Department of Surgery.
Department of Orthopedics.
Curr Opin Clin Nutr Metab Care. 2021 May 1;24(3):216-222. doi: 10.1097/MCO.0000000000000738.
Cancer cachexia is a syndrome of loss of weight and muscle mass that leads to reduced strength, poor physical performance and functional impairment. Muscular fatigue is a distressing syndrome that patients with cachexia suffer from and can impair quality of life. Here, we review recent updates in muscular fatigue in cancer cachexia research with a focus on mechanisms, biomarkers and potential therapies.
Both in mice and humans, research has shown that muscle fatigue can be independent of muscular atrophy and can happen early in cancer development or in precachexia. Inflammatory pathways, mitochondrial dysfunction and gut microbiota have recently been studied to play an important role in muscle fatigue in preclinical models. Exercise can target these pathways and has been studied as a therapeutic intervention to improve muscle fatigue.
Heightened inflammation within muscle, altered muscle function and muscle fatigue can begin prior to clinical evidence of cachexia, making early recognition and intervention challenging. The emergence of cachexia mouse models and translational and clinical research studying muscle fatigue will hopefully lead to new therapies targeting the underlying mechanisms of cancer cachexia. Exercise will need to be tested in larger randomized studies before entering into daily practice.
癌症恶病质是一种体重和肌肉量下降的综合征，导致力量减弱、身体机能差和功能障碍。肌肉疲劳是恶病质患者所遭受的一种痛苦综合征，会降低生活质量。在这里，我们综述了癌症恶病质肌肉疲劳研究的最新进展，重点关注机制、生物标志物和潜在治疗方法。
研究表明，在小鼠和人类中，肌肉疲劳可以独立于肌肉萎缩发生，并且可能在癌症发生早期或在恶病质前期就出现。炎症途径、线粒体功能障碍和肠道微生物群最近被研究为在临床前模型中发挥重要作用的肌肉疲劳的机制。运动可以针对这些途径，并被研究作为一种治疗干预措施来改善肌肉疲劳。
肌肉内炎症加剧、肌肉功能改变和肌肉疲劳可能在恶病质的临床证据出现之前就开始了，这使得早期识别和干预具有挑战性。恶病质小鼠模型的出现以及研究肌肉疲劳的转化和临床研究有望为针对癌症恶病质潜在机制的新疗法提供帮助。运动需要在更大的随机研究中进行测试，然后才能进入日常实践。
