Protein and Amino Acid Metabolism in Cancer Cachexia

283 Pages·1996·6.76 MB·English

by  Peter W. T. Pisters M.D.

MEDICAL
INTELLIGENCE
UNIT
PROTEIN AND AMINO
ACID
METABOLISM
IN CANCER CACHEXIA
Peter W.T. Pisters
University of Texas
M.D. Anderson Cancer Center
Houston, Texas, U.S.A.
Murray F. Brennan
Memorial Sloan-Kettering Cancer Center
New York, New York, U.S.A.
Springer-Verlag Berlin Heidelberg GmbH
MEDICAL INTELLIGENCE UNIT
PROTEIN AND AMINO ACID METABOLISM
IN CANCER CACHEXIA
R.G. LANDES COMPANY
Austin, Texas, U.S.A.
International Copyright © 1996 Springer-Verlag Berlin Heidelberg
Originally published by Springer-Verlag in 1996
Softcover reprint of the hardcover 1st edition 1996
All rights reserved.
No part of this book may be reproduced or transmitted in any form or by any means, elec
tronic or mechanical, including photocopy, recording, or any information storage and retrieval
system, without permission in writing from the publisher.
'Spring"
International ISBN 978-3-662-22348-2
While the authors, editors and publisher believe that drug selection and dosage and the specifications
and usage of equipment and devices, as set forth in this book, are in accord with current recommend
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changes in governmental regulations and the rapid accumulation of information relating to the
biomedical sciences, the reader is urged to carefully review and evaluate the information provided
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Library of Congress Cataloging-in-Publication Data
Protein and amino acid metabolism in cancer cachexial[edited by}
Peter W.T. Pisters, Murray F. Brennan.
p. em. - (Medical intelligence unit)
Includes bibliographical references and index.
ISBN 978-3-662-22348-2 ISBN 978-3-662-22346-8 (eBook)
DOI 10.1007/978-3-662-22346-8
1. Proteins- Metabolism-Disorders. 2. Amino acids-Metabolism-Disorders.
3. Cachexia. 4. Cancer- Complications. 5. Cancer-Nutritional aspects. 6. Anorexia. I.
Pisters, Peter W.T., 1960-. II. Brennan, Murray F. III. Series.
[DNLM: 1. Cachexia-metabolism. 2. Cachexia-therapy. 3. Neoplasms--complications. 4.
Proteins-metabolism. 5. Amino acids-metabolism. WB 146 P967 1995}
RC632.P7P76 1995
616. 99'4-dc20
DNLM/DLC 95-24641
for Library of Congress CIP
NoTE
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CONTENTS========;-]
r;:::::::=====
1. Animal Models of Cancer Cachexia ............................................ 1
Lawrence E. Harrison
Introduction ......................................................................................... 1
Tumor Models ...................................................................................... 2
Rat ........................................................................................................ 4
Mechanisms of Cancer Cachexia ........................................................... 6
Abnormalities in Host Metabolism ....................................................... 7
Therapeutic Intervention .................................................................... 13
Insulin ................................................................................................ 13
Conclusion .......................................................................................... 14
2. Non-Invasive Techniques to Evaluate Protein
and Amino Acid Metabolism .................................................... 21
RussellS. Berman
History and Anthropometric Measurements ....................................... 21
Serum Proteins .................................................................................... 23
Nitrogen Balance Studies .................................................................... 23
3-Methylhistidine Excretion ................................................................ 24
Body Composition Analysis ................................................................ 25
3. Invasive Techniques to Evaluate Protein
and Amino Acid Metabolism:
Regional and Whole Body Amino Acid Kinetic Studies ............ 33
RussellS. Berman
Regional Protein and Amino Acid Metabolism ................................... 33
Whole Body Protein Metabolism ........................................................ 39
4. Cytokines in Cancer Cachexia .................................................. 51
Kevin G. Billingsley and H Richard Alexander
Introduction ....................................................................................... 51
Cytokines and Cachexia ...................................................................... 53
Tumor Necrosis Factor ....................................................................... 54
lnterleukin-1 ....................................................................................... 61
Interferon GAMMA ........................................................................... 63
lnterleukin-6 ....................................................................................... 63
Leukemia Inhibitory Factor ................................................................. 65
Conclusion .......................................................................................... 66
5. Plasma Amino Acid Concentrations in Cancer Cachexia .......... 73
Steven Hochwald and Martin J Heslin
Animal Studies .................................................................................... 74
Human Studies ................................................................................... 74
6. 3-Methylhistidine and Protein Catabolism ............................... 83
David B. Pearlstone
7. Regional Amino Acid Studies in Cancer Cachexia .................... 93
Elliot Newman and Steven Hochwald
Introduction ....................................................................................... 93
Studies Across Skeletal Muscle Beds .................................................... 93
Studies Involving the Liver Bed ......................................................... 102
Studies Across the Gut ...................................................................... 106
Summary .......................................................................................... 108
8. Whole Body Amino Acid Studies in Cancer Cachexia ............ 113
RussellS. Berman
Amino Acid Studies .......................................................................... 113
Whole Body Kinetic Studies ............................................................. 114
Whole Body Studies and Nutritional Support ................................... 117
9. Total Parenteral Nutrition in Cancer ..................................... 123
Peter W T. Pisters and Murray F. Brennan
Surgical Oncology ............................................................................. 123
Medical Oncology Patients ............................................................... 126
Radiation Oncology Patients ............................................................. 127
Summary .......................................................................................... 128
10. Enteral Nutrition in Cancer .................................................... 133
Peter W. T. Pisters and Murray F. Brennan
11. Glutamine and Cancer Cachexia ............................................. 139
Barrie P. Bode, Craig Fischer, Steven Abcouwer,
Masafumi Wa sa and Wiley W. Souba
Physiologic and Biochemical Importance of Glutamine .................... 140
Summary .......................................................................................... 164
12. Gluconeogenic Blockade ......................................................... 171
Steven Hochwald and Michael Burt
Hydrazine Sulfate .............................................................................. 174
3-Mercaptopicolinic Acid .................................................................. 180
13. Insulin to Impact on Protein and Amino Acid Metabolism .... 187
Martin J Heslin
Introduction ..................................................................................... 187
Non-Cancer Studies (animal & human) ........................................... 188
Tumor-Bearing Animal Studies ......................................................... 191
Human Cancer Studies ..................................................................... 194
14. Growth Hormone/IGF-1 ........................................................ 201
Ronald F. Wolf
Introduction ..................................................................................... 201
Alterations in Metabolism of Cancer Patients .................................... 201
Metabolic Effects of Growth Hormone and IGF-1 ........................... 202
Anabolic Effects of Growth Hormone and IGF-1
in the Tumor-Bearing Host ........................................................... 204
Possible Carcinogenic Effects of Growth Hormone and IGF-1 ......... 208
Future Directions .............................................................................. 208
15. Somatostatin ........................................................................... 213
David L. Bartlett
16. Adrenergic Agents ................................................................... 227
james H. F. Shaw and jonathan B. Koea
Introduction ..................................................................................... 227
The Role of Catecholamines
in the Regulation of Protein Metabolism ....................................... 227
The Role of Catecholamines in the Regulation
of Protein Metabolism in Cancer ................................................... 230
The Role of Sympathomimetic Agents
in the Treatment of Cancer Cachexia ............................................ 233
Summary .......................................................................................... 235
17. Steroids and Progestins ........................................................... 241
Kristine Nelson
Introduction ..................................................................................... 241
Progestins .......................................................................................... 241
Glucocortoids (GC) .......................................................................... 250
Anabolic Steroids (AS) ...................................................................... 257
Summary .......................................................................................... 261
Index .............................................................................................. 271
r;=:::=::===============E DI TO RS ==================il
Peter W.T. Pisters, M.D.
Assistant Professor of Surgical Oncology
University ofTexas
M.D. Anderson Cancer Center
Houston, Texas, U.S.A.
Chapters 9, 10
Murray F. Brennan, M.D.
Department of Surgery
Memorial Sloan-Kettering Cancer Center
New York, New York, U.S.A.
Chapters 9, 10
~======CONTRIBUTORS========!
Steven Abcouwer, Ph.D. RussellS. Berman, M.D.
Division of Surgical Oncology New York University
and the Nutrition Support Unit Medical Center
Department of Surgery New York, New York, U.S.A.
Massachusetts General Hospital Chapters 2, 3, 8
Harvard Medical School
Boston, Massachusetts, U.S.A. Kevin G. Billingsley, M.D.
Chapter II Surgical Metabolism Section
National Cancer Institute
H. Richard Alexander, M.D. Bethesda, Maryland, U.S.A.
Surgical Metabolism Section Chapter 4
National Cancer Institute
Bethesda, Maryland U.S.A. Barrie P. Bode, Ph.D.
Chapter 4 Division of Surgical Oncology
and the Nutrition Support Unit
David L. Bartlett, M.D. Department of Surgery
Memorial Sloan-Kettering Massachusetts General Hospital
Cancer Center Harvard Medical School
New York, New York, U.S.A. Boston, Massachusetts, U.S.A.
Chapter I5 Chapter II