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Effects of cachexia due to cancer on whole body and skeletal muscle protein turnover.
Cancer. 1998 Jan 01; 82(1):42-8.C

Abstract

BACKGROUND

Data available in the literature regarding whole body protein (WBP) kinetics in patients with cachexia due to cancer are conflicting. Some authors have reported an increase of WBP synthesis and breakdown, whereas others have not found any significant changes; only a few researchers have investigated more compartments simultaneously. The main purpose of this study was to investigate WBP and skeletal muscle protein (SMP) turnover simultaneously in cachectic patients to understand better the mechanisms underlying the general wasting of the host present in cancer cachexia.

METHODS

WBP and SMP synthesis and breakdown were studied in malnourished patients with advanced gastric carcinoma and in healthy volunteers. Protein turnover was evaluated in a postabsorptive state, using a model based on a primed constant infusion of L-[(2)H5] phenylalanine and L-[(2)H4]tyrosine, and by determining the isotopic enrichment and concentration in plasma during a plateau phase by gas chromatography and mass spectrometry.

RESULTS

Rates of WBP synthesis and breakdown did not differ significantly between the two groups (whole body synthesis [WBS] of 4.35 +/- 0.2 g/kg/day and whole body breakdown [WBB] of 4.77 +/- 0.2 g/kg/day in the control group and WBS of 3.34 +/- 0.7 g/kg/day and WBB of 4.5 +/- 0.4 g/kg/day in the patient group). The skeletal muscle compartment of the patients showed a significantly lower synthesis compared with controls (patients, 9.6 +/- 1.8 nmol/100 mL/minute and control, 25.9 +/- 7.6 nmol/100 mL/minute; P < 0.05), whereas the breakdown was similar in the two groups. Such reduction in SMP synthesis in the gastric carcinoma patients resulted in a more negative net balance.

CONCLUSIONS

Conflicting data in the literature may be accounted for by the different selection of patients and controls. Furthermore, WBP kinetics is the result of the metabolism of at least two compartments, the muscle and the nonmuscle compartments (including the tumor), which can change in opposite ways. In patients with cachexia due to cancer, the skeletal compartment appears to be the more compromised, with a significant decrease in SMP synthesis.

Authors+Show Affiliations

Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9428478

Citation

Dworzak, F, et al. "Effects of Cachexia Due to Cancer On Whole Body and Skeletal Muscle Protein Turnover." Cancer, vol. 82, no. 1, 1998, pp. 42-8.
Dworzak F, Ferrari P, Gavazzi C, et al. Effects of cachexia due to cancer on whole body and skeletal muscle protein turnover. Cancer. 1998;82(1):42-8.
Dworzak, F., Ferrari, P., Gavazzi, C., Maiorana, C., & Bozzetti, F. (1998). Effects of cachexia due to cancer on whole body and skeletal muscle protein turnover. Cancer, 82(1), 42-8.
Dworzak F, et al. Effects of Cachexia Due to Cancer On Whole Body and Skeletal Muscle Protein Turnover. Cancer. 1998 Jan 1;82(1):42-8. PubMed PMID: 9428478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of cachexia due to cancer on whole body and skeletal muscle protein turnover. AU - Dworzak,F, AU - Ferrari,P, AU - Gavazzi,C, AU - Maiorana,C, AU - Bozzetti,F, PY - 1998/1/15/pubmed PY - 2000/6/20/medline PY - 1998/1/15/entrez SP - 42 EP - 8 JF - Cancer JO - Cancer VL - 82 IS - 1 N2 - BACKGROUND: Data available in the literature regarding whole body protein (WBP) kinetics in patients with cachexia due to cancer are conflicting. Some authors have reported an increase of WBP synthesis and breakdown, whereas others have not found any significant changes; only a few researchers have investigated more compartments simultaneously. The main purpose of this study was to investigate WBP and skeletal muscle protein (SMP) turnover simultaneously in cachectic patients to understand better the mechanisms underlying the general wasting of the host present in cancer cachexia. METHODS: WBP and SMP synthesis and breakdown were studied in malnourished patients with advanced gastric carcinoma and in healthy volunteers. Protein turnover was evaluated in a postabsorptive state, using a model based on a primed constant infusion of L-[(2)H5] phenylalanine and L-[(2)H4]tyrosine, and by determining the isotopic enrichment and concentration in plasma during a plateau phase by gas chromatography and mass spectrometry. RESULTS: Rates of WBP synthesis and breakdown did not differ significantly between the two groups (whole body synthesis [WBS] of 4.35 +/- 0.2 g/kg/day and whole body breakdown [WBB] of 4.77 +/- 0.2 g/kg/day in the control group and WBS of 3.34 +/- 0.7 g/kg/day and WBB of 4.5 +/- 0.4 g/kg/day in the patient group). The skeletal muscle compartment of the patients showed a significantly lower synthesis compared with controls (patients, 9.6 +/- 1.8 nmol/100 mL/minute and control, 25.9 +/- 7.6 nmol/100 mL/minute; P < 0.05), whereas the breakdown was similar in the two groups. Such reduction in SMP synthesis in the gastric carcinoma patients resulted in a more negative net balance. CONCLUSIONS: Conflicting data in the literature may be accounted for by the different selection of patients and controls. Furthermore, WBP kinetics is the result of the metabolism of at least two compartments, the muscle and the nonmuscle compartments (including the tumor), which can change in opposite ways. In patients with cachexia due to cancer, the skeletal compartment appears to be the more compromised, with a significant decrease in SMP synthesis. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/9428478/Effects_of_cachexia_due_to_cancer_on_whole_body_and_skeletal_muscle_protein_turnover_ L2 - https://medlineplus.gov/stomachcancer.html DB - PRIME DP - Unbound Medicine ER -