title: Serum levels of rapid turnover proteins are decreased and related to systemic inflammation in patients with ovarian cancer.
abstract: Poor nutritional status is common in ovarian cancer. It is well known that the nutritional status of a patient with malignant disease is associated with survival, and that it can be assessed by serum levels of rapid turnover proteins (RTPs), such as retinol binding protein, prealbumin and transferrin. Systemic inflammation, usually observed in the form of elevated C-reactive protein (CRP) or neutrophil/lymphocyte ratio (NLR), occurs by various mechanisms involving numerous pro-inflammatory cytokines. These include interleukin (IL)-17 and other soluble protein mediators, such as soluble IL-2 receptor (sIL-2R) and vascular endothelial growth factor (VEGF). In this study, circulating levels of RTP were decreased in advanced stages of ovarian cancer, and significant inverse correlations were found between RTP levels and serum levels of CRP or NLR. CRP levels were also correlated with serum levels of VEGF and sIL-2R. Moreover, NLR, VEGF and sIL-2R levels, and IL-17 production, were all inversely correlated with RTP levels. These findings indicate that chronic inflammation may be associated with compromised immune function, such as an impaired T-cell response, via various inflammatory proteins, including sIL-2R, VEGF and IL-17. The key mechanisms leading to cancer cachexia, in which nutritional impairment is a major clinical issue, appear to be primarily immune reactions caused by chronic inflammation. Anti-inflammatory treatments may be effective in clinically improving various symptoms associated with these mechanisms.
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Gastrointestinal Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan ; Department of Tumor and Host Bioscience, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan ; Department of Organ Regulatory Surgery, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibata
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishiyama
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Soeda
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Furukawa
authors.affiliation: Department of Gastrointestinal Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Gonda
authors.affiliation: Department of Organ Regulatory Surgery, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Takenoshita
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
authors.forename: Keiya
authors.initials: K
authors.lastname: Fujimori
keywords: cachexia; inflammation; interleukin-17; malnutrition; ovarian cancer; rapid turnover protein