title: Depressive symptoms and cytokine levels in Serum and Tumor Tissue in patients with an Astrocytoma: a pilot study.
abstract: BACKGROUND
  Preoperative depressive symptoms are associated with poor outcomes in patients with an astrocytoma. Cytokines are associated with depressive symptoms in the general population and are important mediators of tumor growth and progression.The aims of this study were to: (1) characterize depressive symptoms, other treatment-related symptoms and biological mediators; and (2) determine whether preoperative depressive symptoms were associated with the selected biological mediators.
  
  
  METHODS
  A prospective, exploratory study was carried out among 22 patients with a high-grade astrocytoma. Self-report questionnaires and peripheral blood samples were collected on the day of surgery. Tumor tissue was collected intraoperatively. Self-report questionnaires were assessed at 3, 6, 9, and 12-months postoperatively.
  
  
  RESULTS
  In circulation, serum IL-8 was inversely correlated with depressive symptoms while IL-17 measured in tumor tissue supernatant was inversely correlated with depressive symptoms. Depressive symptoms showed a significant increase at 12 months from baseline levels and were positively associated with treatment-related symptoms at 3 months and symptom distress at 12 months post-surgery.
  
  
  CONCLUSIONS
  In this pilot study, depressive symptoms were negatively associated with IL-8 in serum and IL-17 in tumor tissue. The changes among depressive symptoms, treatment-related symptoms and symptom distress highlight the need for multi-faceted symptom management strategies over the treatment trajectory in this patient population.
authors.affiliation: Department of Adult Health and Nursing Systems, Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, P, O, Box 980567, Richmond, VA 23298, USA. astarkweathe@vcu.edu.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Starkweather
authors.forename: Paula
authors.initials: P
authors.lastname: Sherwood
authors.forename: Debra E
authors.initials: DE
authors.lastname: Lyon
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.forename: William C
authors.initials: WC
authors.lastname: Broaddus
authors.forename: R K
authors.initials: RK
authors.lastname: Elswick
authors.forename: Jamie
authors.initials: J
authors.lastname: Sturgill
mesh_terms: D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000150:complications / Q000378:metabolism / Q000523:psychology* / Q000601:surgery; D016543:Central Nervous System Neoplasms / Q000150:complications / Q000378:metabolism / Q000523:psychology* / Q000601:surgery; D003863:Depression / Q000150:complications / Q000378:metabolism / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D020381:Interleukin-17 / Q000378:metabolism*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D010865:Pilot Projects; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D020381:Interleukin-17; D016209:Interleukin-8