Association between pro- and anti-inflammatory cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depression

Abstract

Because multiple symptoms associated with “sickness behavior” have a negative impact on functional status and quality of life, increased information on the mechanisms that underlie inter-individual variability in this symptom experience is needed. The purposes of this study were to determine: if distinct classes of individuals could be identified based on their experience with pain, fatigue, sleep disturbance, and depression; if these classes differed on demographic and clinical characteristics; and if variations in pro- and anti- inflammatory cytokine genes were associated with latent class membership. Self-report measures of pain, fatigue, sleep disturbance, and depression were completed by 168 oncology outpatients and 85 family caregivers (FCs). Using latent class profile analysis (LCPA), three relatively distinct classes were identified: those who reported low depression and low pain (83%), those who reported high depression and low pain (4.7%), and those who reported high levels of all four symptoms (12.3%). The minor allele of IL4 rs2243248 was associated with membership in the “All high” class along with younger age, being White, being a patient (versus a FC), having a lower functional status score, and having a higher number of comorbid conditions. Findings suggest that LPCA can be used to differentiate distinct phenotypes based on a symptom cluster associated with sickness behavior. Identification of distinct phenotypes provides new evidence for the role of IL4 in the modulation of a sickness behavior symptom cluster in oncology patients and their FCs.

Symptom Prevalence and Related Distress in Cancer Patients Undergoing Chemotherapy

“…Although symptoms experienced generally depend on treatment, primary tumour site or other co-morbid conditions, certain symptoms may be more closely related Muthukkumaran Thiagarajan 1 , Caryn Mei Hsien Chan 2 *, Ho Gwo Fuang 1 , Tan Seng Beng 2 , MA Atiliyana 1 , NA Yahaya 3 to psychological reasons (Cleeland, 2007). Multiple symptoms may also occur as a cluster (Illi, Miaskowski, Cooper et al, 2012).…”

Patient factors and quality of life outcomes differ among four subgroups of oncology patients based on symptom occurrence

“…In all 13 studies, subgroups of patients who reported a low and high number of symptoms were found. In the studies that reported three [7,8,10,12,14,15], four [5,6,11], or five [13] subgroups, the distinguishing characteristics of the subgroups of patients with moderate symptoms were highly variable in terms of the number and types of symptoms, as well as in the specific demographic and clinical characteristics that distinguished among these subgroups.…”

“…To date, 13 studies were found that used a variety of analytic approaches to classify oncology patients based on their symptom experience [3][4][5][6][7][8][9][10][11][12][13][14][15]. Across these studies, two [3,4,9] to five [13] groups of patients were identified.…”

“…However, the number of symptoms used in these LCAs varied from four [7,[12][13][14]] to 25 [10]. All except one [8] of the 13 studies evaluated for differences in demographic and clinical characteristics among the latent classes.…”

“…In the earliest studies [3][4][5][6], cluster analysis was used to create the patient groups, while in subsequent studies [7][8][9][10][11][12][13][14][15], latent class analysis (LCA) was used to identify subgroups of patients with distinct symptom profiles. However, the number of symptoms used in these LCAs varied from four [7,[12][13][14]] to 25 [10].…”