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Diminished quality of life in patients with cancer correlates with tryptophan degradation

Journal of Cancer Research and Clinical Oncology volume 133, pages 477–485 (2007)Cite this article

Abstract

Purpose

Quality of life (QoL) is frequently impaired in patients suffering from malignant disease. Disturbed metabolism of neurotransmitter serotonin might be crucially involved, and serotonin-precursor tryptophan is degraded during pro-inflammatory immune response. In this study, we compared QoL and fatigue self-rating scores of patients with various types of malignancy with tryptophan metabolic changes and immune activation status.

Methods

Venous blood was collected from 146 patients with gastrointestinal tumors (n = 43), hematological malignancy (n = 40), gynecological neoplasms (n = 26), lung cancer (n = 20) and from tumors of other localization (n = 17).

Results

QoL was significantly reduced in patients suffering from progressive tumor disease in comparison to stable or remitting disease, also feeling of fatigue was increased (both P < 0.001). Serum tryptophan concentrations were lower in patients with progressive disease (P < 0.01), and decreased tryptophan concentrations were related to decreased QoL (r s = 0.256, P < 0.01) and increased fatigue (r s = −0.179; P < 0.05). Concentrations of tryptophan and kynurenine and the kynurenine to tryptophan ratio were predictive for impaired QoL and increased fatigue in univariate regression analysis, in multivariate analysis higher ESR and neopterin concentration in combination with stage of disease predicted QoL deterioration.

Conclusions

Results suggest that immune-mediated tryptophan degradation may contribute to cancer-induced QoL deterioration.

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Acknowledgment

This work was supported by the “Stiftung Propter Homines, Vaduz -Fürstentum Liechtenstein”, by the government of the State of the Austrian Tyrol, and by the European Community, Project #019031 BAMOD “Austrian Cancer Society/Tyrol”. We thank Miss Astrid Haara for excellent technical assistance.

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Affiliations

  1. Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Fritz Pregl Strasse 3, 6020, Innsbruck, Austria

    Katharina Schroecksnadel, Christiana Winkler & Dietmar Fuchs

  2. Division of Oncology, Hospital Natters/Innsbruck, Natters, Austria

    Michael Fiegl, Karin Prassl & Hubert A. Denz

Authors
  1. Katharina Schroecksnadel
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  2. Michael Fiegl
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  3. Karin Prassl
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  4. Christiana Winkler
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  5. Hubert A. Denz
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  6. Dietmar Fuchs
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Corresponding author

Correspondence to Dietmar Fuchs.

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Schroecksnadel, K., Fiegl, M., Prassl, K. et al. Diminished quality of life in patients with cancer correlates with tryptophan degradation. J Cancer Res Clin Oncol 133, 477–485 (2007). https://doi.org/10.1007/s00432-007-0191-3

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  • DOI: https://doi.org/10.1007/s00432-007-0191-3

Keywords

  • Tryptophan degradation
  • Cancer
  • Quality of life
  • Neopterin
  • Immune activation
  • Fatigue