Dénutrition, cachexie et cancer

The clinical syndrome associated with anorexia, muscle wasting and depletion of fat stores is referred to as cancer cachexia. Several underlying mechanisms of anorexia, stick as food aversions, dysphagia, mucositis, delayed digestion. Intestinal atrophy have been proposed. The exact mechanims of action and the respective responsability of cytokines and other humoral mediators such as lipid mobilizing factors and proteoglycans remain unclear. Energy expenditure is usually elevated in cancer, carbohydrate metabolism is characterized by increased glucose turnover and insulin resistance, depletion of fat stores with hyperlipidemia are common. Alterations in specific protein metabolism include increased protein turnover, decreased skeletal muscle protein synthesis, increased hepatic protein synthesis with repriorization of acute phase reactant poduction and host nitrogen depletion. To date, there have been little success related to therapeutic manipulations of these pathways.