Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial.

Author: Irwin MR1, Olmstead R2, Breen EC2, Witarama T2, Carrillo C2, Sadeghi N2, Arevalo JM2, Ma J2, Nicassio P2, Ganz PA2, Bower JE2, Cole S2.
Affiliation:
1Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB). mirwin1@ucla.edu. 2Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB).
Conference/Journal: J Natl Cancer Inst Monogr.
Date published: 2014 Nov
Other: Volume ID: 2014 , Issue ID: 50 , Pages: 295-301 , Special Notes: doi: 10.1093/jncimonographs/lgu028 , Word Count: 270


BACKGROUND:
Mind-body therapies such as Tai Chi are widely used by breast cancer survivors, yet effects on inflammation are not known. This study hypothesized that Tai Chi Chih (TCC) would reduce systemic, cellular, and genomic markers of inflammation as compared with cognitive behavioral therapy for insomnia (CBT-I).
METHODS:
In this randomized trial for the treatment of insomnia, 90 breast cancer survivors with insomnia were assigned to TCC or CBT-I for 2-hour sessions weekly for 3 months. At baseline and postintervention, blood samples were obtained for measurement of C-reactive protein and toll-like receptor-4-activated monocyte production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF), with a random subsample (n = 48) analyzed by genome-wide transcriptional profiling.
RESULTS:
Levels of C-reactive protein did not change in the TCC and CBT-I groups. Levels of toll-like receptor-4-activated monocyte production of IL-6 and TNF combined showed an overall reduction in TCC versus CBT-I (P < .02), with similar effects for IL-6 (P = .07) and TNF (P < .05) alone. For genome-wide transcriptional profiling of circulating peripheral blood mononuclear cells, expression of genes encoding proinflammatory mediators showed an overall reduction in TCC versus CBT-I (P = .001). TELiS promoter-based bioinformatics analyses implicated a reduction of activity of the proinflammatory transcription factor, nuclear factor-κB, in structuring these differences.
CONCLUSIONS:
Among breast cancer survivors with insomnia, 3 months of TCC reduced cellular inflammatory responses, and reduced expression of genes encoding proinflammatory mediators. Given the link between inflammation and cancer, these findings provide an evidence-based molecular framework to understand the potential salutary effects of TCC on cancer survivorship.
© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PMID: 25749595

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