Association of Depressive Symptoms with Perceived Stress and Proinflammatory Cytokines in Treatment-Naïve Patients with Breast Cancer

Abstract

Objectives: This study aimed to explore the levels and associations among depressive symptoms, perceived stress, and proinflammatory cytokines (interleukin-1β, interleukin-6, and tumor necrosis factor-α) in treatment-naïve patients with breast cancer. Methods: A cross-sectional study with one case and two control groups. Patients with breast cancer, matched patients with depression, and matched healthy women completed questionnaires and blood collection between May 2015 and March 2017. Data were analyzed using the general linear model and linear regression model. Results: The severity of depressive symptoms and perceived stress among patients with breast cancer was significantly higher than that in healthy controls and lower than those in patients with depression. Interleukin-1β was lower in patients with breast cancer than the other two groups. Perceived stress was independently and positively associated with depressive symptoms in patients with breast cancer. There were no significant associations between cytokines and depressive symptoms. Conclusion: Women with breast cancer experienced increased perceived stress prior to anticancer treatment, which was a strong contributor to severe symptoms of depression. Results emphasize the need to screen and identify patients with high perceived stress shortly after the disclosure of the diagnosis of breast cancer. Further research in larger sample is needed to investigate the relationship between proinflammatory cytokines and depressive symptoms.

Differences in Circulating Extracellular Vesicle and Soluble Cytokines in Older Versus Younger Breast Cancer Patients With Distinct Symptom Profiles

“…In addition, in the younger cohort in the All Low class, higher levels of depressive symptoms were associated with higher levels of the anti-inflammatory cytokine, IL-10. Similarly, a recent study found a negative correlation between the pro-inflammatory cytokine, IL-1β, and depressive symptoms in patients with breast cancer with a mean age of 45 years ( Li et al, 2021 ). In another study, higher levels of depressive symptoms were associated with higher levels of IL-1β, and TNF-α post-surgery in breast cancer patients with a mean age of 50 years ( Bouchard et al, 2016 ).…”

“…In another study, higher levels of depressive symptoms were associated with higher levels of IL-1β, and TNF-α post-surgery in breast cancer patients with a mean age of 50 years ( Bouchard et al, 2016 ). While the findings in the literature are inconsistent, previous studies ( Bouchard et al, 2016 ; Li et al, 2021 ) included patients with a wide age range and did not dichotomize the sample into older and younger cohorts. Our findings suggest a pro-inflammatory role in depressive symptoms among the older cohort compared to the younger cohort that is likely related to aging and cancer immune modulations.…”

Association Between Depression and Breast Cancer: TNF/TNFRSF1β and LEP/LEPR Axis

“…Proin ammatory cytokines such as IL-1β and TNF-α show overall upregulation in depression, which suggests that immune activation is present. Indeed, the relationship between these proin ammatory cytokines and depression among patients with breast cancer has been con rmed by many researchers [31,32]. IL-1β and TNF-α are generated by monocytes, and can induce MSCs to differentiate into in ammatory CAFs that promote the metastasis of breast tumor cells [33].…”