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Barsevick A , Frost M , Zwinderman A , Hall P , Halyard M , Geneqol Consortium
I'm so tired: biological and genetic mechanisms of cancer-related fatigue
Qual Life Res. 2010 Dec;19(10) :1419-27
PMID: 20953908 PMCID: PMC3031957
AbstractOBJECTIVE: The goal of this paper is to discuss cancer-related fatigue (CRF) and address issues related to the investigation into potential biological and genetic causal mechanisms. The objectives are to: (1) describe CRF as a component of quality of life (QOL); (2) address measurement issues that have slowed progress toward an understanding of mechanisms underlying this symptom; (3) review biological pathways and genetic approaches that have promise for the exploration of causal mechanisms of CRF; and (4) offer directions for future research. METHODS: Review, synthesis, and interpretation of the literature. RESULTS: Until recently, CRF and QOL have been understood primarily as subjective patient-reported experiences. With increased understanding of human genetics, theories and research are being expanded to incorporate biological and genetic understandings of these subjective experiences. Proposed biological and genetic mechanisms of CRF that have been examined include cytokine dysregulation, hypothalamic-pituitary-adrenal (HPA) axis dysfunction, five hydroxy tryptophan (5-HT) neurotransmitter dysregulation, circadian rhythm disruption, alterations in adenosine triphosphate (ATP) and muscle metabolism, and vagal afferent activation. Approaches to the study of genetic mechanisms have also been addressed including candidate genes, genome-wide scanning, and gene expression. Based on the review and synthesis of the literature, directions for future research are proposed. CONCLUSIONS: Understanding the biological and genetic basis of CRF has the potential to contribute to a more complete understanding of the genetic determinants of QOL.
NotesBarsevick, Andrea Frost, Marlene Zwinderman, Aeilko Hall, Per Halyard, Michele R01 NR004573-07/NR/NINR NIH HHS/United States R21 NR010615-02/NR/NINR NIH HHS/United States Review Netherlands Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation Qual Life Res. 2010 Dec;19(10):1419-27. Epub 2010 Oct 16.