Illman James, Corringham Robert, Robinson Don, Davis Hugh M, Rossi Jean-Francois, Cella David, Trikha Mohit
Centocor, Inc., Malvern, Pennsylvania, USA.
J Support Oncol. 2005 Jan-Feb;3(1):37-50.
The prevalence of depression among patients diagnosed with cancer is higher than among the general medical population and is associated with faster tumor progression and shortened survival time. Cancer-related depression often occurs in association with anorexia and cachexia, although until recently the relationship between these conditions has not been well understood. Cachexia is associated with poorer quality of life and survival outcomes and is theeventual cause of death in approximately 30% of all patients with cancer. Recent evidence has linked elevated levels of inflammatory cytokines with both depression and cachexia, and experiments have shown that introducing cytokines induces depression and cachectic symptoms in both humans and rodents, suggesting that there may be a common etiology at the molecular level. Therapeutic agents targeting specific cytokine molecules, such as interleukin-6 or tumor necrosis factor-alpha, are currently being evaluated for their potential to simultaneously treat both depression and cachexia pharmacologically. This review summarizes the available data suggesting a dual role for cytokines in the development of cancer-related depression and cachexia and describes how biologic therapies targeting specific cytokines may improve outcomes beyond depression and cachexia, such as survival and quality of life.
被诊断患有癌症的患者中抑郁症的患病率高于普通医疗人群，且与肿瘤进展加快和生存时间缩短有关。癌症相关的抑郁症常与厌食和恶病质同时出现，尽管直到最近这些情况之间的关系还没有得到很好的理解。恶病质与较差的生活质量和生存结果相关，并且是大约30%的癌症患者最终的死亡原因。最近的证据表明，炎症细胞因子水平升高与抑郁症和恶病质都有关联，实验表明，注入细胞因子会在人类和啮齿动物中诱发抑郁症和恶病质症状，这表明在分子水平上可能存在共同的病因。目前正在评估靶向特定细胞因子分子（如白细胞介素-6或肿瘤坏死因子-α）的治疗药物在药理学上同时治疗抑郁症和恶病质的潜力。这篇综述总结了现有数据，表明细胞因子在癌症相关抑郁症和恶病质的发展中具有双重作用，并描述了针对特定细胞因子的生物疗法如何改善除抑郁症和恶病质之外的结果，如生存和生活质量。
