Health Studies
Tai Chi Reduces Insomnia In Breast Cancer Survivors
This study sought to determine whether Tai Chi might reduce systemic, cellular, and genomic markers of inflammation from baseline to postintervention within the context of a randomized, relative efficacy trial of Tai Chi versus cognitive behavioral therapy for insomnia (CBT-I); sleep outcomes are to be reported separately once the 1-year follow-up is complete. It is thought that Tai Chi targets stress pathways that activate inflammation, whereas CBT-I targets sleep behaviors. Hence, Tai Chi is hypothesized to result in greater reduction of markers of inflammation and inflammatory gene expression as compared with CBT-I in the immediate postintervention period in breast cancer survivors with insomnia, who by virtue of comorbid sleep disturbance are at risk for having increases in inflammation.
Abstract:
Objectives:
This study hypothesized that Tai Chi Chih (TCC) would reduce systemic, cellular, and genomic markers of inflammation as compared with cognitive behavioral therapy for insomnia (CBT-I).
Design:
In this randomized trial for the treatment of insomnia, 90 breast cancer survivors with insomnia were assigned to TCC or CBT-I for 2-hour sessions weekly for 3 months. At baseline and postintervention, blood samples were obtained for measurement of C-reactive protein and toll-like receptor-4-activated monocyte production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF), with a random subsample (n = 48) analyzed by genome-wide transcriptional profiling.
Results:
Levels of C-reactive protein did not change in the TCC and CBT-I groups. Levels of toll-like receptor-4-activated monocyte production of IL-6 and TNF combined showed an overall reduction in TCC versus CBT-I (P < .02), with similar effects for IL-6 (P = .07) and TNF (P < .05) alone. For genome-wide transcriptional profiling of circulating peripheral blood mononuclear cells, expression of genes encoding proinflammatory mediators showed an overall reduction in TCC versus CBT-I (P = .001). TELiS promoter-based bioinformatics analyses implicated a reduction of activity of the proinflammatory transcription factor, nuclear factor-κB, in structuring these differences.
Conclusion:
Among breast cancer survivors with insomnia, 3 months of TCC reduced cellular inflammatory responses, and reduced expression of genes encoding proinflammatory mediators. Given the link between inflammation and cancer, these findings provide an evidence-based molecular framework to understand the potential salutary effects of TCC on cancer survivorship.
LINK:
Irwin, Michael R, et al. “Tai Chi, Cellular Inflammation, and Transcriptome Dynamics in Breast Cancer Survivors with Insomnia: a Randomized Controlled Trial.” Journal of the National Cancer Institute. Monographs, Oxford University Press, Nov. 2014, www.ncbi.nlm.nih.gov/pubmed/25749595.
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