Jerzy Chwist | PubMed Health

PubMed2006

[Cachexia in chronic pulmonary obstructive disease].

Weight loss is a characteristic feature of chronic obstructive pulmonary disease (COPD) and a negative, independent predictor of outcome. It is a consequence of a misbalance between protein synthesis and breakdown resulting from increased energy requirement unbalanced by dietary intake. A depletion of fat-free mass is seen, especially in muscles (up to 60% of their mass) and leads to the loss of their power and endurance. The impairment of quality of life is very distinct. So far, there is no systemic treatment in cachectic patients with COPD, anti-catabolic treatment by polyunsaturated fatty acid may be of significance but needs further investigation.

Cachexia↗

PubMed2005

[Pathomechanism of cachexia in chronic obstructive pulmonary disease].

Weight loss is a characteristic for advanced chronic obstructive pulmonary disease (COPD), but its mechanism remains unexplained. The decrease of lean body mass is due to a negative energy balance with a noncatabolic hypermetabolic state. Pulmonary inflammation or tissue hypoxia might contribute to it, the decrease in protein content is accompanied by an increase in reactive oxygen forms. Tumor necrosis factor (TNF) has been implicated, other candidates are cytokines IL-1B and IL-6. Activation of apoptosis may be noticed. Pulmonary inflammation and changes in serum leptin may be interrelated. Other hormonal disturbances involve serum IGF-1 level decrease, increase of insulin resistance, raised catecholamine and cortisol levels and other mechanisms which need further investigations. Up to now the attempts undertaken to counteract the observed hormonal changes failed to success.

Apoptosis↗