研究表明，慢性壓力會影響放射治療的效果

研究表明，慢性壓力會影響放射治療的效果

Radiation is one of the oldest and most common therapies for cancer, and typically is delivered locally, or to specific targeted sites in the body. While it has long been thought that locally-delivered radiation therapy typically does not help to shrink tumors outside the field of irradiation, new preclinical research from a team at Roswell Park Comprehensive Cancer Center suggests a strategy for significantly increasing both the local and distant, or "abscopal," effects of radiation. Results of the study, which was led by Elizabeth Repasky, PhD, have been newly published in Nature Communications.

放射療法是最古老、最常見的癌癥治療方法之一，通常是局部地進(jìn)行治療，或者是對身體特定的靶點(diǎn)進(jìn)行治療。 盡管長期以來人們一直認(rèn)為，局部放射治療通常無助于縮小放射治療領(lǐng)域之外的腫瘤，但羅斯韋爾帕克綜合癌癥中心(Roswell Park Comprehensive Cancer Center)的一個團(tuán)隊(duì)的新的臨床前研究提出了一種策略，可以顯著增加局部和遠(yuǎn)處的放射效應(yīng)。 這項(xiàng)由Elizabeth Repasky博士領(lǐng)導(dǎo)的研究結(jié)果最近發(fā)表在《自然通訊》上。

"People often say, 'Stress is a part of life.' And while that's true, because there is frequently more stress that occurs in cancer patients because of their cancer diagnosis, we need to work to mitigate those enduring, longer-term stressors, because our work shows that it can inhibit the ongoing immune responses to cancer and an individual's response to therapy," adds Minhui Chen, PhD, a senior postdoctoral researcher in Dr. Repasky's lab, and first author on the study.

“人們常說，‘壓力是生活的一部分。’ 盡管這是事實(shí)，因?yàn)榘┌Y患者經(jīng)常因?yàn)榘┌Y診斷而承受更多的壓力，我們需要努力減輕這些持久的、長期的壓力，因?yàn)槲覀兊墓ぷ鞅砻?，它可以抑制對癌癥的持續(xù)免疫反應(yīng)和個人對治療的反應(yīng)。” Repasky 博士實(shí)驗(yàn)室的高級博士后醫(yī)學(xué)博士、該研究的第一作者 Minhui Chen 博士補(bǔ)充說。

The effects the team observed in their preclinical study hinge upon the body's "fight or flight" response to stresses through the network of nerves and organs known as the adrenergic nervous system.

研究小組在臨床前研究中觀察到，人體對壓力的“戰(zhàn)斗或逃跑”反應(yīng)，通過神經(jīng)和器官網(wǎng)絡(luò)即腎上腺素能神經(jīng)系統(tǒng)產(chǎn)生影響。

The team reports that when adrenergic stress was lessened, triggering lower levels of the neurotransmitters adrenaline and norepinephrine, tumor control in both irradiated and non-irradiated sites improved. This enhancement of the effects of radiation therapy also occurred when signaling through the β2-adrenergic receptor was reduced, suggesting that blockade of β2 adrenergic signaling could be a safe and feasible option for patients receiving radiation. Based on earlier preclinical research, Dr. Repasky and colleagues are investigating in clinical studies whether the efficacy of chemotherapy and immunotherapy can be improved by giving patients beta blockers, such propranolol -; a common blood pressure medication.

研究小組報告說，當(dāng)腎上腺素能應(yīng)激減輕，引發(fā)較低水平的神經(jīng)遞質(zhì)腎上腺素和去甲腎上腺素時，輻射和非輻射部位的腫瘤控制都得到改善。 當(dāng)通過2腎上腺素能受體發(fā)出的信號減少時，放射治療效果也增強(qiáng)了，這表明阻斷2腎上腺素能信號對于接受放射治療的患者來說是一個安全可行的選擇。 基于早期的臨床前研究，Repasky 博士和他的同事們正在進(jìn)行臨床研究，探討是否可以通過給患者服用 β 受體阻滯劑，如普萘洛爾，來提高化療和免疫療法的療效。

"Researchers have suspected a relationship between stress and cancer treatment outcomes for some time, but many questions remain," notes co-author Anurag Singh, MD, Director of Radiation Research and Professor of Oncology in the Department of Radiation Medicine at Roswell Park. "This research has uncovered a major molecular and immunological pathway that appears to underlie the association between how much stress an individual is experiencing and how they respond to cancer therapy. Our results suggest that by blocking the β2 adrenergic receptor, you may not only make radiation and chemotherapy work better, you give a boost to the immune system -; and may even be able to reduce metastasis, or spread of a tumor to a different part of the body."

“一段時間以來，研究人員一直懷疑壓力和癌癥治療結(jié)果之間的關(guān)系，但許多問題仍然存在，”Roswell Park 放射醫(yī)學(xué)部放射研究主任和腫瘤學(xué)教授、該研究合著者 Anurag Singh 表示， “這項(xiàng)研究揭示了一個主要的分子和免疫途徑，它似乎是個體所經(jīng)歷的壓力程度和他們對癌癥治療的反應(yīng)之間關(guān)系的基礎(chǔ)。 我們的研究結(jié)果表明，通過阻斷腎上腺素能受體，你不僅可以使放療和化療更好地發(fā)揮作用，還可以增強(qiáng)免疫系統(tǒng)，甚至可以減少腫瘤的轉(zhuǎn)移或擴(kuò)散到身體的其他部位。”

New clinical trials are underway or in development at Roswell Park to confirm and expand on these findings in patients and investigate which interventions are most effective at mitigating the effects of stress.

Roswell Park 正在進(jìn)行或開展新的臨床試驗(yàn)，以確認(rèn)和擴(kuò)展這些在患者身上的發(fā)現(xiàn)，并調(diào)查哪些干預(yù)措施最有效地減輕壓力的影響。