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O uso de álcool está aumentando em nossa sociedade e permanece associado a inúmeros problemas sociais, econômicos e de saúde. De fato, o álcool e os problemas de saúde associados a ele exercem um impacto importante na prática médica e representam um dos maiores desafios da saúde pública. O consumo de álcool na sociedade contemporânea é geralmente aceito positivamente, dificultando o reconhecimento de certos padrões de consumo como doença. O alcoolismo é um transtorno recidivante crônico caracterizado pela ingestão compulsiva de quantidades excessivas de etanol, perda de controle em sua ingestão, comportamento inadequado e a presença de um estado emocional negativo. O consumo de quantidades nocivas de álcool resulta em danos físicos e psicológicos e o vicio é um transtorno psiquiátrico que afeta as funções executivas, causando perda de interesse em outros alvos do prazer e comportamento compulsivo de busca por drogas. O álcool interage com vários sistemas neurológicos. O presente trabalho analisou a resposta imunoinflamatória no tecido cerebral de camundongos CRAMP knockout (KO) jovens e tipo selvagem (WT) submetidos ao modelo de intoxicação alcoólica, com o objetivo de investigar o impacto de CRAMP na dependência alcoólica no adolescente. O CRAMP é um peptídeo antimicrobiano com efeitos pleotrópicos e, até onde sabemos, seu papel nunca foi investigado nesse sentido. Também analisamos a secreção de vários neuropeptídeos, proteínas e citocinas. Nossos resultados mostraram uma diferença significativa na ingestão de etanol entre os animais comparados CRAMP KO e WT, o que foi relacionado a um aumento nos níveis cerebelares de IL-1beta. Concluimos que os pepitídeos antimicrobianos podem ter um papel importante na resposta imunoinflamatória que ocorre durante o etilismo agudo / The use of alcohol is increasing in our society and remains associated with countless social, economic and health problems. In fact, alcohol and the health issues associated to its abuse exert an important impact on medical practice and represent one of the biggest challenges of public health. The consumption of alcohol in contemporary society is generally accepted positively, making certain patterns of consumption very difficult to be recognized as a disease. Alcoholism is a chronic relapsing disorder characterized by compulsive ingestion of excessive amounts of ethanol, loss of control in its intake, inappropriated behavior and the presence of a negative emotional state. The consumption of harmful amounts of alcohol results in physical and or psychological damage and addiction is a psychiatric disorder that affects the executive functions, causing loss of interest in other aspects of life and a compulsive behavior. Alcohol interacts with several neurologic systems. The present work analyzed the immuno-inflammatory response in the brain tissue of young CRAMP knockout (KO) and wild-type (WT) mice submitted to a model of alcohol intoxication, in order to investigate the impact of CRAMP in teenager alcohol addiction. CRAMP is an antimicrobial peptide with pleotropic effects and, as far as we know, its role had never been investigation in this regard. We also analysed the secretion of several neuropeptides, proteins and cytokines. Our results showed a significant difference in ethanol intake when CRAMP KO and WT animals were compared, which was related to an increase in the cerebellar levels of IL-1beta. We conclude that antimicrobial peptides may play an important role in the immunoinflammatory response that occurs during acute alcoholism

O uso de álcool está aumentando em nossa sociedade e permanece associado a inúmeros problemas sociais, econômicos e de saúde. De fato, o álcool e os problemas de saúde associados a ele exercem um impacto importante na prática médica e representam um dos maiores desafios da saúde pública. O consumo de álcool na sociedade contemporânea é geralmente aceito positivamente, dificultando o reconhecimento de certos padrões de consumo como doença. O alcoolismo é um transtorno recidivante crônico caracterizado pela ingestão compulsiva de quantidades excessivas de etanol, perda de controle em sua ingestão, comportamento inadequado e a presença de um estado emocional negativo. O consumo de quantidades nocivas de álcool resulta em danos físicos e psicológicos e o vicio é um transtorno psiquiátrico que afeta as funções executivas, causando perda de interesse em outros alvos do prazer e comportamento compulsivo de busca por drogas. O álcool interage com vários sistemas neurológicos. O presente trabalho analisou a resposta imunoinflamatória no tecido cerebral de camundongos CRAMP knockout (KO) jovens e tipo selvagem (WT) submetidos ao modelo de intoxicação alcoólica, com o objetivo de investigar o impacto de CRAMP na dependência alcoólica no adolescente. O CRAMP é um peptídeo antimicrobiano com efeitos pleotrópicos e, até onde sabemos, seu papel nunca foi investigado nesse sentido. Também analisamos a secreção de vários neuropeptídeos, proteínas e citocinas. Nossos resultados mostraram uma diferença significativa na ingestão de etanol entre os animais comparados CRAMP KO e WT, o que foi relacionado a um aumento nos níveis cerebelares de IL-1beta. Concluimos que os pepitídeos antimicrobianos podem ter um papel importante na resposta imunoinflamatória que ocorre durante o etilismo agudo / The use of alcohol is increasing in our society and remains associated with countless social, economic and health problems. In fact, alcohol and the health issues associated to its abuse exert an important impact on medical practice and represent one of the biggest challenges of public health. The consumption of alcohol in contemporary society is generally accepted positively, making certain patterns of consumption very difficult to be recognized as a disease. Alcoholism is a chronic relapsing disorder characterized by compulsive ingestion of excessive amounts of ethanol, loss of control in its intake, inappropriated behavior and the presence of a negative emotional state. The consumption of harmful amounts of alcohol results in physical and or psychological damage and addiction is a psychiatric disorder that affects the executive functions, causing loss of interest in other aspects of life and a compulsive behavior. Alcohol interacts with several neurologic systems. The present work analyzed the immuno-inflammatory response in the brain tissue of young CRAMP knockout (KO) and wild-type (WT) mice submitted to a model of alcohol intoxication, in order to investigate the impact of CRAMP in teenager alcohol addiction. CRAMP is an antimicrobial peptide with pleotropic effects and, as far as we know, its role had never been investigation in this regard. We also analysed the secretion of several neuropeptides, proteins and cytokines. Our results showed a significant difference in ethanol intake when CRAMP KO and WT animals were compared, which was related to an increase in the cerebellar levels of IL-1beta. We conclude that antimicrobial peptides may play an important role in the immunoinflammatory response that occurs during acute alcoholism

The effect of interleukin-1 beta (IL-1β) on the electrical properties of sensory neurons was assessed at comparable levels and exposure times to those found in animal models of neuropathic pain. Experiments involved whole cell current- or voltage-clamp recordings from rat dorsal root ganglion (DRG) neurons in defined medium, neuron enriched cultures. 5-6 days exposure to 100 pM IL-1β produced neuron specific effects. These included an increase in the excitability of medium diameter and small diameter isolectin B4 (IB4)-positive neurons that was comparable to that found after peripheral nerve injury. By contrast, a reduction in excitability was observed in large diameter neurons, while no effect was found in small diameter IB4-negative neurons. Further characterization of changes in medium and small IB4-positive neurons revealed that some, but not all, effects of IL-1β were mediated through its receptor, IL-1RI. Using appropriate voltage protocols and/or ion substitutions, it was found that neuron specific changes in several ionic currents, including alterations in hyperpolarization activated inward current (IH) and decreases in various K+ currents contribute to the increased excitability produced by IL-1β. Overall, these studies revealed that: 1. The effects of long-term exposure of DRG neurons to IL-1β are reflective of the enduring increase in primary afferent excitability reported after peripheral nerve injury. This expands the recognized role of IL-1β in acute inflammatory pain to neuropathic pain. 2. Hyperexcitability in medium neurons exposed to IL-1β likely includes mixed populations of neurons corresponding to nociceptive and non-nociceptive primary afferent fibres and, therefore, has relevance to hyperalgesia and allodynia, respectively. 3. The responsiveness of small IB4-positive neurons, but not IB4-negative, to prolonged IL-1β exposure is consistent with the suggestion that small IB4-negative afferents are involved in inflammatory pain, while small IB4-positive afferents are involved neuropathic pain. 4. The identification of receptor mediated effects and several contributing ionic mechanisms, may have relevance to the development of new therapeutic approaches to neuropathic pain. 5. IL-1β can contribute to increased neuronal excitability by mechanisms that are independent of IL-1RI signalling. This should be taken into account when targeting IL-1β, or more specifically IL-1RI, in the management of neuropathic pain.

Adipositas und ihre Folgeerkrankungen stellen eine wachsende medizinische Herausforde- rung globalen Ausmaßes dar. Im Rahmen der Adipositasforschung wurde das Fettgewebe als endokrines Organ identifiziert. Von ihm sezernierte Proteine, die sogenannten Adipo- kine, beeinflussen maßgeblich Insulinresistenz und Gefäßverletzbarkeit. Adipositas geht im Fettgewebe mit einer subklinischen chronischen Entzündung einher, die zu einer erhöhten Sekretion von proinflammatorischen Adipokinen führt. Die verstärkte Anwesenheit dieser Proteine ist mit den Komplikationen der Adipositas assoziiert. Die vorliegende Arbeit be- fasst sich mit dem Einfluss von Interleukin (IL)-1β, einem wichtigen Entzündungsmediator des Organismus, auf die Sekretion der proinflammatorischen Adipokine tissue inhibitor of metalloproteinase (TIMP)-1, serum amyloid A (SAA)-3, Lipocalin-2 und Chemerin. Die zugrundeliegenden Untersuchungen wurden mit 3T3-L1- und braunen Adipozyten durch- geführt. Es erfolgte der Nachweis auf mRNA- sowie auf Proteinebene. Der Einsatz von spe- zifischen Inhibitoren erlaubte den Rückschluss auf grundlegende Signalwege. Für alle vier untersuchten Adipokine konnte eine signifikante dosis- und zeitabhängige Steige- rung der mRNA- und Proteinexpression durch IL-1β nachgewiesen werden. Die Transduktion des IL-1β-Signals erfolgte im Falle von Lipocalin-2 und SAA-3 über nuclear factor (NF)-κB und janus kinase (Jak)-2, bei TIMP-1 lediglich über Jak-2 und in Bezug auf Chemerin über NFκB, Jak-2, p44/42 mitogen-activated protein kinase und Phosphatidylinositol-3-Kinase. Die in dieser Arbeit nachgewiesenen Expressions- und Sekretionssteigerungen von TIMP-1, SAA-3, Lipocalin-2 und Chemerin in braunen und weißen Adipozyten festigen IL-1β als einen entscheidenden Mediator proinflammatorischer Prozesse im Fettgewebe. Eine umfassende Bewertung der Funktion von IL-1β im Fettgewebe, insbesondere im Zustand der Adipositas, muss jedoch in weitergehenden Studien erfolgen.

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Orientador: Carlos Amilcar Parada / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-20T20:52:22Z (GMT). No. of bitstreams: 1 Araldi_Dioneia_D.pdf: 2812057 bytes, checksum: ba0136e00ebc1ab271d4e1ed908bcd8c (MD5) Previous issue date: 2012 / Resumo: A liberação de Interleucina-1? (IL-1?) no tecido periférico estimula a síntese de Prostaglandinas (PGs), especialmente, da Prostaglandina-E2 (PGE2), que leva a sensibilização dos nociceptores aferentes primários induzindo a hiperalgesia inflamatória. Recentemente demonstramos que a IL-1? pode ativar diretamente o receptor de Interleucina-1 (IL-1R) do nociceptor aferente periférico e levar a liberação de PGE2 associada ao desenvolvimento da hiperalgesia. A IL-1? também é liberada no Gânglio da Raiz Dorsal (GRD), entretanto a função que a IL-1? desempenha no GRD para o desenvolvimento da hiperalgesia inflamatória ainda não está clara. Portanto, o objetivo deste estudo foi investigar se a liberação de IL-1? e a ativação do Receptor de Interleucina-1 Tipo I (IL-1RI) no GRD estão envolvidos no desenvolvimento da hiperalgesia inflamatória. A administração de IL-1Ra (antagonista natural de receptor IL- 1, 6 ?g) no GRD de ratos preveniu a hiperalgesia mecânica (avaliada por meio do von Frey Eletrônico) induzida pela administração intraplantar (i.pl) de Adjuvante Completo de Freund (CFA, 100 ?L), Carragenina (Cg, 100 ?g) ou IL-1? (0,5 pg), mas não pela administração i.pl de PGE2 (100 ng), avaliadas 3 horas após suas administrações. Além disso, a administração i.pl periférica de CFA ou Cg aumentaram as concentrações de IL-1? (avaliadas por ELISA) no GRD. O tratamento ganglionar (GRD-L5) com oligonucleotídeo (ODN) antisense contra IL-1RI (30 ?g/dia durante 4 dias) reduziu de maneira significativa a expressão de IL-1RI no GRD-L5 e a hiperalgesia mecânica induzida por CFA, Cg e IL-1?, mas não pela PGE2, administradas no tecido periférico da pata. Também verificamos a hipótese de que a prévia ativação do receptor neuronal, IL-1RI, no tecido periférico é importante para a liberação de IL-1? no GRD e para a subsequente hiperalgesia induzida por PGE2. A IL-1? (0,5 pg/pata) co-administrada com a dose sub-limiar de PGE2 (10 ng/pata) em patas traseiras tratadas com indometacina induziu uma proeminente hiperalgesia, que foi prevenida pelo prétratamento com ODN antisense contra IL-1RI ou IL-1Ra (6 ?g) administrados no GRD. Além disso, o IL-1Ra reduziu a expressão de COX-2 em células do GRD. Para confirmar a ativação do IL-1RI em células do GRD, administramos Cg ou CFA no tecido periférico o que levou ao aumentou da expressão de IRAK-1 e IRAK-4 em células do GRD. Os resultados deste estudo sugerem que o desenvolvimento da hiperalgesia inflamatória depende da ativação do receptor IL-1RI neuronal no tecido periférico que, em partes, induz a liberação de IL-1? no GRD e subsequente ativação da COX-2. Os dados aqui apresentados oferecem novas perpectivas sobre a participação das células do GRD nos mecanismos envolvidos na hiperalgesia inflamatória e revelam novos e interessantes alvos para o controle das hiperalgesias inflamatórias / Abstract: The release of Interleukin-1? (IL-1?) in the peripheral tissue stimulates the synthesis of Prostaglandins, specially, Prostaglandin-E2 (PGE2) that ultimately sensitize the peripheral afferent nociceptor inducing inflammatory hyperalgesia. We have recently demonstrated that IL-1? can directly activate IL-1R receptor of peripheral afferent nociceptor to induce release of PGE2 associated to development of hyperalgesia. IL-1? is also released in Dorsal Root Ganglion (DRG), however the role that IL-1? in DRG plays to development of inflammatory hyperalgesia is not yet elucidated. Therefore, the aim of this study was to investigate whether IL-1? released in the DRG and the activation of Interleukin-1 Receptor Type I (IL-1RI) is involved in the development of the inflammatory hyperalgesia. Administration of IL-1Ra (IL-1 receptor antagonist, 6 ?g) in the DRG of rats prevented the mechanical hyperalgesia (measured with Electronic von Frey) induced by intraplantar (i.pl) administration of Complete Freund's Adjuvant (CFA, 100 ?L), Carrageenan (Cg, 100 ?g) or IL- 1? (0.5 pg), but not by PGE2 (100 ng), measured 3 hours after their administrations. Also, peripheral i.pl administration of CFA or Cg induced an increase in IL-1? concentrations (measured by ELISA) in the DRG. Ganglionar (DRG-L5) treatment with oligonucleotides (ODN) antisense against IL-1RI (30 ?g/day for four days) reduced the expression of IL-1RI in the DRG-L5 and the mechanical hyperalgesia induced by CFA, Cg, and IL-1?, but not by PGE2 administered in peripheral tissue. We also verified the hypothesis that previous activation of neuronal IL-1RI in the peripheral tissue is important to the release of IL-1? in the DRG and to the subsequent PGE2-induced hyperalgesia. IL-1? (0.5 pg/paw) co-administrated with a sub-threshold dose of PGE2 (10 ng/paw), in hind paws treated with indomethacin, greatly induces hyperalgesia, which was prevented by pre-treatment with ODN antisense against IL-1RI or IL-1Ra (6 ?g) administrated in DRG. Also, IL-1Ra administrations reduced the COX-2 expression in DRG cells. To confirm IL-1RI activation in DRG cells, it was observed that IRAK-1 and IRAK-4 expression was increased in DRG neurons after administration of Cg or CFA in the peripheral tissue. These findings suggest that the development of inflammatory hyperalgesia depends on neuronal IL-RI activation in the peripheral tissue that, in turn, induces the release of IL- 1? in the DRG and subsequent COX-2 activation. These data provide new insights about the participation of DRG cells in the mechanisms underlying inflammatory hyperalgesia and reveal new interesting targets to control inflammatory hyperalgesia / Doutorado / Fisiologia / Doutor em Biologia Funcional e Molecular

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L'arthrose est une maladie multifactorielle complexe. Parmi les facteurs impliqués dans sa pathogénie, les certains prostaglandines exercent un rôle inflammatoire et d’autres un rôle protecteur. La prostaglandine D2 (PGD2) est bien connue comme une PG anti-inflammatoire, qui est régulée par l’enzyme «Lipocalin prostaglandine D-synthase». Avec l’inflammation de l'arthrose, les chondrocytes essaient de protéger le cartilage en activant certaines voies de récupération dont l'induction du gène L-PGDS. Dans cette étude, nous étudions la voie de signalisation impliquée dans la régulation de l'expression du (L-PGDS) sur les chondrocytes traités avec différents médiateurs inflammatoires. Le but de projet: Nous souhaitons étudier la régulation de la L-PGDS dans le but de concevoir des approches thérapeutiques qui peuvent activer la voie intrinsèque anti-inflammatoire. Méthode et conclusions: In vivo, l'arthrose a été suivie en fonction de l’âge chez la souris ou chirurgicalement suivant une intervention au niveau des genoux de souris. Nous avons confirmé les niveaux d’expression de L-PGDS histologiquement et par immunohistochimie. In vitro, dans les chondrocytes humains qui ont été traités avec différents médiateurs de l'inflammation, nous avons observé une augmentation de l’expression de la L-PGDS dose et temps dépendante. Nous avons montré, in vivo et in vitro que l’inflammation induit une sécrétion chondrocytaire de la L-PGDS dans le milieu extracellulaire. Enfin, nous avons observé la production de différentes isoformes de la L-PGDS en réponse à l'inflammation. / Osteoarthritis is a complex multifactorial disease; many factors are involved in its pathogenesis, among those factors prostaglandins. Some prostaglandins have inflammatory role and some have anti-inflammatory role. Prostaglandin D2 (PGD2) is a well-established anti-inflammatory PG which is synthesized by the Lipocalin prostaglandin-D synthase (L-PGDS) enzyme. Upon the initiation of the inflammatory process in osteoarthritis, chondrocytes try to save themselves by activating salvage pathways, among these pathways is the induction of L-PGDS gene. In this study we are addressing the signaling pathways involved in the regulation of (L-PGDS) gene expression, in chondrocytes treated with different inflammatory mediator. Rationale: understanding the regulation of L-PGDS will allow us to design therapeutic targets that can switch on the intrinsic anti-inflammatory pathway. Method and findings: In vivo, osteoarthritis was induced in mice knees surgically or naturally following aging, the development of osteoarthritis was then confirmed histologically. The expression levels of L-PGDS were detected by Immunohistochemistry. In vitro, human chondrocytes were treated with different inflammatory mediators (interleukin-1 beta, interleukin-17, hydrogen peroxide and tert-Butyl hydroperoxide). Interestingly, in most cases chondrocytes increased expression of L-PGDS in a dose and time dependent manner. We discovered that chondrocytes release L-PGDS into the extracellular space in response to inflammation, in vivo and in vitro. Lastly we observed different isoforms of L-PGDS generated in response to inflammation.

Objetivos: avaliar a associação entre dor oncológica crônica e as citocinas pró-inflamatórias interleucina-6 (IL-6), IL-8, IL-1&#946; e TNF-&#945;, e a interferência destas citocinas na relação entre dor, qualidade de vida relacionada à saúde (QVRS) e desempenho funcional (DF). Método: 220 pacientes ambulatoriais com câncer, que não haviam recebido nenhum tratamento antineoplásico nos últimos 30 dias, foram avaliados pelo Inventário Breve de Dor, Questionário de Dor McGill (MPQ), Inventário de Depressão de Beck, Escala de Desempenho Funcional de Karnofsky e a escala de QVRS, EORTC-QLQ-c30. Os níveis plasmáticos das citocinas foram dosados através do teste imunoenzimático ELISA e comparados entre pacientes com dor leve (G1), moderada a intensa (G2) e sem dor (G3) usando a ANOVA ou o teste de Kruskal-Wallis seguido por análise de múltiplas comparações. Os pacientes do G1 e G2 apresentavam apenas dor oncólogica e estavam em uso de analgésicos. Os do G3 tinham câncer, mas não apresentaram dor ou fizeram uso de analgésicos nos últimos 14 dias. 23 voluntários saudáveis (G4) foram incluídos como controle. A ANCOVA foi utilizada para avaliar o efeito das citocinas na relação dor, QVRS e DF. A análise de Árvore de Classificação e Regressão (CART) avaliou a relação entre citocinas e níveis de dor, ajustada por características clínicas, demográficas e sintomas. As correlações foram avaliadas pelos testes de Spearman e Pearson. Resultados: Os pacientes do G2 (n=49) apresentaram significativamente (p<0,05) maiores níveis de IL-6 e IL-8 que todos os demais grupos. Os níveis do TNF-&#945; e da IL-1&#946; foram maiores no G2 que no G1 (n=76) e G4, mas não diferiram significativamente do G3 (n=95). Entre pacientes com dor (n=125) foram observadas correlações significativas (p<0,05) ou com tendência a significância entre: IL-6 e a pior dor (r=0,23) e o escore total do MPQ (r=0,18); TNF-&#945; e os descritores afetivos do MPQ (r=0,33); IL-8 e escore total do MPQ (r=0,16); dimensão emocional da QVRS e IL-8 (p=-0,26) e IL-6 (r=-0,17); escalas de sintomas de dor e IL-6 (r=0,21), e de fadiga com IL-8 (r=0,14). A ANOVA mostrou que os pacientes do G2 tiveram significativamente pior DF e QVRS que os do G1, G3 e G4, na maioria das escalas. Segundo a ANCOVA apenas a IL-8 moderou o efeito da dor sobre a escala de perda de apetite; e independentemente aumentou a fadiga. A análise de CART selecionou o estádio da doença, a IL-8, a insônia moderada a intensa, a fadiga leve a intensa e a idade <=48 anos como preditoras de dor. O maior percentual de casos com dor moderada a intensa foi observado entre os com estádio IV da doença e IL-8 > 5,20 pg/ml. Conclusões: o aumento das citocinas pró-inflamatórias IL-6, IL-8, IL-1&#946; e TNF-&#945; esteve relacionado ao aumento da dor. A IL-6 e IL-8 estavam associadas à ocorrência de dor moderada a intensa. A IL-8 moderou o efeito da dor sobre a perda de apetite em pacientes com dor, não interferindo no impacto da dor sobre o desempenho funcional, a QVRS geral e os domínios físico, emocional, social e cognitivo da QVRS. A IL-8 e IL-6 estavam independentemente correlacionadas com redução da QVRS emocional e a IL-8 com piora da fadiga em pacientes com dor oncológica. Os resultados sugerem que tratamento com antagonistas/inibidores das citocinas IL-6, IL-8, IL-1&#946; e TNF-&#945; pode contribuir para o alívio da dor em pacientes com câncer / Aims: to examine the association between chronic cancer pain and the pro-inflammatory cytokines interleukin-6 (IL-6), IL-8, IL-1&#946; and TNF-&#945;, as well as the interference of these cytokines in the relationship between pain, health-related quality of life (HRQOL), and performance status (PS). Methods: 220 cancer outpatients, who didn`t receive any antineoplastic treatment in the last 30 days, were evaluated by the Brief Pain Inventory (BPI), McGill Pain Questionnaire (MPQ), Beck Depression Inventory (BDI), Karnofsky Performance Scale (KPS), and a HRQOL measurement, the EORTC-QLQ-30. Plasma cytokine levels were measured using an enzyme-linked immunosorbent assay (ELISA) and were compared among patients with mild (G1), moderate to severe (G2) and without pain (G3) using one-way analysis of variance (ANOVA) or Kruskal-Wallis followed by multiple comparison tests. Patients in G1 and G2 had only cancer pain and were using analgesics. G3 members had cancer but felt no pain and didn`t use analgesics in the last 14 days. Twenty-three healthy volunteers (G4) were included as controls. ANCOVA was used to assess the effect of cytokines on the pain, HRQOL and PS relationship. Associations between pain and cytokines, adjusted by cancer symptoms and clinical and demographic characteristics were also examined using Classification and Regression Tree (CART) analysis. Correlations were assessed by Spearman\'s and Pearson\'s tests. Results: the IL-6 and IL-8 levels in G2 (n=49) patients was significantly (p<0.05) higher than of those in all other groups. The IL-1&#946; and TNF-&#945; levels were significantly higher in G2 than in G1 (n=76) and G4, but not significantly different when compared with G3 (n=95). Among patients with pain (n=125), it was observed significant, or almost significant, correlations between: IL-6 with worst pain (r=0.23) and with the total score of MPQ (r=0.18); TNF-&#945; with MPQ affective domain (r=0.33); IL-8 with total score of MPQ (r=0.16); emotional HRQOL domain and IL-8 (p=-0.26) and IL-6 (r=-0.17) and; between HRQOL pain scale and IL-6 (r=0.21), and fatigue scale and IL-8 (r=0.14). ANOVA showed that PS and HRQOL were significantly worse in G2 than in G1, G3 and G4 in most scales. According to ANCOVA, there was an interaction between pain and IL-8 that increased loss of appetite. IL-8 independently increased fatigue. CART analysis selected disease stage, IL-8, moderate to severe insomnia, mild to severe fatigue and age <=48 years as markers for pain. The highest percentage of patients with moderate to severe pain was observed among those with disease stage IV and plasma level of IL-8 > 5.20 pg/ml. Conclusions: increase of pro-inflammatory cytokines IL-6, IL-8, IL-1&#946; and TNF-&#945; was related to increase in pain. IL-6 and IL-8 were related to moderate to severe pain occurrence. IL-8 was a moderator to the pain effect on loss of appetite in patients with pain but has not interfered neither on pain effect over performance status, nor on general HRQOL nor its physical, emotional, social and cognitive domains. IL-8 and IL-6 were found to be independently correlated with the decrease of the emotional domain scores of HRQOL and the IL-8 with increased fatigue on patients with cancer pain. Results suggest that treatment with IL-6, IL-8, IL-1&#946; and TNF-&#945; cytokine inhibitors/antagonists may provide pain relief in cancer patients