In conclusion, despite improvements in HCV therapy the benefits will not be realized unless effective measures for dealing with barriers to care are identified and addressed. A growing number of studies have indicated that the immune alterations resulting from chronic stress and other behavioral conditions may influence cancer development and progression. Chronic stress is associated with dysregulation of the hypothalamic�Cpituitary�Cadrenal axis, with consequent increase in the production of the hormone cortisol, and elevated levels of norepinephrine and epinephrine, which are catecholamines released from the adrenal medulla and the neurons of the sympathetic nervous system. A key component of the stress response involves activation of the sympathetic nervous system and production of mediators which arise both from the SNS and the adrenal medulla. Animal-based research has shown that stress can increase levels of intratumoral NE as well as NE in the ovary and other organs Ginsenoside-Rg3.gif)
that are typical metastatic sites for ovarian cancer such as spleen and omentum. Patients with oral cancer can have high psychological distress levels, but the effects of stress-related hormones on oral cancer cells and possible mechanisms underlying these relationships are unknown. In one study, the effects of stress-related hormones on interleukin-6 secretion and proliferation of oral squamous cell carcinoma cells was investigated. The effects of NE and cortisol were studied and it was shown that NE and isoproterenol significantly enhanced IL-6 mRNA expression and protein production in SCC9 and SCC25 cells. Physiological stress levels of NE and isoproterenol elicited the most robust IL-6 increase at 1 h. The effects of cortisol varied according to the hormone concentration. These findings Yunaconitine suggest that stress hormones can affect oral cancer cell behavior. Noradrenergic pathways have been implicated in the growth and progression of ovarian cancer. Intratumoral NE has been shown to increase with stress in an animal cancer model, but little is known regarding how tumor NE varies with disease stage and with biobehavioral factors in ovarian cancer patients. These results suggest that tumor NE provides distinct information from circulating plasma concentrations. Tumor NE levels were elevated in 20S-Notoginsenoside-R2 correlation to tumor grade and stage. Low subjective social support was associated with elevated intratumoral NE. As betaadrenergic signaling is related to key biological pathways involved in tumor growth, these findings may have implications for patient outcomes in ovarian cancer. In another cancer type, glucocorticoids suppressed androgen-independent prostate cancer growth possibly due to the inhibition of tumor-associated angiogenesis by decreasing VEGF and IL-8 production directly through the glucocorticoid receptor in vivo. Gu et al used two HPLC-MS-MS methods using the Multiple Reaction Monitoring acquisition mode for quantitative analysis of 13 compounds in the catecholamine biosynthetic and metabolic pathways. In contrast to other existing methods, the time consuming sample pretreatment procedure was shortened and even isomeric compounds could be satisfactorily resolved by using the MRM mode. HPLC-MS-MS methods are simple, rapid, reproducible and efficient, and their application might be extended toward other biological samples such as plasma and urine. In this study, we have evaluated the association between psychological problems and stress-related hormones in primary oral cancer patients.