Protection of metabolic and exercise capacity following treatment with recombinant erythropoietin
Anemia in cancer disease is usually regarded a consequence of disease progression explained by several factors, but may as well be a contributing factor and promoter behind the progression of wasting in cancer patients (Mittelman 1996; Moliterno and Spivak 1996; Bertero and Caligaris-Cappio 1997). This unusual concept goes back to our previous studies, which have revealed both increased adrenergic activity and sensitivity in cancer patients (Drott et al. 1989), a phenomenon probably related to the cardiovascular system as indicated by either elevated resting heart rate and increased excretion of stress hormones in cancer patients with progressive weight loss, as well as altered cardiac adrenoceptor expression in heart tissue from tumor bearing animals (Drott et al. 1987, 1988; Hyltander et al. 1991). Results from our laboratory have, thus, suggested anemia as a promoter behind increased energy expenditure in cancer patients, although anemia is also an integrated part of the host systemic inflammation in cancer (Fig. 1A,B,C). However, it has never been evaluated whether anti-inflammatory treatment in itself, by reducing cytokine production, would be sufficient to prevent or attenuate anemia to any significant extent in patients with progressive cancer disease (Nieken et al. 1995). Our recent data suggest that anti-inflammatory treatment can attenuate resting energy expenditure in weight-losing cancer patients, in agreement with findings that provision of fish oils attenuates
KeywordsExercise Capacity Lean Body Mass Rest Energy Expenditure Blood Hemoglobin Recombinant Erythropoietin
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