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Immunology and cachexia: a review


Article: The interplay of immunology and cachexia in infection and cancer

Many types of conditions and diseases are associated with wasting syndromes such as cachexia. However, despite its prevalence, there is limited knowledge regarding the diagnosis and treatment of cachexia due to our lack of understanding of the causative molecular mechanisms. Cachexia must be viewed through an immunological context to understand its full consequences on patient prognosis. For example, it is known that cytokines such as tumour necrosis factor, IL-1β, IL-6 and IFNγ are consistently upregulated in cases of cachexia in both immune and non-immune cells. This appears to lead to the changes in transcriptional regulation, inducing catabolic pathways in muscles and adipose tissue. Yet, despite this understanding, targeting such cytokines has not shown successful in clinical settings. Further research has also been done to identify the involvement of immune cells such as macrophages, neutrophils, myeloid-derived suppressor cells and T cells in cachexia. Yet, their full involvement in the condition is not yet understood. Hence, many questions remain about this interplay between cachexia and immune system. It is vital to discover the common and unique properties of cancer cachexia and infection-associated cachexia to develop effective therapeutic strategies for cachexia.

This review by Baazim H et al. aimed to highlight the relationship between the immune system and cachexia, as well as our current lack of knowledge surrounding this syndrome.

Key learnings

Future research surrounding cachexia must focus on understanding the role of immunology in this condition. Immune cells are highly understudied in this field, and may therefore be an important factor in supporting the development of an effective management strategy for cachexia. Understanding cachexia for such an interdisciplinary angle will allow for a more holistic treatment of cachexia.

Reviewed by: Z. Beketova

Authors: Baazim H, Antonio-Herrera L & Bergthaler A

Published in: Nat Rev Immunol 2022

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