RESUMO
Cachexia, a paraneoplastic syndrome markedly associated with worsened prognosis in cancer patients, provokes profound wasting of both lean and adipose mass in an association with a state of metabolic "chaos". The white adipose tissue responds to cachexia with marked local inflammation and may be thus a relevant contributor to systemic inflammation. To address this hypothesis we examined the correlation between tissue expression of adipokines and plasma concentration in cachectic and stable weight patients with or without cancer. Adiponectin and liver-derived CRP concentration were significantly higher in the cachectic groups when compared with stable weight patients (P<0.01). The concentration of plasma IL-6 was higher (11.4-fold) in the cancer cachectic group when compared with weight-stable controls, and presented a significant correlation with the presence of cancer (P<0.001). A marked increase (5-fold) in IL-6 as a result of the interaction between the presence of cachexia and the presence of tumour was observed in the subcutaneous tissue of the patients, yet not in the visceral depot. Plasma adiponectin levels were higher in cachectic cancer patients, compared with stable weight cancer patients individually matched by age, sex, and BMI, and the subcutaneous depot was found to be the main contributing tissue, rather than the visceral pad. Based on the results we concluded that the subcutaneous adipose tissue is associated with plasma changes that may function as markers of cachexia.
Assuntos
Tecido Adiposo/metabolismo , Biomarcadores Tumorais/sangue , Caquexia/sangue , Neoplasias/sangue , Adiponectina/sangue , Adiponectina/genética , Tecido Adiposo/patologia , Idoso , Caquexia/complicações , Caquexia/patologia , Feminino , Regulação da Expressão Gênica , Humanos , Mediadores da Inflamação/metabolismo , Interleucina-10/genética , Interleucina-10/metabolismo , Interleucina-6/sangue , Interleucina-6/genética , Leptina/genética , Leptina/metabolismo , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/complicações , Neoplasias/patologia , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Cancer cachexia is a multifaceted syndrome whose aetiology is extremely complex and is directly related to poor patient prognosis and survival. Changes in lipid metabolism in cancer cachexia result in marked reduction of total fat mass, increased lipolysis, total oxidation of fatty acids, hyperlipidaemia, hypertriglyceridaemia, and hypercholesterolaemia. These changes are believed to be induced by inflammatory mediators, such as tumour necrosis factor-α (TNF-α) and other factors. Attention has recently been drawn to the current theory that cachexia is a chronic inflammatory state, mainly caused by the host's reaction to the tumour. Changes in expression of numerous inflammatory mediators, notably in white adipose tissue (WAT), may trigger several changes in WAT homeostasis. The inhibition of adipocyte differentiation by PPARγ is paralleled by the appearance of smaller adipocytes, which may partially account for the inhibitory effect of PPARγ on inflammatory gene expression. Furthermore, inflammatory modulation and/or inhibition seems to be dependent on the IKK/NF-κB pathway, suggesting that a possible interaction between NF-κB and PPARγ is required to modulate WAT inflammation induced by cancer cachexia. In this article, current literature on the possible mechanisms of NF-κB and PPARγ regulation of WAT cells during cancer cachexia are discussed. This review aims to assess the role of a possible interaction between NF-κB and PPARγ in the setting of cancer cachexia as well as its significant role as a potential modulator of chronic inflammation that could be explored therapeutically.
Assuntos
Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Caquexia/complicações , Núcleo Celular/metabolismo , Inflamação/complicações , Neoplasias/complicações , Fatores de Transcrição/metabolismo , Animais , Caquexia/patologia , Humanos , Inflamação/patologia , Neoplasias/patologiaRESUMO
Chemoreflex activation with potassium cyanide (KCN, i.v.) produces pressor and bradycardic responses in awake rats in addition to the tachypneic response. In the present study we evaluated the role of the paraventricular nucleus of the hypothalamus (PVN) in the cardiovascular responses to chemoreflex activation in awake rats. Bilateral electrolytic lesion of the PVN was performed 1 day before chemoreflex activation and the results were compared to those obtained with sham-lesioned rats. Bilateral electrolytic lesion of the PVN (n=6) produced a significant reduction in both the magnitude (+51+/-5 vs. +22+/-2 mmHg) and duration (+26+/-5 vs. +6+/-2 s) of the pressor response to chemoreflex activation when compared to sham-lesioned rats (n=10). The bradycardic response to chemoreflex activation in rats with bilateral lesion of the PVN was not significantly different from the response of sham-lesioned rats (-229+/-20 vs. -88+/-76 bpm). Unilateral or partial bilateral lesion of the PVN (n=10) produced no significant changes in the pressor response (+51+/-5 vs. +49+/-3 mmHg), in the duration of the response (+26+/-5 vs. +18+/-3 s) or in the bradycardic response (-229+/-20 vs. -230+/-27 bpm) compared to sham-lesioned rats. The data show that effective bilateral lesion of the PVN produced a significant reduction in the magnitude and duration of the pressor response, indicating that the PVN plays a key role in the processing of the sympathoexcitatory component of the chemoreflex.