Relation between depression and circulating immune products in patients with advanced colorectal cancer

Allen-Mersh, T G; Glover, Clare; Fordy, C; Henderson, D. C.; Davies, Mark

doi:10.1177/014107689809100803

Cited by 57 publications

(21 citation statements)

References 29 publications

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“…In addition to other consequences of tumor progression like metastasis or tumor-cachexia, immune response was also suggested earlier to be involved in the impairment of QoL (Earlam et al 1996). In patients suVering from colorectal liver metastasis, QoL was even shown to be related more closely with the extent of immune activation than with liver metastasis volume or the serum level of the tumor marker carcinoembryonic antigen (Allen-Mersh et al 1998). However, the underlying mechanisms are only poorly understood.…”

Section: Introductionmentioning

confidence: 96%

Diminished quality of life in patients with cancer correlates with tryptophan degradation

Schroecksnadel

Fiegl²,

Prassl³

et al. 2007

J Cancer Res Clin Oncol

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Section: Introductionmentioning

confidence: 96%

Diminished quality of life in patients with cancer correlates with tryptophan degradation

Schroecksnadel

Fiegl²,

Prassl³

et al. 2007

J Cancer Res Clin Oncol

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“…In support of this, QoL impairment in colorectal liver metastasis (CLM) patients has been shown to correlate more closely with extent of immune activation than with liver metastasis volume or the serum level of the tumour marker carcinoembryonic antigen (CEA) (Allen-Mersh et al, 1998). In addition, animal studies suggest that immune activated cytokines induce sickness behaviour (Dantzer et al, 1998) that is similar to QoL impairment in humans (Bauhofer et al, 2001).…”

mentioning

confidence: 97%

Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer

et al. 2002

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Cancer-related indoleamine (2,3)-dioxygenase up-regulation by interferon-g might influence quality of life by depleting serum tryptophan. We correlated serum tryptophan levels with immune activation and quality of life in patients with colorectal liver metastases. Venous blood was sampled from patients with primary colorectal cancer and from patients with metachronous colorectal liver metastases who completed quality of life and psychological questionnaires. Serum tryptophan, kynurenine, neopterin, interleukin 2 soluble receptor a (IL-2 sRa), soluble tumour necrosis factor receptor I (sTNF RI), interleukin 6, and C-reactive protein were measured. Liver metastasis volume was estimated by computerised tomography, and survival from blood sampling was noted. Sixty-six patients with colorectal cancer were studied (39 males; median age 66 years) of whom 25 had colorectal liver metastases only (17 males; median age 62 years; median liver metastasis volume 208 ml; median survival 234 days). Reduced serum tryptophan was significantly associated with Rotterdam Symptom Checklist physical symptom (r=70.51, P=0.01) and Sickness Impact Profile (r=70.42, P=0.04) scores, and correlated with increased serum neopterin (r=70.36, P=0.003), IL-2 sRa (r=70.51, P=0.01) and sTNF RI (r=70.45, P=0.02) levels. Stepwise regression analyses suggested that serum tryptophan was an independent predictor of Rotterdam Symptom Checklist physical symptom (regression coefficient 720.78, P=0.01) and Sickness Impact Profile (regression coefficient 7109.09, P=0.04) scores. The results supported a role for interferon-g-mediated serum tryptophan decrease in cancer-induced quality of life deterioration.

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“…Further, high serum levels of IL-1, IL-6 and TNF-· were present in advancedstage cancer patients, particularly in those with anorexia/ cachexia syndrome [39]. The development of depression in colorectal patients with advanced disease was related to immune activation, as there was a positive correlation between the serum level of soluble IL-2 receptor alpha and the Hospital Anxiety and Depression Scale score [40].The induction of proinflammatory cytokines around nerve endings may play a role in chemotherapy-induced peripheral neuropathy, as cytokines are released from tissues following exposure to chemotherapeutic drugs. Coadministration of vincristine and granulocyte-macrophage colony-stimulating factor (GM-CSF) markedly increases the severity and magnitude of treatment-induced pain and neurological impairment [41,42].…”

mentioning

confidence: 98%

A Cytokine-Based Neuroimmunologic Mechanism of Cancer-Related Symptoms

Lee¹,

Dantzer

Langley

et al. 2004

Neuroimmunomodulation

266

184

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While many of the multiple symptoms that cancer patients have are due to the disease, it is increasingly recognized that pain, fatigue, sleep disturbance, cognitive dysfunction and affective symptoms are treatment related, and may lead to treatment delays or premature treatment termination. This symptom burden, a subjective counterpart of tumor burden, causes significant distress. Progress in understanding the mechanisms that underlie these symptoms may lead to new therapies for symptom control. Recently, some of these symptoms have been related to the actions of certain cytokines that produce a constellation of symptoms and behavioral signs when given exogenously to both humans and animals. The cytokine-induced sickness behavior that occurs in animals after the administration of infectious or inflammatory agents or certain proinflammatory cytokines has much in common with the symptoms experienced by cancer patients. Accordingly, we propose that cancer-related symptom clusters share common cytokine-based neuroimmunologic mechanisms. In this review, we provide evidence from clinical and animal studies that correlate the altered cytokine profile with cancer-related symptoms. We also propose that the expression of coexisting symptoms is linked to the deregulated activity of nuclear factor-kappa B, the transcription factor responsible for the production of cytokines and mediators of the inflammatory responses due to cancer and/or cancer treatment. These concepts open exciting new avenues for translational research in the pathophysiology and treatment of cancer-related symptoms.

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Relation between depression and circulating immune products in patients with advanced colorectal cancer

Cited by 57 publications

References 29 publications

Diminished quality of life in patients with cancer correlates with tryptophan degradation

Diminished quality of life in patients with cancer correlates with tryptophan degradation

Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer

A Cytokine-Based Neuroimmunologic Mechanism of Cancer-Related Symptoms

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