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Costa-da-Silva AC, Villapudua CU, Hoffman MP, Aure MH. Immunomodulation of salivary gland function due to cancer therapy. Oral Dis 2024. [PMID: 38696474 DOI: 10.1111/odi.14972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 05/04/2024]
Abstract
Functional salivary glands (SG) are essential for maintaining oral health, and salivary dysfunction is a persistent major clinical challenge. Several cancer therapies also have off-target effects leading to SG dysfunction. Recent advances highlight the role of SG immune populations in homeostasis, dysfunction and gland regeneration. Here, we review what is known about SG immune populations during development and postnatal homeostasis. We summarize recent findings of immune cell involvement in SG dysfunction following cancer treatments such as irradiation (IR) for head and neck cancers, immune transplant leading to graft-versus-host-disease (GVHD) and immune checkpoint inhibitor (ICI) treatment. The role of immune cells in SG in both homeostasis and disease, is an emerging field of research that may provide important clues to organ dysfunction and lead to novel therapeutic targets.
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Affiliation(s)
- Ana C Costa-da-Silva
- Oral Immunobiology Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Carlos U Villapudua
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Matthew P Hoffman
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Marit H Aure
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
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2
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Talani C, Astradsson T, Farnebo L, Mäkitie A, Ehrsson YT, Laurell G. Pretreatment fat-free mass index correlates with early death in patients with head and neck squamous cell carcinoma. Head Neck 2024; 46:808-818. [PMID: 38193618 DOI: 10.1002/hed.27628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/27/2023] [Accepted: 12/23/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND A significant proportion of patients with head and neck squamous cell carcinoma (HNSCC) are malnourished at diagnosis. In this study, we investigated how pretreatment body mass index (BMI) and fat-free mass index (FFMI) correlate with early death, and whether these measurements are useful markers of prognosis for risk stratification of head and neck cancer patients. METHODS Patients (n = 404) with newly diagnosed, curable HNSCC and WHO performance status 0-2 were prospectively included and met with a study representative before treatment initiation, as well as up to four follow-up visits. All patients provided an estimate of body weight at 6 months prior to diagnosis. Bioelectrical impedance analysis (BIA) was performed for all patients before treatment initiation. RESULTS Most patients had oropharyngeal (46%), oral cavity (28%), or laryngeal cancer (12%). Forty-five (11%) patients met the standardized criteria for malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) at diagnosis. FFMI at diagnosis was lower in patients who died within 6 and 12 months after the start of treatment than in patients who survived these time points (p = 0.035 and p = 0.005, respectively). CONCLUSIONS In this study, pretreatment FFMI was an independent prognostic factor for death within 6 and 12 months after the start of treatment in patients with HNSCC. Pretreatment BMI was not an independent risk factor for death within 6 and 12 months after treatment termination. Thus, FFMI may be useful for risk stratification of patients with head and neck cancer.
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Affiliation(s)
- Charbél Talani
- Faculty of Medicine and Health Sciences, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Linköping University, Linköping, Sweden
- Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
| | | | - Lovisa Farnebo
- Faculty of Medicine and Health Sciences, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Linköping University, Linköping, Sweden
- Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Program in Systems Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, Stockholm, Sweden
| | | | - Göran Laurell
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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3
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Huynh TTM, Aass HCD, Falk RS, Astrup GL, Helland Å, Bjøro T, Bjordal K, Dale E, Hellebust TP, Herlofson BB, Malinen E, Kiserud CE, Osnes T, Amdal CD. Associations between patient-reported late effects and systemic cytokines in long-term survivors of head and neck cancer treated with radiotherapy. J Cancer Surviv 2023; 17:1082-1093. [PMID: 36350483 PMCID: PMC9643919 DOI: 10.1007/s11764-022-01273-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/07/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE Head and neck cancer (HNC) treatment may lead to late effects and impaired health-related quality of life of survivors. Knowledge on long-term late effects after radiotherapy (RT) and potential underlying biological mechanisms is lacking. We assessed the prevalence of xerostomia, dysphagia, and chronic fatigue (CF) in HNC survivors ≥ 5 years post-RT, and examined associations between pro-inflammatory cytokines and late effects. METHODS In a cross-sectional study, 263 HNC survivors treated between 2007 and 2013 were enrolled. They completed validated questionnaires assessing xerostomia and dysphagia (the EORTC QLQ-H&N35), and CF (the Fatigue Questionnaire), and underwent blood sampling and clinical examination. Pro-inflammatory cytokines were analyzed in 262 survivors and 100 healthy age- and gender-matched controls. RESULTS Median time since treatment was 8.5 years. The proportions of survivors reporting xerostomia, dysphagia, and CF were 58%, 31%, and 33%, respectively, with a preponderance of females. We found no significant associations between IL-6, IL-8, IP-10, TARC, TNF, or ENA-78 and the three late effects. The odds of having elevated levels of IL-6 and IP-10 were significantly higher in the survivors compared to the controls. CONCLUSIONS More than one-third of long-term HNC survivors experienced xerostomia, dysphagia, and CF. Persistent inflammation, with elevated systemic cytokines, was not associated with these late effects, although HNC survivors had higher levels of some cytokines than the controls. IMPLICATIONS FOR CANCER SURVIVORS This study provides new knowledge on late effects that can serve as grounds for informing patients with HNC about risk of late effects more than 5 years after RT.
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Affiliation(s)
- T T M Huynh
- Faculty of Medicine, University of Oslo, Oslo, Norway.
- Department of Oncology, Oslo University Hospital, Post Box 4950, NO-0424, NydalenOslo, Norway.
| | - H C D Aass
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - R S Falk
- Research Support Services, Oslo University Hospital, Oslo, Norway
| | - G L Astrup
- Department of Oncology, Oslo University Hospital, Post Box 4950, NO-0424, NydalenOslo, Norway
| | - Å Helland
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Post Box 4950, NO-0424, NydalenOslo, Norway
| | - T Bjøro
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - K Bjordal
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Research Support Services, Oslo University Hospital, Oslo, Norway
| | - E Dale
- Department of Oncology, Oslo University Hospital, Post Box 4950, NO-0424, NydalenOslo, Norway
| | - T P Hellebust
- Department of Physics, University of Oslo, Oslo, Norway
- Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - B B Herlofson
- Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
| | - E Malinen
- Department of Physics, University of Oslo, Oslo, Norway
- Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - C E Kiserud
- Department of Oncology, Oslo University Hospital, Post Box 4950, NO-0424, NydalenOslo, Norway
| | - T Osnes
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
| | - C D Amdal
- Department of Oncology, Oslo University Hospital, Post Box 4950, NO-0424, NydalenOslo, Norway
- Research Support Services, Oslo University Hospital, Oslo, Norway
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4
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Savic Vujovic K, Zivkovic A, Dozic I, Cirkovic A, Medic B, Srebro D, Vuckovic S, Milovanovic J, Jotic A. Oxidative Stress and Inflammation Biomarkers in Postoperative Pain Modulation in Surgically Treated Patients with Laryngeal Cancer-Pilot Study. Cells 2023; 12:1391. [PMID: 37408225 DOI: 10.3390/cells12101391] [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: 04/09/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 07/07/2023] Open
Abstract
(1) Background: Surgical treatment of laryngeal carcinoma includes different types of laryngectomies with neck dissection. Surgical tissue damage triggers an inflammatory response, leading to the release of pro-inflammatory molecules. This increases reactive oxygen species production and decreases antioxidant defense mechanisms, leading to postoperative oxidative stress. The aim of this study was to assess the correlation between oxidative stress (malondialdehyde, MDA; glutathione peroxidase, GPX; superoxide dismutase, SOD) and inflammation (interleukin 1, IL-1; interleukin-6, IL-6; C-reactive protein, CRP) parameters and postoperative pain management in patients surgically treated with laryngeal cancer. (2) Methods: This prospective study included 28 patients with surgically treated laryngeal cancer. Blood samples were taken for the analysis of oxidative stress and inflammation parameters before the operative treatment and after the operative treatment (1st postoperative day and 7th postoperative day). The concentrations of MDA, SOD, GPX, IL-1, IL-6, and CRP in the serum were determined by coated enzyme-linked immunosorbent assay (ELISA). The visual analog scale (VAS) was used for pain assessment. (3) Results and conclusion: There was a correlation between oxidative stress and inflammation biomarkers and postoperative pain modulation in surgically treated patients with laryngeal cancer. Age, more extensive surgery, CRP values, and use of tramadol were predictors for oxidative stress parameters.
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Affiliation(s)
- Katarina Savic Vujovic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr Subotica 1, 11129 Belgrade, Serbia
| | - Andjela Zivkovic
- Faculty of Medicine, University of Belgrade, Dr Subotica 1, P.O. Box 38, 11129 Belgrade, Serbia
| | - Ivan Dozic
- Department of Pathology, School of Dental Medicine, University of Belgrade, Dr Subotica-Starijeg 1, 11000 Belgrade, Serbia
| | - Andja Cirkovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia
| | - Branislava Medic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr Subotica 1, 11129 Belgrade, Serbia
| | - Dragana Srebro
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr Subotica 1, 11129 Belgrade, Serbia
| | - Sonja Vuckovic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr Subotica 1, 11129 Belgrade, Serbia
| | - Jovica Milovanovic
- Faculty of Medicine, University of Belgrade, Dr Subotica 1, P.O. Box 38, 11129 Belgrade, Serbia
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Ana Jotic
- Faculty of Medicine, University of Belgrade, Dr Subotica 1, P.O. Box 38, 11129 Belgrade, Serbia
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
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Saroul N, Tardif N, Pereira B, Dissard A, Montrieul L, Sanchez P, Salles J, Petersen JE, Jakobson T, Gilain L, Mom T, Boirie Y, Rooyakers O, Walrand S. Conditioned Media from Head and Neck Cancer Cell Lines and Serum Samples from Head and Neck Cancer Patients Drive Catabolic Pathways in Cultured Muscle Cells. Cancers (Basel) 2023; 15:cancers15061843. [PMID: 36980729 PMCID: PMC10047086 DOI: 10.3390/cancers15061843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The role of secreted factors from the tumor cells in driving cancer cachexia and especially muscle loss is unknown. We wanted to study both the action of secreted factors from head and neck cancer (HNC) cell lines and circulating factors in HNC patients on skeletal muscle protein catabolism. METHODS Conditioned media (CM) made from head and neck cancer cell lines and mix of sera from head and neck cancer (HNC) patients were incubated for 48 h with human myotubes. The atrophy and the catabolic pathway were monitored in myotubes. The patients were classified regarding their skeletal muscle loss observed at the outset of management. RESULTS Tumor CM (TCM) was able to produce atrophy on myotubes as compared with control CM (CCM). However, a mix of sera from HNC patients was not able to produce atrophy in myotubes. Despite this discrepancy on atrophy, we observed a similar regulation of the catabolic pathways by the tumor-conditioned media and mix of sera from cancer patients. The catabolic response after incubation with the mix of sera seemed to depend on the muscle loss seen in patients. CONCLUSION This study found evidence that the atrophy observed in HNC patients cannot be solely explained by a deficit in food intake.
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Affiliation(s)
- Nicolas Saroul
- Otolaryngology Head and Neck Surgery Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
- Biostatistics Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
| | - Nicolas Tardif
- Anesthesiology and Intensive Care, Department of Clinical Science Intervention and Technology, CLINTEC, Karolinska Institutet, 141 86 Huddinge, Sweden
- Division of Perioperative Medicine and Intensive Care, Karolinska University Hospital, 171 77 Huddinge, Sweden
| | - Bruno Pereira
- Biostatistics Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
| | - Alexis Dissard
- Otolaryngology Head and Neck Surgery Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
| | - Laura Montrieul
- Otolaryngology Head and Neck Surgery Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
| | - Phelipe Sanchez
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
| | - Jérôme Salles
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
| | - Jens Erik Petersen
- Otolaryngology Head and Neck Surgery Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
| | - Towe Jakobson
- Anesthesiology and Intensive Care, Department of Clinical Science Intervention and Technology, CLINTEC, Karolinska Institutet, 141 86 Huddinge, Sweden
| | - Laurent Gilain
- Otolaryngology Head and Neck Surgery Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
| | - Thierry Mom
- Otolaryngology Head and Neck Surgery Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
| | - Yves Boirie
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
- Clinical Nutrition Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
| | - Olav Rooyakers
- Anesthesiology and Intensive Care, Department of Clinical Science Intervention and Technology, CLINTEC, Karolinska Institutet, 141 86 Huddinge, Sweden
- Division of Perioperative Medicine and Intensive Care, Karolinska University Hospital, 171 77 Huddinge, Sweden
| | - Stéphane Walrand
- Human Nutrition Unit, INRAE, Auvergne Human Nutrition Research Center, Clermont Auvergne University, CHU de Clermont-Ferrand France, INRAE, UNH, 63000 Clermont-Ferrand, France
- Clinical Nutrition Department, CHU de Clermont-Ferrand France, 63000 Clermont-Ferrand, France
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Adachi M, Nakayama M, Matsumoto S, Shima Y, Uemaetomari I, Yoshimura T, Onishi K, Senarita M, Tabuchi K. Elevation of C-reactive protein during concurrent chemoradiotherapy is a poor predictive factor for head and neck cancer. Auris Nasus Larynx 2023:S0385-8146(22)00241-3. [PMID: 36604259 DOI: 10.1016/j.anl.2022.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/02/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The prognostic role of pretreatment C-reactive protein (CRP) has been reported for head and neck cancer. However, little is known about the relationship between the changes in CRP levels during treatment and prognosis. This study aimed to investigate the correlation between CRP elevation during concurrent chemoradiotherapy (CCRT) and survival outcomes. METHODS The medical records of patients with oropharyngeal, hypopharyngeal, and laryngeal cancer treated with CCRT at the University of Tsukuba Hospital and National Hospital Organization Mito Medical Center from April 2014 to December 2019 were retrospectively reviewed. Patients were divided into normal (<0.3 mg/dl) and elevated (≥0.3 mg/dl) CRP groups according to the CRP level after the first cycle of cisplatin. The primary endpoint was progression-free survival (PFS). RESULTS A total of 74 patients were enrolled, of whom 36 (49%) showed elevated CRP levels after the first cycle of cisplatin. The 3-year PFS was 83.3% and 61.0% in the normal and elevated CRP groups, respectively, showing significant differences between the two groups. CONCLUSION Elevated CRP levels after the first cycle of cisplatin is an objective predictive marker for survival in patient with head and neck squamous cell carcinoma treated with CCRT.
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Affiliation(s)
- Masahiro Adachi
- Department of Otolaryngology-Head and Neck Surgery, University of Tsukuba, Tsukuba, Japan
| | - Masahiro Nakayama
- Department of Otolaryngology-Head and Neck Surgery, University of Tsukuba, Tsukuba, Japan.
| | - Shin Matsumoto
- Department of Otolaryngology-Head and Neck Surgery, University of Tsukuba, Tsukuba, Japan
| | - Yoshihide Shima
- Department of Otolaryngology-Head and Neck Surgery, University of Tsukuba, Tsukuba, Japan
| | - Isao Uemaetomari
- Department of Otolaryngology-Head and Neck Surgery, University of Tsukuba, Tsukuba, Japan
| | - Tomonori Yoshimura
- Department of Otolaryngology, National Hospital Organization Mito Medical Center, Mito, Japan
| | - Kayoko Onishi
- Department of Radiology, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Masamitsu Senarita
- Department of Otolaryngology, National Hospital Organization Mito Medical Center, Mito, Japan
| | - Keiji Tabuchi
- Department of Otolaryngology-Head and Neck Surgery, University of Tsukuba, Tsukuba, Japan
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7
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Longitudinal Changes in the Fatty Acid Profile in Patients with Head and Neck Cancer: Associations with Treatment and Inflammatory Response. Cancers (Basel) 2022; 14:cancers14153696. [PMID: 35954360 PMCID: PMC9367269 DOI: 10.3390/cancers14153696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Cancer-associated malnutrition affects nutrient metabolism, including the metabolism of lipids. Toxicities associated with the treatment for head and neck cancer (HNC) may contribute to malnutrition through impaired oral intake and inflammation. Studies on lipid metabolism in patients with HNC are very limited. The anti-inflammatory effect of some fatty acids (FAs) is already proven in other cancers but the results of these studies in HNC are not consistent. This prospective study of 174 patients with HNC contributes to our knowledge of alterations in lipid metabolism following treatment for HNC and serves as basis for future research. Abstract Studies on fatty acids (FAs) in patients with head and neck cancer (HNC) are limited. We aimed to investigate the longitudinal changes of circulating FAs in patients with HNC and to examine potential correlations of FA changes with treatment. The secondary aims were to investigate correlations of FAs with cytokines and patient-related factors, and if any FAs correlated with disease recurrence or death. A total of 174 patients with HNC were included before treatment and followed-up at three time points after the start of the treatment through blood sampling and body weight measurements. Serum FA profiling was assessed by gas chromatography. The total follow-up time was 3 years. The levels of almost all FAs changed from baseline to 7 weeks. The change in FA 14:0 was associated with treatment and the change in 18:3n-6 was associated with the patients’ pre-treatment BMI. FAs 14:0 and 18:0 were correlated with weight changes from baseline to 7 weeks. IL-6 was correlated with three FAs at 7 weeks and with two FAs at 1 year. Patients with higher levels 20:5n-3 at 3 months had a higher risk of all-cause death within 3 years (HR 2.75, 95% CI 1.22–6.21). Treatment, inflammation, and weight loss contributed in a complex manner to the altered FA profile in the studied cohort. The association between IL-6 and FAs in patients with HNC is in line with earlier studies and suggests the opportunity for regulating inflammation in HNC patients through modulation of FAs.
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8
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Jotic A, Milovanovic J, Savic-Vujovic K, Radin Z, Medic B, Folic M, Pavlovic B, Vujovic A, Dundjerovic D. Immune Cell and Biochemical Biomarkers in Advanced Laryngeal Cancer. Dose Response 2022; 20:15593258221115537. [PMID: 35898723 PMCID: PMC9309787 DOI: 10.1177/15593258221115537] [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] [Indexed: 01/08/2023] Open
Abstract
Objective The aim of this study was to evaluate cell and biochemical biomarkers and
establish their prognostic value in patients with advanced laryngeal
cancer. Material and Methods A prospective study included 52 patients with advanced laryngeal carcinoma
surgically treated at the tertiary referral center. Tumor tissue was
immunohistochemically stained for T-cell markers (CD4 and CD8), and levels
of cytokines (IL-6 and IL-8) and C-reactive protein were analyzed from blood
samples. Results Overall 3-year survival (OS) of patients included in the study was 69.2% and
the disease specific survival (DSS) 72.5%. Higher expression of
CD4+ and CD8+ were significant prognostic factors
with positive impact on both OS and DSS in univariate analysis, but not in
multivariate analysis. Levels of IL-8 were a significant predictor of 3-year
OS and DSS survival in patients with advanced laryngeal cancer but not
levels of IL-6 and CRP values. Conclusion Though high expression of CD4 and CD8 were demonstrated in the tumor tissue,
but their prognostic role was not established. Higher values of IL-8 proved
to be significant negative predictor of DSS. This could further collaborate
the inclusion of combination of biomarkers in assessment of favorable
treatment choice in patients with advanced laryngeal carcinoma.
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Affiliation(s)
- Ana Jotic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia.,Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Jovica Milovanovic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia.,Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Katarina Savic-Vujovic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zorana Radin
- Ear, Nose and Throat Clinic, Clinical Hospital Center Zvezdara, Belgrade, Serbia
| | - Branislava Medic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miljan Folic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia.,Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Bojan Pavlovic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia.,Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Vujovic
- ENT Hospital, Clinical Hospital Center ''Dr Dragisa Misovic-Dedinje'' Belgrade, Serbia
| | - Dusko Dundjerovic
- Institute of Pathology, Medical Faculty, University of Belgrade, Belgrade, Serbia
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9
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Serum Proteomics in Patients with Head and Neck Cancer: Peripheral Blood Immune Response to Treatment. Int J Mol Sci 2022; 23:ijms23116304. [PMID: 35682983 PMCID: PMC9180944 DOI: 10.3390/ijms23116304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/12/2022] Open
Abstract
In this real-world study, the aims were to prospectively evaluate the expression of inflammatory proteins in serum collected from head and neck cancer patients before and after treatment, and to assess whether there were differences in expression associated with treatment modalities. The mixed study cohort consisted of 180 patients with head and neck cancer. The most common tumor sites were the oropharynx (n = 81), the oral cavity (n = 53), and the larynx (n = 22). Blood tests for proteomics analysis were carried out before treatment, 7 weeks after the start of treatment, and 3 and 12 months after the termination of treatment. Sera were analyzed for 83 proteins using an immuno-oncology biomarker panel (Olink, Uppsala, Sweden). Patients were divided into four treatment groups: surgery alone (Surg group, n = 24), radiotherapy with or without surgery (RT group, n = 94), radiotherapy with concomitant cisplatin (CRT group, n = 47), and radiotherapy with concomitant targeted therapy (RT Cetux group, n = 15). For the overall cohort, the expression levels of 15 of the 83 proteins changed significantly between the pretreatment sample and the sample taken 7 weeks after the start of treatment. At 7 weeks after the start of treatment, 13 proteins showed lower expression in the CRT group compared to the RT group. The majority of the inflammatory proteins had returned to their pretreatment levels after 12 months. It was clearly demonstrated that cisplatin-based chemoradiation has immunological effects in patients with head and neck cancer. This analysis draws attention to several inflammatory proteins that are of interest for further studies.
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Granström B, Holmlund T, Laurell G, Fransson P, Tiblom Ehrsson Y. Addressing symptoms that affect patients' eating according to the Head and Neck Patient Symptom Checklist ©. Support Care Cancer 2022; 30:6163-6173. [PMID: 35426524 PMCID: PMC9135877 DOI: 10.1007/s00520-022-07038-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 04/04/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this prospective study was to assess which nutritional impact symptoms (NIS) interfere with oral intake in patients with head and neck cancer (HNC) and how the symptoms interfere with body weight loss, up to 1 year after treatment. METHODS This was a prospective study of 197 patients with HNC planned for treatment with curative intention. Body weight was measured before the start of treatment, at 7 weeks after the start of treatment, and at 6 and 12 months after completion of treatment. NIS and NIS interfering with oral intake at each follow-up were examined with the Head and Neck Patient Symptom Checklist© (HNSC©). RESULTS At 7 weeks of follow-up, patients experienced the greatest symptom and interference burden, and 12 months after treatment the NIS scorings had not returned to baseline. One year after treatment, the highest scored NIS to interfere with oral intake was swallowing problems, chewing difficulties, and loss of appetite. At all 3 follow-ups, the total cumulative NIS and NIS interfering with oral intake were associated with body weight loss. Factors increasing the risk for a body weight loss of ≥ 10% at 12 months after treatment were pain, loss of appetite, feeling full, sore mouth, difficulty swallowing, taste changes, and dry mouth. Women scored higher than men in NIS and NIS interfering with oral intake. Furthermore, during the study period about half of the population had a body weight loss > 5%. CONCLUSION Because both nutritional and clinical factors may affect body weight, this study highlights the importance of a holistic approach when addressing the patients' nutritional issues. TRIAL REGISTRATION ClinicalTrials.gov NCT03343236, date of registration: November 17, 2017.
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Affiliation(s)
- Brith Granström
- Department of Clinical Science, Otorhinolaryngology, Umeå University, 901 87, Umeå, Sweden.
| | - Thorbjörn Holmlund
- Department of Clinical Science, Otorhinolaryngology, Umeå University, 901 87, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85, Uppsala, Sweden
| | - Per Fransson
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85, Uppsala, Sweden
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Christou CN, Tiblom Ehrsson Y, Lampa E, Risérus U, Laurell G. Circulating fatty acids in patients with head and neck cancer after treatment: an explorative study with a one-year perspective. Acta Otolaryngol 2021; 141:878-884. [PMID: 34392790 DOI: 10.1080/00016489.2021.1959950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Unintended weight loss and nutritional problems are often seen in patients with head and neck cancer, but changes in lipid metabolism are poorly studied. AIM/OBJECTIVES The present study aimed to explore the longitudinal changes in circulating fatty acid (FA) composition in patients with head and neck cancer. MATERIALS AND METHODS This study included 27 patients with head and neck cancer. Treatment consisted of single modality or combined modality treatments. The patients were assessed by repeated blood sampling and body weight assessments before treatment started and on three occasions after the start of treatment. FA profiling included gas chromatography analysis of unsaturated FAs and saturated FAs in serum. RESULTS The values of three fatty acids - FA 14:0, FA 18:3n3, and FA 20:3n6 - changed in a specific pattern over the course of the study and the change in FA 14:0 correlated with weight changes. CONCLUSIONS AND SIGNIFICANCE This study showed altered profiles of both saturated and unsaturated FAs. An improved understanding of the metabolic pathways in patients with head and neck cancer supports the development of better nutritional surveillance and nutritional treatments.
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Affiliation(s)
- Constantina Nadia Christou
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Erik Lampa
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
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Chen SH, Hsiao SY, Chang KY, Chang JY. New Insights Into Oral Squamous Cell Carcinoma: From Clinical Aspects to Molecular Tumorigenesis. Int J Mol Sci 2021; 22:ijms22052252. [PMID: 33668218 PMCID: PMC7956378 DOI: 10.3390/ijms22052252] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/20/2021] [Accepted: 02/20/2021] [Indexed: 12/12/2022] Open
Abstract
Oral squamous cell carcinoma (SCC) is a prevalent malignant disease worldwide, especially so in Taiwan. Early- or even preclinical-stage detection is critical for reducing morbidity and mortality from oral SCC. Epidemiological and genome association studies are useful for identifying clinicopathological risk factors for preventive, diagnostic, and therapeutic approaches of oral SCC. For advanced oral SCC, effective treatments are critical to prolonging survival and enhancing quality of life. As oral SCC is characteristic of regional invasion with lymph node metastases, understanding the aggressive features of oral SCC, particularly in lymphangiogenesis, is essential for determining effective treatments. Emerging evidence has demonstrated that the tumor microenvironment (TME) plays a pivotal role in tumor growth, invasion, and metastases. Recent clinical successes in immune checkpoint inhibitors either alone or combined with chemotherapy have also supported the therapeutic value of immunotherapy in oral SCC. This review summarizes critical advances in basic knowledge of oral SCC from the perspective of clinicopathological risk factors, molecular tumorigenesis, and the TME. We also highlight our recent investigations on the microbiome, genome association studies, lymphangiogenesis, and immunomodulation in oral SCC. This review may provide new insights for oral SCC treatment by systematically interpreting emerging evidence from various preclinical and clinical studies.
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Affiliation(s)
- Shang-Hung Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan; (S.-H.C.); (K.-Y.C.)
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
| | - Sheng-Yen Hsiao
- Division of Hematology-Oncology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan 736402, Taiwan;
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Kwang-Yu Chang
- National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan; (S.-H.C.); (K.-Y.C.)
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
| | - Jang-Yang Chang
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Miaoli 35053, Taiwan
- Correspondence:
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Mytilineos D, Ezić J, von Witzleben A, Mytilineos J, Lotfi R, Fürst D, Tsamadou C, Theodoraki MN, Oster A, Völkel G, Kestler HA, Brunner C, Schuler PJ, Doescher J, Hoffmann TK, Laban S. Peripheral Cytokine Levels Differ by HPV Status and Change Treatment-Dependently in Patients with Head and Neck Squamous Cell Carcinoma. Int J Mol Sci 2020; 21:E5990. [PMID: 32825343 PMCID: PMC7503943 DOI: 10.3390/ijms21175990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 12/24/2022] Open
Abstract
Cytokines and immune mediators play an important role in the communication between immune cells guiding their response to infectious diseases or cancer. In this study, a comprehensive longitudinal analysis of serum cytokines and immune mediators in head and neck squamous cell carcinoma (HNSCC) patients was performed. In a prospective, non-interventional, longitudinal study, blood samples from 22 HNSCC patients were taken at defined time points (TP) before, during, and every 3 months after completion of (chemo)radio)therapy (CRT/RT) until 12 months after treatment. Serum concentrations of 17 cytokines/immune mediators and High-Mobility-Group-Protein B1 (HMGB1) were measured by fluorescent bead array and ELISA. Concentrations of sFas were significantly elevated during and after CRT/RT, whereas perforin levels were significantly decreased after CRT/RT. Levels of MIP-1β and Granzyme B differed significantly during CRT/RT by HPV status. Increased HMGB1 levels were observed at recurrence, accompanied by high levels of IL-4 and IL-10. The sFas increase and simultaneous perforin decrease may indicate an impaired immune cell function during adjuvant radiotherapy. Increased levels of pro-inflammatory cytokines in HPV+ compared to HPV- patients seem to reflect the elevated immunogenicity of HPV-positive tumors. High levels of HMGB1 and anti-inflammatory cytokines at recurrence may be interpreted as a sign of immune evasion.
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Affiliation(s)
- Daphne Mytilineos
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Jasmin Ezić
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Adrian von Witzleben
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
- CRUK and NIHR Experimental Cancer Medicine Center & School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Joannis Mytilineos
- Institute for Clinical Transfusion Medicine and Immune Genetics, German Red Cross Blood Transfusion Service, 89081 Ulm, Germany; (J.M.); (R.L.); (D.F.); (C.T.)
| | - Ramin Lotfi
- Institute for Clinical Transfusion Medicine and Immune Genetics, German Red Cross Blood Transfusion Service, 89081 Ulm, Germany; (J.M.); (R.L.); (D.F.); (C.T.)
- Institute for Transfusion Medicine, University Hospital Ulm, 89081 Ulm, Germany
| | - Daniel Fürst
- Institute for Clinical Transfusion Medicine and Immune Genetics, German Red Cross Blood Transfusion Service, 89081 Ulm, Germany; (J.M.); (R.L.); (D.F.); (C.T.)
| | - Chrysanthi Tsamadou
- Institute for Clinical Transfusion Medicine and Immune Genetics, German Red Cross Blood Transfusion Service, 89081 Ulm, Germany; (J.M.); (R.L.); (D.F.); (C.T.)
| | - Marie-Nicole Theodoraki
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Angelika Oster
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Gunnar Völkel
- Institute for Medical Systems Biology, Ulm University, 89081 Ulm, Germany; (G.V.); (H.A.K.)
| | - Hans A. Kestler
- Institute for Medical Systems Biology, Ulm University, 89081 Ulm, Germany; (G.V.); (H.A.K.)
| | - Cornelia Brunner
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Patrick J. Schuler
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Johannes Doescher
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Thomas K. Hoffmann
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
| | - Simon Laban
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Ulm, 89070 Ulm, Germany; (D.M.); (J.E.); (A.v.W.); (M.-N.T.); (A.O.); (C.B.); (P.J.S.); (J.D.); (T.K.H.)
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Muzumder S, Srikantia N. Toxicity syndrome and early competing deaths in head-and-neck cancer undergoing radiation therapy: Observation and hypothesis. Med Hypotheses 2020; 143:110145. [PMID: 32759015 DOI: 10.1016/j.mehy.2020.110145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/18/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
Radiotherapy (RT) and/or concurrent chemoradiation (CRT) is the mainstay for the treatment of locally advanced head-and-neck cancer (LAHNC). Sepsis remains a poorly understood and unrecognized event in head-and-neck cancer. The study aims to hypothesize a 'toxicity syndrome' leading to sepsis and subsequent sepsis-related deaths. A retrospective audit of all 125 LAHNC patients treated radically from January 2013 to June 2017 was conducted. A total of fifteen toxic deaths were reported. Thirteen deaths were attributed to sepsis. Individual toxicity for death was ascertained only for three cases. A toxicity syndrome namely 'mucositis-dysphagia-aspiration-sepsis (MDAS) complex' was proposed as the cause of death in the rest ten cases. The authors recommend the surveillance of the 'MDAS complex' for the prevention of early toxicity-related deaths in patients with LAHNC undergoing RT or CRT.
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Affiliation(s)
- Sandeep Muzumder
- Department of Radiation Oncology, St John's Medical College and Hospital, Bengaluru, India.
| | - Nirmala Srikantia
- Department of Radiation Oncology, St John's Medical College and Hospital, Bengaluru, India
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