Newsletter

[ Vol. 13 No. 2 ] (May - August 2012 )
Anabolic and catabolic effects on muscle in cancer patients

Rémy Meier
University Clinic, Liestal, Switzerland (Switzerland)

Cancer cachexia and muscle wasting is a complex metabolic disease with a dysbalance of decreased anabolic and increased catabolic factors. In addition, it is an inflammatory disease. Muscle wasting is always seen in progressive cancer patients. A decrease in muscle mass has negative consequences for the host. Tumor mediators (cytokines, prostaglandines, interferons, proteolysing inducing factors [PIF]) change the metabolism of proteins, lipids and carbohydrates. TNF-α, prostaglandines,PIE effect muscle wasting is due to an increase of degradation and a decrease in muscle synthesis.

The most important pathway for intracellular protein breakdown in skeletal muscle is the ATP-Ubiquitin Proteosome Proteolytic Pathway (UPP). The stimulation of UPP is associated with proteolysis. In addition due to inflammation and stimulation of NF-_kB protein synthesis is decreased. Among a lot of proposed agents influencing protein breakdown in cancer patients, the most promising are non steroidal inflammatory drugs, fish oil, branched chain amino acids. In addition, ATP and TNF-αinhibitors are interesting, but are not studied in detail yet. Until now, there are promising studies available to interfere with the muscle breakdown using non-steroidal inflammatory drugs, fish oil and branched chain amino acids. Down regulation the proinflammatory tumor related mediators seems to be the most important approach to treat muscle wasting and cancer cachexia. Further clinical trials with this agents alone or in combinations are needed.

From  
The 14^th Congress of Parenteral and Enteral Nutrition Society of Asia
“From Nutrition Support to Nutrition Therapy”
October 14-16, 2011, Taipei, Taiwan 
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