Interaction of Cytokines and Functional Status

Recently, a body of evidence has emerged suggesting that functional decline is associated with an excess production of cytokines. Cytokines are cell-associated proteins produced and secreted by inflammatory cells. They have the capacity to act at low concentrations on other cells, both locally and systematically, via specific cell receptors. Cytokines act principally in a paracrine fashion, and their concentrations in tissues are often several times higher than those found in the peripheral...

Physiological Causes of Weight Loss in the Elderly

The regulation of food intake changes with age and involve mechanisms that are complex and multifactorial, making the treatment of weight loss more challenging. Weight loss and poor food intake in the elderly may be due to the following 10,11 (Tables 1,2) 1. Changes associated with normal aging (reduced basal hunger, decreased gastric emptying time, failure to adjust food intake after periods of overfeeding or underfeeding) 2. Endocrine disturbances (hyperthyroidism, hyperparathyroidism,...

AntiTNFa Treatment of Cancer Cachexia

Several studies have demonstrated the role of anti-TNF-a treatment in animal models of cachexia. Sherry et al. studied the effect of anti-TNF-a immunoglobulin treatment in C57B1 6 mice bearing a methylcholanthrene-induced sarcoma that produced TNF-a. The anti-TNF-a treatment resulted in a significant reduction of weight loss, protein loss and fat loss. It was concluded that neutralising endogenous TNF-a production with antibodies offers the potential to reduce tissue wasting associated with...

Pathophysiology of Immune Response

The immune system the cells and the molecules responsible for immunity is defined as part of the host's defence against destructive forces either from outside the body e.g., bacteria, viruses and parasites or from within e.g., malignant and autoreactive cells . Innate natural immune defences are those components of the immune system macrophages, monocytes and neu-trophils that function without relying on prior exposure to a particular antigen. They are the early phases of the host defence that...

Acquired Partial Lipodystrophy Barraquer Simons Syndrome

Acquired partial lipodystrophy APLD was first described by Mitchell in 1885 7 as a 'singular case of absence of adipose tissue in the upper part of the body,' and then as segmental atrophy of the subcutaneous fat layer by Barraquer 8 in 1907, and as 'lipodystrofia progressiva' by Simons in 1911 9 . APLD is phenotypically characterised by a loss of fat in the upper body segment, namely, in the face, trunk, and arms. In the lower body segment, the subcutaneous fat depots are spared or even...

Lipid Metabolism in Cachexia

In this chapter we will review the alterations of lipoprotein metabolism observed in cachexia. Other aspects of lipid metabolism in cachexia, in particular those regarding adipose tissue, are covered in other chapters. Lipoproteins are macro-molecules circulating in blood and they are quite easily measured in the clinical chemistry laboratory. For this reason lipoproteins can be used to monitor the alterations of lipid metabolism in several clinical conditions, including cachexia. All lipids,...

Cachexia Related to Multiple Causes

Despite the long and widespread interest in this topic, there is not an univocal definition for cachexia 1 . The term derives from the Greek kakos, which means 'bad,' and from hexis, meaning 'condition.' The clinical syndrome of cachexia is characterised by anorexia, tissue wasting, loss of body weight accompanied by a decrease in muscle mass and adipose tissue, and poor performance status that often precedes death 2-5 . Cachexia can occur as part of many chronic or end-stage diseases, such as...