Although dispositional
optimism has been linked to a number of health outcomes including
enhanced postsurgical recovery, the physiological pathways are not
well-understood. The two studies in this project address the influences
of optimism and mood on neuroendocrine and immune function and wound
healing, and the extent to which relaxation-based interventions
may modulate these relationships; suction blister wound protocols
will provide a mechanism for studying the inflammatory responses
in vivo. The subjects for study 1, 180 men and women who range in
age from 18 to 80, will be admitted to the Ohio State Clinical Research
Center (GCRC) for 26 hours. Half of the subjects will be randomly
assigned to a relaxation intervention, with the first session beginning
prior to the initiation of the blister wounds, and all participants
will be followed after discharge to assess the healing of the blister
wound sites.
To evaluate the extent to which relaxation can buffer the effects
of an acute stressor, the 80 medical students who comprise the sample
in Study 2 will undergo the blister wound procedure during each
of the GCRC admissions, once at a lower stress "baseline,"
and again 2-3 days before a key exam, and they will be followed
daily to assess blister site wound repair after both admissions.
Half of the subjects will be randomly assigned to receive relaxation
training a week prior to the second GCRC admission.
Accordingly, the specific aims of the proposed study are: 1) to
assess the linkages among dispositional optimism, expectancies,
appraisals, mood, hormones, and production of proinflammatory cytokines,
as well as the extent to which relaxation, age and gender mediate
these relationships; 2) to determine the relationships between hormones
and production of proinflammatory cytokines from peripheral blood
and at the wound site, and the influence of age, gender, and relaxation
on these pathways; 3) to assess relationships between proinflammatory
cytokines from peripheral blood and blister chamber fluid, and the
healing of blister sites; and 4) to determine the extent to which
age interacts with optimism and mood to impair cytokine secretion
and wound healing.
Project 1 will dovetail with our newly funded grant (R01 MH58844)
that investigates the interaction among marital behavior, age
neuroendocrine and immune function, and their relationship to
wound healing among 100 couples who range in age from 18 to 75.
To separate the effects of the acute stress of marital conflict
from the chronic strains of marital dissatisfaction on wound healing,
subjects will undergo an initial oral biopsy 3-4 weeks prior to
a 26-hour admission to the GCRC. A second small wound will be
placed in the hard palate shortly after the GCRC admission, and
a suction blister wound protocol will be initiated to provide
a mechanism for studying the inflammatory response in vivo. After
induction of suction blister wounds, each couple will be asked
to discuss an area of disagreement for half an hour, a procedure
that can provoke significant endocrine and immunological changes.
Thus, the protocol provides for concurrent measurement of cytokines
and leukocytes in blister chamber fluid and peripheral blood,
serial evaluations of hormones relevant to wound healing, as well
as the assessment of oral wound healing as a consequence of both
acute and chronic stress.
The studies in our funded R01 will: 1) assess the linkages among
marital behavior, hormones, and production of proinflammatory
cytokines, as well as the extent to which stress of an acute conflict
and gender mediate these relationships; 2) determine the relationships
between hormones and production of proinflammatory cytokines from
peripheral blood and blister fluid, and the influence of age on
these pathways; 3) assess relationships between cytokines from
peripheral blood and blister chamber fluid and the healing of
blister sites and oral wounds; and 4) determine the extent to
which age interacts with marital distress to impair cytokine secretion
and wound healing. Thus, this project provides a window on the
influence of a key personal relationship on wound repair processes,
while Project 1 offers the opportunity to assess the impact of
optimism and relaxation intervention on wound healing.
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