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NIH INTRAMURAL RESEARCH AND CANCER-RELATED FATIGUE

From Winter 2014-2015 Forum

Many patients experience fatigue while receiving standard therapies for cancer. Fatigue during cancer treatment is the most distressing symptom reported by patients contributing to the decline of their health-related quality of life. It is often managed by stopping therapy or lowering the treatment dose for the patient, both of which can adversely affect treatment outcomes. Through his research, Dr. Leorey Saligan aims to develop more effective ways to manage fatigue and, as a result, improve overall treatment outcomes.

Dr. Saligan's current research focuses on understanding biobehavioral mechanisms of fatigue with the longer-term goal of developing novel interventions that can alleviate this symptom in a variety of clinical conditions. His research program is divided into two areas — acute fatigue and chronic fatigue.

Acute Fatigue:

Dr. Saligan aims to understand the role of oxidative stress and inflammation in fatigue development. His current findings show a significant correlation between fatigue development and increased levels of erythrocyte oxidative stress, as well as differential expression of genes associated with impairment of mitochondrial integrity. Furthermore, he recently observed a significant association between upregulation of neuroinflammatory markers and worsening of fatigue symptoms. Dr. Saligan is currently pursuing these markers through in vivo, in vitro, and ex vivo investigations to further understand their role in fatigue development. He is also using neuroimaging techniques to describe signs of oxidative stress and inflammation in the brain during fatigue development. He has developed a novel exercise intervention geared to improve aerobic metabolism of patients in order to potentially reduce oxidative stress, inflammation, and fatigue.

Chronic Fatigue:

This specific area of Dr. Saliganís research program focuses on the lingering fatigue symptoms that are experienced by patients after completion of cancer therapy or years after the initial diagnosis. His group is investigating whether alteration of central mechanisms, including the sympathetic (adrenergic) and hypothalamic-pituitary-adrenal (HPA) pathways, has a role in the prolonged fatigue experience of these patients. Furthermore, he is investigating the relationship of fatigue with other behavioral symptoms including pain, sleep, depression, anxiety, and catastrophizing.

Dr. Saligan's more recent efforts include a NIH grant for the "Correlates of fatigue in fibromyalgia and chronic fatigue syndrome" in association with Dr. James Baraniuk from Georgetown University.

Dr. Saligan's latest medical journal publication is titled the "Association of mitochondrial dysfunction and fatigue: A review of the literature." After selection criteria was determined, 25 articles were approved to be included in this review from a total of 1220 articles. Two publications from Dr. Yoshitsugi Hokama, whose grants were funded by the NCF, were included in this scientific review!


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