Epigenetic Regulation of Inflammatory Mechanisms and a Psychological Symptom Cluster in Patients Receiving Chemotherapy.
Carolyn S Harris, Christine A Miaskowski, Yvette P Conley and 6 others
PMID 36929768WHAT IT FOUND
Chemotherapy patients with a cluster of psychological symptoms had lower DNA methylation at CD40 gene sites.
This is a biological association, not evidence of a treatment.
Key findings
01The analysis compared patients with 0 psychological cluster symptoms to patients with 1 to 6 symptoms.
02CD40 was the only gene identified by rank aggregation as differentially methylated across the 450K and EPIC microarray samples (FDR = 0.017).
03All six CD40 promoter sites measured were hypomethylated in the psychological cluster group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The design was cross-sectional, so it cannot show whether methylation changes came before or after the symptom cluster. The two microarray samples were heterogeneous in gender, cancer type, and sample size, so the finding needs confirmation. Antidepressant use was not measured, so it cannot be ruled out as a possible explanation for the methylation association. The continuous symptom cluster score could not be used because of statistical challenges, so the analysis compared only 0 versus 1 to 6 symptoms. The study looked only at methylation and gene expression regulation, not post-transcriptional processes such as alternative splicing. The analyses included 146 and 923 patients, not all 1,343 consented patients or all 1,071 blood samples.
Declared interests
The authors declared no conflicts of interest. Methylation analyses were funded at two time points, first for a pilot study in women with breast cancer and later for the remaining patients.
The easy way to misread this
Do not conclude that inflammation causes the psychological symptom cluster or that CD40 is a treatment target. The study was cross-sectional, did not measure antidepressant use, and found only an association between symptom cluster group membership and CD40 methylation.