Cachexia, survival and the acute phase response.
Cachexia, survival and the acute phase response.
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DOI：
10.1097/spc.0b013e3283186be2
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发表时间：
2008-12-01
影响因子：
2.1
通讯作者：
Fearon, Kenneth C H
中科院分区：
文献类型：
--
作者：
Stephens, Nathan A;Skipworth, Richard J E;Fearon, Kenneth C H
综述目的：综述细胞因子、急性时相反应(APR)与恶病质发生发展之间的关系。研究结果：细胞因子在急性时相反应(APR)的启动中起重要作用，在恶病质的发生中也起重要作用。已知APR的存在或高水平的促炎细胞因子与癌症患者的不良结局有关。宿主细胞因子基因分型的研究表明，特定宿主细胞因子基因多态与恶病质的发生和患者存活率的降低有关。为了能够准确地预测癌症患者的生存时间，人们描述了各种基于APR的预后评分系统。总结：恶病质是一个重要的临床问题，影响多达三分之二的癌症患者。它是由厌食和代谢变化引起的，并导致脂肪组织和瘦体重的损失，特别是在骨骼肌间室。一半的癌症患者出现APR，临床上最常见的是血浆C反应蛋白浓度升高。不良结局和生存期缩短与急性呼吸窘迫综合征的存在有关。本文探讨了癌症恶病质中APR的原因和后果。
PURPOSE OF REVIEW: To review current knowledge of the relationship between cytokines, the acute phase response (APR) and the development of cachexia.RECENT FINDINGS: Cytokines important in the initiation of the APR are also important in the genesis of cachexia. The presence of an APR or high circulating levels of pro-inflammatory cytokines are known to be related to adverse outcome in cancer patients. Studies of host cytokine genotype have demonstrated that specific host cytokine polymorphisms are associated with both the development of cachexia and reduced patient survival. The desire to be able to predict accurately survival in cancer patients has led to the description of various APR-based prognostic scoring systems.SUMMARY: Cachexia is an important clinical problem affecting up to two thirds of cancer patients. It results from anorexia and metabolic change and leads to loss of both adipose tissue and lean body mass, particularly in the skeletal muscle compartment. An APR is seen in half of cancer patients at presentation, and is most often determined clinically by raised plasma C-reactive protein concentrations. Adverse outcome and shortened survival have been linked to the presence of an APR. This article explores the cause and consequences of the APR in cancer cachexia.