Upregulation of α-synuclein during localized radiation therapy signals the association of cancer-related fatigue with the activation of inflammatory and neuroprotective pathways

Brain Behav Immun. 2013 Jan;27(1):63-70. doi: 10.1016/j.bbi.2012.09.009. Epub 2012 Sep 26.

Abstract

Purpose: Neuroinflammatory mechanisms are associated with fatigue in neurodegenerative conditions such as Parkinson's. The symptoms in Parkinson's including fatigue are thought to be related to α-synuclein overexpression. This study investigated genomic correlates of fatigue experienced by men with prostate cancer receiving external beam radiation therapy (EBRT).

Patients and methods: Sixteen men with non-metastatic prostate cancer who were scheduled to receive EBRT were enrolled. Fatigue scores and blood were obtained at baseline (prior to EBRT, D0); one hour following initiation of EBRT (D1), day 7 (D7), day 14 (D14), midpoint (days 19-21, D21), completion (days 38-42, D42), and four weeks post-EBRT (days 68-72, D72). Gene expression profiling using microarray analysis was performed from peripheral blood and confirmatory qPCR and protein (ELISA) analyses verified the microarray results. Correlations between fatigue and gene/protein expressions were determined using a mixed model approach.

Results: Microarray data showed significant, differential expression of 463 probesets following EBRT. SNCA had a 2.95-fold change at D21 from baseline. SNCA expression was confirmed by qPCR (p<0.001) and ELISA (p<0.001) over time during EBRT. Fatigue scores were significantly correlated with SNCA gene expression on D14 (r=0.55, p<0.05) and plasma α-synuclein concentrations on D42 of EBRT (r=0.54, p=0.04).

Conclusion: Fatigue experienced during EBRT may be mediated by α-synuclein overexpression. Alpha-synuclein may serve as a useful biomarker to understand the mechanisms and pathways related to the development of fatigue in this population.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Enzyme-Linked Immunosorbent Assay
  • Fatigue / etiology
  • Fatigue / metabolism*
  • Gene Expression Profiling
  • Humans
  • Inflammation / metabolism
  • Male
  • Middle Aged
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / radiotherapy*
  • RNA, Messenger / analysis*
  • Real-Time Polymerase Chain Reaction
  • Time Factors
  • Up-Regulation*
  • alpha-Synuclein / metabolism*

Substances

  • RNA, Messenger
  • SNCA protein, human
  • alpha-Synuclein