SINDROME DE ANOREXIA-CAQUEXIA ASOCIADO AL CANCER: PATOGENESIS, CARACTERISTICAS CLINICAS Y ENFOQUES TERAPEUTICOS




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SINDROME DE ANOREXIA-CAQUEXIA ASOCIADO AL CANCER: PATOGENESIS, CARACTERISTICAS CLINICAS Y ENFOQUES TERAPEUTICOS

(especial para SIIC © Derechos reservados)
El síndrome de anorexia y caquexia se observa frecuentemente en las personas con cáncer. Es importante reconocer y tratar este síndrome lo más tempranamente posible para prolongar la supervivencia y mejorar la calidad de vida.
laviano9.jpg Autor:
Alessandro Laviano
Columnista Experto de SIIC

Institución:
Department of Clinical Medicine, University La Sapienza


Artículos publicados por Alessandro Laviano
Coautores
Alessio Molfino*  Filippo Rossi-Fanelli** 
MD, Department of Clinical Medicine, University La Sapienza*
MD, Full Professor of Medicine, Chairman of the Department of Clinical Medicine, University La Sapienza**
Recepción del artículo
12 de Julio, 2005
Aprobación
15 de Julio, 2005
Primera edición
15 de Febrero, 2006
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El síndrome de anorexia-caquexia es muy prevalente en los pacientes con cáncer, repercute sobre la morbimortalidad y altera la calidad de vida. La anorexia se define como la pérdida del deseo de comer; mientras que se considera caquexia la consumición progresiva de la masa muscular esquelética y del tejido adiposo. La patogénesis del síndrome de anorexia-caquexia es multifactorial, pero los factores tumorales y las citoquinas parecen cumplir un papel significativo y representan un objetivo terapéutico adecuado. En los músculos, el incremento de la proteólisis y la disminución de la síntesis de proteínas llevan al deterioro muscular esquelético; mientras que el aumento de la lipólisis y la disminución de la lipogénesis producen la consunción del tejido adiposo. Las alteraciones neuroquímicas parecen representar el mecanismo patogénico de la anorexia y de la reducción de la ingesta alimentaria. El enfoque terapéutico del síndrome de anorexia-caquexia asociado al cáncer debe centrarse en los mecanismos patogénicos. De este modo, la estrategia terapéutica óptima debe dirigirse a contrarrestar los cambios en los hábitos alimentarios y las alteraciones metabólicas relacionadas con el tumor.

Palabras clave
Anorexia, caquexia, cáncer, patogénesis, terapia


Artículo completo

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Abstract
Anorexia-cachexia syndrome is highly prevalent among cancer patients, it impacts on morbidity and mortality, and impinges on quality of life. Anorexia is defined as the loss of the desire to, while cachexia defines the progressive wasting of skeletal muscle mass and adipose tissue. The pathogenesis of anorexia-cachexia is multifactorial, but tumour-derived factors and cytokines appear to play a significant role, representing a suitable therapeutic target. In muscles, increased proteolysis and reduced protein synthesis yield to skeletal muscle wasting. Increased lipolysis and depressed lipogenesis result in adipose tissues wasting. Neurochemical perturbations appear to represent the pathogenic mechanism of anorexia and reduced food intake. Cancer anorexia-cachexia syndrome should be therapeutically approached by targeting the pathogenic mechanisms. Thus, the optimal therapeutic approach should be aimed at counteracting both changes in dietary habits and tumour-related metabolic perturbations.

Key words
Anorexia, cachexia, cancer, pathogenesis, therapy


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Clasificación en siicsalud
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Especialidades
Principal: Oncología, Salud Mental
Relacionadas: Farmacología, Medicina Farmacéutica, Medicina Interna



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