Serum levels of tumour necrosis factor alpha and other cytokines do not correlate with weight loss and anorexia in cancer patients

Maltoni, Marco; Fabbri, L.; Nanni, Oriana; Scarpi, Emanuela; Pezzi, Laura; Flamini, Emanuela; Riccobon, Angela; Derni, Stefania; Pallotti, Gualtiero; Amadori, Dino

doi:10.1007/bf01262570

Cited by 89 publications

(29 citation statements)

References 26 publications

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“…Previous studies have shown conflicting results as to whether serum/plasma cytokine measurements are in fact elevated [6,7,8], leading some investigators to conjecture that serum or plasma cytokines are not reflective of what occurs at the tissue level. Yet, if validated for clinical accuracy, serum or plasma measurement of cytokines potentially offers a practical, cost-efficient approach that would be invaluable for large, multi-institutional trials, an approach that would be far preferable, for example, to the labor-intensive methodology entailed in cytokine measurements from peripheral blood mononuclear cells.…”

Section: Introductionmentioning

confidence: 93%

Investigating the utility of serum cytokine measurements in a multi-institutional cancer anorexia/weight loss trial

Jatoi

Egner

Loprinzi

et al. 2004

Support Care Cancer

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Section: Introductionmentioning

confidence: 93%

Investigating the utility of serum cytokine measurements in a multi-institutional cancer anorexia/weight loss trial

Jatoi

Egner

Loprinzi

et al. 2004

Support Care Cancer

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“…It is also possible that tumour production of cytokines might be responsible for PIF production. However, in general, serum levels of TNF-a, IL-1, IL-6 and IFN-g have not been found to correlate with weight loss in patients with advanced and terminal cancer [22]. In patients with breast cancer, serum levels of TNF-a correlated with stage of disease rather than weight loss [23], although a single report [24] detected TNF-a in the serum of 36.5% of patients with pancreatic cancer, with higher levels in patients with metastatic disease, and such patients had a significantly lower body weight and body mass index.…”

Section: Mediators Of Cachexiamentioning

confidence: 91%

Cancer cachexia

Tisdale

2004

Langenbecks Arch Surg

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CAUSATIVE FACTORS: Nutritional supplementation or pharmacological manipulation of appetite are unable to control the muscle atrophy seen in cancer cachexia. This suggests that tumour and/or host factors might be responsible for the depression in protein synthesis and the increase in protein degradation. An increased expression of the ubiquitin-proteasome proteolytic pathway is responsible for the increased degradation of myofibrillar proteins in skeletal muscle, and this may be due to tumour factors, such as proteolysis-inducing factor (PIF), or host factors such as tumour necrosis factor-alpha (TNF-alpha). In humans loss of adipose tissue is due to an increase in lipolysis rather than a decrease in synthesis, and this may be due to tumour factors such as lipid-mobilising factor (LMF) or TNF-alpha, both of which can increase cyclic AMP in adipocytes, leading to activation of hormone-sensitive lipase (HSL). Levels of mRNA for HSL are elevated twofold in adipose tissue of cancer patients, while there are no changes in lipoprotein lipase (LPL), involved in extraction of fatty acids from plasma lipoproteins for storage. TREATMENT FOR CACHEXIA: This has concentrated on increasing food intake, although that alone is unable to reverse the metabolic changes. Agents interfering with TNF-alpha have not been very successful to date, although more research is required in that area. The only agent tested clinically that is able to interfere with the action of PIF is eicosapentaenoic acid (EPA). EPA attenuates protein degradation in skeletal muscle by preventing the increased expression of the ubiquitin-proteasome pathway, but has no effect on protein synthesis. When used alone EPA prevents further wasting in cachectic patients, and, when it is combined with an energy- and protein-dense nutritional supplement, weight gain is seen, which is totally lean body mass. These results suggest that mechanistic studies into the causes of cancer cachexia will allow appropriate therapeutic intervention.

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“…Some original and review articles by members of the team have appeared in European and North American cancer and palliative care journals [2][3][4].…”

Section: Researchmentioning

confidence: 99%

The specialist palliative care team in Forlì, Italy

Derni¹,

Fabbri²,

Sansoni³

et al. 2000

Supportive Care in Cancer

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A specialist palliative care team (SPCT) for the care of terminal cancer patients was established at Forli in 1986. Over the years, its staff and the patients cared for have been increasing in numbers up to the present levels of importance. For 12 years the service was supplied by a private institution, Istituto Oncologico Romagnolo (IOR). The National Health Service (NHS) has since stepped in and is now supplying home care directly, leaving the IOR with a cultural, supporting, role and with the promotion of volunteer recruitment. The care provided by the specialist group active in the patients' homes is integrated into the primary care provided by the family doctors. A plan is being realized to establish a palliative care unit (PCU) within the city hospital. The group has also been engaged in research for many years, giving special attention both to prognostic factors in very advanced cancer patients and to the organization and evaluation of the service costs. Moreover, two training courses in palliative care are organized biennially, one for all health workers in the region and one for volunteers co-operating with the medical teams.

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Serum levels of tumour necrosis factor alpha and other cytokines do not correlate with weight loss and anorexia in cancer patients

Cited by 89 publications

References 26 publications

Investigating the utility of serum cytokine measurements in a multi-institutional cancer anorexia/weight loss trial

Investigating the utility of serum cytokine measurements in a multi-institutional cancer anorexia/weight loss trial

Cancer cachexia

The specialist palliative care team in Forlì, Italy

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