Prelims: Current events of national and international importance | Science & Technology
Why in News?
New research links cancer cachexia to disrupted brain–liver signalling, redefining it as a neuro-metabolic disorder.
Cachexia – It is a complex; chronic metabolic syndrome associated with cancer.
Prevalence – It affects up to 80% patients with advanced cancers and accounts for a sizeable fraction of cancer deaths.
Nature – Unlike starvation, cachexia involves increased energy expenditure and metabolic breakdown of muscle and fat driven by tumour–host biology.
Symptoms
Persistent loss of body weight.
Loss of appetite (anorexia).
Progressive muscle wasting and weakness.
Reduced response to chemotherapy and radiotherapy.
Causes – Tumour-driven inflammation – Disrupts normal brain–liver nerve signalling through the vagus nerve.
Liver metabolic reprogramming – Altered neural signals suppress HNF4α (a key regulator of liver metabolism), leading to appetite loss, systemic inflammation and muscle wasting.
Progression Stages – Early metabolic imbalance with appetite loss.
Progresses into liver metabolic dysfunction.
Systemic inflammation and muscle breakdown.
Advanced wasting with severe loss of weight and strength.
Diagnosis – Regular monitoring of body weight along with assessment of muscle mass and strength.
Evaluation of appetite and nutritional status.
Metabolic and biochemical assessment.
Treatment – Early Recognition – Cachexia should be identified as early as possible, as slowing progression is easier than reversing advanced wasting.
Integrated Care – Treatment should focus on the whole patient, not just tumour control, combining multiple supportive strategies.
Anti-Inflammatory Support – Inflammation needs to be addressed, though targeting single cytokines alone has shown limited success.
Targeted Nutrition – Nutritional support is necessary to maintain function, even though feeding alone cannot reverse cachexia.
Physical Activity – Exercise, where feasible, helps preserve muscle strength and functional capacity.
New treatment possibilities – Neuro-modulation (experimental) – Interrupting abnormal vagus nerve signalling, including electrical stimulation, has reduced weight and muscle loss in animal models.
Liver-directed therapy (experimental) – Preventing loss of HNF4α (a key regulator of liver metabolism) or restoring hepatic metabolic programmes has limited wasting in preclinical studies.
