Abstract 1833: Longitudinal associations between telomere length, chronic stress, and immune stance in cervical cancer survivors
Authors: Biegler Kelly A. , Wenzel Lari , Osann Kathy , Hsieh Susie , Nelson Edward 
Published: June 2012

Abstract
Introduction: There is a growing recognition of a potential role of chronic psychological stress in increasing the rate of cancer development and growth; however, potential mechanisms remain poorly understood and under active investigation. Recently, accelerated telomere shortening has been observed in cross sectional studies of non-cancer populations experiencing chronic stress suggesting a potential link between chronic stress and genomic integrity thus, raising the possibility that modulation of stress might affect telomere dynamics. We examined archived peripheral blood mononuclear cell (PBMC) samples collected in a longitudinal randomized study evaluating a psychosocial telephone counseling (PTC) intervention to improve cervical cancer patient coping and hence stress, as measured by improvement in quality of life (QOL), and stress-associated biomarkers (Clin Cancer Res 14(7): 2111-18). In this pilot study, we examined the longitudinal associations between telomere length, QOL, and immunologic stance in this cohort obtaining data in support of the above hypothesis. Methods: Archived PBMC specimens were analyzed from a completed randomized trial that demonstrated PTC associated improvement in QOL and an association between improved QOL and a shift to a more prominent Th1 immunologic stance. Briefly, QOL data (FACT-Cx and BSI) and biospecimens were collected at baseline and four months after enrollment (N = 31). Telomere length of archived PBMCs, T cells (including CD4 and CD8 subsets), B cells (CD19) and monocytes (CD14) were examined using the Flow-FISH assay. Results: Longitudinal changes in the Physical Well-Being subscale of the FACT-Cx were significantly associated with increased telomere length within the total PBMC population (r=0.799, p=0.031); the FACT-CX score showed a borderline association, likely due to the fact no other FACT subscales were associated with longitudinal changes in telomere length. Improved BSI scores showed a similar, although non-significant trend. The observed shift toward a Th1 immune stance in subjects with improved QOL were correlated with increased telomere length in CD4 (r=0.810; p=0.027) and CD8 (r=0.705; p=0.075) cellular subsets; however, no significant associations were observed between a more pronounced Th1 stance and CD14 or CD19 subsets. The finding of a longitudinal increase in telomere length in circulating PBMCs is not without precedent as this has been observed in several murine models Discussion: This is the first study of longitudinal changes in telomere length associated with immune profile and QOL as an index of chronic stress and has provocative implications for the association between the psychoneuroimmune axis, telomere dynamics, genomic stability, and cancer survivorship outcomes.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1833. doi:10.1158/1538-7445.AM2011-1833