World Journal of Surgery

, Volume 23, Issue 6, pp 584–588 | Cite as

Pancreatic Cancer as a Model: Inflammatory Mediators, Acute-phase Response, and Cancer Cachexia

  • Kenneth C.H. Fearon
  • Matthew D. Barber
  • J.S. Falconer
  • Donald C. McMillan
  • James A. Ross
  • Tom Preston

Abstract.

Patients with pancreatic cancer frequently develop the syndrome of cancer cachexia. Pro-inflammatory cytokines have been strongly implicated in the pathogenesis of this syndrome. In patients with pancreatic cancer an acute-phase response (an index of pro-inflammatory cytokine activity) is associated with accelerated weight loss, hypermetabolism, anorexia, and a shortened duration of survival. However, little is known about the primary significance of the acute-phase response in terms of altered hepatic export protein synthesis rates and its potential impact on the body's nitrogen economy. In a recent series of studies on weight-losing pancreatic cancer patients with hypoalbuminemia we have demonstrated albumin synthesis to be unaltered whereas fibrinogen synthesis is increased two- to threefold compared with healthy controls. Because of the mismatch in amino acid composition between the body's main labile amino acid reserve (skeletal muscle) and that of acute-phase proteins, these results lend support to the concept that in pancreatic cancer the reprioritization of body protein metabolism during an acute-phase response may well be a significant factor in the loss of lean tissue in these patients.

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Copyright information

© 1999 by the Société Internationale de Chir ugie

Authors and Affiliations

  • Kenneth C.H. Fearon
    • 1
  • Matthew D. Barber
    • 1
  • J.S. Falconer
    • 1
  • Donald C. McMillan
    • 2
  • James A. Ross
    • 1
  • Tom Preston
    • 3
  1. 1.Department of Surgery, University of Edinburgh, Royal Infirmary, Lauriston Place, Edinburgh EH3 9YW, UKGB
  2. 2.Department of Surgery, University of Glasgow, Royal Infirmary, Glasgow G4 OSF, UKGB
  3. 3.Isotope/Biochemistry Laboratory, Scottish Universities Research and Reactor Centre, East Kilbride, Glasgow G75 5OQF, UKGB

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