Lee Lena J, Barb Jennifer J, Son Elisa H, Yang Li, Gerrard Chantal, Wallen Gwenyth R
Translational Biobehavioral and Health Disparities (TBHD) Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, MD, United States.
Translational Biobehavioral and Health Disparities (TBHD) Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, MD, United States.
Brain Behav Immun. 2025 Apr 10;128:362-369. doi: 10.1016/j.bbi.2025.04.013.
Family caregiving has been proposed as chronic stress that may lead to immune health risks through increased systemic inflammation. Cytokines are key modulators of inflammation via a complex network of interactions. However, most studies examined only a single to a few cytokines to determine whether they correlate with psychobehavioral variables of interest. This study aimed to investigate factors influencing multiple inflammatory cytokines in family caregivers of allogeneic hematopoietic stem cell transplantation (HSCT) recipients.
Baseline data from a randomized controlled clinical trial at the National Institutes of Health Clinical Center were collected from caregivers of allogeneic HSCT recipients. The 20 serum cytokine levels were measured using multiplexed cytokine immunoassays. Multiple linear regression was conducted.
Caregivers (N = 45) were 44.6 ± 15.4 years of age; primarily female (87 %), White (66 %), non-Hispanic (82 %), and a spouse/partner of the HSCT recipient (56 %). Caring for HSCT recipients with hematologic malignancy predicted higher IL-12/IL-23p40 than caring for non-malignant HSCT recipients (β = 0.291, p = 0.044). Medication use was associated with higher IL-15 (β = 0.425, p = 0.017). Caregiver BMI overweight (β = 0.342, p = 0.043) or obese (β = 0.411, p = 0.010), taking prescribed medications (β = 0.521, p = 0.007), caregiving 8 to 16 h (β = 0.396, p = 0.027) or more than 16 h per day (β = 0.510, p = 0.006) predicted higher TNF-α than the counterparts.
These findings suggest inflammatory responses may be associated with providing care to an HSCT recipient, especially in caregivers who take medications, provide more hours of care a day and care for patients with hematologic malignancies. The results highlight a physiological response of stress and bring to light the importance of developing interventions focused on reducing time spent caregiving, such as a respite care program for family caregivers.
家庭照护被认为是一种慢性应激，可能通过增加全身炎症反应导致免疫健康风险。细胞因子通过复杂的相互作用网络是炎症的关键调节因子。然而，大多数研究仅检测一种或几种细胞因子，以确定它们是否与感兴趣的心理行为变量相关。本研究旨在调查影响异基因造血干细胞移植（HSCT）受者家庭照护者多种炎症细胞因子的因素。
从美国国立卫生研究院临床中心的一项随机对照临床试验中收集异基因HSCT受者照护者的基线数据。使用多重细胞因子免疫测定法测量20种血清细胞因子水平。进行多元线性回归分析。
照护者（N = 45）年龄为44.6±15.4岁；主要为女性（87%）、白人（66%）、非西班牙裔（82%），且是HSCT受者的配偶/伴侣（56%）。与照护非恶性HSCT受者相比，照护患有血液系统恶性肿瘤的HSCT受者预测IL-12/IL-23p40水平更高（β = 0.291，p = 0.044）。药物使用与更高的IL-15水平相关（β = 0.425，p = 0.017）。照护者体重超重（β = 0.342，p = 0.043）或肥胖（β = 0.411，p = 0.010）、服用处方药（β = 0.521，p = 0.007）、每天照护8至16小时（β = 0.396，p = 0.027）或超过16小时（β = 0.510，p = 0.006），与对照组相比，预测TNF-α水平更高。
这些发现表明炎症反应可能与为HSCT受者提供照护有关，尤其是在服用药物、每天照护时间更长以及照护血液系统恶性肿瘤患者的照护者中。结果突出了应激的生理反应，并揭示了制定专注于减少照护时间的干预措施的重要性，例如为家庭照护者提供临时护理计划。
