2.50
Hdl Handle:
http://hdl.handle.net/10755/211561
Type:
Research Study
Title:
GLYCEMIC STATUS AND BIOMARKERS IN CANCER
Abstract:
Purpose: Patients with cancer become immunocompromised due to a number of factors. Abnormal glycemic status, or maglycemia, is one contributor to immunosuppression becoming more evident. This study aims to prospectively evaluate glycemic status, inflammatory cytokine expression, and infection rates in autologous HCT recipients. This preliminary phase describes blood glucose (BG) trends and white blood cell (WBC) counts, including absolute neutrophil counts (ANCs), as an indicator of immune function. Additionally, a concurrent rodent model experiment was conducted to compare glycemic levels and various markers in mice with and without oral squamous cell carcinoma. Rationale/Background: Malglycemica, particularly hyperglycemic states occur in patients with cancer whether or not they have pre-existing diabetes due to a variety of factors including older age, high BMI, nutritional imbalances, low physical activity levels, high stress levels, glucocorticoids and other therapeutic regimens, and from infections. Physiologically, hyperglycemia triggers the release of select hormone leading to increased insulin resistance, lipolysis, gluconeogenesis, glycogenolysis, and decreased insulin secretion; all further promoting hyperglycemia. Concurrently, hyperglycemia stimulates increased levels of cytosolic calcium that results in oxidative stress. The oxidative stress induces transcription factors to produce and secrete an overabundance of proinflammatory cytokines, chemokines, and prostaglandins, which cause an inhibition of immune cell signaling, leading to impaired immune function, thus allowing infections to manifest and thrive as well as progression of the malignancy. Evaluating the clinical manifestations in patients in addition to measuring underlying biomarkers is essential for finding interventions to best control glycemic status in patients with cancer. Additionally, the concurrent use of the rodent model enhances the physiological understanding and allows exploration into various types of malignancies. Methods: Glycemic levels, WBCs/ANCs from routine laboratory tests were evaluated among adult (ages 18+) autologous HCT recipients treated at the NYU Cancer Institute in 2011. BG from whole blood and TNF-α and IL-6 cytokines, leptin and CRP from serum samples were measured in athymic, immunocompromised (BALD/c) mice with and without oral squamous cell carcinomas. Pearson’s correlation was used for the human subject data analysis and the independent sample t-test was used for analysis of the mice. Outcomes: Human autologous HCT recipients showed an inverse relation between BG levels and WBCs/ANCs (p < .001). Mice with oral carcinomas had higher blood glucose (p = .007), TNF-α (p = .005), and IL-6 (p = .005) levels, and lower leptin (p = .045) levels compared to non-cancerous mice. No statistically significant difference was seen with CRP levels. Conclusions: In this preliminary phase of a larger study, the hyperglycemic component of malglycemia was associated with reduced WBCs/ANCs in human autologous HCT recipients. Mice with oral squamous cell carcinomas also had higher glycemic levels and proinflammatory cytokine expression and lower leptin levels compared to non-cancerous mice. These early study findings reinforce the underlying physiological processes of how glycemic status influences immune function in cancer. Further investigation is anticipated to lead to novel interventions for optimizing glycemic levels and, in turn, enhancing outcomes for patients with cancer.
Keywords:
Cancer patients; Immunosuppression; Maglycemia
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5485
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleGLYCEMIC STATUS AND BIOMARKERS IN CANCERen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211561-
dc.description.abstractPurpose: Patients with cancer become immunocompromised due to a number of factors. Abnormal glycemic status, or maglycemia, is one contributor to immunosuppression becoming more evident. This study aims to prospectively evaluate glycemic status, inflammatory cytokine expression, and infection rates in autologous HCT recipients. This preliminary phase describes blood glucose (BG) trends and white blood cell (WBC) counts, including absolute neutrophil counts (ANCs), as an indicator of immune function. Additionally, a concurrent rodent model experiment was conducted to compare glycemic levels and various markers in mice with and without oral squamous cell carcinoma. Rationale/Background: Malglycemica, particularly hyperglycemic states occur in patients with cancer whether or not they have pre-existing diabetes due to a variety of factors including older age, high BMI, nutritional imbalances, low physical activity levels, high stress levels, glucocorticoids and other therapeutic regimens, and from infections. Physiologically, hyperglycemia triggers the release of select hormone leading to increased insulin resistance, lipolysis, gluconeogenesis, glycogenolysis, and decreased insulin secretion; all further promoting hyperglycemia. Concurrently, hyperglycemia stimulates increased levels of cytosolic calcium that results in oxidative stress. The oxidative stress induces transcription factors to produce and secrete an overabundance of proinflammatory cytokines, chemokines, and prostaglandins, which cause an inhibition of immune cell signaling, leading to impaired immune function, thus allowing infections to manifest and thrive as well as progression of the malignancy. Evaluating the clinical manifestations in patients in addition to measuring underlying biomarkers is essential for finding interventions to best control glycemic status in patients with cancer. Additionally, the concurrent use of the rodent model enhances the physiological understanding and allows exploration into various types of malignancies. Methods: Glycemic levels, WBCs/ANCs from routine laboratory tests were evaluated among adult (ages 18+) autologous HCT recipients treated at the NYU Cancer Institute in 2011. BG from whole blood and TNF-α and IL-6 cytokines, leptin and CRP from serum samples were measured in athymic, immunocompromised (BALD/c) mice with and without oral squamous cell carcinomas. Pearson’s correlation was used for the human subject data analysis and the independent sample t-test was used for analysis of the mice. Outcomes: Human autologous HCT recipients showed an inverse relation between BG levels and WBCs/ANCs (p < .001). Mice with oral carcinomas had higher blood glucose (p = .007), TNF-α (p = .005), and IL-6 (p = .005) levels, and lower leptin (p = .045) levels compared to non-cancerous mice. No statistically significant difference was seen with CRP levels. Conclusions: In this preliminary phase of a larger study, the hyperglycemic component of malglycemia was associated with reduced WBCs/ANCs in human autologous HCT recipients. Mice with oral squamous cell carcinomas also had higher glycemic levels and proinflammatory cytokine expression and lower leptin levels compared to non-cancerous mice. These early study findings reinforce the underlying physiological processes of how glycemic status influences immune function in cancer. Further investigation is anticipated to lead to novel interventions for optimizing glycemic levels and, in turn, enhancing outcomes for patients with cancer.en_GB
dc.subjectCancer patientsen_GB
dc.subjectImmunosuppressionen_GB
dc.subjectMaglycemiaen_GB
dc.date.available2012-02-20T12:02:23Z-
dc.date.issued2012-02-20T12:02:23Z-
dc.date.accessioned2012-02-20T12:02:23Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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