Department of Biobehavioral Health Science, College of Nursing, University of Illinois, Chicago, IL, USA.
University of Illinois Cancer Center, Chicago, IL, USA.
Biol Res Nurs. 2020 Oct;22(4):472-484. doi: 10.1177/1099800420938141. Epub 2020 Jun 30.
The co-occurrence of multiple psychoneurological symptoms, including pain, sleep disturbance, fatigue, depression, anxiety, and cognitive disturbance among adult cancer survivors led us to question which common biological mechanisms are shared among these conditions. Variances in tryptophan (Trp) levels and downstream metabolites of the kynurenine (Kyn) metabolic pathway are known to affect immune response and psychoneurological symptoms. The objective of this systematic review was to help us (a) better understand the role of the Kyn pathway in psychoneurological symptoms among adult cancer survivors and (b) identify common significant biomarkers across psychoneurological symptoms as a guide for future research. Some evidence has shown that decreased Trp levels and increased Kyn, Trp/Kyn ratio, and kynurenic acid/Trp ratio in parallel with immune activation are correlated with some psychoneurological symptoms among people undergoing cancer treatment, although discrepancies exist between studies. Kyn pathway activation could also be associated with psychoneurological symptoms among adult cancer survivors, but further research is needed to confirm its exact etiological role with respect to psychoneurological symptoms.
多种精神神经症状（包括疼痛、睡眠障碍、疲劳、抑郁、焦虑和认知障碍）在成年癌症幸存者中同时出现，这使我们质疑这些病症是否存在共同的生物学机制。众所周知，色氨酸（Trp）水平的变化和犬尿氨酸（Kyn）代谢途径的下游代谢产物会影响免疫反应和精神神经症状。本系统评价的目的是帮助我们（a）更好地了解 Kyn 途径在成年癌症幸存者精神神经症状中的作用，以及（b）确定精神神经症状之间常见的显著生物标志物，为未来的研究提供指导。有一些证据表明，癌症治疗过程中，一些精神神经症状与免疫激活相关，色氨酸（Trp）水平降低、犬尿氨酸（Kyn）、Trp/Kyn 比值和犬尿氨酸/Trp 比值升高平行；但不同研究之间存在差异。Kyn 途径的激活也可能与成年癌症幸存者的精神神经症状有关，但需要进一步的研究来确认其在精神神经症状方面的确切病因作用。
