Relationship between psychoncology and psychoneuroendocrinoimmunology (PNEI): enhanced T-regulatory lymphocyte activity in cancer patients with self-punishement, evaluated by Rorschach test.
BACKGROUND
Psychological studies have documented the presence of a self-punishment profile in cancer patients. Recent immuno-oncological studies have shown that within the group of CD4(+) cells, which play a fundamental role in the generation of anticancer immunity, there is a subtype of cells that in contrast mediates the suppression of the anticancer immunity, the so-called T-regulatory cells (T-reg), which may be identified as CD4(+)CD25(+) cells.


METHODS
On this basis, we performed a psychoncological study to evaluate CD4(+)CD25(+) cell numbers in relation to the response to Rorschach's test in a group of 30 cancer patients suffering from the most frequent tumor histotypes.


RESULTS
Normal values obtained in our laboratory (95% confidence limits) of T-reg lymphocytes and CD4(+)/CD4(+)CD25(+) were <240/mm(3) and >4mm(3), respectively. The psychological profile of self-punishment was found in 18/30 patients (60%). The percentage of patients with abnormally high CD4(+)CD25(+) values observed in the group with self-punishment was significantly higher than that found in patients without self punishment (11/18 vs. 3/12 (25%), p<0.05). In the same way, the percentage of patients with abnormally low CD4(+)/CD4(+)CD25(+) ratios was significantly higher in the group with self-punishment (16/18 vs. 4/12, p<0.01). The mean numbers of T-reg lymphocytes observed in the group with self-punishment was significantly higher than that found in patients who had no self-punishment (314+/-39 vs. 173+/-27, p<0.05). In addition, the mean CD4(+)/ CD4(+)CD25(+) ratio was significantly lower in patients with self-punishment than in the other group (2.6+/-0.2 vs. 5.2+/-0.8, p<0.025). On the contrary, no significant difference was seen in the mean number of CD4(+) lymphocytes.


CONCLUSIONS
The study suggests that self-punishment may inhibit the generation of an effective anticancer immune response by stimulating the activation and proliferation of T-reg lymphocytes, which in turn stimulate tumor dissemination by suppressing anticancer immunity. The abnormally high number of T-reg lymphocytes in patients with self-punishment would suggest a specific immune alteration, as suggested by the evidence of a normal profile for other immune parameters, such as total CD4(+) lymphocytes.
Messina
Giuseppina
G
Psychological Service, Maggiore Policlinico Hospital, Milan, Italy. giusy.messina@libero.it
Lissoni
Paolo
P
Bartolacelli
Erio
E
Magotti
Luciano
L
Clerici
Massimo
M
Marchiori
Paolo
P
Colombo
Elisa
E
D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000276:immunology; D009369:Neoplasms / Q000276:immunology / Q000523:psychology; D011570:Psychiatry; D011598:Psychoneuroimmunology; D011678:Punishment / Q000523:psychology*; D012392:Rorschach Test; D020377:Self Efficacy; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D055815:Young Adult