Recent Developments in Treatment of Cachexia

Abstract

The cachexia syndrome, present in severe diseases such as cancer, AIDS and COPD, typically displays metabolic abnormalities, such as glucose intolerance, fat depletion and muscle protein catabolism and is usually accompanied by anorexia and, naturally, weight loss. Inflammation is also a key feature in this situation. Nutritional strategies have proved to be insufficient to counteract it. In this chapter we review recent therapeutic approaches developed specifically for these wasting states. The importance of the right timing is stressed, in combination with different nutritional/metabolic/pharmacological approaches.

Key Terms and Definitions

Cachexia:

Physical wasting associated with loss of body weight and muscle mass, and often associated to severe diseases.

Muscle wasting:

Loss of muscle mass caused either by disease or by lack of use, with corresponding decreases in strength and mobility.

Myostatin:

Growth differentiation factor involved in the regulation of muscle size, being a potent inhibitor of muscle growth since embryonic development and throughout life.

Ghrelin:

Peptide hormone produced by epithelial cells lining the fundus of the stomach and epsilon cells of the pancreas that is a stimulant of appetite and feeding, and also a stimulator of growth hormone secretion.

Cytokines:

Regulatory proteins mainly released by immune cells and that act as intercellular mediators in the generation of the immune response, although some of them also have important metabolic effects.