P18.09 * STRESS INDUCED IMMUNE DYSFUNCTION IN NEURO-ONCOLOGY CAREGIVERS

Abstract

Family caregivers are vital in the care of persons with a primary malignant brain tumor (PMBT) and also report high levels of psychological distress. The impact of psychological distress on caregivers' physical health has not been explored in neuro-oncology. The aims of the study were to determine profiles of proinflammatory cytokines (IL-6 and IL-1ra) over time in caregivers of persons with a PMBT and to identify the effect of caregivers' psychological distress on their cytokine levels. After institutional review board approval, sociodemographic data, measures of psychological distress (depressive symptoms, anxiety, caregiver burden) and blood samples were collected from 103 caregivers at baseline (time of patient diagnosis), 4, 8, and 12 months. Caregivers were >21, not a primary caregiver for anyone else, and caring for a person diagnosed with a PMBT verified via pathology (NIH R01CA117811). Plasma was batch analyzed using high sensitivity and regular ELISA. Trajectory analyses of log transformed cytokine levels were performed. Then, univariate analyses evaluated potential confounding variables; variables with p < .10 were included in model testing. Multiple logistic regression analyses used high versus low cytokine group membership as outcome variables to determine the impact of psychological distress on cytokine level. With IL-1ra, two groups of caregivers were identified (BIC= -235.28). One-third (34%) had high IL-1ra levels (M = 575.91pg/ml); two-thirds had low levels (M = 252.80pg/ml). With IL-6, two groups of caregivers were identified (BIC= -299.44); 59% had high IL-6 levels (M = 2.30pg/ml) and 41% had low levels (M = .90pg/ml). None of the groups significantly changed over time (baseline to 1 year). After controlling for confounding variables, all female caregivers and those male caregivers reporting increased anxiety were significantly (p = .02) more likely have high IL-1ra. Caregivers that reported higher levels of caregiver burden were significantly more likely to have both high IL-1ra (p = .01) and high IL-6 (p = .03) levels. Depressive symptoms did not significantly affect IL-1ra or IL-6 levels. Poor physical health in family caregivers has the potential to increase institutionalization rates for patients, affect the quality of care delivered in the home, and place a new burden on the healthcare system. These data provide support for mechanistic pathways of stress-induced immune dysfunction and are among the first of their kind to highlight the health risks for neuro-oncology family caregivers.