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Muscle

Muscle Wasting Disease (MWD) in Cachexia and Sarcopenia

AllAgeingCachexiaCancer CachexiaClinical TrialsExerciseFrailtyFrom the literatureGuidelinesMuscleNutritionOther SCWD EventsSarcopenia

2022: A year of research in JCSM

The Journal of Cachexia, Sarcopenia and Muscle mainly publishes research on cachexia, sarcopenia and muscle wasting disorders, but also includes papers on cancer, heart failure, ageing and many other conditions. Before November 2022, there were seen to be 775,000 downloads of the articles within the journal, with the top three countries downloading articles being China, the US and Japan. The most downloaded and cited article is entitled, Cachexia as a major underestimated and unmet medical need: facts and numbers.
This review by Frohlich A et al. aimed to review the successes of the Journal of Cachexia, Sarcopenia and Muscle in 2022.

Read More2022: A year of research in JCSM

Explaining and combatting the knowledge gaps surrounding sarcopenia

Sarcopenia is characterised by an age-related decline in muscle mass and strength combined with impairments in physical function. The risk of falls, fractures, and death is doubled in individuals with sarcopenia compared to those without. This patient population also frequently possesses comorbid diseases, including diabetes, cardiovascular disease, dementia, and chronic obstructive pulmonary disease. This may significantly increase their risk of suffering adverse outcomes post-surgery.

The aim of this editorial was to expose the serious nature of sarcopenia and underscore associated knowledge gaps in clinical practice.

Read MoreExplaining and combatting the knowledge gaps surrounding sarcopenia

The inflammatory response in muscle homeostasis and plasticity: a review

Around half of a healthy personโ€™s body weight is made up of skeletal muscle. This type of muscle is able to demonstrate high levels of plasticity. In muscle homeostasis, as well as repair processes, there are satellite cells and inflammatory cells which play key roles. However, if the recruitment of inflammatory cells is not carefully controlled, muscle atrophy and fibrosis may occur, leading to muscle function impairment. Hence, the inflammation occurring in muscle repair as a double-edged sword. This is because inflammatory mediators play a role in fighting pathogens as well as in the formation of mature myofibres, but may also cause damage to the muscle. For example, inflammation is also associated with cachexia - specifically, there is a correlation between cachexia and high levels of circulating cytokines.
This paper also ends with a summary of approaches to treating muscle wasting disorders, such as cachexia, discussing exercise, nutritional interventions and targeting inflammatory pathways.
This review by Bouredji Z et al. aimed to discuss inflammation in muscle homeostasis and repair, as well as some management approaches to muscle wasting disorders such as cachexia.

Read MoreThe inflammatory response in muscle homeostasis and plasticity: a review

The bone-muscle connection in breast cancer: a review

Breast cancer treatments often lead to musculoskeletal morbidity; muscle loss in general is seen as a complication of breast cancer, affecting survival and quality of life. Emerging new research into the biochemical and molecular links between the skeletal and muscular systems is beginning to be taken into account, alongside the well-known anatomical relationship, to improve our understanding of these effects. This paper discussed treatments such as anti-oestrogen therapy, which deteriorates bone health and muscle mass, and the significance of these effects in lower survival rates and worse outcomes for patients. In this sense, exercise is concluded to be of aid for patients with breast cancer in improving their outcomes.
This review by Ballinger T et al. aimed to understand the relevance of musculoskeletal health to breast cancer, and the strategies that could aid patients in this disease.

Read MoreThe bone-muscle connection in breast cancer: a review

Muscle Wasting Disease (MWD) in Cachexia and Sarcopenia

Weight loss is the hallmark of any progressive acute or chronic disease state. In its extreme form, it involves a significant lean body mass (including skeletal muscle), and fat loss. Skeletal muscle provides a fundamental basis for human function, enabling locomotion and respiration. Muscle wasting is related to a poor quality of life and increased morbidity/ mortality.

Two common but distinct conditions characterized by a loss of skeletal muscle mass are sarcopenia and cachexia. Sarcopenia, cachexia, and anorexic disorders (protein-energy malnutrition) represent the major causes of muscle-wasting disorders.

It has been known for millennia that muscle and fat wasting leads to poor outcomes including deaths in chronic disease states.

It is usually accompanied by physical inactivity, decreased mobility, slow gait, and poor physical endurance which are also common features of the frailty syndrome.

Fig. 1 โ€“ Framework for the suggested classification of MWD by disease etiology and disease progression.

Both cachexia and sarcopenia are characterized by an important muscle dysfunction that leads to increased morbidity and mortality.

Fig. 2 โ€“ The cachexia/ sarcopenia pyramid. Both lead to muscle dysfunction.

References

Kalantar-Zadeh K, Rhee C, Sim JJ, Stenvinkel P, Anker SD, Kovesdy CP.ย Why cachexia kills: examining the causality of poor outcomes in wasting conditions.ย J Cachexia Sarcopenia Muscle 2013; 4: 89โ€“94.

Evans WJ, Morley JE, Argilรฉs J, Bales C, Baracos V, Guttridge D, et al.ย Cachexia: a new definition.ย Clin Nutr 2008; 27: 793โ€“799.

Anker SD, Coats AJS, Morley JE, Rosano G, Bernabei R, Haehling S, et al.ย Muscle wasting disease: a proposal for a new disease classification.ย J Cachexia Sarcopenia Muscle 2014; 5: 1โ€“3.

Argiles JM, Busquets S, Stemmler B, Lรณpez-Soriano FJ.ย Cachexia and sarcopenia: mechanisms and potential targets for intervention.ย Current Opinion in Pharmacology 2015; 22: 100โ€“106.

Bowen TS, Schuler G, Adams V.ย Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training.ย J Cachexia Sarcopenia Muscle 2015; 6: 197โ€“207.

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