Social isolation and breast cancer.

Although the role of life-stressors in breast cancer remains unclear, social isolation is consistently associated with increased breast cancer risk and mortality. Social isolation can be defined as loneliness or an absence of perceived social connections. In female mice and rats, social isolation is mimicked by housing animals one per cage. Social isolation causes many biological changes, of which an increase in inflammatory markers and disruptions in mitochondrial and cellular metabolism are commonly reported. It is not clear how the two traditional stress-induced pathways, i.e., hypothalamic-pituitary axis (HPA), resulting a release of glucocorticoids from the adrenal cortex, and autonomic nervous system (ANS), resulting a release of catecholamines from the adrenal medulla and post-ganglionic neurons, could explain the increased breast cancer risk in socially isolated individuals. For example, glucocorticoid receptor activation in estrogen receptor positive breast cancer cells inhibits their proliferation, and activation of β-adrenergic receptor (β-AR) in immature immune cells promotes their differentiation towards anti-tumorigenic T cells. However, activation of HPA and ANS pathways may cause a disruption in the brain-gut-microbiome axis, resulting gut dysbiosis. Gut dysbiosis, in turn, leads to an alteration in the production of bacterial metabolites, such as short chain fatty acids, causing a systemic low-grade inflammation and inducing dysfunction in mitochondrial and cellular metabolism. A possible causal link between social isolation -induced increased breast cancer risk and mortality and gut dysbiosis should be investigated, as it offers new tools to prevent breast cancer.