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. Author manuscript; available in PMC: 2014 Feb 2.
Published in final edited form as: Curr Pharmacogenomics Person Med. 2013 Sep;11(3):224–230. doi: 10.2174/18756921113119990004

Figure 1. Psychoneuroimmunology Model Integrating Epigenetic and Genomic Factors with a view to personalized medicine in nursing for psychoneurological symptom clusters in women with breast cancer.

Figure 1

Genetic polymorphisms that have been associated with specific symptom phenotypes are depicted in the model as well as potential pathways initiated by prolonged stress, BCA treatment and the tumor microenvironment that may lead to symptom clusters. CRH = corticotropin releasing hormone; TNF-α = tumor necrosis factor – alpha; IL-1β = interleukin 1 – beta; ACTH = adrenocorticotropic hormone; 5-HT = 5-hydroxytryptamine (serotonin); NE = norepinephrine; TAMs = tumor-associated macrophages; MMPs = matrix metalloproteinases.