T-cell homeostasis in breast cancer survivors with persistent fatigue
T-cell homeostasis in breast cancer survivors with persistent fatigue
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DOI：
10.1093/jnci/djg0019
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发表时间：
2003-08-06
影响因子：
10.3
通讯作者：
Cole, SW
中科院分区：
文献类型：
--
作者：
Bower, JE;Ganz, PA;Cole, SW
大约30%成功治疗乳腺癌的妇女遭受不明原因的持续疲劳。最近的研究将炎症过程与中枢神经系统介导的疲劳联系起来，使我们检查了20名疲劳乳腺癌幸存者和19名匹配的非疲劳乳腺癌幸存者的细胞免疫系统状态。与非疲劳的幸存者相比，疲劳的幸存者的循环T淋巴细胞数量在统计学上显著增加（平均增加31%，95%置信区间[CI] = 6%至56%; P = .015，双侧方差分析[ANOVA]），CD 4（+）T淋巴细胞数量显著升高（平均增加41%，95% CI = 15%至68%;双侧ANOVA P = 0.003）和CD 56（+）效应T淋巴细胞（平均增加52%，95% CI = 4%至99%;双侧ANOVA P = 0.027）。这些变化与患者人口统计学和治疗特征无关。B细胞、自然杀伤细胞、粒细胞和单核细胞的绝对数量未发生变化。循环T细胞数量的增加与血清白细胞介素I受体拮抗剂水平的升高相关（通过斯皮尔曼等级相关，对于CD 3（+）细胞，r = 0.56和P = 0.001;对于CD 3（+）/CD 4（+）细胞，r = 0.68和P <0.001）。这项研究的结果表明，乳腺癌幸存者的持续疲劳可能与涉及T细胞室的慢性炎症过程有关。这些结果需要在专门为解决这一假设而设计的更大规模的研究中得到证实。
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 I 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.