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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
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.
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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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