Depression enhanced the production of autoantibodies against 16α‑hydroxyestrone-estrogen receptor adduct in breast cancer

Abstract Mentally depressed breast cancer (MDBC) patients expressed estrogen receptor (ER) and 16α‑hydroxyestrone (16α‑OHE 1 ) is directly responsible for causing breast cancer (BC). This study aimed to identify whether depression in breast cancer patients enhanced the production of autoantibodies against 16α‑OHE 1 -ER adduct in breast cancer patients. The antibodies in the serum of 65 breast cancer patients (including 35 MDBC) and 40 control subjects were screened by direct binding, inhibition enzyme-linked immunosorbent assay (ELISA), and quantitative precipitin titration. Competition ELISA was also utilized for the estimation of 16α‑OHE 1 in the serum of 30 cancer patients. Autoantibodies from MDBC showed strong recognition to 16α‑OHE 1 -ER in comparison to overall breast cancer patients (p  1 -ER in comparison to ER (p  1 (p  1 -ER were found to be 1.38 × 10 −7 and 1.23 × 10 −7 for breast cancer and MDBC patients respectively. No significant difference, either in the level of 16α‑OHE 1 or 2‑hydroxyestrone/16α‑OHE 1 ratio, was observed in the serum of cancer patients compared with controls, although inflammatory cytokines (IL-6, TNF-α) were significantly high in these patients. Depression in breast cancer patients augments the production of autoantibodies against 16α‑OHE 1 -ER through the generation of inflammatory conditions. Depression in these patients increased the release of pro-inflammatory cytokines that generate more autoantibodies and show strong binding with 16α‑OHE 1 -ER.