T-cell homeostasis in breast cancer survivors with persistent fatigue.
Approximately 30% of women successfully treated for breast cancer suffer persistent fatigue of unknown origin. Recent studies linking inflammatory processes to central nervous system-mediated fatigue led us to examine cellular immune system status in 20 fatigued breast cancer survivors and 19 matched non-fatigued breast cancer survivors. Fatigued survivors, compared with non-fatigued survivors, had statistically significantly increased numbers of circulating T lymphocytes (mean 31% increase, 95% confidence interval [CI] = 6% to 56%; P =.015 by two-sided analysis of variance [ANOVA]), with pronounced elevation in the numbers of CD4+ T lymphocytes (mean 41% increase, 95% CI = 15% to 68%; P =.003 by two-sided ANOVA) and CD56+ effector T lymphocytes (mean 52% increase, 95% CI = 4% to 99%; P =.027 by two-sided ANOVA). These changes were independent of patient demographic and treatment characteristics. Absolute numbers of B cells, natural killer cells, granulocytes, and monocytes were not altered. The increased numbers of circulating T cells correlated with elevations in the level of serum interleukin 1 receptor antagonist (for CD3+ cells, r =.56 and P =.001; for CD3+/CD4+ cells, r =.68 and P<.001, by Spearman rank correlation). Results of this study suggest that persistent fatigue in breast cancer survivors might be associated with a chronic inflammatory process involving the T-cell compartment. These results require confirmation in a larger study that is specifically designed to address this hypothesis.
Bower
Julienne E
JE
Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, UCLA Neuropsychiatric Institute, CA 90095-7076, USA. jbower@ucla.edu
Ganz
Patricia A
PA
Aziz
Najib
N
Fahey
John L
JL
Cole
Steve W
SW
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015703:Antigens, CD / Q000097:blood; D001943:Breast Neoplasms / Q000150:complications / Q000276:immunology* / Q000628:therapy; D017252:CD3 Complex / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005221:Fatigue / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D007249:Inflammation; D053590:Interleukin 1 Receptor Antagonist Protein; D008875:Middle Aged; D019798:Neopterin / Q000097:blood; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D047889:Receptors, Tumor Necrosis Factor, Type II; D012795:Sialoglycoproteins / Q000097:blood; D013601:T-Lymphocytes / Q000276:immunology*
D015703:Antigens, CD; D017252:CD3 Complex; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D012795:Sialoglycoproteins; D019798:Neopterin