Serum tumor necrosis factor-α, interleukin-1β, interleukin-6, and interleukin-17 relate to anxiety and depression risks to some extent in non-small cell lung cancer survivor

Abstract

Introduction: Inflammatory cytokines are proposed as modulators for the pathogenesis of anxiety and depression (anxiety/depression), and anxiety/depression are frequently existed in non-small cell lung cancer (NSCLC) survivors. However, no published study has explored the association of inflammation cytokines with anxiety/depression in NSCLC survivors.

Objectives: We aimed to evaluate serum tumor necrosis factor-α (TNF-α), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-17 (IL-17) levels, and their correlations with anxiety/depression in NSCLC survivors.

Methods: Totally, 217 NSCLC survivors and 200 controls were recruited. Then, inflammatory cytokines in serum samples were detected by enzyme-linked immunosorbent assay (ELISA). Besides, their anxiety/depression status was assessed by Hospital Anxiety and Depression Scale (HADS).

Results: HADS-anxiety score, anxiety rate, anxiety severity, HADS-depression score, depression rate, and depression severity were all increased in NSCLC survivors compared with controls (all P < 0.001). Regarding inflammatory cytokines, TNF-α, IL-1β, and IL-17 levels were higher (all P < 0.01), while IL-6 (P = 0.105) level was of no difference in NSCLC survivors compared with controls. Furthermore, TNF-α, IL-1β, IL-6, and IL-17 were all positively associated with HADS-A score (all P < 0.05), anxiety occurrence (all P < 0.05), HADS-D score (all P < 0.05), and depression occurrence (all P < 0.05) in NSCLC survivors, while the correlation-coefficients were weak. Additionally, multivariate logistic regression analyses disclosed that TNF-α (both P < 0.05) and IL-1β (both P < 0.001) were independently correlated with increased anxiety and depression risks in NSCLC survivors.

Conclusion: Serum TNF-α, IL-1β, IL-6, and IL-17 are related to increased anxiety and depression risks to some extent in NSCLC survivors.

Keywords: anxiety; depression; interleukin-1β; non-small cell lung cancer; tumor necrosis factor-α.

FIGURE 1

Difference in anxiety and depression between controls and NSCLC survivors. Comparisons of HADS‐A score (A), anxiety rate (B), anxiety severity (C), HADS‐D score (D), depression rate (E), and depression severity (F) between controls and NSCLC survivors. HADS‐A, Hospital Anxiety and Depression Scale for anxiety; HADS‐D, Hospital Anxiety and Depression Scale for depressionNSCLC, non‐small cell lung cancer

FIGURE 2

Difference in TNF‐α, IL‐1β, IL‐6, and IL‐17 between controls and NSCLC survivors. Comparisons of serum TNF‐α (A), IL‐1β (B), IL‐6 (C), and IL‐17 (D) between controls and NSCLC survivors. IL‐1β, interleukin‐1β; IL‐6, interleukin‐6; IL‐17, interleukin‐17; NSCLC, non‐small cell lung cancer; TNF‐α, tumor necrosis factor‐α

FIGURE 3

Correlations of TNF‐α, IL‐1β, IL‐6, and IL‐17 with anxiety in NSCLC survivors. Correlations of serum TNF‐α (A), IL‐1β (B), IL‐6 (C), and IL‐17 (D) levels with HADS‐A score. Comparisons of serum TNF‐α (E), IL‐1β (F), IL‐6 (G), and IL‐17 (H) levels between anxiety NSCLC survivors and non‐anxiety NSCLC survivors. IL‐1β, interleukin‐1β; IL‐6, interleukin‐6; IL‐17, interleukin‐17; NSCLC, non‐small cell lung cancer; TNF‐α, tumor necrosis factor‐α

FIGURE 4

Correlations of TNF‐α, IL‐1β, IL‐6, and IL‐17 with depression in NSCLC survivors. Correlations of serum TNF‐α (A), IL‐1β (B), IL‐6 (C), and IL‐17 (D) levels with HADS‐D score. Comparisons of serum TNF‐α (E), IL‐1β (F), IL‐6 (G), and IL‐17 (H) levels between depression NSCLC survivors and non‐depression NSCLC survivors. IL‐1β, interleukin‐1β; IL‐6, interleukin‐6; IL‐17, interleukin‐17; NSCLC, non‐small cell lung cancer; TNF‐α, tumor necrosis factor‐α