Cancer Metabolism Research Group, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil.
Cytokine. 2013 Feb;61(2):532-9. doi: 10.1016/j.cyto.2012.10.023. Epub 2012 Nov 27.
Cachexia, a paraneoplastic syndrome markedly associated with worsened prognosis in cancer patients, provokes profound wasting of both lean and adipose mass in an association with a state of metabolic "chaos". The white adipose tissue responds to cachexia with marked local inflammation and may be thus a relevant contributor to systemic inflammation. To address this hypothesis we examined the correlation between tissue expression of adipokines and plasma concentration in cachectic and stable weight patients with or without cancer. Adiponectin and liver-derived CRP concentration were significantly higher in the cachectic groups when compared with stable weight patients (P<0.01). The concentration of plasma IL-6 was higher (11.4-fold) in the cancer cachectic group when compared with weight-stable controls, and presented a significant correlation with the presence of cancer (P<0.001). A marked increase (5-fold) in IL-6 as a result of the interaction between the presence of cachexia and the presence of tumour was observed in the subcutaneous tissue of the patients, yet not in the visceral depot. Plasma adiponectin levels were higher in cachectic cancer patients, compared with stable weight cancer patients individually matched by age, sex, and BMI, and the subcutaneous depot was found to be the main contributing tissue, rather than the visceral pad. Based on the results we concluded that the subcutaneous adipose tissue is associated with plasma changes that may function as markers of cachexia.
恶病质是一种与癌症患者预后恶化显著相关的副瘤综合征,它会导致瘦组织和脂肪组织大量消耗,并伴有代谢“紊乱”状态。白色脂肪组织对恶病质会产生明显的局部炎症反应,因此可能是全身炎症的一个相关因素。为了验证这一假说,我们研究了伴有或不伴有癌症的恶病质和体重稳定患者的组织中脂肪因子的表达与血浆浓度之间的相关性。与体重稳定患者相比,恶病质组的脂联素和肝源性 CRP 浓度显著升高(P<0.01)。与体重稳定对照组相比,癌症恶病质组的血浆 IL-6 浓度更高(11.4 倍),且与癌症的存在呈显著相关性(P<0.001)。在患者的皮下组织中观察到由于恶病质的存在和肿瘤的存在之间的相互作用导致 IL-6 显著增加(5 倍),而在内脏脂肪垫中则没有观察到这种情况。与年龄、性别和 BMI 相匹配的体重稳定癌症患者相比,癌症恶病质患者的血浆脂联素水平更高,并且发现皮下脂肪组织是主要的贡献组织,而不是内脏脂肪垫。基于这些结果,我们得出结论,皮下脂肪组织与可能作为恶病质标志物的血浆变化有关。