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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Fatigue and Proinflammatory Cytokine Activity in Breast Cancer Survivors.
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Fatigue and Proinflammatory Cytokine Activity in Breast Cancer Survivors.

机译：乳腺癌幸存者的疲劳和促炎性细胞因子活性。

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OBJECTIVE: Fatigue is a common problem among cancer patients and survivors, yet the mechanisms underlying the occurrence and persistence of this symptom are not known. Activation of the immune system may evoke feelings of fatigue, which are mediated by proinflammatory cytokines. We examined whether fatigued breast cancer survivors would show elevations in proinflammatory cytokines and markers of cytokine activity compared with nonfatigued survivors. Differences in lymphocyte subsets, cortisol, and behavioral symptoms associated with proinflammatory cytokines were also assessed. METHODS: Forty breast cancer survivors (20 fatigued, 20 nonfatigued) provided blood samples at visits scheduled to control for diurnal variability. Cytokines, soluble markers of cytokine activity, and cortisol were measured by immunoassay and lymphocyte subsets by flow cytometry. Participants also completed questionnaires measuring demographic, medical, and behavioral variables. RESULTS: Fatigued breast cancer survivors had significantly higher serum levels of several markers associated with proinflammatory cytokine activity than nonfatigued survivors, including interleukin-1 receptor antagonist (IL-1ra), soluble tumor necrosis factor receptor type II (sTNF-RII), and neopterin. They were also more likely to report behavioral problems that co-occur with fatigue in the context of immune activation. Fatigued survivors had significantly lower serum levels of cortisol than the nonfatigued group as well as differences in two lymphocyte populations. CONCLUSIONS: Fatigued breast cancer survivors showed elevations in serum markers associated with proinflammatory cytokine activity an average of 5 years after diagnosis. Results suggest mechanisms through which enduring immune activation may occur, including alterations in cortisol and in lymphocyte subsets.
机译：目的：疲劳是癌症患者和幸存者中的普遍问题，但尚不清楚这种症状的发生和持续存在的机制。免疫系统的激活可能会引起疲劳感，这种疲劳感是由促炎性细胞因子介导的。我们检查了疲劳的乳腺癌幸存者与未疲劳的幸存者相比是否会显示出促炎性细胞因子的升高和细胞因子活性的标志物。还评估了与促炎细胞因子有关的淋巴细胞亚群，皮质醇和行为症状的差异。方法：四十名乳腺癌幸存者（20名疲倦，20名未疲劳）在预定就诊以控制昼夜变异性的就诊时提供了血样。通过免疫测定和流式细胞术测量淋巴细胞亚群，测量细胞因子，细胞因子活性的可溶性标记物和皮质醇。参加者还完成了测量人口统计学，医学和行为变量的问卷。结果：与未疲劳的幸存者相比，疲劳的乳腺癌幸存者的血清中与促炎细胞因子活性相关的几种标志物的血清水平显着更高，包括白细胞介素-1受体拮抗剂（IL-1ra），可溶性肿瘤坏死因子受体II型（sTNF-RII）和新蝶呤。他们还更有可能报告在免疫激活的情况下与疲劳共同发生的行为问题。疲劳的幸存者的血清皮质醇水平明显低于未疲劳的组，并且两个淋巴细胞群体之间存在差异。结论：疲劳的乳腺癌幸存者在诊断后平均5年显示与促炎细胞因子活性相关的血清标志物升高。结果表明可能通过持久的免疫激活发生的机制，包括皮质醇和淋巴细胞亚群的改变。

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