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Cachexia
 
 
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Cachexia is loss of weight
Weight loss

Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue....
, muscle atrophy
Muscle atrophy

Muscle atrophy is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle. When a muscle atrophies, it becomes weaker, since the ability to exert force is related to mass; muscle atrophy is a co-morbidity of several common diseases, including cancer, AIDS, congestive heart disease, COPD , renal...
, fatigue, weakness and significant loss of appetite
Anorexia (symptom)

Anorexia is the decreased sensation of appetite. While the term in non-scientific publications is often used interchangeably with anorexia nervosa, many possible causes exist for a decreased appetite, some of which may be harmless, while others indicate a serious clinical condition, or pose a significant risk....
 in someone who is not actively trying to lose weight. It can be a sign of various underlying disorders; when a patient presents with cachexia, a doctor will generally consider the possibility of cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
, metabolic acidosis (from decreased protein synthesis and increased protein catabolism
Catabolism

Catabolism is the set of metabolic pathways which break down molecules into smaller units and release energy. In catabolism, large molecules such as polysaccharides, lipids, nucleic acids and proteins are broken down into smaller units such as monosaccharides, fatty acids, nucleotides and amino acids, respectively....
), certain infectious disease
Infectious disease

An infectious disease is a clinically evident disease resulting from the presence of pathogenic microbial agents, including pathogenic viruses, pathogenic bacteria, Mycosis, protozoa, multicellular parasites, and aberrant proteins known as prions....
s (e.g. tuberculosis
Tuberculosis

Tuberculosis is a common and often deadly infectious disease caused by mycobacterium, mainly Mycobacterium tuberculosis . Tuberculosis usually attacks the lungs but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, the gastrointestinal system, bones, joints, and even the...
, AIDS
AIDS

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the HIV ....
), and some autoimmune disorders, or addiction to drugs such as amphetamine
Amphetamine

Amphetamine and related drugs such as methamphetamine are a group of drugs that act by increasing levels of norepinephrine, serotonin, and dopamine in the brain....
s or cocaine
Cocaine

Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine....
.






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Cachexia is loss of weight
Weight loss

Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue....
, muscle atrophy
Muscle atrophy

Muscle atrophy is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle. When a muscle atrophies, it becomes weaker, since the ability to exert force is related to mass; muscle atrophy is a co-morbidity of several common diseases, including cancer, AIDS, congestive heart disease, COPD , renal...
, fatigue, weakness and significant loss of appetite
Anorexia (symptom)

Anorexia is the decreased sensation of appetite. While the term in non-scientific publications is often used interchangeably with anorexia nervosa, many possible causes exist for a decreased appetite, some of which may be harmless, while others indicate a serious clinical condition, or pose a significant risk....
 in someone who is not actively trying to lose weight. It can be a sign of various underlying disorders; when a patient presents with cachexia, a doctor will generally consider the possibility of cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
, metabolic acidosis (from decreased protein synthesis and increased protein catabolism
Catabolism

Catabolism is the set of metabolic pathways which break down molecules into smaller units and release energy. In catabolism, large molecules such as polysaccharides, lipids, nucleic acids and proteins are broken down into smaller units such as monosaccharides, fatty acids, nucleotides and amino acids, respectively....
), certain infectious disease
Infectious disease

An infectious disease is a clinically evident disease resulting from the presence of pathogenic microbial agents, including pathogenic viruses, pathogenic bacteria, Mycosis, protozoa, multicellular parasites, and aberrant proteins known as prions....
s (e.g. tuberculosis
Tuberculosis

Tuberculosis is a common and often deadly infectious disease caused by mycobacterium, mainly Mycobacterium tuberculosis . Tuberculosis usually attacks the lungs but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, the gastrointestinal system, bones, joints, and even the...
, AIDS
AIDS

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the HIV ....
), and some autoimmune disorders, or addiction to drugs such as amphetamine
Amphetamine

Amphetamine and related drugs such as methamphetamine are a group of drugs that act by increasing levels of norepinephrine, serotonin, and dopamine in the brain....
s or cocaine
Cocaine

Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine....
. Cachexia physically weakens patients to a state of immobility stemming from loss of appetite, asthenia
Asthenia

Asthenia is a medical term denoting symptoms of physical weakness and muscle weakness.A condition in which the body lacks or has lost strength either as a whole or in any of its parts....
, and anemia
Anemia

Anemia or an?mia/anaemia is defined as a qualitative or quantitative deficiency of hemoglobin, a protein found inside red blood cells ....
, and response to standard treatment is usually poor.

Disease settings

Cachexia is often seen in end-stage cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
, and in that context is called "cancer cachexia". It was also prevalent in HIV
HIV

Human immunodeficiency virus is a lentivirus that can lead to AIDS , a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections....
 patients before the advent of highly active anti-retroviral therapy (HAART) for that condition; now it is seen less frequently in those countries where such treatment is available. In those patients who have Congestive Heart Failure
Congestive heart failure

Heart failure is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs....
, there is also a cachectic syndrome. Also, a cachexia co-morbidity is seen in patients that have any of the range of illnesses classified as "COPD
COPD

Chronic obstructive pulmonary disease is a group of diseases of the lungs in which the airways become narrowed. This leads to a limitation of the flow of air to and from the lungs causing shortness of breath....
" (chronic obstructive pulmonary disease), particularly emphysema. Some severe cases of schizophrenia
Schizophrenia

Schizophrenia , from the Ancient Greek Root schizein and phren, phren- is a psychiatry diagnosis that describes a mental disorder characterized by abnormalities in the perception or expression of reality....
 can present this condition where it is named vesanic cachexia (from vesania, a Latin term for insanity).

In each of these settings there is full-body wasting, which hits the skeletal muscle
Skeletal muscle

They generally contract voluntarily , although they can contract involuntarily through Reflex action. The whole muscle is wrapped in a special type of connective tissue, epimysium....
 especially hard, resulting in muscle atrophy
Muscle atrophy

Muscle atrophy is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle. When a muscle atrophies, it becomes weaker, since the ability to exert force is related to mass; muscle atrophy is a co-morbidity of several common diseases, including cancer, AIDS, congestive heart disease, COPD , renal...
 and great muscle loss.

Mechanism

The exact mechanism in which these diseases cause cachexia is poorly understood, but there is probably a role for inflammatory
Inflammation

Inflammation is the complex biological response of Blood vessel tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue....
 cytokine
Cytokine

Cytokines are a category of signaling molecules that, like hormones and neurotransmitters, are used extensively in cell communication. They are proteins, peptides or glycoproteins....
s such as tumor necrosis factor-alpha (TNF-a) - which is also nicknamed cachexin (also spelled cachectin) for this reason, Interferon gamma
Interferon

Interferons are natural proteins produced by the cells of the immune system of most vertebrates in response to challenges by foreign agents such as viruses, parasites and tumor cells....
 (IFN?), and Interleukin 6
Interleukin 6

Interleukin-6 is an interleukin that acts as both a pro-inflammatory and anti-inflammatory cytokine. It is secreted by T cells and macrophages to stimulate immune response to trauma, especially burns or other tissue damage leading to inflammation....
 (IL-6), as well as the tumor
Tumor

A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells . Tumor is not synonymous with cancer. A tumor can be Benign neoplasm, Carcinoma in situ or malignant, whereas cancer is by definition malignant....
-secreted proteolysis
Proteolysis

Proteolysis is the directed degradation of proteins by cellular enzymes called proteases or by intramolecular digestion....
 inducing factor (PIF).

Related malnutrition syndromes are kwashiorkor
Kwashiorkor

Kwashiorkor is a type of malnutrition with controversial causes, but it is commonly believed to be caused by insufficient protein consumption. It usually affects children aged 1?4 years, although it also occurs in older children and adults....
 and marasmus
Marasmus

Marasmus is a form of severe protein-energy malnutrition characterized by energy deficiency.A child with marasmus looks Emaciation. Body weight may be reduced to less than 80% of the normal weight for that height....
, although these do not always have an underlying causative illness; they are most often symptomatic of severe malnutrition
Malnutrition

Malnutrition is a general term for a medical condition caused by an improper or inadequate diet and nutrition.According to the World Health Organization, hunger and malnutrition are the single gravest threats to the world's public health and malnutrition is by far the biggest contributor to child mortality, present in half of all cases....
.

Those suffering from the eating disorder anorexia nervosa appear to have high plasma levels of ghrelin
Ghrelin

Ghrelin is a hormone produced mainly by P/D1 cells lining the fundus of the human stomach and epsilon cells of the pancreas that stimulates appetite....
. Ghrelin levels are also high in patients who have cancer-induced cachexia.

See also

  • Wasting
    Wasting

    In medical circles, wasting refers to the process by which a debilitating disease causes muscle and fat biological tissue to "waste" away. Wasting is sometimes referred to as "acute malnutrition" because it is believed that episodes of wasting have a short duration, in contrast to stunted growth, which is regarded as chronic malnutrition....


External links

  • and of cachexia, from Cancer Medicine