Mechanisms of Anorexia Cancer Cachexia Syndrome and Potential Benefits of Traditional Medicine and Natural Herbs
Mechanisms of Anorexia Cancer Cachexia Syndrome and Potential Benefits of Traditional Medicine and Natural Herbs
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DOI：
10.2174/1389201017666161018123311
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发表时间：
2016-01-01
影响因子：
2.8
通讯作者：
Yu Lei
中科院分区：
文献类型：
--
作者：
Cong Ming-Hua;Zou Bao-Hua;Yu Lei
厌食癌性恶病质综合征是晚期癌症患者的常见病，其特征是厌食、饮食摄入减少、体重减轻（骨骼肌质量减轻），常规营养支持治疗无法逆转。到目前为止，参与癌症恶病质的主要机制包括过度的全身性炎症，其表现为IL-1、IL-6、TNF-α、肿瘤诱导因子如PIF和LMF的血浆水平升高。这些因素最终作用于下丘脑的食欲和食欲抑制神经元或外周组织的蛋白质和脂质代谢，导致食欲减退、摄食量减少、基础代谢率提高和高钙血症。治疗方式包括早期营养干预、体力活动和药物治疗。然而，关于用于治疗恶病质的药物的研究总是有争议的，或者仅仅是有效地刺激食欲和增加体重，而不是瘦体重。药物治疗的主要目标是改善食欲，减少全身炎症和促进合成代谢。然而，化学药物治疗恶病质的有效性在现有的指南中尚未达成共识。补充和替代医学（CAM）是近年来被认为是一种有前途的治疗，以改善恶病质的状态和癌症患者的生活质量。传统中药和天然草药在世界范围内，特别是在中国，用于治疗癌症已有数千年的历史。越来越多的研究表明，传统汉方及一些天然药物具有拮抗促炎细胞因子、增强免疫系统、抑制蛋白质代谢、增加食欲、增加体重等作用，且副作用小，有望成为治疗厌食癌恶病质综合征的一种有前景的治疗策略和发展趋势。
Anorexia cancer cachexia syndrome is prevalent in advanced cancer patients, which is featured by anorexia, decreased dietary intake, body weight loss (skeletal muscle mass loss), and is unable to be reversed by routine nutritional support therapy. Up to now, the main mechanisms involved in cancer cachexia include excessive systemic inflammation, which is represented by increased plasma levels of IL-1, IL-6, TNF-alpha, tumor-induced factors, such as PIF and LMF. These factors eventually act on orexigenic and anorexigenicneurons located in the hypothalamus or protein and lipid metabolism of peripheral tissues, which lead to anorexia, decreased dietary intake, enhanced basic metabolism rate and hypercatabolism. The treatment modality includes early nutritional intervention, physical activity and drug treatment. However, studies about drugs used to treat cachexia are always controversial or merely effective in stimulating appetite and increasing body weight, though not lean body mass. The main target of pharmaceutical treatment is to improve appetite, decrease systemic inflammation and promote anabolic metabolism. Nevertheless, the treatment effectiveness of chemical drugs are not reaching consensus by existing cachexia guidelines. Complementary and alternative medicine (CAM) is recently known as a promising treatment to improve cachaxia status and quality of life of cancer patients. Traditional Chinese medicine (TCM) and natural herbal medicines have been used in the treatment of cancer for thousands of years worldwide, particularly in China. More and more research show that traditional Hanfang (Chinese medicines) and some natural herbs with less side reactions, have the effects of antagonizing pro-inflammatory cytokines, enhancing immune system, inhibiting protein catabolism, boosting the appetite and body weight, which maybe a promising treatment strategy and development tendency for anorexia cancer cachexia syndrome.