Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management

The Role of Rehabilitation for Women with Cancer

As the prevalence of female cancer survivors increases, their quality of life (QOL) and function have become key areas of focus in the context of survivorship and rehabilitation needs. Although behavioral modifications may help to decrease the development of malignancy, women are still at increased risk of developing a cancer diagnosis in their lifetime. Cancer and its treatment can lead to significant functional impairments and symptomatic challenges. However, rehabilitation interventions and medical management provide options to address these issues throughout the oncological continuum of care. With appropriate treatment, women are enabled to experience improved QOL and performance status.

Drug-Induced Cognitive Impairment

Drug-induced cognitive impairment (DICI) is a well-established, yet under-recognised, complication of many types of pharmacological treatment. While there is a large body of scientific literature on DICI, most papers are about drug-induced dementia in the elderly and one specific drug class. However, DICI also comprises subclinical symptoms, domain-specific forms of cognitive impairment as well as mild cognitive impairment (MCI), and delirium. Even mild forms of DICI, if not recognised as such, can have deleterious and life-long consequences. In addition, DICI also occurs in younger adults and in children, and has been reported with many different drug classes. The aim of this review is to raise awareness of DICI by providing an overview on the type(s) and symptoms of observed DICI and the suspected underlying mechanism(s) for various drug classes: antiseizure medications, antidepressants, antiparkinsonian drugs, antipsychotics, lithium, benzodiazepines/Z-drugs, opioids, first-generation antihistamines, drugs for urinary incontinence, proton pump inhibitors, glucocorticoids, NSAIDs, statins, antihypertensives, and chemotherapeutic agents.

Pilot randomized study of adaptive cognitive training's effect on breast cancer survivors assessed through eye tracking

PURPOSE

Cancer-related cognitive impairment (CRCI) is a prevalent comorbidity among breast cancer survivors, yet evidence supporting the efficacy of adaptive cognitive training remains limited. This pilot study seeks to examine participants' adherence and preliminary effect of tablet-based cognitive training as an intervention for CRCI and apply eye tracking technology as an innovative approach to evaluate cognitive training outcomes.

METHODS

Fifty-two eligible participants were randomly assigned to either the biofeedback therapy group (BF) or the combined biofeedback therapy and cognitive training group (BF + COG). Participants completed a 30-session intervention lasting 6 weeks and eye tracking assessments at two timepoints: baseline and immediately after the intervention completion.

RESULTS

Retention rates were 68% in the BF group and 70.4% in the BF + COG group. At the 6-week follow-up, the BF + COG group demonstrated significantly improved fixation stability. Under non-interfering conditions, they maintained fixation 307.76 ms longer (p = 0.022, Cohen's d = 0.307) and had a 32.4% reduction in saccadic distance (p = 0.019, Cohen's d = -0.677) compared to BF. This advantage persisted under interference conditions with a 28.2% shorter saccadic distance (p = 0.034, Cohen's d = -0.579). While within-group changes were not significant, the BF+COG group consistently showed reduced saccade distances across conditions, whereas the BF group exhibited increases.

CONCLUSION

Adaptive cognitive training may enhance attentional engagement and inhibitory control in breast cancer survivors. Large-scale study is needed to confirm these effects and refine eye-tracking applications for CRCI assessment.

IMPLICATIONS FOR CANCER SURVIVORS

Tablet-based cognitive training targeting cognitive control with adaptive difficulty levels may ameliorate CRCI among breast cancer survivors.

MRI Voxel Morphometry Shows Brain Volume Changes in Breast Cancer Survivors: Implications for Treatment

Chemotherapy-related cognitive impairment termed «chemobrain» is a prevalent complication in breast cancer survivors that requires early detection for the development of novel therapeutic approaches. Magnetic resonance voxel morphometry (MR morphometry), due to its high sensitivity, might be employed for the evaluation of the early changes in the volumes of brain structures in order to explore the «chemobrain» condition.

METHODS

The open, prospective, single-center study enrolled 86 breast cancer survivors (43.3 ± 4.4 years) and age-matched 28 healthy female volunteers (44.0 ± 5.68). Conventional MR sequences (T1- and T2-weighted, TIRM, DWI, MPRAGE) were obtained in three mutually perpendicular planes to exclude an organ pathology of the brain. Additionally, the MPRAGE sequence was performed for subsequent MR morphometry of the volume of brain structures using the open VolBrain program. The evaluation was performed at two follow-up visits 6 months and 3 years after the completion of BC treatment.

RESULTS

According to the MR morphometry, breast cancer survivors presented with significantly decreased volumes of brain structures (including total brain volume, cerebellum volume, subcortical gray matter, etc.) as compared to healthy volunteers. Evaluation over the follow-up period of 3 years did not show the restoration of brain volume structures.

CONCLUSIONS

The data obtained employing MR morphometry revealed significant reductions (that were not detected on the conventional MR sequences) in both gray and white matter in breast cancer survivors following chemotherapy. This comprehensive analysis indicated the utility of MR morphometry in detecting subtle yet statistically significant neuroanatomical changes associated with cognitive and motor impairments in patients, which can in turn provide valuable insights into the extent of structural brain alterations, helping to identify specific regions that are most affected by treatment.

Screening for cognitive impairment in routine clinical oncology practice: a pilot study using patient-reported outcome measures and online cognitive testing in melanoma and breast cancer patients

PURPOSE

This pilot study aimed to identify patients with cognitive impairment by a stepped-care use of patient-reported outcome measures (PROMs) and complementary online cognitive tests implemented in routine clinical practice.

METHODS

Self-reported cognitive functioning was measured in breast cancer or melanoma patients, 6 months after start of treatment, with two items of the EORTC QLQ-C30. Scores below a predefined threshold of 75 indicated clinically relevant cognitive impairment. Subsequent objective cognitive functioning was assessed with an online test battery, consisting of seven tests. Impaired cognitive functioning was defined as a z score of ≤  - 1.5 on 2 or more tests, a z score of ≤  - 2 on one single test, or both. Descriptive statistics were used to analyze the prevalence of impairment.

RESULTS

In total, 261 patients completed PROMs 6 months after start treatment; 38/154 (25%) melanoma and 43/107 (40%) breast cancer patients reported clinically relevant self-reported cognitive impairment. Of them, 12/38 (32%) melanoma and 15/43 (35%) breast cancer patients opted for complementary online cognitive testing. Of those completing formal tests, objectively measured cognitive impairment was identified in 4/12 (33%) melanoma and 10/15 (67%) breast cancer patients.

CONCLUSION

A significant number of patients report cognitive problems 6 months after starting treatment. Only onethird was able and/or expressed the need for further diagnostics. Among those who were formally tested, 33-67% had cognitive impairment, which is 3-9% of the total group that completed PROMs in routine care.

IMPLICATIONS FOR CANCER SURVIVORS

This pilot study suggests that a stepped care pathway for cognitive problems is relevant and also mangable in terms of clinical care.

Fall risk factors and mitigation strategies for hematological malignancy patients: insights from a qualitative study using the reason model

PURPOSE

Our study aim was to understand the (human and organizational) factors influencing fall risk among people with hematological malignancies using the Reason model as a framework, providing insights that can inform the development of safe and effective fall management strategies.

METHODS

Purposive sampling was employed to conduct semi-structured interviews with 13 people with hematological malignancies and 12 nurses from the hematology department of a tertiary grade A hospital in Guangzhou from December 2023 to February 2024. The topic analysis method was utilized to analyze the interview data.

RESULTS

Factors influencing fall risk among people with hematological malignancies were categorized into four themes: (1) precondition of unsafe arts (lack of work experience in junior nurses, poor patient compliance, adverse drug reactions, inadequate ward facilities); (2) unsafe supervision (inadequate inspection management, inadequate accompanying capacity); (3) unsafe arts (variability in subjective assessment, lack of bidirectional education); and (4) organizational influences (limited nursing human resources, lack of organizational process management models).

CONCLUSION

The specific fall risk factors among people with hematological malignancies, as summarized based on the Reason model framework, provide a theoretical basis and direction for the construction of specialized fall risk assessment tools, aiming to improve the quality of fall management for inpatients and reduce the incidence of falls.

Neuroscience of cancer: unraveling the complex interplay between the nervous system, the tumor and the tumor immune microenvironment

The study of the multifaceted interactions between neuroscience and cancer is an emerging field with significant implications for understanding tumor biology and the innovation in therapeutic approaches. Increasing evidence suggests that neurological functions are connected with tumorigenesis. In particular, the peripheral and central nervous systems, synapse, neurotransmitters, and neurotrophins affect tumor progression and metastasis through various regulatory approaches and the tumor immune microenvironment. In this review, we summarized the neurological functions that affect tumorigenesis and metastasis, which are controlled by the central and peripheral nervous systems. We also explored the roles of neurotransmitters and neurotrophins in cancer progression. Moreover, we examined the interplay between the nervous system and the tumor immune microenvironment. We have also identified drugs that target the nervous system for cancer treatment. In this review we present the work supporting that therapeutic agent targeting the nervous system could have significant potential to improve cancer therapy.

Cancer-Related Cognitive Impairment and the Potential of Dietary Interventions for the Prevention and Mitigation of Neurodegeneration

Approximately 35% of long-term cancer survivors experience ongoing cancer-related cognitive impairment (CRCI). Yet, few efficacious interventions exist to prevent or ameliorate CRCI. The underlying biological processes driving CRCI are complex and are reported to include changes in brain structure and function, increased oxidative stress and inflammation, and alterations in gut microbiome composition. Some of the mechanisms promoting CRCI have the potential to be modified through behavioral changes, such as dietary changes. Compelling evidence from randomized controlled trials and observational research supports the positive impacts of the Mediterranean-DASH Intervention for Neurodegenerative Delay diet on cognition outside of the context of cancer, but studies investigating the Mediterranean-DASH Intervention for Neurodegenerative Delay diet as an intervention for people who experience CRCI are lacking. This review examines the current state of the science for cognitive outcomes of dietary interventions in aging populations and discusses future opportunities to adapt these interventions to cancer populations.

Cognitive function in long-term testicular cancer survivors: impact of modifiable factors

No study has comprehensively examined associated factors (adverse health outcomes, health behaviors, and demographics) affecting cognitive function in long-term testicular cancer survivors (TC survivors). TC survivors given cisplatin-based chemotherapy completed comprehensive, validated surveys, including those that assessed cognition. Medical record abstraction provided cancer and treatment history. Multivariable logistic regression examined relationships between potential associated factors and cognitive impairment. Among 678 TC survivors (median age = 46; interquartile range [IQR] = 38-54); median time since chemotherapy = 10.9 years, IQR = 7.9-15.9), 13.7% reported cognitive dysfunction. Hearing loss (odds ratio [OR] = 2.02; P = .040), neuropathic pain (OR = 2.06; P = .028), fatigue (OR = 6.11; P < .001), and anxiety/depression (OR = 1.96; P = .029) were associated with cognitive impairment in multivariable analyses. Being on disability (OR = 9.57; P = .002) or retired (OR = 3.64; P = .029) were also associated with cognitive decline. Factors associated with impaired cognition identify TC survivors requiring closer monitoring, counseling, and focused interventions. Hearing loss, neuropathic pain, fatigue, and anxiety/depression constitute potential targets for prevention or reduction of cognitive impairment in long-term TC survivors.

Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

Importance

Return to work after breast cancer (BC) treatment depends on several factors, including treatment-related adverse effects. While cancer-related cognitive impairment is frequently reported by patients with BC, to date, no longitudinal studies have assessed its association with return to work.

Objective

To examine whether cognition, assessed using objective and subjective scores, was associated with return to work 2 years after BC diagnosis.

Design, Setting, and Participants

In a case series of the French Cancer Toxicities (CANTO) cohort, a study of patients with stage I to III BC investigated cognition from April 2014 to December 2018 (2 years' follow-up). Participants included women aged 58 years or younger at BC diagnosis who were employed or looking for a job.

Main Outcomes and Measures

The outcome was return to work assessed 2 years after BC diagnosis. Objective cognitive functioning (tests), cognitive symptoms, anxiety, depression, and fatigue were prospectively assessed at diagnosis (baseline), 1 year after treatment completion, and 2 years after diagnosis. Multivariable logistic regression models were used to explain return to work status at year 2 according to each cognitive measure separately, adjusted for age, occupational class, stage at diagnosis, and chemotherapy.

Results

The final sample included 178 women with BC (median age: 48.7 [range, 28-58] years), including 37 (20.8%) who did not return to work at year 2. Patients who returned to work had a higher (ie, professional) occupational class and were less likely to have had a mastectomy (24.1% vs 54.1%; P < .001). Return to work at year 2 was associated with lower overall cognitive impairment (1-point unit of increased odds ratio [1-pt OR], 0.32; 95% CI, 0.13-0.79; P = .01), higher working memory (1-pt OR, 2.06; 95% CI, 1.23-3.59; P = .008), higher processing speed (1-pt OR, 1.97; 95% CI, 1.20-3.36; P = .01) and higher attention performance (1-pt OR, 1.63; 95% CI, 1.04-2.64; P = .04), higher perceived cognitive abilities (1-pt OR, 1.12; 95% CI, 1.03-1.21; P = .007), and lower depression (1-pt OR, 0.83; 95% CI, 0.74-0.93; P = .001) at year 2 assessment. Return to work at year 2 was associated with several measures assessed at baseline and year 1: higher processing speed (1-pt OR, 2.38; 95% CI, 1.37-4.31; P = .003 and 1.95; 95% CI, 1.14-3.50; P = .02), higher executive performance (1-pt OR, 2.61; 95% CI, 1.28-5.75; P = .01, and 2.88; 95% CI, 1.36-6.28; P = .006), and lower physical fatigue (10-pt OR, 0.81; 95% CI, 0.69-0.95; P = .009 and 0.84; 95% CI, 0.71-0.98; P = .02).

Conclusions and Relevance

In this case series study of patients with BC, return to work 2 years after diagnosis was associated with higher cognitive speed performance before and after BC treatment. Cognitive difficulties should be assessed before return to work to propose suitable management.

Serotonin's Role in Inflammatory Signaling Pathway Modulation for Colon Cancer Suppression

Background Neurons can be effectively regulated by serotonin and dopamine. Their role in anti-inflammatory pathways opens new doors for therapeutic research, particularly in chemotherapeutics. The present study investigated serotonin's role in suppressing inflammation and its potential anticancer effects in KERATIN-forming tumor cell line HeLa cells (KB cells).  Methods - in vitro and in silico analysis The study delved further into the molecular mechanisms by assessing the expression levels of key markers involved in inflammation and cancer progression, such as B-cell leukemia/lymphoma 2 protein (BCl-2), tumor necrosis factor-alpha (TNF-α) and Interleukin-6 (IL-6) using Real-time reverse-transcriptase-polymerase chain reaction at concentrations below the IC50 (50 and 100 µg/ml). The binding capability of serotonin (CID 5202) with glycoform of human interleukin 6 (PDB: 7NXZ) was analyzed with the help of Schrodinger molecular suites. Results The findings showcased serotonin's potent growth inhibition in KB cells, with an IC50 value of 225±3.1µg/ml. Additionally, it demonstrated a multifaceted impact by downregulating the expression of BCl-2, TNF-α, and IL-6, pivotal factors in cancer cell survival and inflammation regulation. The docking score was - 5.65 (kcal/mol) between serotonin and glycoform of Human Interleukin 6. It is bound with ASN 143 by two hydrogen bonds. Thus, molecular docking analysis showed an efficient bounding pattern. The research findings indicate that serotonin successfully blocks NF-κB pathways in KB cells, underscoring its therapeutic promise against colon cancer and offering vital information for additional clinical investigation.  Conclusion According to the study's conclusion, serotonin has a remarkable anticancer potential by effectively blocking NF-κB B pathways in KB cells, revealing its promising potential as a therapeutic agent against colon cancer. These comprehensive findings offer significant insights into serotonin's intricate molecular interactions and its profound impact on cancer-related signaling pathways, paving the way for further exploration and potential clinical applications in cancer treatment strategies.

Immune Checkpoint Inhibition-related Neuroinflammation Disrupts Cognitive Function

Combinatorial blockade of Cytotoxic T-lymphocyte associated protein 4 (CTLA-4) and Programmed Cell Death Protein 1 (PD-1) significantly improve the progression-free survival of individuals with metastatic cancers, including melanoma. In addition to unleashing anti-tumor immunity, combination immune checkpoint inhibition (ICI) disrupts immune-regulatory networks critical for maintaining homeostasis in various tissues, including the central nervous system (CNS). Although ICI- and cancer-related cognitive impairments (CRCI) in survivors are increasingly becoming evident, our understanding of ICI-induced immune-related adverse effects (IREA) in the CNS remains incomplete. Here, our murine melanoma model reveals that combination ICI impairs hippocampal-dependent learning and memory, as well as memory consolidation processes. Mechanistically, combination ICI disrupted synaptic integrity, and neuronal plasticity, reduced myelin, and further predisposed CNS for exaggerated experimental autoimmune encephalomyelitis. Combination ICI substantially altered both lymphoid and myeloid cells in the CNS. Neurogenesis was unaffected, however, microglial activation persisted for two-months post- ICI, concurrently with cognitive deficits, which parallels clinical observations in survivors. Overall, our results demonstrate that blockade of CTLA-4 and PD-1 alters neuro-immune homeostasis and activates microglia, promoting long-term neurodegeneration and driving cognitive impairments. Therefore, limiting microglial activation is a potential avenue to mitigate CNS IRAE while maintaining the therapeutic benefits of rapidly evolving ICIs and their combinations.

SIGNIFICANCE

Despite the superior therapeutic efficacy of immune checkpoint inhibition (ICI) for cancers, its undesired effects on brain function are not fully understood. Here, we demonstrate that combination ICI elevates neuroinflammation, activates microglia, leading to detrimental neurodegenerative and neurocognitive sequelae.

Prevalence and assessment tools of cancer-related cognitive impairment in lung cancer survivors: a systematic review and proportional meta-analysis

PURPOSE

Cancer-related cognitive impairment (CRCI) is a significant risk factor influencing the quality of life in lung cancer survivors. No absolute assessment tool has been confirmed to assess CRCI in lung cancer survivors. This review was undertaken to pool the overall prevalence of CRCI and to summarize the assessment tools in assessing CRCI among lung cancer survivors.

METHODS

PubMed, Cochrane Library, Embase, CINAHL, and CNKI were searched to retrieve articles reported CRCI prevalence. Summary prevalence estimates were pooled using a random effects model, along with corresponding 95% prediction intervals (PIs). The Freeman-Tukey double arcsine transformation of proportions was incorporated in the analysis. Additionally, subgroup analysis, meta-regression, and leave-one-out analysis were performed.

RESULTS

A total of 12 studies, involving 1934 survivors, were included in the review. All of these studies were found to have a low risk of bias in terms of their methodological quality. Four studies (33.3%) utilized the International Cognition and Cancer Task Force (ICCTF) criteria to identify CRCI through neuropsychological tests. The pooled prevalence rate of CRCI was found to be 26% (95% PI, 16-37%), I2 = 95.97%. The region in which the studies were conducted was identified as a significant factor contributing to this heterogeneity (p = 0.013). No indication of small-study effects was found (Egger's test: p = 0.9191).

CONCLUSION

This review provides an overview of CRCI prevalence and assessment tools in lung cancer survivors. The findings can serve as epidemiological evidence to enhance clinicians' and researchers' understanding of early detection and assessment.

Can Some Anticancer Drugs Be Repurposed to Treat Amyotrophic Lateral Sclerosis? A Brief Narrative Review

Amyotrophic lateral sclerosis (ALS) is a rare progressive motor neuron disease that, due to its high complexity, still lacks effective treatments. Development of a new drug is a highly costly and time-consuming process, and the repositioning of approved drugs can represent an efficient strategy to provide therapeutic opportunities. This is particularly true for rare diseases, which are characterised by small patient populations and therefore attract little commercial interest. Based on the overlap between the biological background of cancer and neurodegeneration, the repurposing of antineoplastic drugs for ALS has been suggested. The objective of this narrative review was to summarise the current experimental evidence on the use of approved anticancer drugs in ALS. Specifically, anticancer drugs belonging to different classes were found to act on mechanisms involved in the ALS pathogenesis, and some of them proved to exert beneficial effects in ALS models. However, additional studies are necessary to confirm the real therapeutic potential of anticancer drugs for repositioning in ALS treatment.

Long-term survivorship care after CAR-T cell therapy

While cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome are well-recognized acute toxicities of chimeric antigen receptor (CAR) T cell therapy, these complications have become increasingly manageable by protocolized treatment algorithms incorporating the early administration of tocilizumab and corticosteroids. As CAR-T cell therapy expands to new disease indications and the number of long-term survivors steadily increases, there is growing recognition of the need to appropriately evaluate and manage the late effects of CAR-T cell therapy, including late-onset or persistent neurotoxicity, prolonged cytopenias, delayed immune reconstitution and infections, subsequent malignancies, organ dysfunction, psychological distress, and fertility implications. In this review, we provide a practical approach to the long-term survivorship care of the CAR-T cell recipient, with a focus on the optimal strategies to address the common and challenging late complications affecting this unique population.

The Distant Molecular Effects on the Brain by Cancer Treatment

Cancer survivors experience cancer-related cognitive impairment (CRCI) secondary to treatment. Chemotherapy and radiation therapy independently contribute to cognitive dysfunction; however, the underlying mechanisms leading to dysfunction remain unclear. We characterized brain gene expression changes in a mouse model of CRCI to identify the mechanistic underpinnings. Eleven-to-twelve-week-old SKH1 mice were treated with doxorubicin (DOX), hindlimb radiation (RT), concurrent hindlimb radiation and doxorubicin (DOX-RT), or no treatment (control). Sixteen days following treatment, gene expression was measured from murine brains using the NanoString nCounter® glial profiling panel. Gene expression was normalized and compared between groups. No two groups shared the same expression pattern, and only Gnb1 and Srpr were upregulated in multiple treatment groups. Brains from DOX-treated mice had upregulated Atf2, Atp5b, Gnb1, Rad23b, and Srpr and downregulated Sirt5 expression compared to control brains. Brains from RT-treated mice demonstrated increased Abcg2 and Fgf2 and decreased C1qa and C1qb expression compared to control brains. Brains from DOX-RT-treated mice had upregulated Adar, E2f3, Erlec1, Gnb1, Srpr, Vim, and Pdgfra expression and downregulated Rock2 and Inpp5f expression compared to control brains. The gene expression changes demonstrated here highlight roles for neuronal transmission and oxidative stress in the pathogenesis of doxorubicin-related CRCI and inflammation in RT-related CRCI.

Progress in cancer neuroscience

Cancer of the central nervous system (CNS) can crosstalk systemically and locally in the tumor microenvironment and has become a topic of attention for tumor initiation and advancement. Recently studied neuronal and cancer interaction fundamentally altered the knowledge about glioma and metastases, indicating how cancers invade complex neuronal networks. This review systematically discussed the interactions between neurons and cancers and elucidates new therapeutic avenues. We have overviewed the current understanding of direct or indirect communications of neuronal cells with cancer and the mechanisms associated with cancer invasion. Besides, tumor-associated neuronal dysfunction and the influence of cancer therapies on the CNS are highlighted. Furthermore, interactions between peripheral nervous system and various cancers have also been discussed separately. Intriguingly and importantly, it cannot be ignored that exosomes could mediate the "wireless communications" between nervous system and cancer. Finally, promising future strategies targeting neuronal-brain tumor interactions were reviewed. A great deal of work remains to be done to elucidate the neuroscience of cancer, and future more research should be directed toward clarifying the precise mechanisms of cancer neuroscience, which hold enormous promise to improve outcomes for a wide range of malignancies.

Physiological and cognitive changes after treatments of cyclophosphamide, methotrexate, and fluorouracil: implications of the gut microbiome and depressive-like behavior

Introduction

Chemotherapy-induced cognitive impairment colloquially referred to as chemobrain is a poorly understood phenomenon affecting a highly variable proportion of patients with breast cancer. Here we investigate the association between anxiety and despair-like behaviors in mice treated with cyclophosphamide, methotrexate, and fluorouracil (CMF) along with host histological, proteomic, gene expression, and gut microbial responses.

Methods

Forced swim and sociability tests were used to evaluate depression and despair-like behaviors. The tandem mass tag (TMT) proteomics approach was used to assess changes in the neural protein network of the amygdala and hippocampus. The composition of gut microbiota was assessed through 16S rRNA gene sequencing. Finally, quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to evaluate changes in intestinal gap junction markers.

Results and discussion

We observed that CMF induced social and despair-like behavior in mice 96 hours following treatment. Proteomic analysis identified changes in various proteins related to progressive neurological disease, working memory deficit, primary anxiety disorder, and gene expression revealing increases in NMDA and AMPA receptors in both the hippocampus and the amygdala because of CMF treatment. These changes finally, we observed immediate changes in the microbial population after chemotherapy treatment, with a notable abundance of Muribaculaceae and Romboutsia which may contribute to changes seen in the gut.

Activation of Nuclear Factor Kappa B (NF-kB) Signaling Pathway Through Exercise-Induced Simulated Dopamine Against Colon Cancer Cell Lines

Introduction Dopamine is an important neuroregulatory hormone and is secreted during exercise. Its role in physiological regulation is not fully uncovered. Recent studies showed that it suppresses inflammation. Colon cancer is one of the most predominant cancers in the population and is influenced by prolonged inflammation. The anti-inflammatory effect of dopamine using the colon cancer model was analyzed in KB cells. Methods KB cells were cultured using Dulbecco's Modified Eagle Medium and Inhibitory Concentration- 50 (IC50) was determined by 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay. BCl-2, tumour necrosis factor-α (TNF-α), nuclear factor kappa- B (​​​​​NF-kB), and interleukin (IL)-6 were assessed using reverse transcription polymerase chain reaction (RT-PCR)(at 50 and 100 µg/ ml < IC50). Schrödinger was used for docking analysis using nuclear factor Kappa B (NF-kB) (Protein Data Bank: 5T8O) and dopamine (CID 681). Results Results were represented as mean ± standard deviation and statistically evaluated. Dopamine showed severe growth inhibition in KB cells (IC50- 225±3.1µg/ ml). It downregulated the expression of BCl-2, NF-k, and IL-6, but increased TNF-α expression. Dopamine bonded with NF-kB by two hydrogen bonds with aspartic acid​​-53and alanine-54, respectively). Conclusion The present study revealed that dopamine has a significant anti-cancer potential by blocking NF-kB pathways in KB cells.