Ferreira Rita, Nogueira-Ferreira Rita, Vitorino Rui, Santos Lúcio Lara, Moreira-Gonçalves Daniel
QOPNA, Departamento de Química, Universidade de Aveiro, Aveiro, Portugal.
Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Porto Biomed J. 2017 Nov-Dec;2(6):333-339. doi: 10.1016/j.pbj.2017.02.006. Epub 2017 Jun 11.
Cachexia affects the majority of patients with advanced cancer and no effective treatment is currently available to address this paraneoplastic syndrome. It is characterized by a reduction in body weight due to the loss of white adipose tissue (WAT) and skeletal muscle. The loss of WAT seems to occur at an earlier time point than skeletal muscle proteolysis, with recent evidence suggesting that the browning of WAT may be a major contributor to this process. Several factors seem to modulate WAT browning including pro-inflammatory cytokines; however, the underlying molecular pathways are poorly characterized. Exercise training is currently recommended for the clinical management of low-grade inflammatory conditions as cancer cachexia. While it seems to counterbalance the impairment of skeletal muscle function and attenuate the loss of muscle mass, little is known regarding its effects in adipose tissue. The browning of WAT is one of the mechanisms through which exercise improves body composition in overweight/obese individuals. While this effect is obviously advantageous in this clinical setting, it remains to be clarified if exercise training could protect or exacerbate the cachexia-related catabolic phenotype occurring in adipose tissue of cancer patients. Herein, we overview the molecular players involved in adipose tissue remodelling in cancer cachexia and in exercise training and hypothesize on the mechanisms modulated by the synergetic effect of these conditions. A better understanding of how physical activity regulates body composition will certainly help in the development of successful multimodal therapeutic strategies for the clinical management of cancer cachexia.
恶病质影响大多数晚期癌症患者，目前尚无有效的治疗方法来应对这种副肿瘤综合征。其特征是由于白色脂肪组织（WAT）和骨骼肌的流失导致体重减轻。WAT的流失似乎比骨骼肌蛋白水解发生的时间更早，最近有证据表明WAT的褐变可能是这一过程的主要促成因素。包括促炎细胞因子在内的几个因素似乎调节WAT褐变；然而，其潜在的分子途径尚不清楚。目前建议进行运动训练来临床管理如癌症恶病质等低度炎症性疾病。虽然运动训练似乎可以抵消骨骼肌功能的损害并减轻肌肉质量的损失，但关于其对脂肪组织的影响知之甚少。WAT的褐变是运动改善超重/肥胖个体身体成分的机制之一。虽然这种作用在这种临床情况下显然是有利的，但运动训练是否能保护或加剧癌症患者脂肪组织中发生的恶病质相关分解代谢表型仍有待阐明。在此，我们概述了参与癌症恶病质和运动训练中脂肪组织重塑的分子因素，并对这些情况的协同作用所调节的机制提出假设。更好地理解体育活动如何调节身体成分肯定有助于开发成功的多模式治疗策略，用于癌症恶病质的临床管理。
