Systemische Entzündung, „Sickness Behavior“ und Erwartungsprozesse

Schmidt, J. Alexander; Reinold, Johanna; Klinger, Regine; Benson, Sven

doi:10.1007/s00482-021-00602-0

Cited by 4 publications

(7 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies suggest that the effects of inflammatory factors in the central nervous system could be modified by psychological factors such as positive and negative expectations. 40 However, further research in biomarker profiles considering a larger range of parameters as well as machine learning techniques may be promising approaches. 35 First attempts to develop fatigue prediction models in cancer patients based on clinical or genetic data are published.…”

Section: Discussionmentioning

confidence: 99%

“…They can, but do not necessarily, contribute to fatigue, as indicated by our study, where also several survivors without fatigue had high inflammatory or leptin levels. Previous studies suggest that the effects of inflammatory factors in the central nervous system could be modified by psychological factors such as positive and negative expectations 40 . However, further research in biomarker profiles considering a larger range of parameters as well as machine learning techniques may be promising approaches 35 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cancer‐related fatigue: Towards a more targeted approach based on classification by biomarkers and psychological factors

Schmidt,

Maurer,

Behrens

et al. 2023

Intl Journal of Cancer

View full text Add to dashboard Cite

Cancer‐related fatigue is a frequent, burdensome and often insufficiently treated symptom. A more targeted treatment of fatigue is urgently needed. Therefore, we examined biomarkers and clinical factors to identify fatigue subtypes with potentially different pathophysiologies. The study population comprised disease‐free breast cancer survivors of a German population‐based case‐control study who were re‐assessed on average 6 (FU1, n = 1871) and 11 years (FU2, n = 1295) after diagnosis. At FU1 and FU2, we assessed fatigue with the 20‐item multidimensional Fatigue Assessment Questionnaire and further factors by structured telephone‐interviews. Serum samples collected at FU1 were analyzed for IL‐1ß, IL‐2, IL‐4, IL‐6, IL‐10, TNF‐a, GM‐CSF, IL‐5, VEGF‐A, SAA, CRP, VCAM‐1, ICAM‐1, leptin, adiponectin and resistin. Exploratory cluster analyses among survivors with fatigue at FU1 and no history of depression yielded three clusters (CL1, CL2 and CL3). CL1 (n = 195) on average had high levels of TNF‐α, IL1‐β, IL‐6, resistin, VEGF‐A and GM‐CSF, and showed high BMI and pain levels. Fatigue in CL1 manifested rather in physical dimensions. Contrarily, CL2 (n = 78) was characterized by high leptin level and had highest cognitive fatigue. CL3 (n = 318) did not show any prominent characteristics. Fatigued survivors with a history of depression (n = 214) had significantly higher physical, emotional and cognitive fatigue and showed significantly less amelioration of fatigue from FU1 to FU2 than survivors without depression. In conclusion, from the broad phenotype “cancer‐related fatigue” we were able to delineate subgroups characterized by biomarkers or history of depression. Future investigations may take these subtypes into account, ultimately enabling a better targeted therapy of fatigue.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cancer‐related fatigue: Towards a more targeted approach based on classification by biomarkers and psychological factors

Schmidt,

Maurer,

Behrens

et al. 2023

Intl Journal of Cancer

View full text Add to dashboard Cite

show abstract

“…Such a treatment context could be achieved, e.g., by avoiding negative suggestions and ambiguous information in patient-provider communication and reducing stressand anxiety-provoking stimuli in the treatment surrounding (e.g., noises and alarms from medical equipment), while adapting an authentic, positive, and empathic communication style and providing a safe and comfy treatment setting (for further information, see e.g. [92,[106][107][108]).…”

Section: Mood and Pain Sensitization In Experimental Endotoxemiamentioning

confidence: 99%

“…While experimental research specifically aimed at placebo effects on inflammation-induced pain is currently underway (e.g. [108]), two studies have investigated expectation effects on the broader range of sickness Experimental Endotoxemia and Pain behavior symptoms in the context of experimental endotoxemia. In a study by Lasselin et al [112], healthy volunteers were asked about their expectations regarding psychological and physical sickness symptoms induced by LPS administration prior to injection.…”

Section: Cognitive Pain Modulation: Learning and Expectations During ...mentioning

confidence: 99%

How Can Experimental Endotoxemia Contribute to Our Understanding of Pain? A Narrative Review

Benson,

Karshikoff

2023

Neuroimmunomodulation

Self Cite

View full text Add to dashboard Cite

Background: The immune system and the central nervous system exchange information continuously. This communication is a prerequisite for adaptive responses to physiological and psychological stressors. While the implicate relationship between inflammation and pain is increasingly recognized in clinical cohorts, the underlying mechanisms and the possibilities for pharmacological and psychological approaches aimed at neuro-immune communication in pain are not fully understood yet. This calls for preclinical models which build a bridge from clinical research to laboratory research. Summary: Experimental models of systemic inflammation (experimental endotoxemia) in humans have been increasingly recognized as an approach to study the direct and causal effects of inflammation on pain perception. This narrative review provides an overview of what experimental endotoxemia studies on pain have been able to clarify so far. We report that experimental endotoxemia results in a reproducible increase in pain sensitivity, particularly for pressure and visceral pain (deep pain), which is reflected in responses of brain areas involved in pain processing. Increased levels of blood inflammatory cytokines are required for this effect, but cytokine levels do not always predict pain intensity. We address sex-dependent differences in immunological responses to endotoxin, and discuss why these differences do not necessarily translate to differences in behavioral measures. We summarize psychological and cognitive factors that may moderate pain sensitization driven by immune activation. Key messages: Together, studying the immune-driven changes in pain during endotoxemia offers a deeper mechanistic understanding of the role of inflammation in chronic pain. Experimental endotoxemia models can specifically help to tease out inflammatory mechanisms underlying individual differences, vulnerabilities, and comorbid psychological problems in pain syndromes. The model offers the opportunity to test the efficacy of interventions, increasing their translational applicability for personalized medical approaches.

show abstract

“…Moreover, higher levels of these cytokines resulted in a lower pain threshold and negative affection. Thus, expectation, and therefore open-label placebo (OLP), might influence not only pain perception, but immunological processes as well 28…”

Section: Introductionmentioning

confidence: 99%

Can open label placebos improve pain and gluten tolerance via open label placebos in fibromyalgia patients? A study protocol for a randomised clinical trial in an outpatient centre

Paschke,

Dreyer,

Worm

et al. 2023

BMJ Open

Self Cite

View full text Add to dashboard Cite

IntroductionFibromyalgia syndrome (FMS) is defined as a medical condition with chronic widespread musculoskeletal pain accompanied by mood disorders, fatigue and sleep disturbances. Treatment of this condition can often be challenging. As nutrition in general and nutritional interventions in the context of illness management become more and more important, current research also focuses on the relevance of diets for FMS, including gluten as field of interest. To date, there is no clear evidence that a gluten-free diet or other nutritional interventions are significantly important for the reduction of pain in the context of FMS. Only a very few studies show that FMS patients respond to a gluten-free diet and that cytokine production (also in FMS) can be reduced through the change. However, these studies have not investigated whether and to what extent cognitive factors, such as the expectation of symptom reduction triggered by diet, play a role. Recent research shows that treatment expectation plays an important role in the course of the disease and in the effectiveness of treatment approaches. For example, there are promising pain treatment options using open-label placebos (OLPs), which show that expectation alone, rather than the pharmacological substance of medication, can reduce pain experience. In our study protocol, we hypothesise that treatment expectation can be positively influenced by the given information regarding the placebos, resulting in improved treatment outcomes for pain and indigestions.Methods and analysisIn this trial, patients with FMS will undergo a food challenge and take an OLP (patients will be informed about the placebo), followed by a 3-week OLP treatment. The subjects will be randomised into four groups: (a) gluten-free porridge+neutral OLP instructions; (b) gluten-free porridge+positive OLP instructions; (c) gluten-containing porridge+neutral OLP instructions and (d) gluten-containing porridge+positive OLP instructions. Patients will be recruited via different institutions and support groups in Hamburg. The inclusion criteria are (a) diagnosed FMS, (b) absence of wheat allergy, coeliac disease or pain-related red flags and (c) being a minimum age of 18 years. The study requires 100 subjects to assess the primary outcomes: pain intensity and occurence of indigestion. Secondary outcomes are functional capacity, treatment expectation, and different pain-related and inflammation-related blood parameters. The measure time points will be before and after the food challenge and before and after the 3-week OLP treatment.Ethics and disseminationEthical approval was obtained in October 2021 from the Hamburg Medical Ethics Council. The results of the study will be disseminated through publications, presentations and conference meetings.Trial registration numberGerman Clinical Trials Register (DRKS; DRKS00027130).

show abstract

Systemische Entzündung, „Sickness Behavior“ und Erwartungsprozesse

Cited by 4 publications

References 32 publications

Cancer‐related fatigue: Towards a more targeted approach based on classification by biomarkers and psychological factors

Cancer‐related fatigue: Towards a more targeted approach based on classification by biomarkers and psychological factors

How Can Experimental Endotoxemia Contribute to Our Understanding of Pain? A Narrative Review

Can open label placebos improve pain and gluten tolerance via open label placebos in fibromyalgia patients? A study protocol for a randomised clinical trial in an outpatient centre

Contact Info

Product

Resources

About