Sarcopenia and cachexia
6 important questions on Sarcopenia and cachexia
A stop signal is needed, how does it work
- decrease of neutrophil infiltration
- increase in uptake of apoptotic neutrophils
- increase in exit via lymphatics
- increase in monocyte recruitment
The key histological feature in the resolution of inflammation is the loss of neutrophils from the local inflamed sites. This is a programmed process that is actively regulated at multiple levels: by reducing neutrophil infiltration into the exudate, increasing monocyte recruitment to the exudate, stimulating macrophage uptake of apoptotic neutrophils, and promoting phagocyte exit from the exudate via the lymphatics.
From amino acids to body protein
- DNA
- mRNA (synthesis)
- tRNA (synthesis)
- Proteins
- breakdown
- Free amino acid pool
- amino acids
synthesis - breakdown = net synthesis / breakdown
Muscle resevoir of protein =
- Good: inflammation induced muscle breakdown
- During acute trauma and a acute illness response
- The inflammatory response mobilizes protein building blocks for the wound healing, the brain & the immune system
- Systemic
- Good if: timed: a clear beginning / clear end
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Causes of body weight loss
- Starvation; pure protein deficiency; conserve lean body mass; deplete fat mass
- Sarcopenia; deplete lean body mass; weight may not change; mediated by testosterone; growth hormone, ILGF-1; immobility
- Cachexia; cytokine-mediated; inflammatory disease
What can you measure form CT-scans
- Muscle cross-sectional area
- Visceral adipose tissue (VAT)
- Subcutaneous adipose tissue (SAT)
- Inter muscular adipose tissue (IMAT)
- Total adipose tissue (VAT+SAT+IMAT)
- Muscle attenuation (intra-myocellular fat)
Hypothesis and aim for "is there an association between body composition and chemotherapy induced toxicities in colorectal cancer?
Aim - determine association between body composition and chemotherapy induced toxicities in a retrospective cohort of colon cancer patients receiving CAPOX
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