The relationship between pro-inflammatory cytokines and pain, loss of appetite and fatigue in patients with advanced cancer

Ørnulf Paulsen (Corresponding Author), Barry Laird, Nina Aass, Tor Lea, Peter Fayers, Stein Kaasa, Pål Klepstad

Research output: Contribution to journalArticle

17 Citations (Scopus)
3 Downloads (Pure)

Abstract

Background Systemic inflammation is associated with reduced quality of life and increased symptoms in patients with advanced cancer. The aims of this study were to examine the relationships between inflammatory biomarkers and the Patient Reported Outcome Measures (PROMs) of pain, appetite and fatigue; and to explore whether levels of baseline biomarkers were associated with changes in these PROMs following treatment with corticosteroids. Material and methods An exploratory analysis was done on a trial examining the analgesic properties of corticosteroids in patients with advanced cancer. Inclusion criteria were: >18 years, taking opioids for moderate or severe cancer pain; pain 4 (numerical rating scale 0–10). Serum was extracted and levels of inflammatory biomarkers were assessed. PROMs of pain, appetite and fatigue were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The relationships between PROMs and inflammatory biomarkers were examined using Spearman Rho-Rank and multiple regression analysis. Results Data were available on 49 patients. Levels of sTNF-r1, IL-6, IL-18, MIF, MCP-1, TGF-β1, IL1ra, and C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were elevated; IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12(p70), interferon-γ, MIP-1α, and TNF-α were below the level of detection. The following correlations were observed: appetite and IL-6 and CRP; fatigue and IL-1ra (rs: 0.38–0.41, p< .01). There was no association between pretreatment biomarkers and effect from corticosteroid treatment. Conclusion In patients with advanced cancer and pain, some pro-inflammatory cytokines were related to appetite and fatigue. Inflammatory biomarkers were not associated with pain or with the efficacy of corticosteroid therapy. Further research examining the attenuation of the systemic inflammatory response and possible effects on symptoms would be of interest.
Original languageEnglish
Article number e0177620
Number of pages16
JournalPloS ONE
Volume12
Issue number5
DOIs
Publication statusPublished - 25 May 2017

Fingerprint

Biomarkers
Appetite
anorexia
Fatigue
pain
cytokines
Fatigue of materials
Cytokines
Pain
biomarkers
neoplasms
Adrenal Cortex Hormones
adrenal cortex hormones
appetite
Neoplasms
C-Reactive Protein
Interleukin-6
C-reactive protein
MSH Release-Inhibiting Hormone
quality of life

Cite this

The relationship between pro-inflammatory cytokines and pain, loss of appetite and fatigue in patients with advanced cancer. / Paulsen, Ørnulf (Corresponding Author); Laird, Barry; Aass, Nina; Lea, Tor; Fayers, Peter; Kaasa, Stein; Klepstad, Pål.

In: PloS ONE, Vol. 12, No. 5, e0177620, 25.05.2017.

Research output: Contribution to journalArticle

Paulsen, Ørnulf ; Laird, Barry ; Aass, Nina ; Lea, Tor ; Fayers, Peter ; Kaasa, Stein ; Klepstad, Pål. / The relationship between pro-inflammatory cytokines and pain, loss of appetite and fatigue in patients with advanced cancer. In: PloS ONE. 2017 ; Vol. 12, No. 5.
@article{d2f775a1f0ab41419eadd7d9ff47801a,
title = "The relationship between pro-inflammatory cytokines and pain, loss of appetite and fatigue in patients with advanced cancer",
abstract = "Background Systemic inflammation is associated with reduced quality of life and increased symptoms in patients with advanced cancer. The aims of this study were to examine the relationships between inflammatory biomarkers and the Patient Reported Outcome Measures (PROMs) of pain, appetite and fatigue; and to explore whether levels of baseline biomarkers were associated with changes in these PROMs following treatment with corticosteroids. Material and methods An exploratory analysis was done on a trial examining the analgesic properties of corticosteroids in patients with advanced cancer. Inclusion criteria were: >18 years, taking opioids for moderate or severe cancer pain; pain 4 (numerical rating scale 0–10). Serum was extracted and levels of inflammatory biomarkers were assessed. PROMs of pain, appetite and fatigue were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The relationships between PROMs and inflammatory biomarkers were examined using Spearman Rho-Rank and multiple regression analysis. Results Data were available on 49 patients. Levels of sTNF-r1, IL-6, IL-18, MIF, MCP-1, TGF-β1, IL1ra, and C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were elevated; IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12(p70), interferon-γ, MIP-1α, and TNF-α were below the level of detection. The following correlations were observed: appetite and IL-6 and CRP; fatigue and IL-1ra (rs: 0.38–0.41, p< .01). There was no association between pretreatment biomarkers and effect from corticosteroid treatment. Conclusion In patients with advanced cancer and pain, some pro-inflammatory cytokines were related to appetite and fatigue. Inflammatory biomarkers were not associated with pain or with the efficacy of corticosteroid therapy. Further research examining the attenuation of the systemic inflammatory response and possible effects on symptoms would be of interest.",
author = "{\O}rnulf Paulsen and Barry Laird and Nina Aass and Tor Lea and Peter Fayers and Stein Kaasa and P{\aa}l Klepstad",
note = "Acknowledgments The authors would like to thank the personnel at the participating centers for their contributions recruiting patients and collecting data, and patients for participating in this study",
year = "2017",
month = "5",
day = "25",
doi = "10.1371/journal.pone.0177620",
language = "English",
volume = "12",
journal = "PloS ONE",
issn = "1932-6203",
publisher = "PUBLIC LIBRARY SCIENCE",
number = "5",

}

TY - JOUR

T1 - The relationship between pro-inflammatory cytokines and pain, loss of appetite and fatigue in patients with advanced cancer

AU - Paulsen, Ørnulf

AU - Laird, Barry

AU - Aass, Nina

AU - Lea, Tor

AU - Fayers, Peter

AU - Kaasa, Stein

AU - Klepstad, Pål

N1 - Acknowledgments The authors would like to thank the personnel at the participating centers for their contributions recruiting patients and collecting data, and patients for participating in this study

PY - 2017/5/25

Y1 - 2017/5/25

N2 - Background Systemic inflammation is associated with reduced quality of life and increased symptoms in patients with advanced cancer. The aims of this study were to examine the relationships between inflammatory biomarkers and the Patient Reported Outcome Measures (PROMs) of pain, appetite and fatigue; and to explore whether levels of baseline biomarkers were associated with changes in these PROMs following treatment with corticosteroids. Material and methods An exploratory analysis was done on a trial examining the analgesic properties of corticosteroids in patients with advanced cancer. Inclusion criteria were: >18 years, taking opioids for moderate or severe cancer pain; pain 4 (numerical rating scale 0–10). Serum was extracted and levels of inflammatory biomarkers were assessed. PROMs of pain, appetite and fatigue were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The relationships between PROMs and inflammatory biomarkers were examined using Spearman Rho-Rank and multiple regression analysis. Results Data were available on 49 patients. Levels of sTNF-r1, IL-6, IL-18, MIF, MCP-1, TGF-β1, IL1ra, and C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were elevated; IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12(p70), interferon-γ, MIP-1α, and TNF-α were below the level of detection. The following correlations were observed: appetite and IL-6 and CRP; fatigue and IL-1ra (rs: 0.38–0.41, p< .01). There was no association between pretreatment biomarkers and effect from corticosteroid treatment. Conclusion In patients with advanced cancer and pain, some pro-inflammatory cytokines were related to appetite and fatigue. Inflammatory biomarkers were not associated with pain or with the efficacy of corticosteroid therapy. Further research examining the attenuation of the systemic inflammatory response and possible effects on symptoms would be of interest.

AB - Background Systemic inflammation is associated with reduced quality of life and increased symptoms in patients with advanced cancer. The aims of this study were to examine the relationships between inflammatory biomarkers and the Patient Reported Outcome Measures (PROMs) of pain, appetite and fatigue; and to explore whether levels of baseline biomarkers were associated with changes in these PROMs following treatment with corticosteroids. Material and methods An exploratory analysis was done on a trial examining the analgesic properties of corticosteroids in patients with advanced cancer. Inclusion criteria were: >18 years, taking opioids for moderate or severe cancer pain; pain 4 (numerical rating scale 0–10). Serum was extracted and levels of inflammatory biomarkers were assessed. PROMs of pain, appetite and fatigue were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The relationships between PROMs and inflammatory biomarkers were examined using Spearman Rho-Rank and multiple regression analysis. Results Data were available on 49 patients. Levels of sTNF-r1, IL-6, IL-18, MIF, MCP-1, TGF-β1, IL1ra, and C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were elevated; IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12(p70), interferon-γ, MIP-1α, and TNF-α were below the level of detection. The following correlations were observed: appetite and IL-6 and CRP; fatigue and IL-1ra (rs: 0.38–0.41, p< .01). There was no association between pretreatment biomarkers and effect from corticosteroid treatment. Conclusion In patients with advanced cancer and pain, some pro-inflammatory cytokines were related to appetite and fatigue. Inflammatory biomarkers were not associated with pain or with the efficacy of corticosteroid therapy. Further research examining the attenuation of the systemic inflammatory response and possible effects on symptoms would be of interest.

U2 - 10.1371/journal.pone.0177620

DO - 10.1371/journal.pone.0177620

M3 - Article

VL - 12

JO - PloS ONE

JF - PloS ONE

SN - 1932-6203

IS - 5

M1 - e0177620

ER -