Investigating Molecular-Genetic Correlates of Fatigue

虽然疲劳的潜在机制已经在几种疾病条件下进行了研究，但病因，机制和风险因素仍然难以捉摸，目前这种症状仍然管理不善。已经进行了与癌症患者治疗相关的疲劳相关的纵向研究，但显示癌症治疗前后分子机制变化的数据有限，这些数据可以识别治疗期间和治疗后有疲劳风险的个体。疲劳被概念化为多维症状，其包括时间、感觉、认知/精神、情感/情绪、行为和生理维度。这项前瞻性观察性研究将探索接受各种治疗（例如免疫治疗，激素治疗和化疗）的癌症患者所经历的疲劳的分子遗传机制。 该研究的主要目的是描述癌症患者在癌症治疗之前、期间和之后经历的自我报告的疲劳、抑郁和健康相关生活质量（HRQOL）的变化。本研究的次要目的是研究促炎细胞因子谱（TNF、IGF-I、IL-6、IL-8、TGF和），确定癌症治疗前、治疗期间和治疗后外周血和组织样本的基因表达变化，并将这些生物标志物水平的变化与自我报告的疲劳、抑郁和HRQOL评分相关。 本研究还旨在测量癌症治疗前、治疗期间和治疗完成时患者的骨骼肌强度、认知功能、活动水平和能量消耗，并将这些发现与自我报告的疲劳、抑郁和HRQOL评分相关。

Although the underlying mechanisms of fatigue have been studied in several disease conditions, the etiology, mechanisms, and risk factors remain elusive, and this symptom remains poorly managed at present. Longitudinal studies related to treatment-related fatigue in cancer patients have been conducted, but there are limited data showing changes in molecular mechanisms before and after cancer therapy which can identify individuals who are at risk to experience fatigue during and after therapy. Fatigue is conceptualized as a multidimensional symptom which incorporates temporal, sensory, cognitive/mental, affective/emotional, behavioral, and physiological dimensions. This prospective, observational study will explore the molecular-genetic mechanisms underlying fatigue experienced by cancer patients receiving various therapies (e.g. immune therapy, hormone therapy, and chemotherapy). The primary objective of the study is to describe the changes in the self-reported fatigue, depression, and health-related quality of life (HRQOL) experienced by cancer patients before, during, and after cancer therapy. The secondary objectives of this study are to investigate the pro-inflammatory cytokine profile (TNF, IGF-I, IL-6, IL-8, TGF and ), determine changes in gene expression from peripheral blood and tissue samples before, during, and after cancer treatment and to relate changes in the levels of these biological markers to self-reported fatigue, depression, and HRQOL scores. This study also aims to measure the skeletal muscle strength, cognitive function, activity levels and energy expenditure of patients before, during, and at completion of cancer treatment and relate these findings with self-reported fatigue, depression, and HRQOL scores.