© 2003 by Oxford University Press
© 2003 Oxford University Press
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T-Cell Homeostasis in Breast Cancer Survivors With Persistent Fatigue
Affiliations of authors: J. E. Bower (Cousins Center for Psychoneuroimmunology, University of California, Los Angeles [UCLA] Neuropsychiatric Institute, and Department of Psychiatry and Biobehavioral Sciences), P. A. Ganz (UCLA Schools of Medicine and Public Health, and Jonsson Comprehensive Cancer Center), N. Aziz (Center for Interdisciplinary Research in Immunology and Disease), J. L. Fahey (Department of Medicine and Department of Microbiology, Immunology, and Behavioral Genetics, and Center for Interdisciplinary Research in Immunology and Disease), S. W. Cole (Department of Medicine), UCLA.
Correspondence to: Julienne E. Bower, Ph.D., Cousins Center for Psychoneuroimmunology, UCLA Neuropsychiatric Institute, 300 UCLA Medical Plaza, Rm. 3306, Box 957076, Los Angeles, CA 90095-7076 (e-mail: jbower{at}ucla.edu).
ABSTRACT
Approximately 30% of women successfully treated for breast cancer suffer persistent fatigue of unknown origin. Recent studies linking inflammatory processes to central nervous system–mediated fatigue led us to examine cellular immune system status in 20 fatigued breast cancer survivors and 19 matched non-fatigued breast cancer survivors. Fatigued survivors, compared with non-fatigued survivors, had statistically significantly increased numbers of circulating T lymphocytes (mean 31% increase, 95% confidence interval [CI] = 6% to 56%; P = .015 by two-sided analysis of variance [ANOVA]), with pronounced elevation in the numbers of CD4+ T lymphocytes (mean 41% increase, 95% CI = 15% to 68%; P = .003 by two-sided ANOVA) and CD56+ effector T lymphocytes (mean 52% increase, 95% CI = 4% to 99%; P = .027 by two-sided ANOVA). These changes were independent of patient demographic and treatment characteristics. Absolute numbers of B cells, natural killer cells, granulocytes, and monocytes were not altered. The increased numbers of circulating T cells correlated with elevations in the level of serum interleukin 1 receptor antagonist (for CD3+ cells, r = .56 and P = .001; for CD3+/CD4+ cells, r = .68 and P<.001, by Spearman rank correlation). Results of this study suggest that persistent fatigue in breast cancer survivors might be associated with a chronic inflammatory process involving the T-cell compartment. These results require confirmation in a larger study that is specifically designed to address this hypothesis.
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