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Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass
Low skeletal muscle mass is highly prevalent in older cancer patients and affects 5% to 89% depending on the type and stage of cancer. Low skeletal muscle mass is associated with poor clinical outcomes such as post‐operative complications, chemotherapy toxicity and mortality in older cancer patients...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757176/ https://www.ncbi.nlm.nih.gov/pubmed/32478975 http://dx.doi.org/10.1111/apha.13516 |
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author | Looijaard, Stéphanie M. L. M. te Lintel Hekkert, Miriam L. Wüst, Rob C. I. Otten, René H. J. Meskers, Carel G. M. Maier, Andrea B. |
author_facet | Looijaard, Stéphanie M. L. M. te Lintel Hekkert, Miriam L. Wüst, Rob C. I. Otten, René H. J. Meskers, Carel G. M. Maier, Andrea B. |
author_sort | Looijaard, Stéphanie M. L. M. |
collection | PubMed |
description | Low skeletal muscle mass is highly prevalent in older cancer patients and affects 5% to 89% depending on the type and stage of cancer. Low skeletal muscle mass is associated with poor clinical outcomes such as post‐operative complications, chemotherapy toxicity and mortality in older cancer patients. Little is known about the mediating pathophysiological mechanisms. In this review, we summarize proposed pathophysiological mechanisms underlying the association between low skeletal muscle mass and poor clinical outcomes in older cancer patients including a) systemic inflammation; b) insulin‐dependent glucose handling; c) mitochondrial function; d) protein status and; e) pharmacokinetics of anticancer drugs. The mechanisms of altered myokine balance negatively affecting the innate and adaptive immune system, and altered pharmacokinetics of anticancer drugs leading to a relative overdosage of anticancer drugs are best‐substantiated. The effects of glucose intolerance and circulating mitochondrial DNA as a consequence of low skeletal muscle mass are topics of interest for future research. Restoring myokine balance through physical exercise, exercise mimetics, neuro‐muscular activation and adapting anticancer drug dosing on skeletal muscle mass could be targeted approaches to improve clinical outcomes in older cancer patients with low skeletal muscle mass. |
format | Online Article Text |
id | pubmed-7757176 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77571762020-12-28 Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass Looijaard, Stéphanie M. L. M. te Lintel Hekkert, Miriam L. Wüst, Rob C. I. Otten, René H. J. Meskers, Carel G. M. Maier, Andrea B. Acta Physiol (Oxf) Review Articles Low skeletal muscle mass is highly prevalent in older cancer patients and affects 5% to 89% depending on the type and stage of cancer. Low skeletal muscle mass is associated with poor clinical outcomes such as post‐operative complications, chemotherapy toxicity and mortality in older cancer patients. Little is known about the mediating pathophysiological mechanisms. In this review, we summarize proposed pathophysiological mechanisms underlying the association between low skeletal muscle mass and poor clinical outcomes in older cancer patients including a) systemic inflammation; b) insulin‐dependent glucose handling; c) mitochondrial function; d) protein status and; e) pharmacokinetics of anticancer drugs. The mechanisms of altered myokine balance negatively affecting the innate and adaptive immune system, and altered pharmacokinetics of anticancer drugs leading to a relative overdosage of anticancer drugs are best‐substantiated. The effects of glucose intolerance and circulating mitochondrial DNA as a consequence of low skeletal muscle mass are topics of interest for future research. Restoring myokine balance through physical exercise, exercise mimetics, neuro‐muscular activation and adapting anticancer drug dosing on skeletal muscle mass could be targeted approaches to improve clinical outcomes in older cancer patients with low skeletal muscle mass. John Wiley and Sons Inc. 2020-07-24 2021-01 /pmc/articles/PMC7757176/ /pubmed/32478975 http://dx.doi.org/10.1111/apha.13516 Text en © 2020 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Articles Looijaard, Stéphanie M. L. M. te Lintel Hekkert, Miriam L. Wüst, Rob C. I. Otten, René H. J. Meskers, Carel G. M. Maier, Andrea B. Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass |
title | Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass |
title_full | Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass |
title_fullStr | Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass |
title_full_unstemmed | Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass |
title_short | Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass |
title_sort | pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757176/ https://www.ncbi.nlm.nih.gov/pubmed/32478975 http://dx.doi.org/10.1111/apha.13516 |
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