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Montgomery KE, Basha M, Nyholm L, Smith C, Ananiev G, Fedorov A, Kapoor A, Brown R, Capitini C, Kwekkeboom K. Exploring Inflammation and Stress as Biological Correlates of Symptoms in Children With Advanced Cancer: A Longitudinal Feasibility Study. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:157-171. [PMID: 38588659 DOI: 10.1177/27527530231214544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Background: Few studies have examined biomarkers of stress and inflammation as underlying mechanisms of symptoms in adolescents and young adults with cancer. This study determined the feasibility of collecting blood and saliva samples across time, described the range and distribution of biomarkers, and explored the association of biomarkers with symptom adverse events (AEs). Method: This longitudinal, prospective repeated-measures single-site feasibility study recruited N = 10 children (M = 12.5 years) receiving treatment for advanced cancer. Symptom AE data and inflammation (cytokines and C-reactive protein) and physiologic response to stress (salivary cortisol and salivary alpha-amylase) biomarker levels were collected at three time points. Descriptive statistics were used to examine feasibility and acceptability and to summarize symptom AE, stress, and inflammatory biomarker data. A linear regression model was used to determine cortisol diurnal slopes. The relationship between symptom and inflammatory biomarker data was explored and Hedges's g statistic was used to determine its effect size. Results: Participants provided 83% of saliva samples (n = 199/240) and 185 samples were sufficient to be analyzed. Nurses collected 97% (n = 29/30) of blood samples. Participants reported the saliva collection instructions, kits, and reminders were clear and helpful. Insomnia, pain, fatigue, and anxiety demonstrated the most medium and large negative effects with inflammatory markers. Symptom AEs demonstrated the highest number of medium and large negative effects with interleukin-8 and tumor necrosis factor-alpha (-0.53 to -2.00). Discussion: The results indicate longitudinal concurrent collection of symptom and biomarker data is feasible and inflammatory and stress biomarkers merit consideration for inclusion in future studies.
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Affiliation(s)
| | - Mays Basha
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Leah Nyholm
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Corey Smith
- Department of Medicine - Pulmonary/Critical Care, UW Health, Madison, WI, USA
| | - Gene Ananiev
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Alexander Fedorov
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Amita Kapoor
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Roger Brown
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Christian Capitini
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Amendola A, Borghi E, Bianchi S, Gori M, Fappani C, Barcellini L, Forlanini F, Garancini N, Nava C, Mari A, Sala A, Gasparini C, Ottaviano E, Colzani D, Biganzoli EM, Tanzi E, Zuccotti GV. Preschool-located influenza vaccination and influenza-like illness surveillance: an Italian pilot experience. Ital J Pediatr 2023; 49:91. [PMID: 37480047 PMCID: PMC10362647 DOI: 10.1186/s13052-023-01481-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/01/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND We describe the first school-located influenza vaccination campaign with quadrivalent live-attenuated influenza vaccine (LAIV) among pre-school children in Italy, coupled with an innovative school-centred influenza-like illnesses (ILIs) surveillance using a self-sampling non-invasive saliva collection method. METHODS The pilot study was proposed during the 2021/2022 influenza season to fifteen pre-schools in the Milan municipality. LAIV was offered directly in school to all healthy children without contraindications. ILI differential diagnosis was conducted by real-time RT-PCR for influenza A/B and SARS-CoV-2. RESULTS Five pre-schools were involved in the pilot project and overall, 135 families (31.2%) participated in the study, adhering to both surveillance and vaccination; 59% of families had an immigrant background. No pupil experienced adverse reactions after vaccination. Nineteen saliva samples were collected from sixteen children (11.8%). Six samples (31.6%) tested positive for SARS-CoV-2; none was positive for influenza A/B. CONCLUSIONS The participation in the immunisation campaign was good, considering possible absences due to COVID-19 pandemic, and the intranasal administration was well tolerated and helped to overcome parental hesitancy. Saliva sampling represented a useful tool to reduce children's stress and increase parents' compliance. The high participation of families with an immigrant background suggests that school-based interventions can represent an effective strategy to overcome socioeconomic and cultural barriers.
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Affiliation(s)
- Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy.
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy.
| | - Elisa Borghi
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, 20133, Italy
| | - Lucia Barcellini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Federica Forlanini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Nicolò Garancini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Chiara Nava
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Alessandra Mari
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Anna Sala
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Chiara Gasparini
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
| | - Emerenziana Ottaviano
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
| | - Elia Mario Biganzoli
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, 20157, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, 20142, Italy
- EpiSoMI CRC-Coordinated Research Centre, Università degli Studi di Milano, Milan, 20133, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, 20154, Italy
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