The role of neuro‐immune interactions in cancer‐related fatigue: Biobehavioral risk factors and mechanisms

Abstract

Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer‐related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro‐immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer‐related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biologic systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue. The identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective.

The Effect of Fermented Porcine Placental Extract on Fatigue-Related Parameters in Healthy Adults: A Double-Blind, Randomized, Placebo-Controlled Trial

“…In particular, IL-1 is of great interest because of its important role in congenital immune system and other physiological systems. Studies reported the role of two of the 11 members belonging to the IL-1 family, including IL-1α and IL-1β in fatigue [ 39 , 40 , 41 ] In this study, we have shown that 8-week FPP supplementation improves the level of IL-1β. Therefore, it is suggested that the anti-fatigue effect of FPP is mediated via regulation of inflammation, and the anti-fatigue effects result via downregulation of metabolite accumulation in exercise-induced fatigue.…”

Fatigue in Multiple Sclerosis Is Associated With Childhood Adversities

“…This would help to disentangle the specificity of the link between adverse emotional experiences and fatigue as an MS-related or a more general phenomenon. A link between adverse emotional experiences and fatigue has also been reported in other medical conditions, such as CFS or cancer (40,41).…”

Chemotherapy-induced neuroinflammation is associated with disrupted colonic and bacterial homeostasis in female mice

“…Reduced locomotion may be indicative of fatigue in mice, another common side effect of chemotherapy, although further analyses to assess fatigue are necessary. Each of these sickness behaviors is associated with peripheral inflammation in chemotherapy patients 44,45 and other rodent models 46 . Indeed, in the present study, paclitaxel-treated mice demonstrated evidence of peripheral inflammation including increased spleen mass in conjunction with increased transient concentrations of circulating LBP, IL-1β, TNFα, and CXCL1.…”