{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:40:31Z","timestamp":1790206831004,"version":"4.1.0"},"reference-count":145,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic and Slovak Academy of Sciences","award":["VEGA 1\/0090\/22"],"award-info":[{"award-number":["VEGA 1\/0090\/22"]}]},{"name":"Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic and Slovak Academy of Sciences","award":["APVV-22-0231"],"award-info":[{"award-number":["APVV-22-0231"]}]},{"name":"Slovak Research and Development Agency","award":["VEGA 1\/0090\/22"],"award-info":[{"award-number":["VEGA 1\/0090\/22"]}]},{"name":"Slovak Research and Development Agency","award":["APVV-22-0231"],"award-info":[{"award-number":["APVV-22-0231"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Stress responses can impact bladder cancer (BC) outcomes via immune\u2013inflammatory pathway modulation. This study explores heart rate variability (HRV) associations with serum immune\u2013inflammatory biomarkers, blood count inflammatory markers, and psychosocial self-report measures in patients versus healthy controls. The TREM-1 and TREM-2 expressions on peripheral blood monocytes were analysed via flow cytometry; serum inflammatory biomarkers by ELISA; HRV (5-min ECG) pre-tumour resection; blood counts by haematology analyser; and psychosocial factors by validated questionnaires. Patients exhibited altered immune\u2013inflammatory profiles with increased TREM-1\/TREM-2, sTREM-1, sTREM-1\/sTREM-2 ratio, BDNF, MCP-1, and NLR, and reduced IFN-\u03b3, IL-10, LMR, and PMR. HRV analysis indicated sympathetic dominance (SNS, Stress indices, ACmod) and reduced parasympathetic modulation (PNS index, SDNN, RMSSD, 2UV%, DCmod, SD1). Sympathetic HRV indices correlated positively with sTREM-1, sTREM-1\/sTREM-2 ratio, fractalkine, and inflammatory markers (SII, NLR, PLR) and negatively with parasympathetic HRV indices\u2014correlations absent in controls. Only in patients, reduced physical function and social support, and higher anxiety, depression, and fatigue, associated positively with sympathetic HRV indices and inflammatory markers. This study links immune\u2013inflammatory markers, HRV parameters, and psychosocial factors in BC, suggesting that immune and autonomic variations may relate to unfavourable outcomes. Incorporating these assessments could help tailor more personalised treatment strategies for BC patients.<\/jats:p>","DOI":"10.3390\/ijms252312765","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T11:26:08Z","timestamp":1732706768000},"page":"12765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association of Sympathovagal Imbalance with Increased Inflammation and Impaired Adaptive Immunity in Bladder Cancer Patients"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4443-9069","authenticated-orcid":false,"given":"Iveta","family":"Mikolaskova","sequence":"first","affiliation":[{"name":"Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske namestie 14, 811 08 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0165-6066","authenticated-orcid":false,"given":"Milan","family":"Zvarik","sequence":"additional","affiliation":[{"name":"Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Computer Science, Comenius University in Bratislava, Mlynska dolina F1, 842 48 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinga","family":"Szaboova","sequence":"additional","affiliation":[{"name":"Medirex, s.r.o., Galvaniho 17\/C, 820 16 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Tibenska","sequence":"additional","affiliation":[{"name":"Medirex, s.r.o., Galvaniho 17\/C, 820 16 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimira","family":"Durmanova","sequence":"additional","affiliation":[{"name":"Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske namestie 14, 811 08 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda","family":"Suchankova","sequence":"additional","affiliation":[{"name":"Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske namestie 14, 811 08 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Kollarik","sequence":"additional","affiliation":[{"name":"Department of Urology, Saint Cyril and Methodius Hospital, Antolska 11, 851 07 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Hesko","sequence":"additional","affiliation":[{"name":"Department of Urology, Saint Cyril and Methodius Hospital, Antolska 11, 851 07 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Palacka","sequence":"additional","affiliation":[{"name":"2nd Department of Oncology, Faculty of Medicine, Comenius University in Bratislava, Kolarska 12, 812 50 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bucova","sequence":"additional","affiliation":[{"name":"Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske namestie 14, 811 08 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2159-0807","authenticated-orcid":false,"given":"Luba","family":"Hunakova","sequence":"additional","affiliation":[{"name":"Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske namestie 14, 811 08 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1038\/s41568-021-00395-5","article-title":"Stress and cancer: Mechanisms, significance and future directions","volume":"21","author":"Eckerling","year":"2021","journal-title":"Nat. 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