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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(08): 786-793
DOI: 10.1055/s-0042-1755234
Original Article

Cognitive impairment and elevated peripheral cytokines in breast cancer patients receiving chemotherapy

Comprometimento cognitivo e citocinas periféricas elevadas em pacientes com câncer de mama recebendo quimioterapia
Mohd Ashif Khan 
1   Jamia Hamdard, School of Chemical and Life Sciences, Centre for Translational and Clinical Research, New Delhi, India.
2   Jamia Hamdard, School of Pharmaceutical Education and Research, Department of Pharmaceutical Medicine, New Delhi, India.
,
Dinesh Bhurani 
3   Rajiv Gandhi Cancer Institute & Research Centre, Department of Hemato-Oncology & Bone Marrow Transplantation, Rohini, New Delhi, India.
,
Ubedul Hoda 
4   Jamia Hamdard, School of Pharmaceutical Education and Research, Department of Pharmacology, New Delhi, India.
,
Nouroz Sehar 
5   Jamia Hamdard, School of Chemical and Life Sciences, Department of Medical Elementology and Toxicology, New Delhi, India.
,
Nidhi Agarwal 
1   Jamia Hamdard, School of Chemical and Life Sciences, Centre for Translational and Clinical Research, New Delhi, India.
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Abstract

Background Anthracyclines-based regimen (5-fluorouracil, doxorubicin, and cyclophosphamide (FAC); cyclophosphamide, epirubicin, and 5-fluorouracil [CEF]) and non-anthracycline based regimens (cyclophosphamide, methotrexate, and 5-fluorouracil [CMF]) are widely used as neoadjuvant chemotherapy for breast cancer patients.

Objective The present study was conducted to observe the effects of FAC, CEF, and CMF regimen on cognition and circulatory proinflammatory cytokines (interleukin 6 [IL-6] and interleukin 1β [IL-1β]) for the duration of three cycles of chemotherapy in breast cancer patients.

Methods Eighty newly diagnosed HER-2 negative breast cancer patients were enrolled and divided into 3 groups as FAC- (n = 27), CEF- (n = 26), and CMF- (n = 27) receiving patients. Serum IL-6 and IL-1β levels were measured by using enzyme-linked immunosorbent assay (ELISA), and cognition was assessed using the Mini-Mental State examination (MMSE) questionnaire.

Results Anthracycline-based regimen was found to increase the levels of IL-6, IL-1β, and decreased MMSE scores compared with CMF regimen (p < 0.05).

Conclusion Anthracycline-based regimen caused comparatively higher peripheral inflammation, which could be the reason for more decline in cognition in anthracycline-receiving patients than non-anthracycline group.

Resumo

Antecedentes Regime baseado em antraciclinas (5-fluorouracil, doxorrubicina e ciclofosfamida [FAC]; ciclofosfamida, epirrubicina e 5-fluorouracil [CEF]) e regimes não baseados em antraciclina (ciclofosfamida, metotrexato e 5-fluorouracil (CMF]) são amplamente utilizados como quimioterapia neoadjuvante para pacientes com câncer de mama.

Objetivo O presente estudo foi realizado para observar os efeitos do regime FAC, CEF e CMF na cognição e citocinas pró-inflamatórias circulatórias (interleucina 6 [IL-6] e interleucina 1β [IL-1β]) durante três ciclos de quimioterapia em pacientes com câncer de mama.

Métodos Oitenta pacientes recém-diagnosticadas com câncer de mama HER-2 negativo foram recrutadas e divididas em 3 grupos de pacientes que receberam FAC (n = 27), CEF (n = 26) ou CMF (n = 27). Os níveis séricos de IL-6 e IL-1β foram medidos por enzyme-linked immunosorbent assay (ELISA) e a cognição foi avaliada por meio do questionário Mini-Mental State Examination (MMSE).

Resultados O regime baseado em antraciclinas aumentou os níveis de IL-6, IL-1β e diminuiu os escores do MMSE em comparação com o regime CMF (p < 0,05).

Conclusão O regime baseado em antraciclinas causou inflamação periférica comparativamente mais alta, o que pode ser a razão para maior declínio na cognição em pacientes que receberam antraciclinas do que no grupo que não recebeu antraciclina.

Keywords

Cognitive Dysfunction - Mental Status and Dementia - Tests - Breast Neoplasms - Neoadjuvant Therapy - Cytokines

Palavras-chave

Disfunção Cognitiva - Testes de Estado Mental e Demência - Neoplasias da Mama - Terapia Neoadjuvante - Citocinas

Authors' Contributions

MAK, DB, NA: had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis; N. A., M. A. K.: study concept and design, drafting of the manuscript; M. A. K.: statistical analysis; All authors: approved the final manuscript as submitted and agreed to be accountable for all aspects of the work; acquisition, analysis, or interpretation of data; and critical revision of the manuscript for important intellectual content.




Publication History

Received: 04 August 2021

Accepted: 09 December 2021

Article published online:
17 October 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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