Puppa Melissa J, Carson James A
College of Health Sciences, The University of Memphis, Memphis, TN, USA.
Huffines Institute for Sports Medicine and Human Performance, Texas A&M University, College Station, TX, USA.
Adv Exp Med Biol. 2025;1478:285-314. doi: 10.1007/978-3-031-88361-3_12.
Skeletal muscle's metabolic and mechanical functions make it critical for maintaining human health, physical function, and quality of life in adults. The impact of skeletal muscle mass and the metabolic quality of muscle tissue becomes even more critical with advancing age and in patients with chronic diseases. To this end, cachexia is the involuntary loss of body weight, including muscle and fat loss, accompanying an underlying disease or condition. Cancer-induced cachexia occurs across many types of cancer and contributes to increased patient mortality, morbidity, and treatment toxicities, negatively impacting survival. Furthermore, there are currently no approved pharmacological treatments and limited evidence-based therapeutic options to prevent muscle loss or promote muscle recovery in cancer patients. While the systemic effects of cancer and subsequent treatment continue to be examined as drivers of overall wasting, the impact of skeletal muscle mass and metabolic quality in the cancer patient remains a critical area of investigation. A vital knowledge gap exists in understanding how maintaining muscle function and metabolic properties improves cancer patients' survival. The chapter explores the current understanding of how cancer and subsequent treatment impact skeletal muscle mass, function, and metabolic quality. To this end, the current understanding of systemic mediators and metabolic crosstalk between tissues that promote cancer-induced wasting is explored. Additional factors related to sex, physical activity level, chemotherapy-specific effects, and cancer heterogeneity are discussed concerning their impact on cancer-induced muscle wasting.
骨骼肌的代谢和机械功能对于维持成年人的身体健康、身体机能及生活质量至关重要。随着年龄的增长以及在慢性病患者中，骨骼肌质量和肌肉组织代谢质量的影响变得愈发关键。为此，恶病质是指伴随潜在疾病或状况而出现的体重非自愿性减轻，包括肌肉和脂肪流失。癌症诱发的恶病质在多种类型的癌症中都会发生，并导致患者死亡率、发病率上升以及治疗毒性增加，对生存产生负面影响。此外，目前尚无获批的药物治疗方法，且在预防癌症患者肌肉流失或促进肌肉恢复方面，基于证据的治疗选择有限。虽然癌症及后续治疗的全身效应作为整体消瘦的驱动因素仍在研究之中，但骨骼肌质量和代谢质量在癌症患者中的影响仍是一个关键的研究领域。在理解维持肌肉功能和代谢特性如何提高癌症患者生存率方面，存在着重要的知识空白。本章探讨了目前对于癌症及后续治疗如何影响骨骼肌质量、功能和代谢质量的理解。为此，探讨了目前对于促进癌症诱发消瘦的全身介质以及组织间代谢相互作用的理解。还讨论了与性别、身体活动水平、化疗特异性效应和癌症异质性相关的其他因素对癌症诱发肌肉消瘦的影响。
