Nádorová anorexie a kachexie je multiorgánový, multifaktoriální a často ireverezibilní syndrom postihující mnoho pacientů s nádory. Nádorová kachexie je charakterizována poklesem tělesné hmotnosti, hlavně ztrátou svalové hmoty a tukové tkáně, vedoucí ke zhoršení kvality života. Léčebné možnosti nádorové kachexie jsou omezené. Přístup je multimodální a zahrnuje léčbu sekundárních gastrointestinálních symptomů, nutriční podporu, léky a nefarmakologické postupy. Nutriční poradenství a fyzická aktivita jsou vhodné k oddálení nebo k prevenci rozvoje anorexie a kachexie. Nicméně tyto postupy jsou z hlediska účinnosti omezené a neexistuje lék, který by zcela potlačil jednotlivé komponenty syndromu. V tomto přehledu je nastíněna patofyziologie syndromu anorexie a kachexie, možnosti a efektivita léčby.

Cancer cachexia is a multi‑organ, multifactorial and often irreversible syndrome affecting many patients with cancer. Cancer cachexia is invariably associated with weight loss, mainly from loss of skeletal muscle and body fat, conditioning a reduced quality of life. Treatment options for treating cancer cachexia are limited. The approach is multimodal and may include: treatment of secondary gastrointestinal symptoms, nutritional treatments, drug, and non‑drug treatments. Nutritional counselling and physical training may be beneficial in delaying or preventing the development of anorexia‑cachexia. However, these interventions are limited in their effect, and no definitive pharmacological treatment is available to address the relevant components of the syndrome. In this review we examine the pathophysiology of cancer anorexia cachexia syndrome and potential therapeutic options and their effectivity.

• MeSH
• antiflogistika nesteroidní aplikace a dávkování   MeSH
• glukokortikoidy aplikace a dávkování   MeSH
• kachexie * diagnóza   farmakoterapie   patofyziologie   MeSH
• lidé MeSH
• nádory komplikace   MeSH
• nechutenství diagnóza   epidemiologie   etiologie   farmakoterapie   MeSH
• nutriční podpora MeSH
• progestiny aplikace a dávkování   MeSH
• syndrom chřadnutí epidemiologie   farmakoterapie   patofyziologie   MeSH
• životní styl MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Beta-hydroxy-beta-methylbutyrate (HMB) is a metabolite of the essential amino acid leucine that has been reported to have anabolic effects on protein metabolism. The aims of this article were to summarize the results of studies of the effects of HMB on skeletal muscle and to examine the evidence for the rationale to use HMB as a nutritional supplement to exert beneficial effects on muscle mass and function in various conditions of health and disease. The data presented here indicate that the beneficial effects of HMB have been well characterized in strength-power and endurance exercise. HMB attenuates exercise-induced muscle damage and enhances muscle hypertrophy and strength, aerobic performance, resistance to fatigue, and regenerative capacity. HMB is particularly effective in untrained individuals who are exposed to strenuous exercise and in trained individuals who are exposed to periods of high physical stress. The low effectiveness of HMB in strength-trained athletes could be due to the suppression of the proteolysis that is induced by the adaptation to training, which may blunt the effects of HMB. Studies performed with older people have demonstrated that HMB can attenuate the development of sarcopenia in elderly subjects and that the optimal effects of HMB on muscle growth and strength occur when it is combined with exercise. Studies performed under in vitro conditions and in various animal models suggest that HMB may be effective in treatment of muscle wasting in various forms of cachexia. However, there are few clinical reports of the effects of HMB on muscle wasting in cachexia; in addition, most of these studies evaluated the therapeutic potential of combinations of various agents. Therefore, it has not been possible to determine whether HMB was effective or if there was a synergistic effect. Although most of the endogenous HMB is produced in the liver, there are no reports regarding the levels and the effects of HMB supplementation in subjects with liver disease. Several studies have suggested that anabolic effects of HMB supplementation on skeletal muscle do not occur in healthy, non-exercising subjects. It is concluded that (i) HMB may be applied to enhance increases in the mass and strength of skeletal muscles in subjects who exercise and in the elderly and (ii) studies examining the effects of HMB administered alone are needed to obtain conclusions regarding the specific effectiveness in attenuating muscle wasting in various muscle-wasting disorders.

• MeSH
• kachexie dietoterapie   patofyziologie   MeSH
• kosterní svaly účinky léků   fyziologie   MeSH
• lidé MeSH
• potravní doplňky MeSH
• sarkopenie dietoterapie   patofyziologie   MeSH
• svalová atrofie dietoterapie   patofyziologie   MeSH
• svalová síla účinky léků   MeSH
• syndrom chřadnutí dietoterapie   patofyziologie   MeSH
• valeráty aplikace a dávkování   farmakologie   MeSH
• zdraví MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH