nutrizione sla

1. Cori cycle with sources of gluconeogenic substrates. Tumours produce factors such as lipid-mobilizing factor (LMF), which induces breakdown of adipose tissue into fatty acids, and proteolysis-inducing factor (PIF), which induces protein degradation (amino acids) in skeletal muscle. Tumour necrosis factor (TNF)-  also contributes to these processes. These are important gluconeogenic substrates that can be used in acute-phase protein (APP) synthesis by the liver. Tumours convert glucose to lactate, which is transferred to the liver, where it is converted back into glucose. This cycle uses a large amount of energy, and might contribute to cachexia.

2. Interactions between pro-inflammatory cytokines and PIF

3. MUSCLE WASTE AND ACUTE-PHASE RESPONSE IL-6, TNF, IL- 1 , IFN-  PROTEINS  AA ACUTE PHASE PROTEINS AA  PROTEIN DEGRADATION THE MOST PARADIGMATIC METABOLIC DERANGEMENTS INDUCED BY THE TUMOR ARE THE ACTIVATION OF PROTEOLYSIS IN SKELETAL MUSCLE AND THE REDISTRIBUTION OF PROTEIN SYNTHESIS IN THE LIVER (  SYNTHESIS OF ALBUMIN, ETC AND  CRP, ETC). THESE ALTERATIONS CAN BE INDUCED BY DIFFERENT CYTOKINES From Tisdale “Cachexia in Medicine” 2004

8. Evidenze cliniche

10. Modificazioni di peso e LBM dopo 8 settimane nel gruppo con omega 3 vs gruppo di controllo 0.09 1.21 0.46 1.46 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 weight LBM kg p = NS Fearon et al 2003 n = 30 n = 26 n = 28 n = 22 EXP Controls

11. Variazioni della LBM conseguenti ad EPA nel tumore pancreatico. cans LBm (kg) EXP: p = 0,036 r = 0,332 Controlli = NS Fearon et al 2003