Fletcher Autumn L, Marks Daniel L
Center for Study of Weight Regulation and Associated Disorders, Oregon Health and Science University, Portland, Oregon 97239, USA.
Curr Opin Support Palliat Care. 2007 Dec;1(4):306-11. doi: 10.1097/SPC.0b013e3282f14c4e.
Cachexia, also known as disease-associated wasting, is an important factor in the mortality of many patients with diseases such as cancer, as well as renal and congestive heart failure. Yet the syndrome is not yet well defined, making diagnosis difficult and often subjective on the part of the physician. Nor are the central mechanisms of cachexia fully elucidated. Recent studies have begun to address these gaps by focusing on three areas: the role of cytokines in cachexia, other proteins and peptides that might be involved, and potential treatments for this devastating syndrome.
Cachexia can be caused, in the absence of disease, by inflammatory stimuli and some chemotherapy drugs, suggesting possible central mechanisms in cachexia. Promising treatments include melanocortin antagonism and some hormones.
While more research is necessary to illuminate causal mechanisms and uncover potential therapies of cachexia, several of its major molecular pathways have become elucidated, suggesting directions for therapeutic approaches.
恶病质,也称为疾病相关性消瘦,是许多患有癌症、肾衰和充血性心力衰竭等疾病的患者死亡的重要因素。然而,该综合征尚未得到明确界定,这使得诊断困难,且往往依赖医生的主观判断。恶病质的核心机制也尚未完全阐明。最近的研究开始通过关注三个领域来填补这些空白:细胞因子在恶病质中的作用、可能涉及的其他蛋白质和肽,以及针对这种破坏性综合征的潜在治疗方法。
在没有疾病的情况下,炎症刺激和一些化疗药物可导致恶病质,这提示了恶病质可能的核心机制。有前景的治疗方法包括黑素皮质素拮抗作用和一些激素。
虽然需要更多研究来阐明恶病质的因果机制并发现潜在治疗方法,但已经阐明了其一些主要分子途径,为治疗方法指明了方向。