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9b - From inflammation to sickness and depression: the cytokine connection

from Section 2 - Cancer Symptom Mechanisms and Models: Clinical and Basic Science

Published online by Cambridge University Press:  05 August 2011

By
Robert Dantzer  and
Keith W. Kelley
Edited by
Charles S. Cleeland ,
Michael J. Fisch  and
Adrian J. Dunn
Robert Dantzer
Affiliation:
University of Illinois
Keith W. Kelley
Affiliation:
University of Illinois
Charles S. Cleeland
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Michael J. Fisch
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Adrian J. Dunn
Affiliation:
University of Hawaii, Manoa
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Summary

The possibility that inflammation plays a major role in the symptoms of sickness and depression experienced by cancer patients was initially proposed by a group of investigators led by Charles Cleeland, one of the editors of this book. The authors' reasoning was based on analogies. Laboratory animals injected with proinflammatory cytokines, or with cytokine inducers such as lipopolysaccharide, develop striking signs of sickness characterized by pain, wasting, cognitive impairment, anxiety, and fatigue. The same symptoms are observed in many patients with cancer and are exacerbated during inflammation-inducing cancer treatments, such as chemotherapy and radiotherapy. In addition, cancer patients subjected to long-term immunotherapy with interferon (IFN)-α and/or interleukin (IL)-2 for the treatment of metastatic kidney cancer or metastatic melanoma rapidly develop symptoms of sickness that can culminate in true depressive disorders. Since Cleeland's seminal paper was published, many studies have confirmed that nonspecific symptoms such as fatigue, even in long-term cancer survivors, are associated with inflammatory biomarkers and cannot be explained away solely as psychological difficulties related to coping with a diagnosis of cancer or living with the disease. A recent review paper confirmed the plausibility of the relationship between inflammation and the behavioral comorbidities experienced by patients with cancer and pointed to the pivotal role of neuroendocrine-immune mechanisms in this relationship.

The objective of this chapter is to discuss the neuroimmune mechanisms that are likely to be responsible for the development of symptoms of sickness and depression in patients with cancer.

Type
Chapter
Information
Cancer Symptom Science
Measurement, Mechanisms, and Management
 , pp. 95 - 109
Publisher: Cambridge University Press
Print publication year: 2010

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