title: Mechanism and novel therapeutic approaches to wasting in chronic disease.
abstract: Cachexia is a multifactorial syndrome defined by continuous loss of skeletal muscle mass - with or without loss of fat mass - which cannot be fully reversed by conventional nutritional support and which may lead to progressive functional impairment and increased death risk. Its pathophysiology is characterized by negative protein and energy balance driven by a variable combination of reduced food intake and abnormal metabolism. Muscle wasting is encountered in virtually all chronic disease states in particular during advanced stages of the respective illness. Several pre-clinical and clinical studies are ongoing to ameliorate this clinical problem. The mechanisms of muscle wasting and cachexia in chronic diseases such as cancer, chronic heart failure, chronic obstructive pulmonary disease and chronic kidney disease are described. We discuss therapeutic targets and such potential modulators as appetite stimulants, selective androgen receptor modulators, amino acids and naturally occurring peptide hormones.
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité-University, Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ebner
authors.forename: Jochen
authors.initials: J
authors.lastname: Springer
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
authors.forename: Wolfram
authors.initials: W
authors.lastname: Doehner
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
mesh_terms: D000596:Amino Acids / Q000627:therapeutic use; D019167:Appetite Stimulants / Q000627:therapeutic use; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology; D002908:Chronic Disease / Q000188:drug therapy*; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy; D006801:Humans; D009133:Muscular Atrophy / Q000188:drug therapy* / Q000209:etiology; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D036361:Peptide Hormones / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy; D019282:Wasting Syndrome / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000596:Amino Acids; D019167:Appetite Stimulants; D036361:Peptide Hormones