Changes in plasma IL-1β, TNF-α and IL-4 levels are involved in chemotherapy-related cognitive impairment in early-stage breast cancer patients.
Jingjing Zhao, He Zuo, Ke Ding, Xiuqing Zhang, Ziran Bi, Huaidong Cheng
Abstract
To investigate changes in cytokine (IL-1β, TNF-α and IL-4) levels before and after chemotherapy and their correlation with cognitive impairment in early-stage breast cancer (BC) patients, the 190 BC patients enrolled in this study were divided into two groups: a before chemotherapy group (BCG) and an after chemotherapy group (ACG). The BCG was also divided into two subgroups according to the cognitive assessment results: one group with normal cognition (CNG) and one group with impaired cognition (CIG). Plasma cytokine levels (IL-1β, TNF-α, and IL-4) were evaluated in all patients. The mini-mental state examination (MMSE), prospective and retrospective memory questionnaire (PRMQ), and functional assessment of cancer therapy-cognitive function version 3 (FACT-Cog, version 3) were used to evaluate patients' self-perceived cognitive impairments. Furthermore, their quality of life (QOL) was evaluated. Plasma IL-1β, TNF-α and IL-4 levels were higher in the ACG than in the BCG (Z = -3.089, -2.458 and -1.987; P = 0.002, 0.014, and 0.047; respectively). Moreover, plasma IL-1β, TNF-α and IL-4 levels were higher in the CIG than in the CNG (Z = -4.353, -3.383 and -2.522; P = 0.000, 0.001 and 0.012; respectively). Furthermore, a correlation was noted between cognition (MMSE, retrospective memory (RM), prospective memory (PM), and FACT-Cog scores) and QOL in BC patients (r = -0.790, 0.852, 0.847 and 0.937, respectively), and a correlation was observed between cognition and cytokine levels (IL-1β, TNF-α, and IL-4) in BC patients (r = -0.681, -0.572 and -0.626; respectively). The present results indicated that changes in cytokine levels may occur in BC patients with chemotherapy-related cognitive impairment (CRCI). We also found that CRCI was associated with QOL after chemotherapy in BC patients. This study provides a theoretical basis for the improvement of QOL in BC patients.