NPY and brain monoamines in the pathogenesis of cancer anorexia
NPY and brain monoamines in the pathogenesis of cancer anorexia
复制标题
DOI：
10.1016/j.nut.2008.06.005
复制
发表时间：
2008-09-01
期刊：
影响因子：
4.4
通讯作者：
Rossi Fanelli, Filippo
中科院分区：
文献类型：
--
作者：
Laviano, Alessandro;Inui, Akio;Rossi Fanelli, Filippo
癌症厌食症经常是癌症患者临床征程的特征，并影响患者的发病率、死亡率和生活质量。一系列症状与厌食症的诊断一致，早饱、味觉/气味变化和恶心是更常见的报告。癌症厌食症的发病机制是多因素的，但越来越多的证据表明，下丘脑黑素皮质素和神经肽Y系统对外周输入产生抵抗。这会导致黑素皮质素活性增加，神经肽Y功能降低，从而导致分解代谢刺激的促进(即减少能量摄入，增加能量消耗，可能增加肌肉蛋白分解，以及脂肪组织损失)。有趣的是，下丘脑促炎症细胞因子和5-羟色胺等因素是触发下丘脑抵抗的关键。在临床环境中，癌症厌食症的发展具有不同的表现症状(即早饱和/或恶心和/或口味变化)和不同程度的严重程度。现有证据表明，这种综合征的一系列症状应被认为是慢性炎症状态下常见神经化学/代谢改变的不同表型，至少部分如此。(C)2008 Elsevier Inc.保留所有权利。
Cancer anorexia frequently characterizes the clinical journey of patients with cancer and affects patients' morbidity, mortality, and quality of life. A constellation of symptoms concur to the diagnosis of anorexia, and early satiety, changes in taste/smell, and nausea are the more frequently reported. The pathogenesis of cancer anorexia is multifactorial, but accumulating evidence indicates that the hypothalamic melanocortin and neuropeptide Y systems become resistant to peripheral inputs. This results in increased melanocortin activity and reduced neuropeptide Y function, thereby leading to the promotion of catabolic stimuli (i.e., reduced energy intake, increased energy expenditure, possibly increased muscle proteolysis, and adipose tissue loss). Interestingly, hypothalamic proinflammatory cytokines and serotonin, among other factors, are key in triggering hypothalamic resistance. In the clinical setting, cancer anorexia develops with heterogeneous presenting symptoms (i.e., early satiety and/or nausea and/or changes of taste) and varying degrees of severity. Available evidence suggests that the constellation of symptoms characterizing this syndrome should be considered, at least in part, as different phenotypes of common neurochemical/metabolic alterations in the presence of a chronic inflammatory state. (C) 2008 Elsevier Inc. All rights reserved.