Polymorphisms in Cytokine Genes are Associated with Higher Levels of Fatigue and Lower Levels of Energy in Women Following Breast Cancer Surgery

• Published in: Journal of pain and symptom management Vol. 52; no. 5; pp. 695 - 708.e4
• Main Authors: Kober, Kord M., PhD, Smoot, Betty, PT, DPTSc, Paul, Steven M., PhD, Cooper, Bruce A., PhD, Levine, Jon D., MD, PhD, Miaskowski, Christine, RN, PhD
• Format: Journal Article
• Language: English
• Published: 21.09.2016
• Subjects: Anesthesia & Perioperative Care; Pain Medicine; cytokine genes; breast cancer; fatigue; symptom trajectories; growth mixture modeling; energy
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2016.04.014

Abstract Context Little is known about the phenotypic and molecular characteristics associated with changes over time in fatigue and lack of energy in patients with breast cancer. Objectives To identify subgroups (i.e., latent classes) of women with distinct fatigue and energy trajectories; evaluate for differences in phenotypic characteristics between the latent classes for fatigue and energy; and evaluate for associations between polymorphisms in genes for pro- and anti-inflammatory cytokines, their receptors, and their transcriptional regulators and latent class membership. Methods Patients were enrolled prior to and followed for six months after breast cancer surgery. Latent class analyses were done to identify subgroups of patients with distinct fatigue and energy trajectories. Candidate gene analyses were done to identify cytokine genes associated with these two symptoms. Results For both fatigue and lack of energy, two distinct latent classes were identified. Phenotypic characteristics associated with the higher fatigue class were: younger age, higher education, lower KPS score, higher comorbidity, higher number of lymph nodes removed, and receipt of chemotherapy (CTX). Polymorphisms in interleukin (IL) 1 beta and IL10 were associated with membership in the higher fatigue class. Phenotypic characteristics associated with the lower energy class included: a lower KPS score and a higher comorbidity score. A polymorphism in IL1R1 was associated with membership in the lower energy class. Conclusion Within each latent class, the severity of fatigue and decrements in energy were relatively stable over the first six months following breast cancer surgery. Distinct phenotypic characteristics and genetic polymorphisms were associated with membership in the higher fatigue and lower energy classes.