Tsumura Research Laboratories, Tsumura & Co., Yoshiwara, Ami-machi, Inashiki-gun, Ibaraki, Japan.
Vitam Horm. 2013;92:301-17. doi: 10.1016/B978-0-12-410473-0.00012-X.
Cisplatin, a formidable anticancer treatment, is used for several varieties of cancer. There are, however, many cases in which treatment must be abandoned due to a decrease in the patient's quality of life from loss of appetite associated with vomiting and nausea. There is a moderate degree of improvement in prevention of cisplatin-induced nausea and vomiting when serotonin (5-HT) 3 receptor antagonists, neurokinin 1 receptor antagonists, and steroids-either alone or in combination-are administered. The mechanism of action for anorexia, which continues during or after treatment, is, however, still unclear. This anorexia is, similar to the onset of vomiting and nausea, caused by the action of large amounts of 5-HT released as a result of cisplatin administration on tissue 5-HT receptors. Among the 5-HT receptors, the activation of 5-HT2b and 5-HT2c receptors, in particular, seems to play a major role in cisplatin-induced anorexia. Following activation of these two receptors, there is reduced gastric and hypothalamic secretion of the appetite-stimulating hormone ghrelin. There is ample evidence of the usefulness of exogenous ghrelin, synthetic ghrelin agonists, and the endogenous ghrelin signal-enhancer rikkunshito, which are expected to play significant roles in the clinical treatment and prevention of anorexia in future.
顺铂是一种强大的抗癌治疗药物，用于多种癌症。然而，由于呕吐和恶心引起的食欲不振，许多患者的生活质量下降，导致治疗必须中断。当单独或联合使用 5-羟色胺（5-HT）3 受体拮抗剂、神经激肽 1 受体拮抗剂和类固醇时，可在一定程度上预防顺铂引起的恶心和呕吐。然而，用于治疗期间或之后持续存在的厌食症的作用机制仍不清楚。这种厌食症类似于呕吐和恶心的发生，是由于顺铂给药后大量 5-HT 释放作用于组织 5-HT 受体引起的。在 5-HT 受体中，5-HT2b 和 5-HT2c 受体的激活似乎在顺铂诱导的厌食症中起主要作用。这两种受体被激活后，胃和下丘脑分泌的食欲刺激激素胃饥饿素减少。外源性胃饥饿素、合成胃饥饿素激动剂和内源性胃饥饿素信号增强剂 rikkunshito 的有效性有充分的证据，预计它们将在未来的临床治疗和预防厌食症中发挥重要作用。
