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      Chronic Unpredictable Mild Stress Accelerates the Growth of Bladder Cancer in a Xenograft Mouse Model

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          Abstract

          Objective

          Chronic psychological stress is common in patients with bladder cancer. An increasing number of evidence demonstrated that psychiatric disorder leads to worse prognostic outcomes in bladder cancer. This study was to investigate the effects of chronic psychological stress on the growth of bladder cancer and its potential mechanisms.

          Methods

          A xenograft mouse model was established by subcutaneously implanting the human bladder cancer cell line T24 into nude mice. All of the tumor-bearing mice (N=20) were randomly separated into two groups. Mice in the control group were subjected to normal feeding conditions, while in another group, a chronic unpredictable mild stress (CUMS) model was established, in which mice were exposed to various types of stressors. Various analyses were performed on parameters including the tumor volume, tumor weight, expression of Caspase-3 and VEGF, proportion of Ki-67 positive cells (Ki-67 index), microvessel density (MVD) and serum concentrations of epinephrine and cortisol.

          Results

          In the CUMS group, the growth of transplanted tumors was distinctly accelerated, with the weight of removed tumors at the end of experiment increased by 34.07% compared to that of the control. Serum levels of epinephrine and cortisol determined by ELISA were significantly increased by CUMS. Immunohistochemistry and Western blot analysis showed that the expression of Caspase-3 was downregulated, whereas the expression of VEGF was upregulated in the CUMS group. Meanwhile, CUMS could increase the Ki-67 index and MVD.

          Conclusion

          Our research supports the hypothesis that CUMS could affect the growth of bladder cancer in nude mice, indicating that the intervention of chronic psychological stress may be a possible therapeutic strategy for bladder cancer.

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          Most cited references32

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          EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016.

          The European Association of Urology (EAU) panel on Non-muscle-invasive Bladder Cancer (NMIBC) released an updated version of the guidelines on Non-muscle-invasive Bladder Cancer.
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            Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma.

            Stress can alter immunological, neurochemical and endocrinological functions, but its role in cancer progression is not well understood. Here, we show that chronic behavioral stress results in higher levels of tissue catecholamines, greater tumor burden and more invasive growth of ovarian carcinoma cells in an orthotopic mouse model. These effects are mediated primarily through activation of the tumor cell cyclic AMP (cAMP)-protein kinase A (PKA) signaling pathway by the beta(2) adrenergic receptor (encoded by ADRB2). Tumors in stressed animals showed markedly increased vascularization and enhanced expression of VEGF, MMP2 and MMP9, and we found that angiogenic processes mediated the effects of stress on tumor growth in vivo. These data identify beta-adrenergic activation of the cAMP-PKA signaling pathway as a major mechanism by which behavioral stress can enhance tumor angiogenesis in vivo and thereby promote malignant cell growth. These data also suggest that blocking ADRB-mediated angiogenesis could have therapeutic implications for the management of ovarian cancer.
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              Chronic mild stress (CMS) revisited: consistency and behavioural-neurobiological concordance in the effects of CMS.

              The chronic mild stress (CMS) model of depression has high validity but has in the past been criticized for being difficult to replicate. However, a large number of recent publications have confirmed that CMS causes behavioural changes in rodents that parallel symptoms of depression. This review summarizes studies from over sixty independent research groups that have reported decreases in reactivity to rewards, and a variety of other depression-like behaviours, in rats or mice, following exposure to CMS. Together, these changes are referred to as a 'depressive' behavioural profile. Almost every study that has examined the effects of chronic antidepressant treatment in these procedures has reported that antidepressants were effective in reversing or preventing these 'depressive' behavioural changes. (The single exception is a study in which the duration of treatment was too brief to constitute an adequate trial.) There are also a handful of reports of CMS causing significant effects in the opposite direction, termed here an 'anomalous' behavioural profile. There are six neurobiological parameters that have been studied in both 'anhedonic' and 'anomalous' animals: psychostimulant and place-conditioning effects of dopamine agonists; dopamine D2 receptor number and message; inhibition of dopamine turnover by quinpirole, and beta-adrenergic receptor binding. On all six measures, CMS caused opposite effects in animals displaying 'depressive' and 'anomalous' profiles. Thus, there is overwhelming evidence that under appropriate experimental conditions, CMS can cause antidepressant-reversible depressive-like effects in rodents; however, the 'anomalous' profile that is occasionally reported appears to be a genuine phenomenon, and these two sets of behavioural effects appear to be associated with opposite patterns of neurobiological changes.
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                Author and article information

                Journal
                Psychol Res Behav Manag
                Psychol Res Behav Manag
                prbm
                prbm
                Psychology Research and Behavior Management
                Dove
                1179-1578
                23 December 2020
                2020
                : 13
                : 1289-1297
                Affiliations
                [1 ]Department of Urology, Huashan Hospital, Fudan University , Shanghai, People’s Republic of China
                [2 ]Fudan Institute of Urology, Huashan Hospital, Fudan University , Shanghai, People’s Republic of China
                [3 ]Department of Urology, Ruijin Hospital, Medical School of Shanghai Jiao Tong University , Shanghai, People’s Republic of China
                Author notes
                Correspondence: Ke Xu Department of Urology, Huashan Hospital, Fudan University , No. 12 Middle Urumqi Road, Shanghai200040, People’s Republic of ChinaTel/Fax +86 21 52887080 Email drkexu@163.com
                Article
                288983
                10.2147/PRBM.S288983
                7767701
                33380846
                5b9f3435-ea90-4123-b16a-6f1f9a5d05f8
                © 2020 Zhou et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 27 October 2020
                : 10 December 2020
                Page count
                Figures: 4, Tables: 1, References: 32, Pages: 9
                Categories
                Original Research

                Clinical Psychology & Psychiatry
                bladder cancer,chronic unpredictable mild stress,tumor growth,cell proliferation,angiogenesis

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