title: Dietary and pharmacological management of severe catabolic conditions.
abstract: BACKGROUND
  Nutritional debilitation is among the most devastating and life-threatening complications of cancers and various chronic 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 agents 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. This review will provide up-to-date information about different pharmacological management of cachexia.
  
  
  RESULTS
  Until recently, the 2 major options for pharmacological therapy have been either progestational agents or corticosteroids. However, knowledge of the mechanisms of cachexia has led to newer therapeutic interventions for treating several aspects of the syndrome. These include antiserotonergic agents, branched-chain amino acids, eicosapentanoic acid, melanocortin antagonists and antimyostatin agents-all of which act on the feeding-regulatory circuitry to increase appetite and inhibit illness-derived catabolic elements.
  
  
  CONCLUSIONS
  Information from this review will guide health care providers in limiting weight loss and improve performance status of the cachectic patients through dietary and pharmacological therapy, with the hope that such approach would extend patients survival and improve their quality of life.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine Section, James A. Haley Veterans Hospital, Tampa, Florida 33612, USA. eelamin@health.usf.edu
authors.forename: E
authors.initials: E
authors.lastname: Elamin
mesh_terms: D000855:Anorexia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D002100:Cachexia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D004035:Diet Therapy; D004734:Energy Metabolism; D006801:Humans