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Depression in older patients with advanced colorectal cancer is closely connected with immunosuppressive acidic protein

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Abstract

Colorectal cancer (CRC) is one of the most common tumors. CRC patients are susceptible to suffering from depression. Whether the immune system of CRC patients with depression is impaired or stimulated is controversial. Possible reasons for this conflict are the involvement of confounding factors, such as the age of the patient, the stage of the CRC and the types of treatment in previous studies. To demonstrate clearly the relationship between depression and the immune system in the context of CRC, the present study included only older patients with advanced CRC who received only chemotherapy, and the study adopted immunosuppressive acidic protein (IAP) as an immune parameter for the first time. A total of 56 older patients with advanced CRC completed the Zung Self-Rating Depression Scale (SDS) and were divided into two groups according to SDS scores. The patients exhibiting depression were treated with fluoxetine until their symptoms remitted. The serum levels of IAP and the percentages of CD3-positive (CD3+), CD4+, CD8+ T lymphocytes and CD56+ natural killer (NK) cells and Neutrophil-lymphocyte ratio (NLR) were calculated at the time of enrollment and once the symptoms remitted. Correlation analyses revealed that the SDS score was positively associated with serum IAP levels but negatively associated with CD3 and CD4 levels. Among the depressed and non-depressed patients, serum IAP levels and the percentages of CD3 and CD4 cells were dramatically different. After the depression symptoms were treated, the IAP levels dramatically decreased, while the levels of CD3, CD4, CD8 and CD56 were unchanged. All of above suggested that IAP was closely correlated with depression and might be a relatively objective parameter for predicting depression.

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References

  • Alacacioglu A, Binicier O, Gungor O, Oztop I, Dirioz M, Yilmaz U (2010) Quality of life, anxiety, and depression in Turkish colorectal cancer patients. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 18:417–421

    Google Scholar 

  • Blume J, Douglas SD, Evans DL (2011) Immune suppression and immune activation in depression. Brain Behav Immun 25:221–229

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Boyd CA, Benarroch-Gampel J, Sheffield KM, Han Y, Kuo YF, Riall TS (2012) The effect of depression on stage at diagnosis, treatment, and survival in pancreatic adenocarcinoma. Surgery 152:403–413

    Article  PubMed Central  PubMed  Google Scholar 

  • Brenner H, Bouvier AM, Foschi R, Hackl M, Larsen IK, Lemmens V, Mangone L, Francisci S (2012) Progress in colorectal cancer survival in Europe from the late 1980s to the early 21st century: the EUROCARE study. Int J Cancer 131:1649–1658

    Article  CAS  PubMed  Google Scholar 

  • Chiang SF, Hung HY, Tang R, Changchien CR, Chen JS, You YT, Chiang JM, Lin JR (2012) Can neutrophil-to-lymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively. Int J Color Dis 27:1347–1357

    Article  Google Scholar 

  • Chua W, Charles KA, Baracos VE, Clarke SJ (2011) Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Br J Cancer 104:1288–1295

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Cole S, Branagan G (2012) Rectal cancer management and high levels of anxiety and depression. Surgeon J R Coll Surg Edinb Irel 10:303

    CAS  Google Scholar 

  • Deng M, Lan Y, Luo S (2013) Quality of life estimate in stomach, colon, and rectal cancer patients in a hospital in China. Tumour Biol J Int Soc Oncodev Biol Med

  • Ebina T, Murata K, Tamura K (1994) Antitumor effect of intratumoral administration of biological response modifiers: induction of immunosuppressive acidic protein, a type of alpha 1-acid glycoprotein, in mice. Jpn J Cancer Res Gann 85:93–100

    Article  CAS  Google Scholar 

  • Evans DL, Ten HTR, Douglas SD, Gettes DR, Morrison M, Chiappini MS, Brinker-Spence P, Job C, Mercer DE, Wang YL, Cruess D, Dube B, Dalen EA, Brown T, Bauer R, Petitto JM (2002) Association of depression with viral load, CD8 T lymphocytes, and natural killer cells in women with HIV infection. Am J Psychiatry 159:1752–1759

    Article  PubMed  Google Scholar 

  • Frick LR, Rapanelli M, Arcos ML, Cremaschi GA, Genaro AM (2011) Oral administration of fluoxetine alters the proliferation/apoptosis balance of lymphoma cells and up-regulates T cell immunity in tumor-bearing mice. Eur J Pharmacol 659:265–272

    Article  CAS  PubMed  Google Scholar 

  • Gao Y, Lin F, Su J, Gao Z, Li Y, Yang J, Deng Z, Liu B, Tsun A, Li B (2012) Molecular mechanisms underlying the regulation and functional plasticity of FOXP3(+) regulatory T cells. Gene Immun 13:1–13

    Article  CAS  Google Scholar 

  • Glaser R, Kiecolt-Glaser JK (1998) Stress-associated immune modulation: relevance to viral infections and chronic fatigue syndrome. Am J Med 105:35S–42S

    Article  CAS  PubMed  Google Scholar 

  • Graca PM, Figueiredo AP, Fincham FD (2012) Anxiety, depression, traumatic stress and quality of life in colorectal cancer after different treatments: a study with Portuguese patients and their partners. Eur J Oncol Nurs Off J Eur Oncol Nurs Soc 16:227–232

    Article  Google Scholar 

  • Holt PR, Kozuch P, Mewar S (2009) Colon cancer and the elderly: from screening to treatment in management of GI disease in the elderly. Best Pract Res Clin Gastroenterol 23:889–907

    Article  PubMed Central  PubMed  Google Scholar 

  • Irwin MR, Miller AH (2007) Depressive disorders and immunity: 20 years of progress and discovery. Brain Behav Immun 21:374–383

    Article  CAS  PubMed  Google Scholar 

  • Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K (2013) Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients with colorectal cancer. Br J Cancer 109:401–407

    Article  CAS  PubMed  Google Scholar 

  • Iversen LH (2012) Aspects of survival from colorectal cancer in Denmark. Dan Med J 59:B4428

    PubMed  Google Scholar 

  • Kaneko M, Nozawa H, Sasaki K, Hongo K, Hiyoshi M, Tada N, Murono K, Nirei T, Kawai K, Sunami E, Tsuno NH, Kitayama J (2012) Elevated neutrophil to lymphocyte ratio predicts poor prognosis in advanced colorectal cancer patients receiving oxaliplatin-based chemotherapy. Oncology 82:261–268

    Article  CAS  PubMed  Google Scholar 

  • Kogure M, Kashimura S, Matsuyama S, Ohtani S, Saze Z, Odashima Y, Saitoh T, Soeta N, Osuka F, Hoshino Y, Saito T, Terashima S, Terashima M, Gotoh M (2008) Prognostic role of immunosuppressive acidic protein in patients with esophageal cancer. Dis Esophagus Off J Int Soc Dis Esophagus/I S D E 21:214–219

    Article  CAS  Google Scholar 

  • Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Choi HJ, Park KJ, Roh MS, Kim SG, Kim HJ, Lee JH (2012) Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomark Biochem Indic Expo Response Suscept Chem 17:216–222

    CAS  Google Scholar 

  • Lavretsky H, Kumar A (2003) Practical geriatrics: clinically significant nonmajor geriatric depression. Psychiatr Serv (Washington, DC) 54:297–299

    Google Scholar 

  • Li R, Hou J, Xu Q, Liu QJ, Shen YJ, Rodin G, Li M (2012) High level interleukin-6 in the medium of human pancreatic cancer cell culture suppresses production of neurotransmitters by PC12 cell line. Metab Brain Dis 27:91–100

    Article  PubMed  Google Scholar 

  • Lloyd-Williams M (2000) Difficulties in diagnosing and treating depression in the terminally ill cancer patient. Postgrad Med J 76:555–558

    Article  CAS  PubMed  Google Scholar 

  • Lopez CR, Antoni MH, Pereira D, Seay J, Whitehead N, Potter J, O'Sullivan M, Fletcher MA (2013) Stress management, depression and immune status in lower income racial/ethnic minority women co-infected with HIV and HPV. J Appl Biobehav Res 18:37–57

    Article  PubMed  Google Scholar 

  • Lutgendorf SK, Sood AK (2011) Biobehavioral factors and cancer progression: physiological pathways and mechanisms. Psychosom Med 73:724–730

    Article  PubMed Central  PubMed  Google Scholar 

  • Marszalek A, Szylberg L, Wisniewska E, Janiczek M (2012) Impact of COX-2, IL-1beta, TNF-alpha, IL-4 and IL-10 on the process of carcinogenesis in the large bowel. Pol J Pathol Off J Pol Soc Pathol 63:221–227

    Article  CAS  Google Scholar 

  • Miller AH, Maletic V, Raison CL (2009) Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry 65:732–741

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Raison CL, Capuron L, Miller AH (2006) Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol 27:24–31

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Rodriguez VB, Bayon PC, Palaotarrero A, Fernandez LA (2013) Mindfulness-based narrative therapy for depression in cancer patients.LID. Clin Psychol Psychother. doi:10.1002/cpp.1847

    Google Scholar 

  • Sadahiro S, Suzuki T, Maeda Y, Tanaka A, Kamijo A, Murayama C, Nakayama Y, Akiba T (2010) Effects of preoperative immunochemoradiotherapy and chemoradiotherapy on immune responses in patients with rectal adenocarcinoma. Anticancer Res 30:993–999

    CAS  PubMed  Google Scholar 

  • Sakamoto J, Koike A, Saji S, Teramukai S, Ohashi Y, Nakazato H (1992) Preoperative serum immunosuppressive acidic protein (IAP) test for the prognosis of gastric cancer: a statistical study of the threshold level and evaluation of the effect of the biological response modifier PSK. Surg Today 22:530–536

    Article  CAS  PubMed  Google Scholar 

  • Sakamoto J, Teramukai S, Koike A, Saji S, Ohashi Y, Nakazato H (1996) Prognostic value of preoperative immunosuppressive acidic protein in patients with gastric carcinoma. Findings from three independent clinical trials. Tumor Marker Committee for the Study Group of Immunochemotherapy with PSK for Gastric Cancer. Cancer 77:2206–2212

    Article  CAS  PubMed  Google Scholar 

  • Storli KE, Sondenaa K, Bukholm IR, Nesvik I, Bru T, Furnes B, Hjelmeland B, Iversen KB, Eide GE (2011) Overall survival after resection for colon cancer in a national cohort study was adversely affected by TNM stage, lymph node ratio, gender, and old age. Int J Color Dis 26:1299–1307

    Article  Google Scholar 

  • Tamura K, Shibata Y, Matsuda Y, Ishida N (1981) Isolation and characterization of an immunosuppressive acidic protein from ascitic fluids of cancer patients. Cancer Res 41:3244–3252

    CAS  PubMed  Google Scholar 

  • Teng PR, Yeh CJ, Lee MC, Lin HS, Lai TJ (2013) Depressive symptoms as an independent risk factor for mortality in elderly persons: results of a national longitudinal study. Aging Ment Health 17:470–478

    Article  PubMed  Google Scholar 

  • Toiyama Y, Miki C, Inoue Y, Okugawa Y, Koike Y, Watanabe H, Yokoe T, Hiro J, Ojima E, Tanaka K, Kusunoki M (2008) Serum immunosuppressive acidic protein reflects systemic deterioration of colorectal cancer patient condition. J Surg Oncol 97:404–408

    Article  CAS  PubMed  Google Scholar 

  • Tsunoda A, Nakao K, Hiratsuka K, Yasuda N, Shibusawa M, Kusano M (2005) Anxiety, depression and quality of life in colorectal cancer patients. Int J Clin Oncol Jpn Soc Clin Oncol 10:411–417

    Article  Google Scholar 

  • Zhang AY, Cooper GS (2010) Recognition of depression and anxiety among elderly colorectal cancer patients. Nurs Res Pract 2010:693961

    PubMed Central  PubMed  Google Scholar 

  • Zhou FL, Zhang WG, Wei YC, Xu KL, Hui LY, Wang XS, Li MZ (2005) Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers. World J Gastroenterol WJG 11:2313–2318

    Google Scholar 

Download references

Acknowledgments

This work was supported by grants from National Natural Science Funds (Grant Nos. 30828017 and 81102284).

Conflict-of-interest disclosure

The authors declare no competing financial interests.

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Authors and Affiliations

  1. Myeloma and Lymphoma Center, Department of Hematology, Chang Zheng Hospital, Second Military Medical University, Shanghai, 200003, China

    Rong Li, Weijun Fu, Hua Jiang, Juan Du, Chunyang Zhang, Hao Xi & Jian Hou

  2. Blood Engineering Laboratory, Shanghai Blood Center, Shanghai, China

    Jie Yang

  3. Division of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China

    Jie Yang

  4. Department of Medical Oncology, The People’s Liberation Army General Hospital, Beijing, China

    Jihua Yang

Authors
  1. Rong Li
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  2. Jie Yang
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  3. Jihua Yang
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  4. Weijun Fu
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  5. Hua Jiang
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  6. Juan Du
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  7. Chunyang Zhang
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  8. Hao Xi
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  9. Jian Hou
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Corresponding author

Correspondence to Jian Hou.

Additional information

Rong Li, Jie Yang, Jihua Yang contributed equally to this study as first authors.

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Li, R., Yang, J., Yang, J. et al. Depression in older patients with advanced colorectal cancer is closely connected with immunosuppressive acidic protein. Metab Brain Dis 29, 87–92 (2014). https://doi.org/10.1007/s11011-013-9429-8

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  • DOI: https://doi.org/10.1007/s11011-013-9429-8

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