Psychosocial Factors and Cancer Progression: Psychoneuroimmunology (PNI) Mechanisms

Psychosocial factors have been found to play important roles in the development of various diseases, including cancer progression. Such associations are mediated via the biobehavioral pathways in various patient populations, including the hematopoietic stem cell transplant (HCT) patients (Knight et al., 2013). The exploration of these biopsychosocial pathways that connect psychosocial factors with clinical outcomes may ultimately result in better clinical outcomes for those patient groups that are psychologically and immunologically vulnerable.

For example, studies focusing on psychoneuroimmunology (PNI) and developmental neuroscience have identified the influences on the regulation of cancer progression by catecholamine hormones including norepinephrine and epinephrine, as well as their receptors, the β-adrenergic receptors (β-ARs) (Yang and Eubank, 2013). Specifically, psychological stress may have effects on different types of tumor progression from proliferation to angiogenesis, as well as metastasis. Such effects can be mediated by molecular factors such as the catecholamines norepinephrine and epinephrine. The β-adrenergic receptors (β-ARs) are also critical in these effects. The understanding of such mechanisms may be helpful for the development of β-blockers for the purpose of adjuvant cancer therapy.

For the hematopoietic stem cell transplant (HCT) patients, studies on the relationships among psychosocial, endocrine and immune factors have revealed pathways that may mediate the connections between psychosocial factors and disease progressions. These pathways involve catecholamines, glucocorticoids, and vascular endothelial growth factor (VEGF) (Knight  et al., 2013). Mechanisms of inflammation, immune reconstitution, as well as infectious susceptibility have also been found important. Based on these mechanisms, immunomodulating and psychosocial interventions may be applied as potential strategies.




Knight JM, Lyness JM, Sahler OJ, Liesveld JL, Moynihan JA. Psychosocial factors and hematopoietic stem cell transplantation: Potential biobehavioral pathways. Psychoneuroendocrinology. 2013 Jul 8. doi:pii: S0306-4530(13)00233-3. 10.1016/j.psyneuen.2013.06.016.


Yang EV, Eubank TD. The impact of adrenergic signaling in skin cancer progression: Possible repurposing of β-blockers for treatment of skin cancer. Cancer Biomark. 2013 Jan 1;13(3):155-60. doi: 10.3233/CBM-130325.

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