Biomarkers of fatigue related to adjuvant chemotherapy for breast cancer: evaluation of plasma and lymphocyte expression

Abstract

Background Fatigue is common in cancer patients receiving adjuvant chemotherapy. To further understand the mechanism of fatigue and search for potential biomarkers, we conducted this prospective study. Methods We enrolled breast cancer (BC) patients before their first adjuvant Adriamycin-based chemotherapy cycle. Patients responded to the brief fatigue inventory (BFI) and Chalder fatigue questionnaires and had their blood drawn for both plasma evaluation and evaluation of the peripheral mononuclear cell fraction (PMNCF) mRNA expression of various biomarkers. We evaluated FSH, LH, estradiol, DHEA, DHEAS, IL6, IL2, ILIRA, IL1β, CRP, Cortisol in the plasma and IL2, IL10, IL6, TGF-β, KLRC1, TNF, BTP, SNCA, SOD1, BLNK, PTGS2 and INF γ expression in the PMNCF. Results 11 patients did not exhibit an increase in their BFI scores and served as controls, whereas 32 patients exhibited an increase in their BFI scores compared with the baseline scores. From the biomarkers we evaluated in the PMNCF, the only one significantly associated with fatigue was TGF-β (p = 0.0343), while there was a trend towards significance with KLRC1 (p = 0.0627). We observed no evidence of significant associations of any plasma biomarkers with the development of fatigue. However when we analyzed patients with more severe fatigue, plasma IL1-RA levels correlated directly with higher fatigue scores (p = 0.0136). Conclusions We conclude that fatigue induced by chemotherapy in BC patients is associated with changes in IL1-ra plasma levels and in TGF-β lymphocyte expression. Its mechanism may be different than that observed in long-term BC survivors or that induced by radiation therapy. Trial registration NCT02041364 [ClinicalTrials.gov]

Adrenal fatigue does not exist: a systematic review

“…Mental arithmetic and public speech stressors also performedLennartsson [24]201556H/BDCSRD; exclusion w/ SEQDHEA-S; ACTH; ACTH and DHEA-S post-TSST (TSST stress test performed)↓DHEA-S, ↓post-TSST DHEA-S, Nl ACTH, Nl post-TSST ACTHTao [23]2015171H/BMaslachMSC, ACTH↑ACTH, ↑MSCJonsson [29]201551H/BSMBQMSC, MSTNl MSC, ↓MSTLennartsson [27]201556H/BDCSRD and SMBQMSC, MST, ACTH, ACTH post-TSST (TSST stress test performed)Nl MSC, Nl MST, Nl ACTH, Nl post-TSST ACTHSevere BO: lower ACTH, cortisol response to TSST vs controls, whereas low BO: higher ACTH, cortisol responses vs controlsSchmaling [26]201562HealthyADASAUC, SCR↓AUC, ↓SCR31 couples studied, one of which had chronic fatigue (but not CFS)Sveinsdottir [68]20151150Chronic LombalgiaCFQDAC, CAR, SCR, NSCNl DAC, Nl CAR, Nl NSC, Nl SCR**Colocar como SAUDÁVEL – porque é só lombalgia (increased CAR in Low back pain)Powell [67]201576Multiple SclerosisCFQDAC, CAR, SCR↓DAC, ↑CAR, Nl SCRSleep disorders excluded; adjusted for depressive symptoms; NSC not published. Multiple sclerosis had increased awakening cortisol and decreased CARCruz [70]201543Breast cancerBFI and CFQMSC, DHEA-SNl MSC, Nl DHEA-SPts undergoing ChTx included anthracyclinesMarchand [31]20141043H/BMaslachDAC, CAR, SCR, NSC↑DAC, ↓CAR, ↑SCR, ↓NSCOnly BO; Groups of severe distress or depression not includedAggarwal [30]2014227HealthyCFQMSC, NSC, 0.25 mg DST, DHEA-SNl MSC, Nl NSC, Nl 0.25 mg DST, ↓DHEA-SEvaluation of chronic, widespread pain, chronic orofacial pain, chronic fatigue (but not CFS), irritable bowel syndromeTell D [71]2014130Breast cancerMFIDAC, CAR, SCR,...…”

Fatigue reduction diet in breast cancer survivors: a pilot randomized clinical trial

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The Relationship Between Inflammatory Biomarkers and Symptom Distress in Lung Cancer Patients Undergoing Chemotherapy

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