Abstract

This “integrative single-case study” investigated the bidirectional cause and effect relations between various emotional states (i.e., mood, irritation, mental activity) and urinary IL-6 levels in a 49-year-old female breast cancer survivor (woman) under conditions of “life as it is lived.” During a period of 28 days, the patient collected her entire urine in 12-h intervals for IL-6 measurement and completed each morning and evening a list of adjectives regarding mood, irritation, and mental activity (55 measurements in total). Autoregressive integrated moving average modeling revealed a 4-day (circasemiseptan) cycle in the IL-6 time series. Furthermore, cross-correlational analyses after controlling for serial dependencies (significance level: p < 0.05) showed that worsening in mood and increases in irritation were followed by increases in urinary IL-6 levels with temporal delays between 12 and 36 h. In the opposite direction of effect, increases in urinary IL-6 levels were followed by elevations in mood and mental activity as well as decreases in irritation with temporal delays between 48 and 72 h. These results from cross-correlational analyses suggest that IL-6 may have a regulatory function in psychoneuroimmunological interplay and that, under certain conditions, IL-6 may be involved in health rather than sickness behavior. Moreover, the findings of this study are indicators of real-life negative feedback loops and are in line with psychoneuroimmunological research postulating complex brain-to-body-to-brain network-like structures.

Highlights

  • Interleukin-6 (IL-6) is a pleiotropic cytokine with pro- and anti-inflammatory properties orchestrating a broad spectrum of immunological and non-immunological reactions (Naugler and Karin, 2008; Scheller et al, 2011; Yirmiya and Goshen, 2011)

  • Over a period of 55 12h intervals (28 days), we investigated in the current study the correlations between urinary IL-6 levels and mood, irritation, and mental activity in a patient with prior breast cancer under conditions of “life as it is lived.”

  • In the opposite direction of effect, increases in urinary IL-6 levels were followed by significant elevations in mood by 48–60 h (−lag 4: r = +0.275, p = 0.049)

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Summary

Introduction

Interleukin-6 (IL-6) is a pleiotropic cytokine with pro- and anti-inflammatory properties orchestrating a broad spectrum of immunological and non-immunological reactions (Naugler and Karin, 2008; Scheller et al, 2011; Yirmiya and Goshen, 2011). IL-6 displays regulatory functions in important homeostatic processes of the immune system, the metabolism and the central nervous system. It represents a keystone cytokine in pathophysiological conditions of a variety of diseases As evidence linking IL-6 to poor outcome and low quality of life in breast cancer patients grows, it has become increasingly important to understand how psychosocial factors of daily life affect the synthesis and function of this versatile cytokine. Jehn et al (2012) found a positive correlation between IL-6 blood levels and depression in a sample of 70 breast cancer patients receiving chemotherapy. Jehn et al (2012) found a positive correlation between IL-6 blood levels and depression in a sample of 70 breast cancer patients receiving chemotherapy. Mills et al (2005), by contrast, found no clear correlation in a sample of 29 breast cancer patients undergoing chemotherapy

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