Depression in older patients with advanced colorectal cancer is closely connected with immunosuppressive acidic protein

Single-cell RNA sequencing reveals that the immunosuppression landscape induced by chronic stress promotes colorectal cancer metastasis

The high prevalence of depressive disorders in individuals with cancer and their contribution to tumour progression is a topic that is gradually gaining attention. Recent evidence has shown that there are prominent connections between immune gene variants and mood disorders. The homeostasis of the tumour immune microenvironment (TIME) and the infiltration and activation of immune cells play a very important role in the antitumour effect. In this study, we established a compound mouse model with chronic unpredictable mild stress (CUMS) and orthotopic colorectal cancer to simulate colorectal cancer (CRC) patients with depression. Using 10✕Genomics single-cell transcriptome sequencing technology, we profiled nearly 30,000 cells from tumour samples of 8 mice from the control and CUMS groups, revealed that immune cells in tumours under a chronic stress state trend toward a more immunosuppressive and exhaustive status, and described the crosstalk between the overall inflammatory environment and immunosuppressive landscape to provide mechanistic information or efficacious strategies for immune-oncology treatments in CRC with depressive disorders.

Identification of Gene Co-Expression Modules and Core Genes Related to Immune Disorders in Major Depression Disorder

Introduction

Various studies have confirmed the connection between the mental state and the immune system, that is, mental activities can regulate immune function, and immune system disorders can not only lead to bodily diseases but also changes related to mentality, behavior, personality, and aging. However, the specific regulatory mechanism and key genes are still unclear.

Methods

We obtained the peripheral blood gene sequencing data from patients with major depression and normal volunteers from the GEO database and evaluated the scores of different immune cells by immune scoring algorithm. Using the immune scores as clinical data, a weighted gene co-expression network analysis (WGCNA) was carried out to study the association between the clinical characteristics and modules. Therefore, providing an opportunity to lock modules and core genes which are highly related to the immune regulation of major depression.

Results

Thirteen co-expression modules were clustered from 20,011 genes, the yellow module had a positive correlation with CD4⁺ T cell, CD8⁺ T cell, B cell, and NK cell immune scores, and a negative correlation with purple module. Functional annotation and signaling pathway analysis illustrated that the yellow module is mostly enriched in thymus development, T cell co-stimulation and differentiation, and B cell activation. Genes in the purple module were primarily related to inhibition of protein phosphorylation, leukocyte migration, promotion of apoptosis and hypoxia and other signaling pathways. Additionally, hub genes in the yellow and purple modules were detected, in which SKAP1 and RALB may be important regulatory genes affecting the immune status of patients with depression.

Discussion

In general, our study reveals the key genes related to the decrease in CD4⁺ T cells, CD8⁺ T cells, and B cells, in the peripheral blood of patients with depression, which provides some new insights and understandings for the clinical treatment and diagnosis of major depression. Drug design targeting these targets may provide the possibility for the treatment of major depression.

Influence of Diagnostic Informing on Negative Emotions, Illness Perception, Self-Perceived Burden, and Posttraumatic Stress Disorder in Patients with Gastrointestinal Tumors

Objective

To investigate the influence of diagnostic informing on negative emotions, illness perception (IP), self-perceived burden (SPB), and posttraumatic stress disorder (PTSD) in patients with gastrointestinal tumors.

Methods

A total of 261 patients with gastrointestinal tumors admitted to our hospital from January 2018 to December 2020 were selected. According to whether the patients were informed of the disease diagnosis, they were divided into the informing group (n = 125) and the concealment group (n = 136). The self-rating anxiety scale (SAS), the self-rating depression scale (SDS), the brief illness perception questionnaire (BIPQ), the self-perceived burden scale (SPBS), and the PTSD checklist-civilian version (PCL-C) were used to investigate the two groups.

Results

The SAS and SDS scores of the informing group were lower than those of the concealment group (t = 7.853 and 6.444, P < 0.05). The total BIPQ score of the informing group was higher than that of the concealment group (t = -4.089, P < 0.05). The total SPBS score of the informing group was lower than that in the concealment group (t = 2.443, P < 0.05). The total PCL-C score of the informing group was lower than that of the concealment group (t = 2.173, P < 0.05).

Conclusion

Diagnosis informing can reduce the negative emotions, increase positive IP, and reduce the risk of SPB and PTSD in patients with gastrointestinal tumors.

Assigning Clinical Significance and Symptom Severity Using the Zung Scales: Levels of Misclassification Arising from Confusion between Index and Raw Scores

BACKGROUND

The Zung Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) are two norm-referenced scales commonly used to identify the presence of depression and anxiety in clinical research. Unfortunately, several researchers have mistakenly applied index score criteria to raw scores when assigning clinical significance and symptom severity ratings. This study examined the extent of this problem.

METHOD

102 papers published over the six-year period from 2010 to 2015 were used to establish two convenience samples of 60 usages of each Zung scale.

RESULTS

In those papers where cut-off scores were used (i.e., 45/60 for SDS and 40/60 for SAS), up to 51% of SDS and 45% of SAS papers involved the incorrect application of index score criteria to raw scores. Inconsistencies were also noted in the severity ranges and cut-off scores used.

CONCLUSIONS

A large percentage of publications involving the Zung SDS and SAS scales are using incorrect criteria for the classification of clinically significant symptoms of depression and anxiety. The most common error-applying index score criteria to raw scores-produces a substantial elevation of the cut-off points for significance. Given the continuing usage of these scales, it is important that these inconsistencies be highlighted and resolved.