癌症相关的肌肉无力：骨骼与之有何关联？
Cancer-associated muscle weakness: What's bone got to do with it?
作者信息
Waning David L, Guise Theresa A
机构信息
Department of Medicine, Division of Endocrinology, Indiana University School of Medicine , Indianapolis, IN, USA.
出版信息
Bonekey Rep. 2015 May 20;4:691. doi: 10.1038/bonekey.2015.59. eCollection 2015.
Abstract
Cancer-associated muscle weakness is an important paraneoplastic syndrome for which there is currently no treatment. Tumor cells commonly metastasize to bone in advanced cancer to disrupt normal bone remodeling and result in morbidity that includes muscle weakness. Tumor in bone stimulates excessive osteoclast activity, which causes the release of growth factors stored in the mineralized bone matrix. These factors fuel a feed-forward vicious cycle of tumor growth in bone and bone destruction. Recent evidence indicates that these bone-derived growth factors can act systemically to cause muscle weakness. Muscle weakness can be caused by reduced muscle mass or reduced muscle function; in advanced disease, it is likely due to a combination of both reduced quantity and quality of muscle. In this review, we discuss possible mechanisms that lead to skeletal muscle weakness due to bone metastases.
摘要
癌症相关的肌肉无力是一种重要的副肿瘤综合征，目前尚无治疗方法。在晚期癌症中，肿瘤细胞通常会转移至骨骼，破坏正常的骨重塑，导致包括肌肉无力在内的发病情况。骨骼中的肿瘤会刺激破骨细胞过度活跃，从而导致存储在矿化骨基质中的生长因子释放。这些因子助长了骨骼中肿瘤生长和骨质破坏的前馈恶性循环。最近的证据表明，这些源自骨骼的生长因子可通过全身作用导致肌肉无力。肌肉无力可能由肌肉量减少或肌肉功能降低引起；在晚期疾病中，可能是由于肌肉数量和质量均下降所致。在本综述中，我们讨论了因骨转移导致骨骼肌无力的可能机制。
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