title: A randomized controlled pilot study of inflammatory gene expression in response to a stress management intervention for stem cell transplant caregivers.
abstract: Few studies have addressed whether stress-associated physiological changes in caregivers are reversible by psychological interventions mitigating distress. We report on pro-inflammatory, sympathetic, and oxidative stress gene expression in response to stress management for caregivers of allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients. Following randomization by permuted block to either treatment as usual (TAU, n = 11) or a stress management intervention (PsychoEducation, Paced Respiration, and Relaxation, PEPRR, n = 13), twenty-four caregivers were selected at the conclusion of a larger trial of 149 caregivers. PEPRR was provided one-on-one beginning around transplant. Genome-wide transcriptional profiling was conducted on peripheral blood mononuclear cells collected prior to randomization and on completion of PEPRR 3 months post-transplant. Bioinformatics analysis of differentially expressed genes indicated reduced activity of transcription control pathways associated with inflammation (NF-κB), sympathetic nervous system (CREB), and oxidative stress (NRF2) in caregivers receiving PEPRR compared to TAU aligning with reductions in stress, depression, and anxiety. This suggests that PEPRR may alter transcriptomic effects reported for distressed individuals.
authors.affiliation: Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, 12700 E. 17th Ave., Mail Stop C-268-09, Aurora, CO, 80045, USA. mark.laudenslager@ucdenver.edu.
authors.forename: Mark L
authors.identifier: http://orcid.org/0000-0002-9815-3026
authors.initials: ML
authors.lastname: Laudenslager
authors.affiliation: Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, 12700 E. 17th Ave., Mail Stop C-268-09, Aurora, CO, 80045, USA.|Presbyterian St. Luke's Medical Center, Denver, CO, 80218, USA.
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Simoneau
authors.affiliation: Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, 12700 E. 17th Ave., Mail Stop C-268-09, Aurora, CO, 80045, USA.
authors.forename: Sam
authors.initials: S
authors.lastname: Philips
authors.affiliation: Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, 12700 E. 17th Ave., Mail Stop C-268-09, Aurora, CO, 80045, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Benitez
authors.affiliation: Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, 12700 E. 17th Ave., Mail Stop C-268-09, Aurora, CO, 80045, USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Natvig
authors.affiliation: Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Cole
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000193:education / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D005260:Female; D015870:Gene Expression / Q000235:genetics*; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012064:Relaxation Therapy / Q000193:education; D013315:Stress, Psychological / Q000150:complications / Q000235:genetics* / Q000523:psychology*
chemical_list: D018836:Inflammation Mediators
keywords: Allogeneic hematopoietic stem cell transplant; Caregiver; Inflammatory pathways; Peripheral blood lymphocytes; Social genomics; Stress