Lower content of cerebrospinal fluid chemokines in patients with cancer cachexia.

PURPOSE: Cancer-associated cachexia (CC) is characterized by involuntary weight loss and poor prognosis. Central nervous system (CNS) inflammation has been linked to CC symptoms. This study evaluated inflammatory mediators in the cerebrospinal fluid (CSF) of patients with CC.

METHODS

Volunteers were recruited in Santarém, PA, Brazil, and divided into three groups: patients undergoing herniorrhaphy or cholecystectomy (n = 43)-control; cancer without cachexia (CWC, n = 13); and CC (n = 49). Blood and CSF were collected before anesthetic injection.

RESULTS

CSF vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1) levels were reduced in CC (p < 0.0001; p 0.00017) and CWC (p = 0.0269; p = 0.0421) compared to control. CSF IP-10 was lower in CC (p = 0.0048). In CWC, CSF MCP-1 correlated with serum C reactive protein (rs = 0.78, p = 0.0098), leukocytes (rs = 0.72, p = 0.0235), lymphocytes (rs = -0.67, p = 0.0390) and monocytes (rs = -0.82, p = 0.0058). In CC, CSF interleukin (IL)-8 correlated with leukocytes (rs = 0.48, p = 0.0032) and MCP-1 with neutrophils (rs = 0.36, p = 0.0265) and eosinophils (rs = -0.37, p = 0.0218). CC patients showed lower quality of life than CWC (functional scale p = 0.0087; symptoms scale p = 0.0386).

CONCLUSION

Cancer was related to changes in CSF cytokine levels, indicating that both tumor presence and cachexia modulate central inflammatory signaling. Correlations between CSF chemokines and blood immune cells suggest systemic interaction between peripheral immunity and the CNS.