Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
Vitam Horm. 2013;92:271-99. doi: 10.1016/B978-0-12-410473-0.00011-8.
Cachexia is a multifactorial syndrome characterized by body weight loss, depletion of adipose tissue and skeletal muscle mass, and marked alterations in the metabolic homeostasis. The occurrence of cachexia significantly impinges on patients' morbidity and mortality, and on quality of life. Inflammation, anorexia/malnutrition, alterations of protein and lipid metabolism are among the main mechanisms involved in the development of cachexia. While anorexia and malnutrition have long been known to be contributing factors, the mechanisms leading to inflammation and metabolic alterations were clarified much later. On these premises, several therapeutic approaches were proposed. Most of them are in the preclinical phase, but some have already reached the clinical experimentation stage. This review focuses on treatment options proposed on the basis of mechanistic alterations. In this regard, in addition to nutritional and anti-inflammatory strategies, approaches based on perturbation of specific signal transduction pathways are taken into consideration.
恶病质是一种多因素综合征，其特征为体重下降、脂肪组织和骨骼肌量耗竭，以及代谢稳态的明显改变。恶病质的发生显著影响患者的发病率、死亡率和生活质量。炎症、厌食/营养不良、蛋白质和脂质代谢改变是恶病质发展过程中涉及的主要机制之一。虽然厌食和营养不良早已被认为是促成因素，但导致炎症和代谢改变的机制直到后来才被阐明。在此基础上，提出了几种治疗方法。其中大多数处于临床前阶段，但也有一些已进入临床实验阶段。本综述重点介绍了基于机制改变提出的治疗选择。在这方面，除了营养和抗炎策略外，还考虑了基于特定信号转导通路干扰的方法。
