Biobehavioral mechanisms underlying symptoms in cancer patients with chronic graft-versus-host disease.

Autor: Hansen JL; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53719, USA., Rumble ME; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53719, USA; University of Wisconsin Center for Sleep Medicine and Research, Madison, WI, 53719, USA., Coe CL; Department of Psychology, University of Wisconsin- Madison, Madison, WI, 53706, USA., Juckett MB; Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, 55455, USA; Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455,USA., Foster MA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53719, USA., Dickson D; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53719, USA; University of Wisconsin Center for Sleep Medicine and Research, Madison, WI, 53719, USA., Morris KE; Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA., Hematti P; Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA; Froedtert Cancer Center, Milwaukee, WI, 53226, USA., Costanzo ES; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53719, USA; Carbone Cancer Center, University of Wisconsin- Madison, Madison, WI, 53792, USA. Electronic address: ecostanzo@wisc.edu.
Jazyk: angličtina
Zdroj: Brain, behavior, and immunity [Brain Behav Immun] 2024 Sep 15; Vol. 123, pp. 185-192. Date of Electronic Publication: 2024 Sep 15.
DOI: 10.1016/j.bbi.2024.09.017
Abstrakt: Chronic graft-versus-host disease (cGVHD) is a complication of allogeneic hematopoietic cell transplant (HCT) and is associated with morbidity and high symptom burden. This study evaluated two biobehavioral mechanisms, inflammation and circadian rest-activity rhythms, that may underly commonly reported psychological and physical symptoms in cGVHD patients. Adults with cGVHD (N=57) wore a wrist actigraph for 7 days, provided a blood sample, and completed patient-reported outcome (PRO) measures. 24-hour rest-activity indices were derived from actigraphy. Cytokines and chemokines relevant to cGVHD were measured in peripheral blood plasma using multi-analyte immunoassays. Multiple regression evaluated the extent to which rest-activity indices and inflammatory biomarkers predicted PROs. Higher levels of circulating IL-8 and MIP-1α were associated with worse depression (β = 0.35, p = 0.01; β = 0.33, p = 0.02) and sexual function (β = -0.41, p = 0.01; β = -0.32, p = 0.03). MIP-1α was associated with more severe insomnia (β = 0.36, p = 0.01). Higher circulating MIF was associated with more severe anxiety (β = 0.28, p = 0.048) and fatigue (β = 0.35, p = 0.02). Il-6, TNFα, and MCP-1 showed few associations with PROs. There were few associations between actigraphy indices and PROs; however, participants with a later daily activity peak (acrophase) reported poorer sexual function (β = -0.31, p = 0.04). Models covarying for age, cGVHD severity, and time since HCT yielded a similar pattern of results. Results suggest that pro-inflammatory cytokines and chemokines associated with cGVHD may contribute to PROs, identifying a biobehavioral mechanism that may be a useful target for future interventions.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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