Wang Wenhua, Danielsson Anna, Svanberg Elisabeth, Lundholm Kent
Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Nutrition. 2003 Jan;19(1):47-53. doi: 10.1016/s0899-9007(02)00921-8.
Anorexia is a major clinical problem in large number of patients with advanced cancer disease. Serotonergic mechanisms are assumed to play a role in the process of feeding behavior during normal and pathologic circumstances, which may also involve cancer anorexia according to previous experimental and clinical studies.
In the present study, we evaluated the effect of the tricyclic antidepressants desipramine (7.5 mg x kg(-1) x d(-1), intraperitoneal) and imipramine (2 to 5 mg. kg(-1) x d(-1), intraperitoneal) the serotonin synthesis inhibitor para-chlorophenylalanine (300 mg x kg(-1) x d(-1), intraperitoneal), the serotonin receptor 5-HT(2C) antagonist cyproheptadine (5 mg x kg(-1) x d(-1), intraperitoneal) and the selective serotonin reuptake inhibitor citalopram (20 mg x kg(-1) x d(-1), intraperitoneal) on anorexia in MCG-101 tumor-bearing mice, a model with significant anorexia and cachexia sensitive to cyclooxygenase inhibition. Also, MCG 101-bearing mice develop well-recognized alterations in brain tryptophan/serotonin metabolism as increased Trp, 5-HPT, and 5-HIAA during tumor progression.
Daily provision of desipramine, imipramine, para-chloropheylalanine, cyproheptadine, and citalopram at doses that cause behavioral and metabolic alterations in normal mice did not alter food intake or body weight in tumor-bearing and healthy control mice. Also, the treatments did not decrease elevated plasma concentrations of interleukin-6 and prostaglandin E(2) in the tumor-bearing mice.
Thus, our results do not support previous observations that serotonin metabolism itself is a major factor behind anorexia in tumor-bearing animals in general. Rather, other mechanisms, such as eicosanoid and nitric oxide-dependent pathways, seem to be more important for induction of anorexia along tumor progression in the present model.
厌食是大量晚期癌症患者的一个主要临床问题。根据以往的实验和临床研究,血清素能机制在正常和病理情况下的进食行为过程中发挥作用,这可能也与癌症厌食有关。
在本研究中,我们评估了三环类抗抑郁药地昔帕明(7.5毫克/千克/天,腹腔注射)、丙咪嗪(2至5毫克/千克/天,腹腔注射)、血清素合成抑制剂对氯苯丙氨酸(300毫克/千克/天,腹腔注射)、血清素受体5-HT(2C)拮抗剂赛庚啶(5毫克/千克/天,腹腔注射)以及选择性血清素再摄取抑制剂西酞普兰(20毫克/千克/天,腹腔注射)对MCG - 101荷瘤小鼠厌食的影响,该模型具有明显的厌食和恶病质,对环氧化酶抑制敏感。此外,MCG 101荷瘤小鼠在肿瘤进展过程中脑色氨酸/血清素代谢出现公认的改变,如色氨酸、5 - 羟色氨酸和5 - 羟吲哚乙酸增加。
以能引起正常小鼠行为和代谢改变的剂量每日给予地昔帕明、丙咪嗪、对氯苯丙氨酸、赛庚啶和西酞普兰,并未改变荷瘤小鼠和健康对照小鼠的食物摄入量或体重。而且,这些治疗并未降低荷瘤小鼠升高的血浆白细胞介素 - 6和前列腺素E(2)浓度。
因此,我们的结果不支持先前的观察结果,即一般而言血清素代谢本身是荷瘤动物厌食背后的主要因素。相反,在本模型中,其他机制,如类花生酸和一氧化氮依赖性途径,似乎对肿瘤进展过程中厌食的诱导更为重要。