Fatigue in chronic inflammation - a link to pain pathways

Rheumatoid Arthritis (RA) is a chronic autoimmune disease characterised by high gradeinflammation, and associated with elevated cardiovascular risk, rheumatoid-cachexia and functional impairment. Sedentary behaviour is linked to heightened inflammation, and is highly pervasive in RA -likely as a result of compromised physical function and persistent fatigue. This high sedentarity may exacerbate the inflammatory process in RA, and hold relevance for disease-related outcomes. The aim of this narrative review is to provide an overview of the definition, measurement and health relevance of sedentary behaviour in the context of RA. Contradictions are highlighted with regards to the manner in which sedentary behaviour is operationalized, and the significance of sedentary behaviour physiology for disease-outcomes in RA is outlined. The advantages and disadvantages of sedentary behaviour measurement approaches are also discussed. Against this background, we summarise studies that have reported sedentary behaviour and its health correlates in RA, and propose directions for future research.

show abstract

“…depression), reduced quality of life, high CVD risk, and cachexia, amongst others [29][30][31][32][33][34][35][36][37][38].…”

Section: Sedentary-inflammation Hypothesismentioning

confidence: 99%

Sedentary behaviour in rheumatoid arthritis: definition, measurement and implications for health

et al. 2017

View full text Add to dashboard Cite

show abstract

“…LPS acts by stimulating the Toll-like receptor (TLR)-4. In turn, increases in TLR-4 stimulated production of IL-6 and TNF correlate with symptoms of fatigue (20,21); elevated TNF levels also occur in association with fatigue and daytime sleepiness in patients with chronic fatigue syndrome, insomnia, or obstructive sleep apnea (22). …”

Section: Introductionmentioning

confidence: 99%

Reciprocal Relationship Between Sleep Macrostructure and Evening and Morning Cellular Inflammation in Rheumatoid Arthritis

Bjurström¹,

Olmstead²,

Irwin³

2017

Psychosom Med

View full text Add to dashboard Cite

Objective This study examines the reciprocal associations between sleep macrostructure and levels of cellular inflammation in rheumatoid arthritis (RA) patients and controls. Methods RA patients (n=24) and matched controls (n=48) underwent all-night polysomnography (PSG), along with assessment of spontaneous- and Toll-like receptor (TLR)-4 stimulated monocytic production of tumor necrosis factor-α (TNF) and interleukin (IL)-6 at 23:00 and 8:00. Results As compared to controls, RA patients showed lower levels of sleep efficiency (mean ± SD, 88.1 ±6.1 vs. 83.8 ± 7.0), a higher percentage Stage 3 sleep (9.3 ± 6.4 vs. 13.1 ± 6.9), and higher levels of percentage of monocytes either spontaneously expressing TNF at 23:00 (log transformed, 1.07 ± 0.28 vs. 1.22 ± 0.17), and higher TLR4 stimulated production of IL6 at 8:00 (log transformed, 3.45 ± 0.80 vs. 3.83 ± 0.39). Higher levels of stimulated production of TNF at 23:00 were associated with higher sleep efficiency (.74). In turn, sleep efficiency had a countervailing relationship on TNF production at 8:00 (. 64). Higher levels of spontaneous and stimulated production of IL6 at 23:00 were associated with more Stage 3 (.39), 4 (.43), and slow wave sleep (.49), with evidence that Stage 4 had a countervailing relationship on IL6 production at 8:00 (.60). Conclusion RA patients show evidence of sleep fragmentation, greater sleep depth, and higher levels of cellular inflammation. Sleep maintenance and sleep depth show countervailing relationships with evening- and morning levels of monocytic production of TNF and IL-6, respectively, which support the hypothesis of a feedback loop between sleep maintenance, slow wave sleep and cellular inflammation that is cytokine specific.

show abstract

“…Pro-inflammatory cytokines have been suggested to play a role in activating the central and autonomic nervous systems to trigger fatigue and other behavioural symptoms in both cancerrelated fatigue as well as in inflammatory diseases-related fatigue [36,37]. A larger body of literature also suggests that there is an association between fatigue and inflammatory markers among breast cancer patients and survivors [38][39][40][41][42][43].…”

Section: Fatigue and Energy Levelsmentioning

confidence: 99%

Genetic polymorphisms associated with common symptoms experienced by breast cancer patients

Abubakar

Gan²

2018

biomedicalresearch

View full text Add to dashboard Cite

The recent advances have led to a considerable increase in the proportion of breast cancer survivors, however, majority of them experience symptoms such as fatigue, pain, depression and sleep disturbances that impair their Quality of Life (QOL) significantly. In addition, a significant inter-individual variability in QOL of breast cancer patients exists which has been partly attributed to genetic variations. However, details of how these variations are influenced by genetic factors remain largely unknown. Therefore, detecting patients with greater susceptibility to reduced QOL using genetic markers may help in designing intervention strategies for personalized medicine. Although limited number of studies have reported on the associations between genetic polymorphisms and QOL, cytokine gene polymorphisms has consistently been linked to increased susceptibility to the development of common symptoms (fatigue, pain, depression and sleep disturbances) in breast cancer patients. More interestingly, these symptoms share some common molecular pathways making it possible to consider them as symptom cluster. In this review, the relationship between genetic variation and common symptoms among breast cancer patients is discussed. In order for genetic factors to be integrated into clinical practice and nursing care of breast cancer patients with impaired QOL, additional studies are encouraged to understand the underlying molecular mechanisms involved in the development of these symptoms and their impact on QOL for identification of patients based on the presence of a symptom cluster using genetic biomarkers.

show abstract

Fatigue in chronic inflammation - a link to pain pathways

Cited by 162 publications

References 83 publications

Sedentary behaviour in rheumatoid arthritis: definition, measurement and implications for health

Sedentary behaviour in rheumatoid arthritis: definition, measurement and implications for health

Reciprocal Relationship Between Sleep Macrostructure and Evening and Morning Cellular Inflammation in Rheumatoid Arthritis

Genetic polymorphisms associated with common symptoms experienced by breast cancer patients

Contact Info

Product

Resources

About