期刊
PAIN MANAGEMENT NURSING
卷 24, 期 1, 页码 52-59出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.pmn.2022.09.002
关键词
Breast cancer; Psychoneurological symptoms; Tryptophan; Kynurenine; Metabolites
类别
This study investigated the relationship between the metabolites involved in the tryptophan-kynurenine pathway and psychoneurological symptoms among breast cancer survivors, and found that the tryptophan-kynurenine pathway and impaired tryptophan availability may contribute to the development of psychoneurological symptoms.
Background: Among breast cancer survivors, pain, fatigue, depression, anxiety, and sleep disturbance are common psychoneurological symptoms that cluster together. Inflammation-induced activation of the tryptophan-kynurenine metabolomic pathway may play an important role in these symptoms.Aims: This study investigated the relationship between the metabolites involved in the tryptophan-kynurenine pathway and psychoneurological symptoms among breast cancer survivors. Design: Cross-sectional study.Setting: Participants were recruited at the oncology clinic at the University of Illinois Hospital & Health Sciences System. Participants/Subjects: 79 breast cancer survivors after major cancer treatment.Methods: We assessed psychoneurological symptoms with the PROMIS-29 and collected metabolites from fasting blood among breast cancer survivors after major cancer treatment, then analyzed four ma-jor metabolites involved in the tryptophankynurenine pathway (tryptophan, kynurenine, kynurenic acid, and quinolinic acid). Latent profile analysis identified subgroups based on the five psychoneurological symptoms. Mann-Whitney U tests and multivariable logistic regression compared targeted metabolites between subgroups.Results: We identified two distinct symptom subgroups (low, 81%; high, 19%). Compared with participants in the low symptom subgroup, patients in the high symptom subgroup had higher BMI ( p = .024) and were currently using antidepressants ( p = .008). Using multivariable analysis, lower tryptophan levels ( p = .019) and higher kynurenine/tryptophan ratio ( p = .028) were associated with increased risk of being in the high symptom subgroup after adjusting for BMI and antidepressant status.Conclusion: The tryptophan-kynurenine pathway and impaired tryptophan availability may contribute to the development of psychoneurological symptoms.(c) 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
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