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Yang L, Cao M, Tian J, Cui P, Ai L, Li X, Li H, Gao M, Fang L, Zhao L, Gong F, Zhou C. Identification of Plasma Inflammatory Markers of Adolescent Depression Using the Olink Proteomics Platform. J Inflamm Res 2023; 16:4489-4501. [PMID: 37849645 PMCID: PMC10577244 DOI: 10.2147/jir.s425780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023] Open
Abstract
Purpose The quality of life of worldwide adolescents has been seriously affected by depression. Notably, the inflammatory response is closely associated with the pathophysiology of depression. The present study applied a novel targeted proteomics technology, Olink proximity extension assay (PEA), to profile circulating immune-related proteins in adolescents with depression. Methods In the present study, the expression levels of 92 inflammation-related proteins were compared between adolescents with depression (ADs) (n=15) and healthy controls (HCs) (n=15), using the OLINK PEA inflammation panel. We further validated 5 top proteins that were identified through KEGG and GO analyses between 40 HCs and 50 ADs, including CCL4, CXCL5, CXCL6, CXCL11, and IL-18 using enzyme linked immunosorbent assay (ELISA). Results We identified 13 differentially expressed proteins between the two cohorts, including 5 up-regulated and 8 down-regulated proteins. Among them, the TRAIL protein levels were significantly negatively correlated with the HAMA-14 score (r=-0.538, p= 0.038), and the levels of transforming growth factor α (TGF-α) were significantly associated with a change in appetite (r = -0.658, p = 0.008). After validation by ELISA, CCL4, CXCL5, CXCL11, and IL-18 showed significant changes between ADs and HCs (p < 0.05), while CXCL6 showed an up-regulated tendency in ADs (p=0.0673). The pooled diagnostic efficacy (area under the curve [AUC]) of these five inflammation markers in clinical diagnosis for adolescent depression was 0.819 (95% CI: 0.735-0.904). Conclusion We report a number of inflammation-related plasma biomarkers, which uncover a potential involvement of chemokines, cytokines, and cytokine receptors in adolescent depression. Their roles in the pathophysiology of depression need to be further elucidated.
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Affiliation(s)
- Ling Yang
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, People’s Republic of China
| | - Maolin Cao
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jing Tian
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Peijin Cui
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ling Ai
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xue Li
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Hua Li
- Department of Ophthalmology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Menghan Gao
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Liang Fang
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, People’s Republic of China
- Chongqing Clinical Research Center for Geriatric Disease, Chongqing, People’s Republic of China
| | - Libo Zhao
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, People’s Republic of China
| | - Fang Gong
- Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, People’s Republic of China
- Chongqing Clinical Research Center for Geriatric Disease, Chongqing, People’s Republic of China
| | - Chanjuan Zhou
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Clinical Research Center for Geriatric Disease, Chongqing, People’s Republic of China
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Panjwani AA, Aguiar S, Gascon B, Brooks DG, Li M. Biomarker opportunities in the treatment of cancer-related depression. Trends Mol Med 2022; 28:1050-1069. [PMID: 36371336 DOI: 10.1016/j.molmed.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/10/2022]
Abstract
Depression comorbid with cancer is common and associated with a host of negative health outcomes. The inflammatory basis of depression is a growing area of research in cancer, focused on how stressors transduce into inflammation and contribute to the emergence of depression. In this review, we synthesize inflammatory biomarker associations with both depression and the currently available pharmacotherapies and psychotherapies in cancer, underscoring the need for expanding research on anti-inflammatory agents with antidepressant effects. Modulation of inflammatory neuroimmune pathways can slow tumor progression and reduce metastases. Biomarkers associated with depression in cancer may help with diagnosis and treatment monitoring, as well as inform research on novel drug targets to potentially improve cancer survival.
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Affiliation(s)
- Aliza A Panjwani
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Stefan Aguiar
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Bryan Gascon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - David G Brooks
- Princess Margaret Research Institute, Toronto, ON, Canada; Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Madeline Li
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Princess Margaret Research Institute, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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3
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Is depression the missing link between inflammatory mediators and cancer? Pharmacol Ther 2022; 240:108293. [PMID: 36216210 DOI: 10.1016/j.pharmthera.2022.108293] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
Patients with cancer are at greater risk of developing depression in comparison to the general population and this is associated with serious adverse effects, such as poorer quality of life, worse prognosis and higher mortality. Although the relationship between depression and cancer is now well established, a common underlying pathophysiological mechanism between the two conditions is yet to be elucidated. Existing theories of depression, based on monoamine neurotransmitter system dysfunction, are insufficient as explanations of the disorder. Recent advances have implicated neuroinflammatory mechanisms in the etiology of depression and it has been demonstrated that inflammation at a peripheral level may be mirrored centrally in astrocytes and microglia serving to promote chronic levels of inflammation in the brain. Three major routes to depression in cancer in which proinflammatory mediators are implicated, seem likely. Activation of the kynurenine pathway involving cytokines, increases tryptophan catabolism, resulting in diminished levels of serotonin which is widely acknowledged as being the hallmark of depression. It also results in neurotoxic effects on brain regions thought to be involved in the evolution of major depression. Proinflammatory mediators also play a crucial role in impairing regulatory glucocorticoid mediated feedback of the hypothalamic-pituitary-adrenal axis, which is activated by stress and considered to be involved in both depression and cancer. The third route is via the glutamatergic pathway, whereby glutamate excitotoxicity may lead to depression associated with cancer. A better understanding of the mechanisms underlying these dysregulated and other newly emerging pathways may provide a rationale for therapeutic targeting, serving to improve the care of cancer patients.
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4
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McFarland DC, Doherty M, Atkinson TM, O'Hanlon R, Breitbart W, Nelson CJ, Miller AH. Cancer-related inflammation and depressive symptoms: Systematic review and meta-analysis. Cancer 2022; 128:2504-2519. [PMID: 35417925 DOI: 10.1002/cncr.34193] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Depressive symptoms in patients with cancer are associated with poor quality of life and decreased survival. Although inflammation is reliably associated with depression in otherwise healthy individuals, the association in patients with cancer remains unclear. Given the high prevalence of cancer-related inflammation, the authors aimed to establish the relationship between inflammation and depression in cancer patients based on extant literature. METHODS A systematic review and meta-analysis was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and registered under Prospero ID CRD42021226743. Three databases were searched including PubMed, the Cochrane Library, and PsycINFO using the following criteria for inclusion: 1) measurement of a peripheral inflammatory marker, 2) use of a validated tool/scale to measure depression, and 3) a cancer diagnosis. Risk of publication bias was assessed by Funnel plot and Egger test. RESULTS Seventy-three studies were included in the systematic review and 54 studies (n = 5017) were included in meta-analyses. Associations with depressive symptoms were significant for peripheral blood interleukin (IL)-6 (standardized mean difference [SMD] = 0.59; 95% confidence interval [CI], 0.35-0.82), I2 = 57.9%; tumor necrosis factor (TNF) (SMD = 0.73; 95% CI, 0.35-1.11), I2 = 74.1%; and C-reactive protein (CRP) (SMD = 0.57; 95% CI, 0.27-0.87), I2 = 0%. IL-5, IL-13, albumin, and neutrophil-to-lymphocyte ratio were associated with depressive symptoms but based on fewer studies. Most cancer settings were represented; the number of studies per inflammatory marker varied from 1 to 52. CONCLUSIONS Although peripheral inflammatory markers were unevenly studied, the most studied markers (IL-6, TNF, and CRP) were associated with depressive symptoms in cancer patients and may be useful for management of depressive symptoms in the cancer setting. LAY SUMMARY Peripheral blood inflammatory markers (IL-6, TNF, and CRP) were associated with depressive symptoms in various cancer settings. Although further studies are warranted, these findings may help identify and manage depressive symptoms in patients with cancer.
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Affiliation(s)
- Daniel C McFarland
- Department of Medicine, Northwell Health/Lenox Hill Hospital, New York, New York
| | - Meredith Doherty
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Thomas M Atkinson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robin O'Hanlon
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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5
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Iglesias-González M, Boigues M, Sanagustin D, Giralt-López M, Cuevas-Esteban J, Martínez-Cáceres E, Díez-Quevedo C. Association of serum interleukin-6 and C-reactive protein with depressive and adjustment disorders in COVID-19 inpatients. Brain Behav Immun Health 2021; 19:100405. [PMID: 34927104 PMCID: PMC8664764 DOI: 10.1016/j.bbih.2021.100405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 12/27/2022] Open
Abstract
Background Immune mechanisms are part of the pathophysiology of mental disorders, although their role remains controversial. In depressive disorders a chronic low-grade inflammatory process is observed, with higher interleukin-6 (IL-6) values. Furthermore, in SARS-CoV2 infection, which is closely related to depressive disorders, there is a proinflammatory cascade of cytokines that causes systemic inflammation. Methods The present study evaluates the relationship between IL-6 and C-reactive protein (CRP) serum levels and the presence of depressive and adjustment disorders in a sample of 1851 patients admitted to hospital for SARS-CoV2 infection from March to November 2020. Concentrations of IL-6 and CRP were determined within the first 72 h at admission and compared among groups of patients according to previous history and current presence of depression or adjustment disorders. Results IL-6 serum levels were significantly higher in the group of patients with depression and adjustment disorders compared to patients without such disorders (114.25 pg/mL (SD, 225.44) vs. 86.41 (SD, 202.97)), even after adjusting for several confounders. Similar results were obtained for CRP (103.94 mg/L (SD, 91.16) vs. 90.14 (SD, 85.73)). The absolute levels of IL-6 and CRP were higher than those of previous depression studies, and differences were only found for the subgroup of De Novo depressive or adjustment disorders. Conclusions Serum concentrations of IL-6 and CRP are higher in COVID-19 patients with De Novo but not persistent depressive or adjustment disorders. Clinical features such as fatigue, asthenia, anhedonia, or anxiety can be the basis for this finding. Inflammation markers are higher in COVID inpatients with affective symptoms and no previous psychiatric history. Sickness behavior overlaps with stress-related disorders symptomatology. Cytokine levels equalize in non-depressed and chronically depressed COVID inpatients. COVID inpatients with affective symptoms may show a worse prognosis.
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Affiliation(s)
- Maria Iglesias-González
- Psychiatry Service, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Marc Boigues
- Division of Immunology, LCMN. Germans Trias i Pujol University Hospital and Research Institute, Campus Can Ruti, Badalona, Spain.,Department of Cellular Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - David Sanagustin
- Psychiatry Service, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Maria Giralt-López
- Psychiatry Service, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Jorge Cuevas-Esteban
- Psychiatry Service, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Eva Martínez-Cáceres
- Division of Immunology, LCMN. Germans Trias i Pujol University Hospital and Research Institute, Campus Can Ruti, Badalona, Spain.,Department of Cellular Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Crisanto Díez-Quevedo
- Psychiatry Service, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
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6
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Relationship between cytokines and symptoms in people with incurable cancer: A systematic review. Crit Rev Oncol Hematol 2021; 159:103222. [PMID: 33482344 DOI: 10.1016/j.critrevonc.2021.103222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/24/2020] [Accepted: 01/16/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Development and spread of cancer is linked to the inflammatory response, in which cytokines serve a key role. The inflammatory response may also form the basis for symptoms of cancer. This systematic review examines the relationship between cytokines and symptoms in incurable cancer. METHODS MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science and PsycINFO databases were searched for studies from January 2004 to January 2020. RESULTS Twenty studies were selected (n = 1806 patients, 119 controls). Symptoms studied included depression, fatigue, pain, and loss of appetite. Nine studies examined patients with a specified tumour type, the remainder included patients with a mix of tumour types. Thirty-one cytokines were examined; multiple associations between cytokines and symptoms were described, supporting the hypothesis that cytokines may have a key role in symptom generation. CONCLUSION Symptoms of incurable cancer are associated with circulating cytokines. Further study is required to characterise these relationships, and to explore their therapeutic potential.
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7
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Ting EYC, Yang AC, Tsai SJ. Role of Interleukin-6 in Depressive Disorder. Int J Mol Sci 2020; 21:ijms21062194. [PMID: 32235786 PMCID: PMC7139933 DOI: 10.3390/ijms21062194] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 12/20/2022] Open
Abstract
Major depressive disorder (MDD), which is a leading psychiatric illness across the world, severely affects quality of life and causes an increased incidence of suicide. Evidence from animal as well as clinical studies have indicated that increased peripheral or central cytokine interleukin-6 (IL-6) levels play an important role in stress reaction and depressive disorder, especially physical disorders comorbid with depression. Increased release of IL-6 in MDD has been found to be a factor associated with MDD prognosis and therapeutic response, and may affect a wide range of depressive symptomatology. However, study results of the IL6 genetic effects in MDD are controversial. Increased IL-6 activity may cause depression through activation of hypothalamic-pituitary-adrenal axis or influence of the neurotransmitter metabolism. The important role of neuroinflammation in MDD pathogenesis has created a new perspective that the combining of blood IL-6 and other depression-related cytokine levels may help to classify MDD biological subtypes, which may allow physicians to identify the optimal treatment for MDD patients. To modulate the IL-6 activity by IL-6-related agents, current antidepressive agents, herb medication, pre-/probiotics or non-pharmacological interventions may hold great promise for the MDD patients with inflammatory features.
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Affiliation(s)
- Emily Yi-Chih Ting
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
| | - Albert C. Yang
- Brain Research Center, National Yang-Ming University, Taipei 11221, Taiwan;
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess, Medical Center, Boston, MA 02115, USA
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Brain Research Center, National Yang-Ming University, Taipei 11221, Taiwan;
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
- Correspondence: ; Tel.: +886-2-28757027 (ext. 276); Fax: +886-2-28725643
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8
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Robinson SM, Rasch S, Beer S, Valantiene I, Mickevicius A, Schlaipfer E, Mann J, Maisonneuve P, Charnley RM, Rosendahl J. Systemic inflammation contributes to impairment of quality of life in chronic pancreatitis. Sci Rep 2019; 9:7318. [PMID: 31086257 PMCID: PMC6513859 DOI: 10.1038/s41598-019-43846-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 05/01/2019] [Indexed: 02/07/2023] Open
Abstract
Chronic pancreatitis (CP) is a fibrotic disorder of the pancreas leading to clinical sequelae like pain and an excess of comorbidity including cardiovascular disease and cancers. The aim of this study was to determine the relationship between systemic inflammation and quality of life in patients with CP. Patients were prospectively recruited and underwent a quality of life assessment (EORTC QLQ-C30 and PAN 28). The serum inflammatory profile was assessed using an MSD 30-plex array. The relationship between clinical variables, inflammatory cytokines and quality of life was determined by a GLM-MANOVA and the individual impact of significant variables evaluated by a second ANOVA. In total, 211 patients with a median age of 53 years were recruited across 5 European centres. Gender, age, nicotine and alcohol abuse were clinical variables associated with altered quality of life. Systemic inflammation with high levels of pro-inflammatory cytokines (Eotaxin, IL-1β, IL-7, IL-8, IL-12/IL-23p40, IL-12p70, IL-13, IL-16, IP-10, MCP-1, MCP-4, MDC, MIP-1a, TARC, TNFß) was associated with diminished quality of life in general and specific domains including pain, physical and cognitive functioning. As conclusion, CP is associated with a systemic inflammatory response that has a negative impact on quality of life and accelerates aging.
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Affiliation(s)
- Stuart M Robinson
- HPB Unit, Department of Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Sebastian Rasch
- Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany.
| | - Sebastian Beer
- Department for Internal Medicine, Neurology and Dermatology, Division of Gastroenterology, University of Leipzig, Leipzig, Germany
| | - Irena Valantiene
- Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Artautas Mickevicius
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos & Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - Elisabeth Schlaipfer
- Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany
| | - Jelena Mann
- HPB Unit, Department of Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Richard M Charnley
- HPB Unit, Department of Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jonas Rosendahl
- Department of Internal Medicine I, Martin Luther University, Halle, Saale, Germany
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9
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Zhu C, Wang B, Gao Y, Ma X. Prevalence and relationship of malnutrition and distress in patients with Cancer using questionnaires. BMC Cancer 2018; 18:1272. [PMID: 30567507 PMCID: PMC6299972 DOI: 10.1186/s12885-018-5176-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/04/2018] [Indexed: 02/05/2023] Open
Abstract
Background Negative feelings, such as anxiety and depression, are common in patients with cancer. Our aim was to investigate the prevalence of malnutrition and distress in cancer patients and to examine the relationship between them. Materials and methods We did a cross-sectional study in West China hospital, China, using adapted questionnaires derived from Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening 2002 (NRS2002) and Distress Thermometer (DT). We also focused on the factors associated with distress. Results We found that psychological distress in cancer patients was common, with 39.5% patients suffering from distress. The mean score of PG-SGA was 3.37 (0–6), and 39.1% patients had malnutrition when using 4 as a cut-off value. Meanwhile, the mean score of NRS2002 was 1.91 (0–11), and 25.8% patients presented with malnutrition when using 3 as the cut-off value. Higher scores of nutritional risks confirmed by PG-SGA (r = 0.148, p < 0.001) and NRS2002 (r = 0.142, p < 0.001) were significantly correlated with higher levels of psychological stress. Conclusion Malnutrition was correlated with psychological stress in cancer patients. Early intervention in the mental problems and nutrition was meaningful, which could improve the psychological statuses of cancer patients. Electronic supplementary material The online version of this article (10.1186/s12885-018-5176-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chenjing Zhu
- Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. .,West China Hospital, Chengdu, 610041, People's Republic of China.
| | - Baoqing Wang
- Department of Oncology, The Second Affiliated Hospital of Xuzhou Medical University, Jiangsu, People's Republic of China
| | - Yuan Gao
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xuelei Ma
- Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
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10
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Saracino RM, Rosenfeld B, Nelson CJ. Performance of four diagnostic approaches to depression in adults with cancer. Gen Hosp Psychiatry 2018; 51:90-95. [PMID: 29427869 PMCID: PMC5869111 DOI: 10.1016/j.genhosppsych.2018.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The potentially confounding influence of somatic symptoms in identifying depression in medically ill patients has long been of concern, resulting in several proposed alternative diagnostic approaches. These approaches have been compared in the cancer setting, but the strengths and weaknesses of the alternative approaches have rarely been examined. The purpose of the current study was to examine the performance of four approaches to depression assessment among ambulatory cancer patients. METHOD Outpatients were recruited from a large cancer center (N = 611). Participants had to be 40 years or older, English-speaking, and have a cancer diagnosis. All participants completed a sociodemographic questionnaire and a modified Patient Health Questionnaire-9 with additional items targeting the Endicott and Cavanaugh substitutive criteria. RESULTS Depression prevalence varied significantly by diagnostic approach, with the inclusive approach identifying the largest proportion as depressed (9.3%, n = 57), followed by the Endicott-substitutive (6.2%, n = 38), exclusive (4.6%, n = 28), and Cavanaugh-substitutive approach (1.8%, n = 11). Somatic items were significantly elevated across all four approaches. CONCLUSIONS The inclusive approach that retains use of somatic symptoms is appropriate when screening cancer patients for depression. The fact that somatic symptoms were more prevalent across approaches suggests that they may not inflate the prevalence of depression as much as some have feared. Rather, somatic items may explain variance in depressive symptoms beyond that explained by the presence of cancer and its treatment. Additionally, the Endicott items appeared useful for capturing depressive symptoms that are not included in the existing DSM criteria, and may have a place in clinical and research settings.
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Affiliation(s)
- Rebecca M Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, NY, New York 10022, United States; Psychology Department, Fordham University, Dealy Hall 226, 441 East Fordham Road, Bronx, NY 10458, United States.
| | - Barry Rosenfeld
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, NY, New York 10022, United States; Psychology Department, Fordham University, Dealy Hall 226, 441 East Fordham Road, Bronx, NY 10458, United States
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, NY, New York 10022, United States
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11
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Li M, Kouzmina E, McCusker M, Rodin D, Boutros PC, Paige CJ, Rodin G. Cytokines and depression in cancer patients and caregivers. Neuropsychiatr Dis Treat 2017; 13:2903-2911. [PMID: 29238195 PMCID: PMC5713706 DOI: 10.2147/ndt.s144774] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE A better understanding of the biobehavioral mechanisms underlying depression in cancer is required to translate biomarker findings into clinical interventions. We tested for associations between cytokines and the somatic and psychological symptoms of depression in cancer patients and their healthy caregivers. PATIENTS AND METHODS The GRID Hamilton Rating Scale for Depression (Ham-D) was administered to 61 cancer patients of mixed type and stage, 26 primary caregivers and 38 healthy controls. Concurrently, blood was drawn for multiplexed plasma assays of 15 cytokines. Multiple linear regression, adjusted for biobehavioral variables, identified cytokine associations with the psychological (Ham-Dep) and somatic (Ham-Som) subfactors of the Ham-D. RESULTS The Ham-Dep scores of cancer patients were similar to their caregivers, but their Ham-Som scores were significantly higher (twofold, p=0.016). Ham-Som was positively associated with IL-1ra (coefficient: 1.27, p≤0.001) in cancer patients, and negatively associated with IL-2 (coefficient: -0.68, p=0.018) in caregivers. Ham-Dep was negatively associated with IL-4 (coefficient: -0.67, p=0.004) in cancer patients and negatively associated with IL-17 (coefficient: -1.81, p=0.002) in caregivers. CONCLUSION The differential severity of somatic symptoms of depression in cancer patients and caregivers and the unique cytokine associations identified with each group suggests the potential for targeted interventions based on phenomenology and biology. The clinical implication is that depressive symptoms in cancer patients can arise from biological stressors, which is an important message to help destigmatize the development of depression in cancer patients.
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Affiliation(s)
- Madeline Li
- Princess Margaret Cancer Centre, Department of Supportive Care, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ekaterina Kouzmina
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Megan McCusker
- Princess Margaret Cancer Centre, Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Danielle Rodin
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Paul C Boutros
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.,Department of Pharmacology & Toxicology, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Christopher J Paige
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Immunology, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Gary Rodin
- Princess Margaret Cancer Centre, Department of Supportive Care, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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12
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Li M, Kouzmina E, McCusker M, Rodin D, Boutros PC, Paige CJ, Rodin G. Pro- and anti-inflammatory cytokine associations with major depression in cancer patients. Psychooncology 2016; 26:2149-2156. [DOI: 10.1002/pon.4316] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 10/19/2016] [Accepted: 11/11/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Madeline Li
- Princess Margaret Cancer Centre, University Health Network; Toronto Ontario Canada
- Department of Supportive Care; University Health Network; Toronto Ontario Canada
- Department of Psychiatry; University of Toronto; Toronto Ontario Canada
| | - Ekaterina Kouzmina
- Informatics & Biocomputing Program; Ontario Institute for Cancer Research; Toronto Ontario Canada
| | - Megan McCusker
- Princess Margaret Cancer Centre, University Health Network; Toronto Ontario Canada
- Department of Supportive Care; University Health Network; Toronto Ontario Canada
| | - Danielle Rodin
- Princess Margaret Cancer Centre, University Health Network; Toronto Ontario Canada
- Department of Supportive Care; University Health Network; Toronto Ontario Canada
| | - Paul C. Boutros
- Informatics & Biocomputing Program; Ontario Institute for Cancer Research; Toronto Ontario Canada
- Department of Pharmacology & Toxicology; University of Toronto; Toronto Ontario Canada
- Department of Medical Biophysics; University of Toronto; Toronto Ontario Canada
| | - Christopher J. Paige
- Princess Margaret Cancer Centre, University Health Network; Toronto Ontario Canada
- Department of Medical Biophysics; University of Toronto; Toronto Ontario Canada
- Department of Immunology; University of Toronto; Toronto Ontario Canada
| | - Gary Rodin
- Princess Margaret Cancer Centre, University Health Network; Toronto Ontario Canada
- Department of Supportive Care; University Health Network; Toronto Ontario Canada
- Department of Psychiatry; University of Toronto; Toronto Ontario Canada
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13
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Low-grade inflammation differentiates between symptoms of apathy and depression in community-dwelling older individuals. Int Psychogeriatr 2015; 27:639-47. [PMID: 25729001 DOI: 10.1017/s1041610214002683] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Systemic low-grade inflammation has repeatedly been associated with depression in old age, but the relationship with apathy is less clear. The present study assessed whether C-reactive protein (CRP) is differentially associated with symptoms of apathy and depression. METHODS A population-based cohort study was carried-out. At baseline and after two and four years of follow-up, CRP levels were assessed and symptoms of apathy and depression were measured using the 15-item Geriatric Depression Scale. Logistic regression analysis was used to investigate the cross-sectional and longitudinal associations of CRP with symptoms of apathy and depression. RESULTS Two thousand forty-seven community-dwelling participants (70-78 years) without a history of cardiovascular disease or stroke were studied. A cross-sectional association was found between CRP and apathy symptoms at three time points (odds ratio (OR) per natural log unit increase in CRP: baseline visit = 1.40, 95% CI = 1.12-1.75; two-year follow-up visit = 1.62, 95% CI = 1.17-2.25; four-year follow-up visit = 1.51, 95% CI = 1.03-2.21). This did not change after adjustment for demographics and depressive symptoms, and was slightly attenuated after adjustment for cardiovascular risk factors. No cross-sectional association was found with depressive symptoms. Baseline CRP did not predict incident apathy or depressive symptoms during four years of follow-up. CONCLUSIONS Increased CRP levels are associated with apathy symptoms but not with depressive symptoms. This suggests a differential effect of inflammation on apathy and depression. In older persons, symptoms of apathy may be a behavioral manifestation of concurrent low-grade inflammation.
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14
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Muscatell KA, Dedovic K, Slavich GM, Jarcho MR, Breen EC, Bower JE, Irwin MR, Eisenberger NI. Greater amygdala activity and dorsomedial prefrontal-amygdala coupling are associated with enhanced inflammatory responses to stress. Brain Behav Immun 2015; 43:46-53. [PMID: 25016200 PMCID: PMC4368432 DOI: 10.1016/j.bbi.2014.06.201] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/20/2014] [Accepted: 06/29/2014] [Indexed: 12/27/2022] Open
Abstract
Psychological stress is implicated in the etiology of many common chronic diseases and mental health disorders. Recent research suggests that inflammation may be a key biological mediator linking stress and health. Nevertheless, the neurocognitive pathways underlying stress-related increases in inflammatory activity are largely unknown. The present study thus examined associations between neural and inflammatory responses to an acute laboratory-based social stressor. Healthy female participants (n=31) were exposed to a brief episode of stress while they underwent an fMRI scan. Blood samples were taken before and after the stressor, and plasma was assayed for markers of inflammatory activity. Exposure to the stressor was associated with significant increases in feelings of social evaluation and rejection, and with increases in levels of inflammation. Analyses linking the neural and inflammatory data revealed that heightened neural activity in the amygdala in response to the stressor was associated with greater increases in inflammation. Functional connectivity analyses indicated that individuals who showed stronger coupling between the amygdala and the dorsomedial prefrontal cortex (DMPFC) also showed a heightened inflammatory response to the stressor. Interestingly, activity in a different set of neural regions was related to increases in feelings of social rejection. These data show that greater amygdala activity in response to a stressor, as well as tighter coupling between the amygdala and the DMPFC, are associated with greater increases in inflammatory activity. Results from this study begin to identify neural mechanisms that might link stress with increased risk for inflammation-related disorders such as cardiovascular disease and depression.
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Affiliation(s)
- Keely A. Muscatell
- Robert Wood Johnson Foundation Health and Society Scholars Program, University of California, San Francisco and University of California, Berkeley, San Francisco, CA, USA,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katarina Dedovic
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychiatry, Research Centre of the Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - George M. Slavich
- Department of Psychiatry & Biobehavioral Sciences and Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael R. Jarcho
- Department of Psychiatry & Biobehavioral Sciences and Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA,Department of Neuroscience, Loras College, Dubuque, IA, USA
| | - Elizabeth C. Breen
- Department of Psychiatry & Biobehavioral Sciences and Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Julienne E. Bower
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychiatry & Biobehavioral Sciences and Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael R. Irwin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychiatry & Biobehavioral Sciences and Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Naomi I. Eisenberger
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA,Corresponding author. Address: UCLA Psychology Department, Box 951563, 1285 Franz Hall, Los Angeles, CA 90095-1563, USA. (N.I. Eisenberger)
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15
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Low CA, Bovbjerg DH, Jenkins FJ, Ahrendt SA, Choudry HA, Holtzman MP, Jones HL, Pingpank JF, Ramalingam L, Zeh HJ, Zureikat AH, Bartlett DL. Preoperative inflammatory biomarkers and neurovegetative symptoms in peritoneal carcinomatosis patients. Brain Behav Immun 2014; 42:65-8. [PMID: 25004281 PMCID: PMC4252780 DOI: 10.1016/j.bbi.2014.06.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/04/2014] [Accepted: 06/25/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Inflammation plays a central role in peritoneal carcinomatosis (PC) etiology and progression, and circulating levels of inflammatory biomarkers prior to surgery predict progression-free and overall survival in PC patients. Depression and fatigue are prevalent among PC patients, and experimental research shows that these symptoms may be mediated by proinflammatory cytokines. As yet unstudied is the possibility that the heightened levels of inflammatory markers in PC patients may contribute to their experience of common neurovegetative symptoms. METHODS Validated self-report measures of fatigue, depressive symptoms, and quality of life were administered to 64 patients scheduled to undergo aggressive surgical treatment for PC. Serum samples were collected the morning of surgery, and ELISAs were conducted to quantify circulating IL-6, CRP, and TNF-α levels. RESULTS Consistent with hypotheses, higher IL-6 levels were associated with more severe fatigue (β=-.39, p<.01) and neurovegetative symptoms of depression (β=.30, p<.05). IL-6 was also related to poorer physical quality of life (β=-.28, p<.05). CRP showed similar significant relationships with fatigue and physical quality of life. Inflammatory biomarkers were not significantly related to emotional symptoms of depression or to emotional or social functioning aspects of quality of life, and TNF-α levels were not related to patient-reported measures. CONCLUSION Preoperative inflammatory activity may contribute to patients' experiences of fatigue and neurovegetative depressive symptoms as well as impaired quality of life. These biological mechanisms warrant consideration in the clinical management of neurovegetative symptoms in PC patients.
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Affiliation(s)
- Carissa A Low
- University of Pittsburgh Cancer Institute, United States.
| | | | | | | | | | | | | | | | | | - Herbert J Zeh
- University of Pittsburgh Cancer Institute, United States
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16
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Lee KA, Gay CL, Lerdal A, Pullinger CR, Aouizerat BE. Cytokine polymorphisms are associated with fatigue in adults living with HIV/AIDS. Brain Behav Immun 2014; 40:95-103. [PMID: 24632226 PMCID: PMC4102618 DOI: 10.1016/j.bbi.2014.02.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/19/2014] [Accepted: 02/25/2014] [Indexed: 11/16/2022] Open
Abstract
Fatigue has been associated with inflammation and cytokine activity among adults, but this relationship has not been evaluated among adults living with HIV. Diurnal patterns of fatigue have been previously identified in adults with HIV/AIDS. Thus, the purpose of this study was to describe these fatigue patterns in relation to cytokine plasma concentrations and gene polymorphisms. A convenience sample of 317 adults living with HIV/AIDS completed a measure of fatigue in the morning and evening for three consecutive days; participants reporting low levels of both morning and evening fatigue (n=110) or high levels of fatigue in the morning and evening (n=114) were included in the analysis, resulting in a final sample of 224 adults (151 men, 55 women, and 18 transgender). Plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB-1 and -2), and tumor necrosis factor alpha (TNFA). Demographic and clinical variables were evaluated as potential covariates. Controlling for genomic estimates of ancestry and self-reported race/ethnicity and gender, the high fatigue pattern was associated with five single nucleotide polymorphisms (SNPs): IL1B rs1071676 and rs1143627, IL4 rs2243274, and TNFA rs1800683 and rs1041981. The IL1B and TNFA polymorphisms were not associated with plasma levels of IL-1β or TNFα, respectively. This study strengthens the evidence for an association between inflammation and fatigue. In this chronic illness population, the cytokine polymorphisms associated with high levels of morning and evening fatigue provide direction for future personalized medicine intervention research.
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Affiliation(s)
- Kathryn A. Lee
- Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
| | - Caryl L. Gay
- Department of Family Health Care Nursing, University of California, San Francisco, CA, USA,Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway,Lovisenberg Diakonale University of College, Oslo, Norway
| | - Anners Lerdal
- Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
| | - Clive R. Pullinger
- Department of Physiological Nursing, University of California, San Francisco, CA, USA,Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Bradley E. Aouizerat
- Department of Physiological Nursing, University of California, San Francisco, CA, USA,Institute for Human Genetics, University of California, San Francisco, CA, USA
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17
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Poulin C, Shiner B, Thompson P, Vepstas L, Young-Xu Y, Goertzel B, Watts B, Flashman L, McAllister T. Predicting the risk of suicide by analyzing the text of clinical notes. PLoS One 2014; 9:e85733. [PMID: 24489669 PMCID: PMC3904866 DOI: 10.1371/journal.pone.0085733] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/30/2013] [Indexed: 12/21/2022] Open
Abstract
We developed linguistics-driven prediction models to estimate the risk of suicide. These models were generated from unstructured clinical notes taken from a national sample of U.S. Veterans Administration (VA) medical records. We created three matched cohorts: veterans who committed suicide, veterans who used mental health services and did not commit suicide, and veterans who did not use mental health services and did not commit suicide during the observation period (n = 70 in each group). From the clinical notes, we generated datasets of single keywords and multi-word phrases, and constructed prediction models using a machine-learning algorithm based on a genetic programming framework. The resulting inference accuracy was consistently 65% or more. Our data therefore suggests that computerized text analytics can be applied to unstructured medical records to estimate the risk of suicide. The resulting system could allow clinicians to potentially screen seemingly healthy patients at the primary care level, and to continuously evaluate the suicide risk among psychiatric patients.
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Affiliation(s)
- Chris Poulin
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
- The Durkheim Project, Portsmouth, New Hampshire, United States of America
| | - Brian Shiner
- United States Department of Veterans Affairs, White River Junction VA Medical Center, White River Junction, Vermont, United States of America
| | - Paul Thompson
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
- The Durkheim Project, Portsmouth, New Hampshire, United States of America
| | - Linas Vepstas
- The Durkheim Project, Portsmouth, New Hampshire, United States of America
| | - Yinong Young-Xu
- United States Department of Veterans Affairs, White River Junction VA Medical Center, White River Junction, Vermont, United States of America
| | | | - Bradley Watts
- United States Department of Veterans Affairs, White River Junction VA Medical Center, White River Junction, Vermont, United States of America
| | - Laura Flashman
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
| | - Thomas McAllister
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
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Krogh J, Benros ME, Jørgensen MB, Vesterager L, Elfving B, Nordentoft M. The association between depressive symptoms, cognitive function, and inflammation in major depression. Brain Behav Immun 2014; 35:70-6. [PMID: 24016864 DOI: 10.1016/j.bbi.2013.08.014] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 08/28/2013] [Accepted: 08/28/2013] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study was to assess the association between IL-6 and CRP with depressive items and cognitive function. We included 112 outpatients with major depression from an exercise trial and 57 healthy controls. IL-6, high sensitive CRP (hsCRP), and cognitive function were assessed in all subjects. After baseline assessment, patients were randomised to either a 3months exercise intervention or an exercise control group. Post-intervention IL-6, hsCRP, depressive symptoms, and cognitive function were reassessed in the patient group. IL-6 and hsCRP were significantly increased in depressed patients compared to healthy controls (p=0.02 and 0.04). These differences were no longer significant after adjustment for lifestyle associated variables. We found no association between immune markers and specific depressive symptoms at baseline or as change over time. Regarding the cognitive tests, IL-6 was positively associated with Serial sevens (p=0.008) and hsCRP was inversely associated with Trail making A (p=0.02) and design fluency (p=0.001) at baseline. At 3months follow-up IL-6 and hsCRP levels did not significantly change from baseline and did not differ between the two patient groups. Depression scores was lower compared to baseline but did not differ between groups. Combining the two groups, a decrease in IL-6 was associated to decreased verbal fluency (p=0.02), and a decrease in hsCRP was associated with improvement in Trail making A (p=0.005). In conclusion, the level of IL-6 and hsCRP was increased in depressed outpatients but was not associated to specific depressive symptoms. In terms of cognitive function, we found that higher hsCRP levels were associated to lower psychomotor speed both at baseline and at follow-up.
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Affiliation(s)
- Jesper Krogh
- Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Denmark.
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