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癌症恶病质中的循环因子:转化研究的新机遇。

Circulating factors in cancer cachexia: recent opportunities for translational research.

机构信息

Cancer Metabolism Research Group, Laboratory of Experimental Surgery (LIM 26), Faculdade de Medicina da Universidade de São Paulo, HC-FMUSP, São Paulo - Brazil.

出版信息

Curr Opin Clin Nutr Metab Care. 2024 May 1;27(3):226-233. doi: 10.1097/MCO.0000000000001037. Epub 2024 Mar 26.

Abstract

PURPOSE OF REVIEW

To discuss the recent discoveries and limitations of the available literature on emerging circulating biomarkers of cancer cachexia.

RECENT FINDINGS

Studies on circulating factors in cancer cachexia show promising alternatives for diagnosing the syndrome in a minimally invasive manner in the clinic setting, as well as potential targets for cancer cachexia treatment. Factors secreted by the tumor and the adipose tissue, such as extracellular vesicles and soluble proteins, respectively, have been shown to either directly induce wasting in vitro and in vivo or to be altered in the cachectic phenotype. The detection and characterization of circulating cells allows detection of the precachectic stage and the levels of the soluble immune checkpoint protein programmed death ligand-1 (PD-L1) are correlated with the presence of the hallmarks of cancer cachexia.

SUMMARY

Structural, molecular, and metabolic alterations have been observed in various tissues, revealing the occurrence of sustained inter-compartment crosstalk in cachectic patients. Early diagnosis of cancer cachexia becomes crucial to avoid the establishment of refractory cachexia through the implementation of interventions that may attenuate systemic inflammation and muscle loss. More studies on human cancer cachexia are required in order to address the recently discovered cachexia-associated circulating factors' value as biomarkers of the syndrome.

摘要

目的综述

讨论癌症恶病质新兴循环生物标志物相关文献的最新发现和局限性。

最近的发现

癌症恶病质相关循环因子的研究为以微创方式在临床环境中诊断该综合征提供了有前景的替代方法,也为癌症恶病质的治疗提供了潜在靶点。肿瘤和脂肪组织分泌的因子,如细胞外囊泡和可溶性蛋白,分别被证明可直接在体外和体内诱导消耗,或在恶病质表型中发生改变。循环细胞的检测和特征分析可检测出预恶病质阶段,可溶性免疫检查点蛋白程序性死亡配体-1(PD-L1)的水平与癌症恶病质的标志存在相关。

总结

在各种组织中观察到结构、分子和代谢改变,揭示了恶病质患者持续的隔室间串扰的发生。早期诊断癌症恶病质变得至关重要,以避免通过实施可能减轻全身炎症和肌肉损失的干预措施而导致难治性恶病质的发生。需要更多关于人类癌症恶病质的研究,以解决最近发现的恶病质相关循环因子作为该综合征生物标志物的价值。

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