title: Immunomodulatory agents for the treatment of cachexia.
abstract: OBJECTIVE
  In patients with advanced cancer, AIDS and end-stage organ diseases, symptoms of cachexia syndrome include decrease in appetite, weight loss, decreased performance status, and an increase in the systemic inflammatory response. Inflammatory cytokines and other immune interactions affect the lean tissue mass and body fat. It is hopeful that modulation of these inflammatory interactions may contribute to the delay in the development and treatment of cachexia. This review summarizes the current state of the art.
  
  
  RESULTS
  This article covers the role of inflammatory response in cachexia, measurement of inflammatory response, mechanism and measurement of cachexia, immunomodulation in cancer, drugs targeting inflammatory cytokines, effect of exercise in cachexia, and treatment of cancer cachexia using immunomodulatory agents.
  
  
  CONCLUSIONS
  Understanding the immune response associated with cachexia may improve future pharmacological modification of the cytokines. In addition, the multifactorial contributions to the mechanisms of cachexia indicate that a multimodal approach may be necessary to treat cachexia and its associated symptoms.
authors.affiliation: aDivision of Palliative Care, Élisabeth-Bruyère Hospital bDepartment of Medicine, University of Ottawa cBruyère Research Institute dDepartment of Medicine, The Ottawa Hospital, Ottawa, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Chasen
authors.forename: Ravi
authors.initials: R
authors.lastname: Bhargava
authors.forename: Shalom
authors.initials: S
authors.lastname: Hirschman
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001066:Appetite; D002097:C-Reactive Protein / Q000032:analysis; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology*; D016207:Cytokines / Q000494:pharmacology*; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use; D015444:Exercise; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000378:metabolism; D007371:Interferon-gamma / Q000378:metabolism; D009133:Muscular Atrophy / Q000378:metabolism; D009369:Neoplasms / Q000150:complications*; D026741:Physical Therapy Modalities; D013792:Thalidomide / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016207:Cytokines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007155:Immunologic Factors; D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; D013792:Thalidomide; D007371:Interferon-gamma; D002097:C-Reactive Protein; D015118:Eicosapentaenoic Acid