Abstract
Cachexia occurs in many chronic diseases and is associated with increased morbidity and mortality. It is treated by nutritional support but often with limited effectiveness, leading to the search of other therapeutic strategies. The modulation of gut microbiota, whether through pro-, pre-, syn- or antibiotics or fecal transplantation, is attracting ever-growing interest in the field of obesity, but could also be an interesting and innovative alternative for treating cachexia. This article reviews the evidence linking the features of malnutrition, as defined by the Global Leadership Initiative on Malnutrition [low body mass index (BMI), unintentional body weight loss, low muscle mass, low appetite, and systemic inflammation] and the gut microbiota in human adults with cachexia-associated diseases, and shows the limitations of the present research in that field with suggestions for future directions.
Highlights
Cachexia is “a multifactorial syndrome characterized by a progressive loss of body weight and skeletal muscle mass” (Evans et al, 2008)
Some features of cachexia may differ from other types of malnutrition, the authors recommend using these clinical diagnostic criteria whatever the type of malnutrition, as the priority is to determine whether a patient needs nutritional support
This article reviews the evidence linking the features of malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM) and the gut microbiota in human adults with cachexia-associated diseases, and shows the limitations of the present research in that field with suggestions for future directions
Summary
Cachexia is “a multifactorial syndrome characterized by a progressive loss of body weight and skeletal muscle mass” (Evans et al, 2008) This term is mostly used in the context of cancer, cachexia can be found in other chronic diseases as for instance chronic obstructive pulmonary disease, chronic heart, kidney, or liver failure, AIDS and rheumatoid arthritis (Muscaritoli et al, 2010). The Global Leadership Initiative on Malnutrition (GLIM), which involves experts of several nutritional societies from all over the world, recommended to diagnose malnutrition with at least one phenotypic criterion [low body mass index (BMI), unintentional weight loss, or decreased muscle mass] and one etiologic criterion (reduced food intake or assimilation, disease burden or inflammatory state) (Cederholm et al, 2018; Jensen et al, 2019). Some features of cachexia may differ from other types of malnutrition (for instance the inherent inclusion of disease burden in cachexia), the authors recommend using these clinical diagnostic criteria whatever the type of malnutrition, as the priority is to determine whether a patient needs nutritional support
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