Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran; Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Clin Nutr. 2022 Dec;41(12):2843-2857. doi: 10.1016/j.clnu.2022.11.009. Epub 2022 Nov 9.
Cachexia, a multifactorial and often irreversible wasting syndrome, is often associated with the final phase of several chronic disorders. Although cachexia is characterized by skeletal muscle wasting and adipose tissue loss, it is a syndrome affecting different organs, which ultimately results in systemic complications and impaired quality of life. The pathogenesis and underlying molecular mechanisms of cachexia are not fully understood, and currently there are no effective standard treatments or approved drug therapies to completely reverse cachexia. Moreover, adequate nutritional interventions alone cannot significantly improve cachexia. Other approaches to ameliorate cachexia are urgently needed, and thus, the role of medicinal plants has received considerable importance in this respect due to their beneficial health properties. Increasing evidence indicates great potential of medicinal plants and their phytochemicals as an alternative and promising treatment strategy to reduce the symptoms of many diseases including cachexia. This article reviews the current status of cachexia, the molecular mechanisms of primary events driving cachexia, and state-of-the-art knowledge that reports the preventive and therapeutic activities of multiple families of phytochemical compounds and their pharmacological mode of action, which may hold promise as an alternative treatment modality for the management of cachexia. Based on our review of various in vitro and in vivo models of cachexia, we would conclude that phytochemicals may have therapeutic potential to attenuate cachexia, although clinical trials are required to unequivocally confirm this premise.
恶病质是一种多因素且常不可逆的消耗综合征,常与多种慢性疾病的终末期相关。尽管恶病质的特征为骨骼肌消耗和脂肪组织丢失,但它是一种影响不同器官的综合征,最终导致全身并发症和生活质量受损。恶病质的发病机制和潜在的分子机制尚未完全阐明,目前尚无有效的标准治疗方法或批准的药物疗法可完全逆转恶病质。此外,仅充分的营养干预并不能显著改善恶病质。因此,迫切需要其他方法来改善恶病质,由于药用植物具有有益的健康特性,因此其在这方面受到了相当大的重视。越来越多的证据表明,药用植物及其植物化学物质具有巨大的潜力,可以作为一种替代的有前途的治疗策略,以减轻许多疾病的症状,包括恶病质。本文综述了恶病质的现状、驱动恶病质的主要事件的分子机制,以及最新的知识,这些知识报告了多种植物化学化合物的预防和治疗活性及其药理学作用模式,这些可能有希望成为管理恶病质的替代治疗方式。基于我们对各种恶病质的体外和体内模型的综述,我们得出结论,尽管需要临床试验来明确证实这一前提,但植物化学物质可能具有减轻恶病质的治疗潜力。