research article What is the Personal Immune Price for Hospice Caregivers? A Case-Control Study
Abdullah Ladha1, Wendy Kay Nevala2, Sarah Lee3, Robert A Vierkant4, Judith Salmon Kaur5
1Department of
Hematology-Oncology, State University of New York, USA
2Oncology Research,
Mayo Clinic MN, USA
3Division of
Internal Medicine, Palliative Medicine, Kaiser Permanente, USA
4Division of
Biomedical Statistics and Informatics, Mayo Clinic MN, USA
5Division of Hematology-Oncology, Mayo Clinic FL, USA
*Corresponding author(s): Abdullah Ladha, Department of Hematology-Oncology, State University of New York, USA. Tel: +1-3154648286; Fax: +1-3154648279; Email: ladhaa@upstate.edu;
Judith Salmon Kaur, Department of Hematology-Oncology, Mayo Clinic, USA. Tel: +1-9049532795; Fax: +1-9049532315; Email: kaur.judith@mayo.edu
Received
Date: 21 July, 2018; Accepted Date: 16 November, 2018; Published Date: 23 November, 2018
Citation: Ladha A, Nevala WK, Lee S, Vierkant RA, Kaur JS (2018) What is the Personal Immune Price for Hospice Caregivers? A Case-Control Study. Arch Palliat Care Med: APCM-111. DOI:10.29011/APCM-111.00011
Variables | N=37, Frequency (%) |
Sex | |
Female | 33 (89.2) |
Male | 4 (10.8) |
Age, y, mean (range) | 69.7 (45-88) |
Marital status | |
Married | 34 (91.9) |
Single | 2 (5.4) |
Widowed | 1 (2.7) |
Annual household income | |
<$25K | 2 (5.4) |
$25-50K | 17 (45.9) |
$50-75K | 8 (21.6) |
$75-100K | 4 (10.8) |
>$100K | 3 (8.1) |
Unknown | 3 (8.1) |
Employment | |
Full-time | 5 (13.5) |
Part-time | 6 (16.2) |
Not working | 4 (10.8) |
Retired | 21 (56.8) |
Unknown | 1 (2.7) |
Table 1: Caregivers Demographics.
Variables | N=37, Frequency (%) |
Hours per day spent as caregiver | |
0-10 | 16 (43.2) |
>10 | 21 (56.8) |
Total duration of caregiving in months | |
<1 | 12 (32.4) |
1-12 | 9 (24.3) |
12-24 | 3 (8.1) |
>24 | 13 (35.1) |
Relationship to patient | |
Spouse | 33 (89.2) |
Child | 2 (5.4) |
Parent | 2 (5.4) |
Medical Problems | |
Hypertension | 16 (56.7) |
Cardiac | 3 (8.1) |
Diabetes Mellitus | 5 (13.8) |
Pulmonary disease | 2 (5.56) |
Sleep disorder | 3 (8.1) |
History of cancer | 9 (18.4) |
Gastrointestinal disorder | 7(19.4) |
Mood disorder | 7(19.4) |
Table 2: Caregiver characteristics.
|
Biomarkers |
Pairs |
Caregiver, Median |
Control, Median |
Paired Difference, Median (IQR) |
P Value |
|
IL-2 |
38 |
3.2 |
1.9 |
0.3 (−1.1, 5.8) |
0.01 |
|
IL-4 |
38 |
2.1 |
8.4 |
−1.3 (−23.3, 0.3) |
<.001 |
|
IL-6 |
38 |
2.3 |
2.1 |
0.1 (−1.6, 1.5) |
0.24 |
|
IL-8 |
38 |
4.2 |
1.6 |
1.4 (−0.4, 4.8) |
0.005 |
|
IL-13 |
38 |
2.5 |
2.5 |
0.1 (−3.5, 2.1) |
0.05 |
|
IL-12 |
38 |
12.2 |
7.7 |
5.5 (−0.6, 17.4) |
0.003 |
|
IL-1α |
38 |
6.2 |
3.9 |
−1.1 (−2.2, 15.2) |
0.65 |
|
IL-1β |
38 |
2.8 |
1.6 |
1.1 (−0.7, 6.1) |
0.001 |
|
IFNγ |
38 |
10.3 |
14.1 |
−1.8 (−10.0, 7.0) |
0.33 |
|
TGFα |
38 |
2.8 |
2.7 |
−0.2 (−0.9, 1.9) |
0.54 |
|
TNFα |
38 |
9.6 |
10 |
1.1 (−5.0, 4.2) |
0.88 |
|
TNFβ |
38 |
4.1 |
3.2 |
−0.9 (−2.7, 7.4) |
0.21 |
|
CRP |
38 |
2.3 |
0.9 |
1.2 (−0.1, 4.3) |
<.001 |
|
CD3+CD8+ |
35 |
18.5 |
10.6 |
8.0 (−0.2, 15.6) |
0.003 |
|
CD3+CD4+ |
35 |
35 |
25.9 |
9.1 (−1.1, 18.5) |
0.001 |
|
CD16+56+ |
38 |
11.3 |
7.2 |
5.5 (−1.6, 10.6) |
0.003 |
|
CD3+69+ |
39 |
5.4 |
2 |
3.4 (1.0, 6.5) |
<.001 |
|
CD3+62L+ |
39 |
19 |
5.9 |
11.9 (6.4, 21.5) |
<.001 |
|
CD4+TIM3+ |
39 |
4.1 |
1 |
3.1 (0.6, 4.5) |
<.001 |
|
Treg |
39 |
64.9 |
57 |
6.3 (−1.7, 15.3) |
0.005 |
|
G-CSF |
38 |
75.8 |
134.6 |
−59.3 (−107.3, 1.3) |
<.001 |
|
GM-CSF |
38 |
21.7 |
7.5 |
8.4 (−5.1, 29.9) |
<.001 |
|
EGF |
38 |
61 |
13.8 |
49.9 (5.5, 93.4) |
<.001 |
|
Abbreviations: |
|||||
|
CRP
: C-Reactive Protein |
|||||
|
EGF
: Epidermal Growth Factor |
|||||
|
G-CSF
: Granulocyte–Colony-Stimulating Factor |
|||||
|
GM-CSF : Granulocyte
Macrophage–Colony-Stimulating Factor |
|||||
|
IFN
: Interferon |
|||||
|
IL
: Interleukin |
|||||
|
IQR
: Interquartile Ranges |
|||||
|
TGF
: Transforming Growth Factor |
|||||
|
TNF
: Tumor Necrosis Factor |
|||||
|
Treg
: Regulatory T Cell |
|||||
Table 3: Cytokines.
|
Biomarkers |
Pairs |
Caregiver, Median |
Control, Median |
Paired Difference Median (IQR) |
P Value |
|
Eotaxin (CCL11, CCL24, CCL26) |
38 |
95.3 |
241.7 |
−148.3 (−246.3, −94.5) |
<.001 |
|
Fractalkine (CX3CL1) |
38 |
93.4 |
127.4 |
−32.6 (−85.3, 13.0) |
0.009 |
|
GRO (CXCL1, CXCL2, CXCL3) |
37 |
356.7 |
239 |
127.7 (−73.0, 339.1) |
0.007 |
|
IP10 (CXCL10) |
38 |
335.8 |
1506.5 |
−1,092 (−2,211, −538.8) |
<.001 |
|
MCP-3 (CCL7) |
38 |
17 |
159.6 |
−144.2 (−151.7, −132.5) |
<.001 |
|
MDC (CCL22) |
38 |
784.8 |
1434 |
−698.4 (−1051, −355.0) |
<.001 |
|
MIP1b (CCL4) |
38 |
20.8 |
37.6 |
−14.5 (−32.9, 2.6) |
<.001 |
|
MCP-1 (CCL2) |
38 |
241 |
199.8 |
−0.8 (−75.6, 190.4) |
0.351 |
|
Abbreviations: |
|||||
|
GRO
: Growth-regulated oncogene; |
|||||
|
IP
: Induced protein; |
|||||
|
IQR
: Interquartile range; |
|||||
|
MCP
: Monocyte chemotactic protein;
|
|||||
|
MDC : Macrophage-derived chemokine; |
|||||
|
MIP
: Macrophage inflammatory
protein; |
|||||
Table 4: Chemokines.
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