Abstract
Body weight loss, mostly due to the wasting of skeletal muscle and adipose tissue, is the hallmark of the so-called cachexia syndrome. Cachexia is associated with several acute and chronic disease states such as cancer, chronic obstructive pulmonary disease (COPD), heart and kidney failure, and acquired and autoimmune diseases and also pharmacological treatments such as chemotherapy. The clinical relevance of cachexia and its impact on patients’ quality of life has been neglected for decades. Only recently did the international community agree upon a definition of the term cachexia, and we are still awaiting the standardization of markers and tests for the diagnosis and staging of cancer-related cachexia. In this review, we discuss cachexia, considering the evolving use of the term for diagnostic purposes and the implications it has for clinical biomarkers, to provide a comprehensive overview of its biology and clinical management. Advances and tools developed so far for the in vitro testing of cachexia and drug screening will be described. We will also evaluate the nomenclature of different forms of muscle wasting and degeneration and discuss features that distinguish cachexia from other forms of muscle wasting in the context of different conditions.
Highlights
Cachexia is a multifactorial syndrome characterized by body weight loss, declining muscle mass and function, wasting, and inflammation of adipose tissues accompanied by metabolic disarrangement, anorexia, systemic inflammation, and insulin resistance
Since body weight loss is the main feature of malnutrition, and systemic inflammation is present in the vast majority of the patients affected by chronic degenerative diseases [7], a unified definition for the clinical management of cachexia based on the nutritional status, as well as on the inflammatory background of the patients, was proposed in 2010
The use of a correct, distinct, and widely recognized definition of cachexia syndrome is central for the identification of a muscle-wasting condition that has been neglected for decades while being responsible for a significant percentage of deaths
Summary
Emanuele Berardi 1,2,† , Luca Madaro 3,† , Biliana Lozanoska-Ochser 3, Sergio Adamo 3 , Lieven Thorrez 1 , Marina Bouche 3,* and Dario Coletti 3,4.
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