Cancer survivors' cardiorespiratory fitness often declines substantially during and following cancer treatment, and this pattern is alarming because inflammation is higher in sedentary than in active individuals. Indeed, when cardiorespiratory fitness is assessed objectively by maximal exercise testing, poorer physical fitness (VO2peak) is associated with higher inflammation. Chronic elevations in inflammation increase the risk for age- related diseases; the ability to limit initial inflammatory responses isan important homeostatic process. An immune challenge provides a useful paradigm for studying individual differences in inflammatory responses to infection or tissue injury. Accordingly, this project will use a typhoid vaccine as a peripheral immune stimulus to assess the magnitude and kinetics of a transient inflammatory response in breast cancer survivors. Inflammation-associated behavioral changes that have particular importance for breast cancer survivors will also be assessed--depressive symptoms, fatigue, pain, and cognitive problems. Our study addresses a novel question: does poorer cardiorespiratory fitness heighten the magnitude and duration of inflammatory responses to immune challenges, as well as magnifying maladaptive behavioral responses? Furthermore, biological and behavioral vulnerabilities intensify adverse responses to immune challenges. For example, both aging and depression enhance and prolong inflammatory responses to vaccines, and thus the ability of cardiorespiratory fitness to moderate age- and depression-related proinflammatory responses will also be assessed. This double-blind, randomized, crossover trial will evaluate inflammatory and behavioral responses to typhoid and placebo inoculations as a function of cardiorespiratory fitness, age, and depression in breast cancer survivors.
The aims of the project are (1) to evaluate the relationships between cardiorespiratory fitness and inflammatory and behavioral responses (negative mood, fatigue, pain, and cognitive problems) to typhoid vaccine; (2) to determine the effects of age and depressive symptoms on inflammatory and behavioral responses to typhoid vaccine and placebo; and (3) to assess the ability of cardiorespiratory fitness to moderate age- and depression-related responses to typhoid vaccine. These questions are important because inflammation, a robust and reliable predictor of all-cause mortality in older adults, is one of the key candidate mechanisms for age-related decrements in physical function and disability. Individuals frequently encounter immune challenges in daily life, and the ability to minimize inflammatory responsiveness influences the total burden that infectious challenges or tissue injury place on an individual. Larger, more frequent, or more persistent inflammatory changes have negative consequences for health. If better cardiorespiratory fitness dampens or limits inflammatory responsiveness, then this study could demonstrate a new and novel mechanism through which regular exercise produces its substantial health benefits.

Public Health Relevance

Heightened inflammation is associated with many diseases of aging. Inflammation is higher in sedentary than in active individuals, and cardiorespiratory fitness often declines substantially during and following cancer treatment. The data from this study would improve our understanding of how physical fitness influences inflammation, as well as adverse inflammation-associated behavioral changes including negative mood, fatigue, increased pain sensitivity, and cognitive deficits. This study will provide insight into the pathwas through which regular exercise produces its substantial health benefits.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA186251-03
Application #
9313843
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Green, Paige A
Project Start
2015-07-16
Project End
2020-06-30
Budget Start
2017-07-01
Budget End
2018-06-30
Support Year
3
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Ohio State University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
832127323
City
Columbus
State
OH
Country
United States
Zip Code
43210
Kiecolt-Glaser, Janice K; Wilson, Stephanie J; Madison, Annelise (2018) Marriage and Gut (Microbiome) Feelings: Tracing Novel Dyadic Pathways to Accelerated Aging. Psychosom Med :
Kiecolt-Glaser, Janice K; Wilson, Stephanie J (2017) Caregiver Vulnerability and Brain Structural Markers: Compounding Risk. Am J Geriatr Psychiatry 25:592-594
Kiecolt-Glaser, Janice K; Wilson, Stephanie J (2017) Lovesick: How Couples' Relationships Influence Health. Annu Rev Clin Psychol 13:421-443
Kiecolt-Glaser, Janice K; Wilson, Stephanie J (2016) Psychiatric Disorders, Morbidity, and Mortality: Tracing Mechanistic Pathways to Accelerated Aging. Psychosom Med 78:772-5
Belury, Martha A; Cole, Rachel M; Bailey, Brittney E et al. (2016) Erythrocyte linoleic acid, but not oleic acid, is associated with improvements in body composition in men and women. Mol Nutr Food Res 60:1206-12
Kiecolt-Glaser, Janice K; Derry, Heather M; Fagundes, Christopher P (2015) Inflammation: depression fans the flames and feasts on the heat. Am J Psychiatry 172:1075-91
Derry, Heather M; Padin, Avelina C; Kuo, Jennifer L et al. (2015) Sex Differences in Depression: Does Inflammation Play a Role? Curr Psychiatry Rep 17:78