conditions including depression, anxiety, and/or increased distress levels. Previous work has highlighted the impact of uncontrolled psychological distress among brain tumor patients. Given the negative impact of maladaptive psychosocial and biobehavioral factors on normal immune system functions, the question remains as to how psychological conditions potentially affect the brain tumor patient anti-tumor immune response. Since immunotherapy has yet to show efficacy at increasing malignant glioma patient survival in all randomized, phase III clinical trials to-date, this review provides new insights into the potential negative effects of chronic distress on brain tumor patient immune functions and outcomes.

Keywords: Psychosocial; biobehavioral; glioblastoma; glioma; immunosuppression.

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Conflict of interest statement

Conflict of interest None

Figures

Figure 1.
Figure 1.. Proposed interactions between inflammation, depression, and immune cell dysfunction in subjects with brain cancer.
Brain tumors and psychosocial stress independently contribute to brain inflammation, which provide favorable conditions for the development of depression. High distress levels lead to a cycle of increased sympathetic signaling and dysfunctional HPA signaling. Together, signaling due to the sympathetic and HPA axes decrease immune effector control of tumor cell proliferation, resulting in worse outcomes for patients. Breaking these cycles and addressing increased distress / depression in brain cancer patients may improve survival outcomes.
Figure 2.
Figure 2.. Psychological distress in patients with brain cancer.
The needs and actionable items of psychological distress are summarized for brain cancer patients. Addressing and acknowledging these challenges may help to improve the overall prognosis of brain cancer patients
See this image and copyright information in PMC

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