Abstract
Advanced cancer patients exhibit cachexia, a condition characterized by a significant reduction in the body weight predominantly from loss of skeletal muscle and adipose tissue. Cachexia is one of the major causes of morbidity and mortality in cancer patients. Decreased food intake and multi-organ energy imbalance in cancer patients worsen the cachexia syndrome. Cachectic cancer patients have a low tolerance for chemo- and radiation therapies and also have a reduced quality of life. The presence of tumors and the current treatment options for cancer further exacerbate the cachexia condition, which remains an unmet medical need. The onset of cachexia involves crosstalk between different organs leading to muscle wasting. Recent advancements in understanding the molecular mechanisms of skeletal muscle atrophy/hypertrophy and adipose tissue wasting/browning provide a platform for the development of new targeted therapies. Therefore, a better understanding of this multifactorial disorder will help to improve the quality of life of cachectic patients. In this review, we summarize the metabolic mediators of cachexia, their molecular functions, affected organs especially with respect to muscle atrophy and adipose browning and then discuss advanced therapeutic approaches to cancer cachexia.
Keywords:
Adipose tissue browning; Cachexia; Cancer; Cytokines; Mediators; Skeletal muscle wasting.
Copyright © 2020. Published by Elsevier B.V.
Publication types
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Research Support, N.I.H., Extramural
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Review
MeSH terms
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Adipose Tissue / drug effects
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Adipose Tissue / metabolism
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Adipose Tissue / pathology
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Adipose Tissue / radiation effects
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Antineoplastic Agents / adverse effects
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Appetite Stimulants / pharmacology
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Appetite Stimulants / therapeutic use*
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Bone and Bones / drug effects
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Bone and Bones / metabolism
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Bone and Bones / pathology
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Bone and Bones / radiation effects
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Cachexia / etiology
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Cachexia / metabolism
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Cachexia / pathology*
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Cachexia / therapy
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Cytokines / metabolism
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Dietary Supplements
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Energy Metabolism / drug effects
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Energy Metabolism / radiation effects
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Glucocorticoids / metabolism
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Humans
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Intercellular Signaling Peptides and Proteins / metabolism
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Intestinal Mucosa / drug effects
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Intestinal Mucosa / metabolism
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Intestinal Mucosa / pathology
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Intestinal Mucosa / radiation effects
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Liver / drug effects
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Liver / metabolism
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Liver / pathology
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Liver / radiation effects
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Muscle, Skeletal / drug effects
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Muscle, Skeletal / metabolism
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Muscle, Skeletal / pathology
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Muscle, Skeletal / radiation effects
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Muscular Atrophy / etiology
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Muscular Atrophy / metabolism
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Muscular Atrophy / pathology*
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Neoplasms / complications*
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Neoplasms / therapy
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Nutritional Support / methods*
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Pancreas / drug effects
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Pancreas / metabolism
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Pancreas / pathology
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Pancreas / radiation effects
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Parathyroid Hormone / metabolism
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Parathyroid Hormone-Related Protein / metabolism
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Quality of Life
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Radiotherapy / adverse effects
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Weight Gain / drug effects
Substances
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Antineoplastic Agents
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Appetite Stimulants
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Cytokines
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Glucocorticoids
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Intercellular Signaling Peptides and Proteins
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Parathyroid Hormone
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Parathyroid Hormone-Related Protein