title: Cancer cachexia and depressive states: a neuro-endocrine-immunological disease?
abstract: Plasma 5-hydroxytryptamine (serotonin), tryptophan, neopterin and cortisol levels were measured in patients with depressive cancer cachexia and in healthy controls during the same time period. Patients with advanced cancers had significantly raised neopterin, a marker of endogenous gamma-interferon (IFN-gamma) production, and cortisol values, but decreased serotonin and tryptophan levels. Much work has been done to elucidate the possible role of serotonin in depressive states. IFN-gamma induces a high level of indoleamine dioxygenase (IDO), a tryptophan degrading enzyme, and high cortisol levels induce high tryptophan oxygenase activity, which in turn increases metabolism along the tryptophan-nicotinic acid pathway. These results suggest that persistent immune activation and intense adrenal activity occur in patients with cancer cachexia, resulting in disorders involving tryptophan metabolism followed by depression in cancer cachexia.
authors.affiliation: First Department of Surgery, Okayama University Medical School, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iwagaki
authors.forename: A
authors.initials: A
authors.lastname: Hizuta
authors.forename: M
authors.initials: M
authors.lastname: Uomoto
authors.forename: Y
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: S
authors.initials: S
authors.lastname: Saito
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood; D002100:Cachexia / Q000097:blood*; D003863:Depression / Q000097:blood*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019798:Neopterin; D012701:Serotonin / Q000097:blood*; D014364:Tryptophan / Q000097:blood
chemical_list: D001708:Biopterins; D012701:Serotonin; D019798:Neopterin; D014364:Tryptophan; D006854:Hydrocortisone