Interleukin-6, cortisol, and depressive symptoms in ovarian cancer patients

Susan K. Lutgendorf, Aliza Z. Weinrib, Frank Penedo, Daniel Russell, Koenraad De Geest, Erin S. Costanzo, Patrick J. Henderson, Sandra E. Sephton, Nicolas Rohleder, Joseph A. Lucci, Steven Cole, Anil K. Sood, David M. Lubaroff

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Abstract

Purpose: Inflammatory processes have been implicated in the pathogenesis of both depression and cancer. Links between depressive symptoms, interleukin-6 (IL-6), and cortisol dysregulation have been demonstrated in cancer patients, but vegetative versus affective components of depression have been minimally examined. The objective of the current study was to examine associations between IL-6, diurnal cortisol rhythms, and facets of depression in epithelial ovarian cancer patients. Patients and Methods: Patients awaiting surgery for a pelvic mass suspected for ovarian cancer completed questionnaires, collected salivary samples for 3 days presurgery, and gave a presurgical blood sample. Ascites was obtained during surgery. IL-6 was measured by enzyme-linked immunosorbent assay and cortisol by a chemiluminescence immunoassay. The final sample included 112 invasive ovarian cancer patients (86 advanced stage, 26 early stage) and 25 patients with tumors of low malignant potential (LMP). Results: Advanced-stage ovarian cancer patients demonstrated elevations in vegetative and affective depressive symptoms, plasma IL-6, and the cortisol area under the curve (AUC) compared with patients with LMP tumors (all P <.05). Among invasive ovarian cancer patients, greater vegetative depression was related to elevated IL-6 in plasma (P = .008) and ascites (P = .024), but affective depression was unrelated to IL-6. Elevations in total depression (P = .026) and vegetative depression (P = .005) were also related to higher evening cortisol levels. Plasma IL-6 was related to greater afternoon and evening cortisol and cortisol AUC (all P values <.005). Conclusion: These results demonstrate significant relationships between IL-6, cortisol, and vegetative depression, and may have implications for treatment of depression in ovarian cancer patients.

Original languageEnglish (US)
Pages (from-to)4820-4827
Number of pages8
JournalJournal of Clinical Oncology
Volume26
Issue number29
DOIs
StatePublished - Oct 10 2008
Externally publishedYes

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Ovarian Neoplasms
Hydrocortisone
Interleukin-6
Depression
Ascites
Area Under Curve
Neoplasms
Affective Symptoms
Circadian Rhythm
Luminescence
Immunoassay
Enzyme-Linked Immunosorbent Assay

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Lutgendorf, S. K., Weinrib, A. Z., Penedo, F., Russell, D., De Geest, K., Costanzo, E. S., ... Lubaroff, D. M. (2008). Interleukin-6, cortisol, and depressive symptoms in ovarian cancer patients. Journal of Clinical Oncology, 26(29), 4820-4827. https://doi.org/10.1200/JCO.2007.14.1978

Interleukin-6, cortisol, and depressive symptoms in ovarian cancer patients. / Lutgendorf, Susan K.; Weinrib, Aliza Z.; Penedo, Frank; Russell, Daniel; De Geest, Koenraad; Costanzo, Erin S.; Henderson, Patrick J.; Sephton, Sandra E.; Rohleder, Nicolas; Lucci, Joseph A.; Cole, Steven; Sood, Anil K.; Lubaroff, David M.

In: Journal of Clinical Oncology, Vol. 26, No. 29, 10.10.2008, p. 4820-4827.

Research output: Contribution to journalArticle

Lutgendorf, SK, Weinrib, AZ, Penedo, F, Russell, D, De Geest, K, Costanzo, ES, Henderson, PJ, Sephton, SE, Rohleder, N, Lucci, JA, Cole, S, Sood, AK & Lubaroff, DM 2008, 'Interleukin-6, cortisol, and depressive symptoms in ovarian cancer patients', Journal of Clinical Oncology, vol. 26, no. 29, pp. 4820-4827. https://doi.org/10.1200/JCO.2007.14.1978
Lutgendorf, Susan K. ; Weinrib, Aliza Z. ; Penedo, Frank ; Russell, Daniel ; De Geest, Koenraad ; Costanzo, Erin S. ; Henderson, Patrick J. ; Sephton, Sandra E. ; Rohleder, Nicolas ; Lucci, Joseph A. ; Cole, Steven ; Sood, Anil K. ; Lubaroff, David M. / Interleukin-6, cortisol, and depressive symptoms in ovarian cancer patients. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 29. pp. 4820-4827.
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AU - Lutgendorf, Susan K.

AU - Weinrib, Aliza Z.

AU - Penedo, Frank

AU - Russell, Daniel

AU - De Geest, Koenraad

AU - Costanzo, Erin S.

AU - Henderson, Patrick J.

AU - Sephton, Sandra E.

AU - Rohleder, Nicolas

AU - Lucci, Joseph A.

AU - Cole, Steven

AU - Sood, Anil K.

AU - Lubaroff, David M.

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N2 - Purpose: Inflammatory processes have been implicated in the pathogenesis of both depression and cancer. Links between depressive symptoms, interleukin-6 (IL-6), and cortisol dysregulation have been demonstrated in cancer patients, but vegetative versus affective components of depression have been minimally examined. The objective of the current study was to examine associations between IL-6, diurnal cortisol rhythms, and facets of depression in epithelial ovarian cancer patients. Patients and Methods: Patients awaiting surgery for a pelvic mass suspected for ovarian cancer completed questionnaires, collected salivary samples for 3 days presurgery, and gave a presurgical blood sample. Ascites was obtained during surgery. IL-6 was measured by enzyme-linked immunosorbent assay and cortisol by a chemiluminescence immunoassay. The final sample included 112 invasive ovarian cancer patients (86 advanced stage, 26 early stage) and 25 patients with tumors of low malignant potential (LMP). Results: Advanced-stage ovarian cancer patients demonstrated elevations in vegetative and affective depressive symptoms, plasma IL-6, and the cortisol area under the curve (AUC) compared with patients with LMP tumors (all P <.05). Among invasive ovarian cancer patients, greater vegetative depression was related to elevated IL-6 in plasma (P = .008) and ascites (P = .024), but affective depression was unrelated to IL-6. Elevations in total depression (P = .026) and vegetative depression (P = .005) were also related to higher evening cortisol levels. Plasma IL-6 was related to greater afternoon and evening cortisol and cortisol AUC (all P values <.005). Conclusion: These results demonstrate significant relationships between IL-6, cortisol, and vegetative depression, and may have implications for treatment of depression in ovarian cancer patients.

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