Cachexia – The Interplay Between the Immune System, Brain Control and Metabolism

摘要: Systemic inflammation involves powerful immune response that interferes with homeostatic regulation of many physiological processes including those controlling appetite and nutritional balance. In advanced chronic diseases, such as obstructive pulmonary disease (COPD), rheumatoid arthritis, infection or sepsis, renal failure, heart failure cancer, the is frequently exaggerated insofar it ultimately leads to a severe debilitating state known cachexia. It well this condition deteriorates quality life predicts increased morbidity mortality. According recent definition, cachexia characterized complex metabolic syndrome associated loss body weight. condition, inflammation, anorexia, insulin resistance muscle protein breakdown are present result in depletion skeletal without fat mass (Evans et al., 2008). These hallmarks considerably distinguish from other conditions also catabolic/anabolic imbalance composition disorders (e.g. starvation, dehydratation, sarcopenia, malabsorption, hyperthyroidism lipoatrophy). At present, despite clinical relevance an increasing interest scientists clinicians topic, its causal mechanisms not yet completely understood. There large evidence crucial factor pathogenesis Since proinflammatory cytokines, tumor necrosis factor-alpha (TNF-┙), interleukin (IL)-1, IL-6, able modulate brain functions, dysregulate hormone levels cause disturbances, these molecules paramount importance. Nonetheless, multidimensional nature apparent process very one underlying do encompass only but rather cytokines along inflammatory mediators, hormones, neurotransmitters factors. This chapter reviews current knowledge about role catabolism main features human diseases their experimental animal models. The presented insight into intertwined immune, neuroendocrine pathways contributing may lead better understanding pathological phenomenon appearing possible directions for future research.