Elamin Elamin M, Glass Maresa, Camporesi Enrico
University of South Florida, College of Medicine, Tampa, Florida 33612-4799, USA.
Curr Opin Clin Nutr Metab Care. 2006 Jul;9(4):449-54. doi: 10.1097/01.mco.0000232906.89662.bb.
Nutritional debilitation is among the most devastating and life-threatening aspect of various diseases. It arises from a complex interaction between the illness and the host. This process includes cytokine production, release of lipid-mobilizing and proteolysis-inducing factors, and alterations in intermediary metabolism. As a result, many patients develop cachexia with progressive body fat and muscle tissue wasting with associated worsening of their clinical status and a lower quality of life. In this review, up-to-date information about different approaches to pharmacologic management of cachexia will be addressed.
Until recently, the two major options for pharmacological therapy were either progestational agents or corticosteroids. Knowledge of the mechanisms of cachexia, however, has led to newer therapeutic interventions for treating several aspects of the syndrome. These include antiserotonergic agents, branched-chain amino acids, eicosapentaenoic acid, cannabinoids, melatonin, and thalidomide--all of which act on the feeding-regulatory circuitry to increase appetite and inhibit illness-derived catabolic factors.
Information from this review will guide health care providers in limiting weight loss and improving performance status of cachectic patients through pharmacological therapy, with the hope that such therapy will extend patients' survival and improve their qualities of life.
营养衰弱是多种疾病中最具破坏性和威胁生命的方面之一。它源于疾病与宿主之间的复杂相互作用。这个过程包括细胞因子的产生、脂质动员和蛋白水解诱导因子的释放，以及中间代谢的改变。结果，许多患者会出现恶病质，伴有身体脂肪和肌肉组织逐渐消瘦，临床状况随之恶化，生活质量降低。在本综述中，将探讨有关恶病质药物治疗不同方法的最新信息。
直到最近，药物治疗的两个主要选择是孕激素类药物或皮质类固醇。然而，对恶病质机制的了解已促使针对该综合征的多个方面采取新的治疗干预措施。这些措施包括抗5-羟色胺能药物、支链氨基酸、二十碳五烯酸、大麻素、褪黑素和沙利度胺——所有这些药物都作用于进食调节回路，以增加食欲并抑制疾病衍生的分解代谢因子。
本综述中的信息将指导医疗保健提供者通过药物治疗来限制恶病质患者的体重减轻并改善其身体状况，希望此类治疗能够延长患者的生存期并提高他们的生活质量。
