Pharmacological approaches to ameliorating catabolic conditions.
OBJECTIVE
Nutritional debilitation is among the most devastating and life-threatening aspect of various diseases. It arises from a complex interaction between the illness and the host. This process includes cytokine production, release of lipid-mobilizing and proteolysis-inducing factors, and alterations in intermediary metabolism. As a result, many patients develop cachexia with progressive body fat and muscle tissue wasting with associated worsening of their clinical status and a lower quality of life. In this review, up-to-date information about different approaches to pharmacologic management of cachexia will be addressed.


RESULTS
Until recently, the two major options for pharmacological therapy were either progestational agents or corticosteroids. Knowledge of the mechanisms of cachexia, however, has led to newer therapeutic interventions for treating several aspects of the syndrome. These include antiserotonergic agents, branched-chain amino acids, eicosapentaenoic acid, cannabinoids, melatonin, and thalidomide--all of which act on the feeding-regulatory circuitry to increase appetite and inhibit illness-derived catabolic factors.


CONCLUSIONS
Information from this review will guide health care providers in limiting weight loss and improving performance status of cachectic patients through pharmacological therapy, with the hope that such therapy will extend patients' survival and improve their qualities of life.
Elamin
Elamin M
EM
University of South Florida, College of Medicine, Tampa, Florida 33612-4799, USA. eelamin@health.usf.edu
Glass
Maresa
M
Camporesi
Enrico
E
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000818:Animals; D000855:Anorexia / Q000150:complications / Q000188:drug therapy*; D002100:Cachexia / Q000150:complications / Q000188:drug therapy*; D004734:Energy Metabolism / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D011372:Progestins / Q000627:therapeutic use*; D011788:Quality of Life; D019282:Wasting Syndrome / Q000188:drug therapy* / Q000209:etiology
D000305:Adrenal Cortex Hormones; D011372:Progestins