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

IF 8.8 2区 医学 Q1 IMMUNOLOGY Brain, Behavior, and Immunity Pub Date : 2024-09-15 DOI:10.1016/j.bbi.2024.09.017
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Abstract

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.

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慢性移植物抗宿主疾病癌症患者症状的生物行为机制
慢性移植物抗宿主疾病(cGVHD)是异基因造血细胞移植(HCT)的一种并发症,与发病率和高症状负担有关。本研究评估了炎症和昼夜节律-休息-活动节律这两种生物行为机制,它们可能是 cGVHD 患者常见的心理和生理症状的基础。成人 cGVHD 患者(57 人)佩戴腕式活动仪 7 天,提供血液样本,并完成患者报告结果 (PRO) 测量。24小时静息活动指数由腕动图得出。外周血血浆中与 cGVHD 相关的细胞因子和趋化因子是通过多分析免疫测定法测定的。多元回归评估了静息活动指数和炎症生物标志物对PROs的预测程度。较高水平的循环 IL-8 和 MIP-1α 与抑郁(β = 0.35,p = 0.01;β = 0.33,p = 0.02)和性功能(β = -0.41,p = 0.01;β = -0.32,p = 0.03)恶化相关。MIP-1α 与更严重的失眠有关(β = 0.36,p = 0.01)。较高的循环 MIF 与较严重的焦虑(β = 0.28,p = 0.048)和疲劳(β = 0.35,p = 0.02)有关。Il-6、TNFα和MCP-1与PROs几乎没有关联。活动量指数与PROs之间几乎没有关联;但是,每日活动量峰值(acrophase)较晚的参与者的性功能较差(β = -0.31,p = 0.04)。与年龄、cGVHD严重程度和接受造血干细胞移植后的时间相关的模型也得出了类似的结果。结果表明,与 cGVHD 相关的促炎细胞因子和趋化因子可能会导致 PROs,从而确定了一种生物行为机制,该机制可能成为未来干预的有用目标。
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来源期刊
CiteScore
29.60
自引率
2.00%
发文量
290
审稿时长
28 days
期刊介绍: Established in 1987, Brain, Behavior, and Immunity proudly serves as the official journal of the Psychoneuroimmunology Research Society (PNIRS). This pioneering journal is dedicated to publishing peer-reviewed basic, experimental, and clinical studies that explore the intricate interactions among behavioral, neural, endocrine, and immune systems in both humans and animals. As an international and interdisciplinary platform, Brain, Behavior, and Immunity focuses on original research spanning neuroscience, immunology, integrative physiology, behavioral biology, psychiatry, psychology, and clinical medicine. The journal is inclusive of research conducted at various levels, including molecular, cellular, social, and whole organism perspectives. With a commitment to efficiency, the journal facilitates online submission and review, ensuring timely publication of experimental results. Manuscripts typically undergo peer review and are returned to authors within 30 days of submission. It's worth noting that Brain, Behavior, and Immunity, published eight times a year, does not impose submission fees or page charges, fostering an open and accessible platform for scientific discourse.
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