Early Depressive Symptoms in Cancer Patients Receiving Interleukin 2 and/or Interferon Alfa-2b Therapy

PURPOSE: Depressive symptomatology is frequently associated with interleukin (IL)-2 and interferon alfa-2b (INFα-2b) therapy in cancer patients. The objective of the present study was to evaluate the depressive and anxiety symptoms induced by IL-2 and/or INFα-2b in cancer patients during the first days of cytokine immunotherapy. PATIENTS AND METHODS: The study included 48 patients with renal cell carcinoma or melanoma. Patients were treated either with subcutaneous IL-2, alone (n = 20) or in combination with INFα-2b (n = 6); or with INFα-2b alone, administered subcutaneously at a low dose (n = 8) or intravenously at a high dose (n = 14). Depressive symptoms were evaluated using the Montgomery and Asberg Depression Rating Scale (MADRS), and anxiety symptoms were evaluated using the Covi scale. Evaluations were performed just before initiation of treatment (day 1) and on days 3 and 5 of treatment. RESULTS: Patients treated with IL-2 alone or in association with INFα-2b had significantly higher MADRS scores after 5 days of cytokine therapy, and patients who received both cytokines had increased scores on day 3. In contrast, patients treated with INFα-2b alone did not have varying MADRS scores during the course of treatment. Cytokine therapy had no effect on anxiety, except in patients treated with IL-2 in combination with INFα-2b. In these patients, the enhancement in anxiety scores that was observed on day 5 was mainly attributable to increased somatic complaints. CONCLUSION: IL-2 and INFα-2b have differential effects on mood, and IL-2 therapy induces depressive symptoms early in treatment.

Download Full-text

Can BDNF and IL-2 be indicators for the diagnosis in schizophrenic patients with depressive symptoms?

Acta Neuropsychiatrica ◽

10.1017/neu.2014.13 ◽

2014 ◽

Vol 26 (5) ◽

pp. 291-297 ◽

Cited By ~ 6

Author(s):

Salih Saygin Eker ◽

Ebru Oztepe Yavasci ◽

Sengul Cangur ◽

Selcuk Kirli ◽

Emre Sarandol

Keyword(s):

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Disorder ◽

Rating Scale ◽

Depressive Symptomatology ◽

Interleukin 2 ◽

Depression Scale ◽

Control Group ◽

Major Depressive ◽

Serum Bdnf

ObjectiveThe aim of the current study is to determine whether serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-2 (IL-2) can be biological indicators for the diagnosis of schizophrenia in patients with depressive symptoms.MethodForty-seven patients (11 patients diagnosed with schizophrenia, 16 patients diagnosed with schizophrenia and comorbid depression and 20 patients diagnosed with major depressive disorder) and 20 healthy subjects were enrolled. The Positive and Negative Symptoms Scale, the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale were used for assessment. The serum BDNF and IL-2 levels of all the subjects were studied.ResultsDecreased levels of serum BDNF and increased levels of serum IL-2 were found in the patients diagnosed with either schizophrenia, schizophrenia with depression, or major depressive disorder (p = 0.049, p = 0.010; p = 0.001 and p = 0.044; p = 0.027, p = 0.003; respectively) compared with control group. There were no significant differences between the patient groups in their serum BDNF and IL-2 levels.ConclusionsThe present study suggests that neurotrophic factors and immune system changes are involved in the pathogenesis of schizophrenia with or without depressive symptomatology. However, the data do not clarify whether depressive symptoms in schizophrenia occur as a dimension of schizophrenia or as symptoms of major depression that is comorbid with schizophrenia.

Download Full-text

An intervention for depressive symptoms using a commercial game in a mental health impatient setting. (Preprint)

10.2196/preprints.13890 ◽

2019 ◽

Author(s):

Pablo Rodrigo Guzman Cortez ◽

Matias Marzocchi ◽

Neus Freixa Fontanals ◽

Mercedes Balcells-Olivero

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Health Outcomes ◽

Serious Games ◽

Rating Scale ◽

Depressive Symptomatology ◽

Pilot Test ◽

Potential Health ◽

Depressive Episodes ◽

Hamilton Rating Scale

BACKGROUND Computerized mental health interventions have shown evidence of their potential benefit for mental health outcomes in young users. All of the studied interventions available in the review and scientific literature can be classified as "serious games". Serious games are computerized interventions designed from the start with the objective of improving specific desired health outcomes. Moreover, there are reports of users experiencing subjective benefits in mental health after playing specific commercial games. These were games not intentionally made with a therapeutic objective in the design process. An example is the videogame "Journey", first released for the Playstation 3 console in 2012 which won "Game of the Year" in the 2013 D.I.C.E awards. The creator of the game describes the game as a short, 2-3-hour narrative experience in which the player goes through the "Hero's Journey" following a classic 3-part structure. There were more than 100 testimonials from players describing how the game helped them cope with psychological or personal issues. Some of them explicitly described recovering from depressive episodes through playing the game. OBJECTIVE To conduct a pilot test of the efficacy of the videogame Journey in reducing depressive symptoms in an acute impatient setting METHODS Depressive symptomatology was measured before and after the intervention using the Hamilton Rating Scale for Depression (HRSD) The intervention was conducted in an isolated room using a Playstation 3 console with the videogame "Journey" developed by Thatgamecompany. No internet access was allowed. The game was played over the course of 4 30-45 min sessions in a two week period. RESULTS The initial score in the Hamilton Rating Scale for Depression (HRSD) was 30, indicating a very severe depression. After the intervention the HRSD score was 10, showing a mild depression. CONCLUSIONS The Videogame Journey, a commercial game first available for the Playstation 3 console in 2012, was not created as a serious game with potential health benefits. Our pilot test is the first case report of a commercial game showing a potential effect in reducing depressive symptoms, which is consistent with the previous informal reports of users online.

Download Full-text

Reduction of circulating regulatory T cells by intravenous high-dose interferon alfa-2b treatment in melanoma patients

Clinical & Experimental Metastasis ◽

10.1007/s10585-012-9504-2 ◽

2012 ◽

Vol 29 (7) ◽

pp. 801-805 ◽

Cited By ~ 12

Author(s):

Nicola Mozzillo ◽

Paolo Ascierto

Keyword(s):

T Cells ◽

Regulatory T Cells ◽

Interferon Alfa ◽

High Dose ◽

Melanoma Patients ◽

High Dose Interferon

Download Full-text

An Open Study of Two Dose Levels of ‘Vivalan’ (Viloxazine Hydrochloride ICI 58 834) in Depression in General Practice

Journal of International Medical Research ◽

10.1177/030006057400200401 ◽

1974 ◽

Vol 2 (4) ◽

pp. 253-259 ◽

Cited By ~ 4

Author(s):

P F C Bayliss ◽

J W Harcup ◽

M Mayer ◽

R Million ◽

J E Murphy ◽

...

Keyword(s):

General Practice ◽

Depressive Symptoms ◽

Side Effects ◽

Side Effect ◽

Open Study ◽

Anxiety Symptoms ◽

High Dose ◽

Dose Levels

Forty-eight mild to moderate depressives were treated by six genera practitioners with a chemically novel anti-depressant, ‘Vivalan’ (viloxazine hydrochloride, ICI 58 834). Twenty-five patients took 150 mg/day in three divided doses, and twenty-three took 200 mg/day in two divided doses, each for twenty-one days. The severity of both the depressive symptoms and the anxiety symptoms showed a statistically highly significant reduction over the duration of the study. There was no difference between the efficacy of the two dose levels. Viloxazine was generally well tolerated and there was no difference between the two dose levels as far as side-effects or withdrawals were concerned. The usual sedative and anti-cholinergic side-effects of the tricyclic anti-depressants were virtually absent. The only side-effect seen was a transient upper gastro-intestinal disturbance. It was commoner at the high dose but not significantly so. It is concluded that viloxazine hydrochloride appears to be an effective anti-depressant in this type of patient and produces little or no sedative or anti-cholinergic side-effects. Either 150 mg/day or 200 mg/day would seem a reasonable dose to use in general practice.

Download Full-text

Effect of Cytokine Therapy on Survival for Patients With Advanced Renal Cell Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.9.1928 ◽

2000 ◽

Vol 18 (9) ◽

pp. 1928-1935 ◽

Cited By ~ 147

Author(s):

Robert J. Motzer ◽

Madhu Mazumdar ◽

Jennifer Bacik ◽

Paul Russo ◽

William J. Berg ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Survival Time ◽

Median Survival ◽

Renal Cell ◽

Interleukin 2 ◽

Interferon Alfa ◽

Cytokine Therapy ◽

Survival Times ◽

Long Term Survivors

PURPOSE: To evaluate the relationship between treatment with cytokine therapy and survival, investigate the effect of nephrectomy on survival, and identify long-term survivors among a cohort of 670 patients with advanced renal cell carcinoma (RCC). PATIENTS AND METHODS: A total of 670 patients with advanced RCC treated on 24 clinical trials of systemic chemotherapy or cytokine therapy were the subjects of this retrospective analysis. Treatment was categorized as cytokine (containing interferon alfa and/or interleukin-2) in 396 patients (59%) and as chemotherapy (cytotoxic or hormonal therapy) in 274 (41%). Among the 670 patients, those with survival times of greater than 5 years were identified as long-term survivors. RESULTS: Patients treated with cytokine therapy had a longer survival time than did those treated with chemotherapy, regardless of the year of treatment or risk category based on pretreatment features. The median survival times for favorable-, intermediate-, and poor-risk patients were 27, 12, and 6 months for those treated with cytokines and 15, 7, and 3 months for those treated with chemotherapy, respectively. The magnitude of difference in median survival was greater in the favorable- and intermediate-risk groups. The median survival time was less than 6 months in the poor-risk group for both treatment programs. Median survival time was 14 months among patients with prior nephrectomy plus time from diagnosis to treatment greater than 1 year versus 8 months among those with time from diagnosis to treatment less than 1 year, regardless of pretreatment nephrectomy status. Thirty patients (4.5%) among the 670 patients were identified as long-term survivors; 12 were free of disease after nephrectomy and treatment with interferon alfa, interleukin-2, or surgical resection of metastasis. CONCLUSION: The low proportion of patients with advanced RCC who achieve long-term survival emphasizes the need for clinical investigation to identify more effective therapy.

Download Full-text

In vivo production of interleukin-5, granulocyte-macrophage colony- stimulating factor, macrophages colony-stimulating factor, and interleukin-6 during intravenous administration of high-dose interleukin-2 in cancer patients [see comments]

Blood ◽

10.1182/blood.v78.8.1981.1981 ◽

1991 ◽

Vol 78 (8) ◽

pp. 1981-1987 ◽

Cited By ~ 29

Author(s):

MR Schaafsma ◽

JH Falkenburg ◽

JE Landegent ◽

N Duinkerken ◽

S Osanto ◽

...

Keyword(s):

Cancer Patients ◽

Mononuclear Cells ◽

Bone Marrow Cells ◽

Interleukin 2 ◽

Mononuclear Phagocytes ◽

High Dose ◽

Colony Stimulating Factor ◽

Gm Csf ◽

Stimulating Factor

Abstract Recombinant human interleukin-2 (IL-2), administered to cancer patients by continuous intravenous (IV) infusion (3 x 10(6) U/m2/d), was found to induce the in vivo production of colony-stimulating factors (CSF). Plasma obtained from patients during IL-2 treatment stimulated in vitro colony formation of normal human bone marrow cells, depleted of mononuclear phagocytes and T lymphocytes. This colony-stimulating activity (CSA) was identified as IL-5, granulocyte-macrophage CSF (GM- CSF), and macrophage CSF (M-CSF), by the ability of specific antibodies against these factors to neutralize their effects. The presence of IL-2- induced GM-CSF and M-CSF was also demonstrated by specific radioimmunoassays. During IL-2 treatment, plasma also contained detectable levels of IL-6, which was measured in a bioassay. Using a cDNA-polymerase chain reaction (PCR) with specific primer sets for the various CSF, we showed that IL-2 treatment induced the expression of mRNA for M-CSF, GM-CSF, IL-3, and IL-5, but not for granulocyte CSF (G- CSF) in peripheral blood mononuclear cells, suggesting differential expression of CSF in vivo in response to IL-2. Furthermore, no negative regulators of hematopoiesis, such as interferon gamma (IFN-gamma) or tumor necrosis factor-alpha (TNF-alpha), were found in plasma. These data illustrate that in vivo administration of high-dose IL-2 may result in a stimulatory effect on hematopoiesis. The induction of detectable levels of IL-5 and GM-CSF in the circulation may explain the eosinophilia and neutrophilia observed in these patients.

Download Full-text