Cancer-related fatigue, inflammation and thyrotropin-releasing hormone

Curr Aging Sci. 2012 Dec;5(3):195-202. doi: 10.2174/1874609811205030005.

Abstract

Aging and aging related illnesses such as cancer have been associated with inflammatory changes. Cancer-related behavioral comorbidities such as fatigue, sleep disturbances, depression have also been associated with inflammation, hypothalamic-pituitary-adrenal (HPA) axis dysregulation and other neuroendocrine changes. From a clinical perspective, cancer-related fatigue demonstrates striking similarities with the cytokine-induced sickness phenomenon in animal models. Thyrotopin-releasing hormone (TRH) plays a homeostatic role in its interaction with several biological systems, including a critical role in its interactions with the immune system. Considerable evidence supports a pivotal role for TRH in the inflammatory processes with specific relevance to the "cytokine-induced sickness behavior" paradigm. Additionally, TRH exerts arousing and analeptic effects in instances of behavioral depression. In a small proof-of-concept study conducted by our group, we investigated TRH administration as a treatment fatigue in cancer survivors in comparison with saline administration using a double-blind, crossover design. We also evaluated impact of TRH/saline administration on the inflammatory markers in these patients. TRH administration was associated with significant improvement (p < 0.05) in fatigue levels as measured by the Visual Analog Scale-Energy (VAS-E), was associated with significant (p < 0.05) improvement in sleep disturbances and improved quality of life. Notably, TRH administration was associated with decrease in C-reactive protein (CRP) levels, a marker of inflammation. This decrease in CRP level with TRH administration was associated with improvement in energy levels as measured by the VAS-E. The present review supports potential utility of TRH-based therapeutics in medical and psychiatric disorders with underlying inflammatory processes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Aging / immunology
  • Aging / metabolism
  • Anti-Inflammatory Agents / administration & dosage
  • Comorbidity
  • Controlled Clinical Trials as Topic
  • Cross-Over Studies
  • Double-Blind Method
  • Fatigue / drug therapy
  • Fatigue / etiology*
  • Fatigue / immunology
  • Fatigue / metabolism
  • Fatigue / psychology
  • Homeostasis
  • Humans
  • Inflammation / complications*
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Inflammation / metabolism
  • Inflammation / psychology
  • Inflammation Mediators / metabolism
  • Neoplasms / complications*
  • Neoplasms / immunology
  • Neoplasms / metabolism
  • Neoplasms / psychology
  • Neoplasms / therapy
  • Quality of Life
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / etiology*
  • Sleep Wake Disorders / immunology
  • Sleep Wake Disorders / metabolism
  • Sleep Wake Disorders / psychology
  • Thyrotropin-Releasing Hormone / administration & dosage
  • Thyrotropin-Releasing Hormone / metabolism*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Inflammation Mediators
  • Thyrotropin-Releasing Hormone