The Relationship between a New Biomarker of Vagal Neuroimmunomodulation and Survival in Two Fatal Cancers.

Author: Gidron Y1,2, De Couck M3,4, Schallier D5, De Greve J4, Van Laethem JL6, Maréchal R6
1Vrije Universiteit Brussel, Center for Neuroscience, Brussels, Belgium.
2Scalab, Université Lille 3, Lille, France.
3Faculty of Health Care, University College Odisee, Aalst, Belgium.
4Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Ixelles, Belgium.
5Oncological Center, UZ Brussels, Jette, Belgium.
6Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium.
Conference/Journal: J Immunol Res.
Date published: 2018 May 8
Other: Volume ID: 2018 , Pages: 4874193 , Special Notes: doi: 10.1155/2018/4874193. eCollection 2018. , Word Count: 198

Background: The vagus nerve may slow tumor progression because it inhibits inflammation. This study examined the relationship between a new vagal neuroimmunomodulation (NIM) index and survival in fatal cancers.

Method: We retroactively derived markers of vagal nerve activity indexed by heart rate variability (HRV), specifically the root mean square of successive differences (RMSSD), from patients' electrocardiograms near diagnosis. The NIM index was the ratio of RMSSD to C-reactive protein levels (RMSSD/CRP). Sample 1 included 202 Belgian patients with advanced pancreatic cancer (PC), while sample 2 included 71 Belgian patients with non-small cell lung cancer (NSCLC). In both samples, we examined the overall survival, while in sample 2, we additionally examined the survival time in deceased patients.

Results: In PC patients, in a multivariate Cox regression controlling for confounders, the NIM index had a protective relative risk (RR) of 0.68 and 95% confidence interval (95% CI) of 0.51-0.92. In NSCLC patients, the NIM index also had a protective RR of 0.53 and 95% CI of 0.32-0.88. Finally, in NSCLC, patients with a higher NIM index survived more days (475.2) than those with lower NIM (285.1) (p < 0.05).

Conclusions: The NIM index, reflecting vagal modulation of inflammation, may be a new independent prognostic biomarker in fatal cancers.

PMID: 29854838 PMCID: PMC5964597 DOI: 10.1155/2018/4874193