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ʻO ka Cachexia kahi maʻi ʻōnaehana i hōʻike ʻia e ka pohō kaumaha, ka ʻiʻo a me ka adipose tissue atrophy, a me ka mumū ʻōnaehana. ʻO Cachexia kekahi o nā pilikia nui a me nā kumu o ka make i nā maʻi maʻi kanesa. Ma waho aʻe o ka maʻi kanesa, hiki ke hoʻoulu ʻia ka cachexia e nā ʻano maʻi maʻi maʻi ʻole, ʻo ia hoʻi ka pau ʻole o ka naʻau, ka hōʻino ʻana o ka puʻuwai, ka maʻi obstructive pulmonary maʻi, nā maʻi neurological, AIDS, a me ka rheumatoid arthritis. Ua manaʻo ʻia ʻo ka nui o ka cachexia i ka poʻe maʻi maʻi maʻi hiki ke piʻi i ka 25% a i ka 70%, ka mea e hoʻopilikia koʻikoʻi i ka maikaʻi o ke ola o nā maʻi (QOL) a hoʻonui i ka ʻona pili i ka mālama ʻana.

He mea koʻikoʻi ka hana kūpono o cachexia no ka hoʻomaikaʻi ʻana i ka maikaʻi o ke ola a me ka wānana o nā maʻi maʻi maʻi. Eia nō naʻe, ʻoiai ka holomua o ke aʻo ʻana i nā ʻano pathophysiological o cachexia, ʻoi aku ka nui o nā lāʻau lapaʻau i kūkulu ʻia e pili ana i nā mīkini hiki ke hana wale ʻia a ʻaʻole pono. ʻAʻohe lāʻau lapaʻau maikaʻi i ʻae ʻia e ka US Food and Drug Administration (FDA).

Nui nā kumu no ka hiki ʻole o nā hoʻokolohua lapaʻau ma ka cachexia, a ʻo ke kumu kumu paha aia ma ka ʻike ʻole ʻana i ke ʻano a me ke ʻano kūlohelohe o cachexia. I kēia mau lā, ua paʻi pū ʻo Professor Xiao Ruiping a me ka mea noiʻi ʻo Hu Xinli mai ke College of Future Technology of Peking University i kahi ʻatikala ma Nature Metabolism, e hōʻike ana i ke kuleana koʻikoʻi o ke ala lactic-GPR81 i ka hanana ʻana o ka cachexia maʻi kanesa, e hāʻawi ana i kahi manaʻo hou no ka mālama ʻana i ka cachexia. Hōʻuluʻulu mākou i kēia ma ka hoʻohui ʻana i nā pepa mai Nat Metab, Science, Nat Rev Clin Oncol a me nā puke pai ʻē aʻe.

Ma muli o ka emi ʻana o ka meaʻai a/a i ʻole ka hoʻonui ʻana i ka ikehu. ʻO nā haʻawina mua i manaʻo ʻia e alakaʻi ʻia kēia mau loli physiological i ka cachexia pili i ka tumor e kekahi mau cytokines huna ʻia e ka microenvironment tumor. No ka laʻana, hiki i nā mea e like me ka ulu ʻokoʻa kumu 15 (GDF15), lipocalin-2 a me ka insulin-like protein 3 (INSL3) hiki ke kāohi i ka ʻai ʻana i ka meaʻai ma o ka hoʻopaʻa ʻana i nā wahi hoʻoponopono makemake i loko o ka ʻōnaehana nerve waena, e alakaʻi ana i ka anorexia i nā maʻi. ʻO IL-6, PTHrP, activin A a me nā mea ʻē aʻe e alakaʻi i ka pohō kaumaha a me ka atrophy ʻiʻo ma o ka hoʻoulu ʻana i ke ala catabolic a me ka hoʻonui ʻana i ka ikehu. I kēia manawa, ʻo ka noiʻi ʻana e pili ana i ka hana o ka cachexia i kālele nui ʻia i kēia mau protein huna, a he liʻiliʻi nā haʻawina i pili i ka hui ma waena o nā metabolites tumo a me cachexia. Ua lawe ʻo Professor Xiao Ruiping a me ka mea noiʻi ʻo Hu Xinli i kahi ala hou e hōʻike i ke ʻano koʻikoʻi o ka cachexia pili i ka maʻi maʻi mai ka ʻike o nā metabolites tumor.

ʻO ka mea mua, ua nānā ka hui o Professor Xiao Ruiping i nā tausani o nā metabolites i loko o ke koko o nā mana olakino a me nā ʻiole kumu hoʻohālike o ka maʻi maʻi maʻi maʻi cachexia, a ʻike ʻia ʻo ka lactic acid ka metabolite kiʻekiʻe loa i nā ʻiole me ka cachexia. Ua hoʻonui ʻia ka pae serum lactic acid me ka ulu ʻana o ka maʻi maʻi, a ua hōʻike i ka pilina ikaika me ka hoʻololi kaumaha o nā ʻiole e lawe ana i ka maʻi. ʻO nā laʻana serum i hōʻiliʻili ʻia mai ka poʻe maʻi maʻi maʻi maʻi maʻi e hōʻoia ana he hana nui ka lactic acid i ka holomua o ka cachexia maʻi maʻi kanaka.

No ka hoʻoholo ʻana i ke kumu o ka cachexia, ua hāʻawi ka hui noiʻi i ka waika lactic i ke koko o nā ʻiole olakino ma o ka pauma osmotic i hoʻokomo ʻia ma lalo o ka ʻili, me ka hoʻonui ʻana i ke kiʻekiʻe o ka serum lactic acid i ke kiʻekiʻe o nā ʻiole me ka cachexia. Ma hope o 2 mau pule, ua hoʻomohala nā ʻiole i kahi phenotype maʻamau o cachexia, e like me ka poho kaumaha, ka momona a me ka ʻiʻo ʻiʻo atrophy. Hōʻike kēia mau hopena i ka hoʻoponopono hou ʻana o ka momona i ka lactate me ka mea i hoʻoulu ʻia e nā maʻi kanesa. ʻAʻole ʻo Lactate wale nō kahi metabolite hiʻohiʻona o ka cachexia maʻi maʻi, akā he mea koʻikoʻi hoʻi o ka phenotype hypercatabolic i hoʻokomo ʻia i ke kanesa.

Ma hope aʻe, ua ʻike lākou i ka holoi ʻana i ka lactate receptor GPR81 i mea maikaʻi i ka hoʻohaʻahaʻa ʻana i ka ʻōpū a me ka serum lactate-induced cachexia hōʻike me ka ʻole e pili ana i nā pae lactate serum. No ka mea, ua hōʻike nui ʻia ka GPR81 i loko o ke kiko adipose a me nā loli i ka ʻiʻo adipose ma mua o ka ʻiʻo ʻiʻo i ka wā o ka hoʻomohala ʻana o ka cachexia, ʻo ka hopena knockout kikoʻī o GPR81 i ka ʻiʻo adipose kiʻi e like me ka knockout systemic, ka hoʻomaikaʻi ʻana i ka pohō kaumaha a me ka momona a me ka ʻiʻo iwi. Hōʻike kēia i ka GPR81 i loko o ke kiko adipose e koi ʻia no ka hoʻomohala ʻana i ka cachexia maʻi kanesa i alakaʻi ʻia e ka lactic acid.

Ua hōʻoia nā haʻawina hou aʻe ma hope o ka hoʻopaʻa ʻana i ka GPR81, nā molekala lactic acid e hoʻokele i ka momona Browning, lipolysis a me ka hoʻonui ʻana i ka wela ʻōnaehana ma o ke ala hōʻailona Gβγ-RhoA/ROCK1-p38, ma mua o ke ala PKA maʻamau.

ʻOiai nā hopena hoʻohiki i ka pathogenesis o cachexia pili i ka maʻi kanesa, ʻaʻole i unuhi ʻia kēia mau ʻike i nā lāʻau lapaʻau maikaʻi, no laila ʻaʻohe kūlana lapaʻau i kēia manawa no kēia mau maʻi, akā ua kūkulu kekahi mau hui, e like me ESMO a me ka European Society of Clinical Nutrition and Metabolism, i nā alakaʻi alakaʻi. I kēia manawa, ʻōlelo ikaika nā alakaʻi honua i ka hoʻolaha ʻana i ka metabolism a me ka hōʻemi ʻana i ka catabolism ma o nā ala e like me ka meaʻai, hoʻomaʻamaʻa a me ka lāʻau lapaʻau.