Effects of Administration of Oral Branched-Chain Amino Acids on Anorexia and Caloric Intake in Cancer Patients

Cangiano, C.; Laviano, Alessandro; Meguid, Michael M.; Mulieri, Massimo; Conversano, L.; Preziosa, I.; Rossi-Fanelli, Filippo

doi:10.1093/jnci/88.8.550

Cited by 81 publications

(49 citation statements)

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“…Clinical data indicate that BCAA supplementation reduces the incidence of anorexia in cancer and malnourished patients and in patients with liver cirrhosis (Cangiano et al, 1996;Hiroshige et al, 2001;Marchesini et al, 2003;Laviano et al, 2005Laviano et al, , 2006Biolo et al, 2006). In a placebocontrolled multi-center trial in cirrhotic patients (n ¼ 174), 1 year supplementation with BCAA resulted in a decreased prevalence of anorexia from 52 to 25%, whereas anorexia prevalence remained unchanged in the control group (Marchesini et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…In a placebocontrolled multi-center trial in cirrhotic patients (n ¼ 174), 1 year supplementation with BCAA resulted in a decreased prevalence of anorexia from 52 to 25%, whereas anorexia prevalence remained unchanged in the control group (Marchesini et al, 2003). The incidence of anorexia also decreased in the BCAA supplemented group, whereas it did not change in the placebo group in a study in cachectic cancer patients supplemented with 14.4 g/day BCAA (7.1 g leucine) (Cangiano et al, 1996). Moreover, caloric intake in the BCAA group increased.…”

Section: Discussionmentioning

confidence: 99%

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Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

et al. 2009

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Cancer cachexia is characterised by metabolic alterations leading to loss of adipose tissue and lean body mass and directly compromises physical performance and the quality of life of cancer patients. In a murine cancer cachectic model, the effects of dietary supplementation with a specific combination of high protein, leucine and fish oil on weight loss, muscle function and physical activity were investigated. Male CD2F1 mice, 6 -7 weeks old, were divided into body weight-matched groups: (1) control, (2) tumourbearing, and (3) tumour-bearing receiving experimental diets. Tumours were induced by s.c. inoculation with murine colon adenocarcinoma (C26) cells. Food intake, body mass, tumour size and 24 h-activity were monitored. Then, 20 days after tumour/ vehicle inoculation, the animals were killed and muscle function was tested ex vivo. Tumour-bearing mice showed reduced carcass, muscle and fat mass compared with controls. EDL muscle performance and total daily activity were impaired in the tumour-bearing mice. Addition of single nutrients resulted in no or modest effects. However, supplementation of the diet with the all-in combination of high protein, leucine and fish oil significantly reduced loss of carcass, muscle and fat mass (loss in mass 45, 52 and 65% of TB-con, respectively (Po0.02)) and improved muscle performance (loss of max force reduced to 55 -64% of TB-con (Po0.05)). Moreover, total daily activity normalised after intervention with the specific nutritional combination (50% of the reduction in activity of TB-con (Po0.05)). In conclusion, a nutritional combination of high protein, leucine and fish oil reduced cachectic symptoms and improved functional performance in cancer cachectic mice. Comparison of the nutritional combination with its individual modules revealed additive effects of the single components provided.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

et al. 2009

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“…This approach has been previously and reliably utilized in patients with cancer and liver cirrhosis [22, 27, 28]. The questionnaire was also previously validated in HD patients [29], and its appropriateness to disclose the presence of anorexia in this clinical setting has been recognized by others [30].…”

Section: Discussionmentioning

confidence: 99%

“…All these symptoms interfere with eating and are related to deranged central nervous system regulation of feeding behavior. The patients reporting one or more of these symptoms were considered as anorexic [21, 22]. The questionnaire was administered before starting the first HD treatment of the week.…”

Section: Methodsmentioning

confidence: 99%

Anorexia in Hemodialysis Patients: The Possible Role of Des-Acyl Ghrelin

et al. 2007

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Background: Anorexia is frequently found in end-stage renal disease and is a reliable predictor of morbidity and mortality in hemodialysis (HD) patients. The pathogenesis of anorexia is complex and the appetite-modulating hormone ghrelin could be involved. Two forms of circulating ghrelin have been described: acylated ghrelin (<10% of circulating ghrelin) which promotes food intake, and des-acyl ghrelin which induces a negative energy balance. The aim of this cross-sectional study is to clarify whether anorexia and body weight change in HD patients relate to plasma des-acyl ghrelin levels. Methods: 34 HD patients and 15 healthy controls were studied. The presence of anorexia was assessed by a questionnaire. Serum des-acyl ghrelin was measured in HD patients and in 15 body mass index-, sex- and age-matched controls by ELISA. Energy intake was assessed by a 3-day dietary diary, and fat-free mass (FFM) was evaluated by body impedance analysis. Data have been statistically analyzed and are presented as mean ± SD. Results: 14 patients (41%) were found to be anorexic, and 20 patients (59%) non-anorexic. Energy intake (kcal/day) was significantly lower in anorexic than in non-anorexic patients (1,682 ± 241 vs. 1,972.50 ± 490; p < 0.05). FFM (%) was lower in anorexic than in non-anorexic patients (65.8 ± 4.4 vs. 70.9 ± 8.7; p = 0.05). Plasma des-acyl ghrelin levels (fmol/ml) were significantly higher in HD patients than in controls (214.88 ± 154.24 vs. 128.93 ± 51.07; p < 0.05), and in anorexic HD patients than in non-anorexic (301.7 ± 162.4 vs. 159.1 ± 115.5; p < 0.01). Conclusion: Anorexia is highly prevalent among HD patients and des-acyl ghrelin could be involved in its pathogenesis.

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“…In this regard, the branched-chain amino acids (BCAA) leucine, isoleucine and valine, were shown to exert clinically relevant metabolic effects (Bianchi et al, 2005). BCAA administration to cancer patients is reported to result in improved anorexia and energy intake, likely in view of their ability to modulate the synthesis of serotonin in the hypothalamus (Cangiano et al, 1996).…”

Section: Nutritional Interventionsmentioning

confidence: 99%

Mechanism-Based Therapeutic Approaches to Cachexia

et al. 2013

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Cachexia is a multifactorial syndrome characterized by body weight loss, depletion of adipose tissue and skeletal muscle mass, and marked alterations of the metabolic homeostasis.The occurrence of cachexia significantly impinges on patient's morbidity and mortality, and on quality of life. Inflammation, anorexia/malnutrition, alterations of protein and lipid metabolism are among the main mechanisms involved in the development of cachexia. While anorexia and malnutrition are long known contributing factors, the mechanisms leading to inflammation and metabolic alterations were clarified later on. On these premises, several therapeutic approaches were proposed. Most of them are in the pre-clinical phase, but some already reached the clinical experimentation. The present review will focus on treatment options proposed on the basis of mechanistic alterations. In this regard, in addition to nutritional and anti-inflammatory strategies, also approaches based on perturbation of specific signal transduction pathways are taken into consideration.

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Effects of Administration of Oral Branched-Chain Amino Acids on Anorexia and Caloric Intake in Cancer Patients

Cited by 81 publications

References 0 publications

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

Anorexia in Hemodialysis Patients: The Possible Role of Des-Acyl Ghrelin

Mechanism-Based Therapeutic Approaches to Cachexia

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