M Rosie Shrout1, Annelise A Madison2, Megan E Renna3, Catherine M Alfano4, Stephen P Povoski5, Adele M Lipari5, Doreen M Agnese5, William E Carson5, William B Malarkey6, Michael T Bailey7, Janice K Kiecolt-Glaser8. 1. Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA; Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA. Electronic address: shrout@purdue.edu. 2. Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA. 3. School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA. 4. Northwell Health Cancer Institute, New York, NY, USA. 5. Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA. 6. Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA. 7. Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Pediatrics, The Ohio State College of Medicine, Columbus, OH, USA; Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Oral and Gastrointestinal Microbiology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. 8. Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA.
Abstract
BACKGROUND: Breast cancer survivors are prone to weakened gut barriers, allowing bacteria to migrate into the blood stream. Gut permeability fuels inflammation, which, among survivors, can elevate risk for comorbid disease development, cancer recurrence, and a poor quality of life; however, survivors' satisfying relationships can provide health benefits. This longitudinal study used a conceptual model addressing how intimate relationships is associated with health through changes in gut permeability and inflammation. METHOD: Breast cancer survivors (n = 139, stages 0-IIIC) completed a baseline visit before treatment and two follow-up visits 6 and 18 months after treatment ended. Women who had an abnormal breast cancer test followed by a benign diagnosis completed visits within a comparable timeframe (noncancer patient controls; n = 69). All women completed questionnaires assessing their relationship satisfaction and provided blood samples to assess two bacterial endotoxin biomarkers, lipopolysaccharide-binding protein (LBP) and soluble CD14 (sCD14), as well as C-reactive protein (CRP) and interleukin 6 (IL-6). RESULTS: Within-person multilevel mediation analyses showed that when a survivor's relationship satisfaction was higher than usual, her own LBP and LBP/sCD14 were lower, which was associated with lower than her own average CRP and IL-6 (95% CIs [-0.0104, -0.0002]). IL-6 was also higher when older survivors, but not younger survivors, experienced higher than usual intestinal permeability (p = .001). These effects of satisfying relationships held after accounting for cancer-related and behavioral factors. Post-hoc analyses showed LBP, sCD14, and LBP/sCD14 were associated with CRP for the cancer survivors, but only LBP and LBP/sCD14 were linked to CRP among the noncancer control patients. CONCLUSION: The gut environment is a new promising candidate for understanding a relationship's long-term health impact, particularly among those with elevated health risks. Survivors may reap multiple physiological benefits from satisfying relationships.
BACKGROUND: Breast cancer survivors are prone to weakened gut barriers, allowing bacteria to migrate into the blood stream. Gut permeability fuels inflammation, which, among survivors, can elevate risk for comorbid disease development, cancer recurrence, and a poor quality of life; however, survivors' satisfying relationships can provide health benefits. This longitudinal study used a conceptual model addressing how intimate relationships is associated with health through changes in gut permeability and inflammation. METHOD: Breast cancer survivors (n = 139, stages 0-IIIC) completed a baseline visit before treatment and two follow-up visits 6 and 18 months after treatment ended. Women who had an abnormal breast cancer test followed by a benign diagnosis completed visits within a comparable timeframe (noncancer patient controls; n = 69). All women completed questionnaires assessing their relationship satisfaction and provided blood samples to assess two bacterial endotoxin biomarkers, lipopolysaccharide-binding protein (LBP) and soluble CD14 (sCD14), as well as C-reactive protein (CRP) and interleukin 6 (IL-6). RESULTS: Within-person multilevel mediation analyses showed that when a survivor's relationship satisfaction was higher than usual, her own LBP and LBP/sCD14 were lower, which was associated with lower than her own average CRP and IL-6 (95% CIs [-0.0104, -0.0002]). IL-6 was also higher when older survivors, but not younger survivors, experienced higher than usual intestinal permeability (p = .001). These effects of satisfying relationships held after accounting for cancer-related and behavioral factors. Post-hoc analyses showed LBP, sCD14, and LBP/sCD14 were associated with CRP for the cancer survivors, but only LBP and LBP/sCD14 were linked to CRP among the noncancer control patients. CONCLUSION: The gut environment is a new promising candidate for understanding a relationship's long-term health impact, particularly among those with elevated health risks. Survivors may reap multiple physiological benefits from satisfying relationships.
Authors: John R Kelly; Yuliya Borre; Ciaran O' Brien; Elaine Patterson; Sahar El Aidy; Jennifer Deane; Paul J Kennedy; Sasja Beers; Karen Scott; Gerard Moloney; Alan E Hoban; Lucinda Scott; Patrick Fitzgerald; Paul Ross; Catherine Stanton; Gerard Clarke; John F Cryan; Timothy G Dinan Journal: J Psychiatr Res Date: 2016-07-25 Impact factor: 4.791
Authors: John R Stehle; Xiaoyan Leng; Dalane W Kitzman; Barbara J Nicklas; Stephen B Kritchevsky; Kevin P High Journal: J Gerontol A Biol Sci Med Sci Date: 2012-09-07 Impact factor: 6.053
Authors: Barbara L Andersen; Robert J DeRubeis; Barry S Berman; Jessie Gruman; Victoria L Champion; Mary Jane Massie; Jimmie C Holland; Ann H Partridge; Kate Bak; Mark R Somerfield; Julia H Rowland Journal: J Clin Oncol Date: 2014-04-14 Impact factor: 44.544
Authors: Peter Willeit; Simon G Thompson; Stefan Agewall; Göran Bergström; Horst Bickel; Alberico L Catapano; Kuo-Liong Chien; Eric de Groot; Jean-Philippe Empana; Thorleif Etgen; Oscar H Franco; Bernhard Iglseder; Stein H Johnsen; Maryam Kavousi; Lars Lind; Jing Liu; Ellisiv B Mathiesen; Giuseppe D Norata; Michael H Olsen; Aikaterini Papagianni; Holger Poppert; Jackie F Price; Ralph L Sacco; David N Yanez; Dong Zhao; Ulf Schminke; Alpaslan Bülbül; Joseph F Polak; Matthias Sitzer; Albert Hofman; Liliana Grigore; Marcus Dörr; Ta-Chen Su; Pierre Ducimetière; Wuxiang Xie; Kimmo Ronkainen; Stefan Kiechl; Tatjana Rundek; Christine Robertson; Björn Fagerberg; Lena Bokemark; Helmuth Steinmetz; M Arfan Ikram; Henry Völzke; Hung-Ju Lin; Matthieu Plichart; Tomi-Pekka Tuomainen; Moise Desvarieux; Stela McLachlan; Caroline Schmidt; Jussi Kauhanen; Johann Willeit; Matthias W Lorenz; Dirk Sander Journal: Eur J Prev Cardiol Date: 2014-11-21 Impact factor: 7.804