Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diabetic neuropathic cachexia is characterized by bilateral, painful neuropathy usually involving the anterior thighs, with dramatic weight loss. The cause is unknown. Most patients to date have been middle-aged type 2 diabetics on oral agents, and it has rarely been reported in patients with type 1 diabetes. Most patients recover spontaneously, although residual deficits may persist. No specific therapy has been found useful. Antidepressants aid in managing neuropathy and depression. Therapy of painful neuropathy is challenging. Tramadol, dextromethorphan, topical capsaicin, clonidine, tricyclic antidepressants, and gabapentin are often effective. Opioids are rarely beneficial and carry a high risk of addiction. Proper nutrition is essential to avoid further deterioration.
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PMID:Diabetic neuropathic cachexia: a rare manifestation of diabetic neuropathy. 1920 23

Up to 50% of cancer patients suffer from a progressive atrophy of adipose tissue and skeletal muscle, called cachexia, resulting in weight loss, a reduced quality of life, and a shortened survival time. Anorexia often accompanies cachexia, but appears not to be responsible for the tissue loss, particularly lean body mass. An increased resting energy expenditure is seen, possibly arising from an increased thermogenesis in skeletal muscle due to an increased expression of uncoupling protein, and increased operation of the Cori cycle. Loss of adipose tissue is due to an increased lipolysis by tumor or host products. Loss of skeletal muscle in cachexia results from a depression in protein synthesis combined with an increase in protein degradation. The increase in protein degradation may include both increased activity of the ubiquitin-proteasome pathway and lysosomes. The decrease in protein synthesis is due to a reduced level of the initiation factor 4F, decreased elongation, and decreased binding of methionyl-tRNA to the 40S ribosomal subunit through increased phosphorylation of eIF2 on the alpha-subunit by activation of the dsRNA-dependent protein kinase, which also increases expression of the ubiquitin-proteasome pathway through activation of NFkappaB. Tumor factors such as proteolysis-inducing factor and host factors such as tumor necrosis factor-alpha, angiotensin II, and glucocorticoids can all induce muscle atrophy. Knowledge of the mechanisms of tissue destruction in cachexia should improve methods of treatment.
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PMID:Mechanisms of cancer cachexia. 1934 10

Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the "spill-over" of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and cachexia. Systemic inflammation may also initiate or worsen comorbid diseases, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes. Comorbid diseases potentiate the morbidity of COPD, leading to increased hospitalisations, mortality and healthcare costs. Comorbidities complicate the management of COPD and need to be evaluated carefully. Current therapies for comorbid diseases, such as statins and peroxisome proliferator-activated receptor-agonists, may provide unexpected benefits for COPD patients. Treatment of COPD inflammation may concomitantly treat systemic inflammation and associated comorbidities. However, new broad-spectrum anti-inflammatory treatments, such as phosphodiesterase 4 inhibitors, have significant side-effects so it may be necessary to develop inhaled drugs in the future. Another approach is the reversal of corticosteroid resistance, for example with effective antioxidants. More research is needed on COPD comorbidities and their treatment.
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PMID:Systemic manifestations and comorbidities of COPD. 1994 19

Unloading-induced atrophy is a relatively uncomplicated form of muscle loss, dependent almost solely on the loss of mechanical input, whereas in disease states associated with inflammation (cancer cachexia, AIDS, burns, sepsis, and uremia), there is a procatabolic hormonal and cytokine environment. It is therefore predictable that muscle loss mainly due to disuse alone would be governed by mechanisms somewhat differently from those in inflammatory states. We suggest that in vivo measurements made in human subjects using arterial-venous balance, tracer dilution, and tracer incorporation are dynamic and thus robust by comparison with static measurements of mRNA abundance and protein expression and/or phosphorylation in human muscle. In addition, measurements made with cultured cells or in animal models, all of which have often been used to infer alterations of protein turnover, appear to be different from results obtained in immobilized human muscle in vivo. In vivo measurements of human muscle protein turnover in disuse show that the primary variable that changes facilitating the loss of muscle mass is protein synthesis, which is reduced in both the postabsorptive and postprandial states; muscle proteolysis itself appears not to be elevated. The depressed postprandial protein synthetic response (a phenomenon we term "anabolic resistance") may even be accompanied by a diminished suppression of proteolysis. We therefore propose that most of the loss of muscle mass during disuse atrophy can be accounted for by a depression in the rate of protein synthesis. Thus the normal diurnal fasted-to-fed cycle of protein balance is disrupted and, by default, proteolysis becomes dominant but is not enhanced.
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PMID:Alterations of protein turnover underlying disuse atrophy in human skeletal muscle. 1960 31

D-myo-inositol 1,2,6-triphosphate (alpha trinositol, AT) has been shown to attenuate muscle atrophy in a murine cachexia model through an increase in protein synthesis and a decrease in degradation. The mechanism of this effect has been investigated in murine myotubes using a range of catabolic stimuli, including proteolysis-inducing factor (PIF), angiotensin II (Ang II), lipopolysaccharide, and tumor necrosis factor-alpha/interferon-gamma. At a concentration of 100 muM AT was found to attenuate both the induction of protein degradation and depression of protein synthesis in response to all stimuli. The effect on protein degradation was accompanied by attenuation of the increased expression and activity of the ubiquitin-proteasome pathway. This suggests that AT inhibits a signalling step common to all four agents. This target has been shown to be activation (autophosphorylation) of the dsRNA-dependent protein kinase (PKR) and the subsequent phosphorylation of eukaryotic initiation factor 2 on the alpha-subunit, together with downstream signalling pathways leading to protein degradation. AT also inhibited activation of caspase-3/-8, which is thought to lead to activation of PKR. The mechanism of this effect may be related to the ability of AT to chelate divalent metal ions, since the attenuation of the increased activity of the ubiquitin-proteasome pathway by PIF and Ang II, as well as the depression of protein synthesis by PIF, were reversed by increasing concentrations of Zn(2+). The ability of AT to attenuate muscle atrophy by a range of stimuli suggests that it may be effective in several catabolic conditions.
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PMID:Mechanism of attenuation of protein loss in murine C2C12 myotubes by D-myo-inositol 1,2,6-triphosphate. 1971 18

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible, though a number of pulmonary phenotypes are recognized. These include small airways diseases, chronic bronchitis and bronchiectasis, as well as pulmonary emphysema, which can be further subdivided by the zone of the lung which it affects, and its radiological appearance. In addition COPD is associated with a number of comorbidities, which are found more frequently than would be expected by chance, even after controlling for common etiological factors (such as smoking or steroid use). These comorbid conditions may be responsible for some of the deterioration and de-conditioning seen in COPD, as well as a significant proportion of mortality, and should be sought and managed where clinically appropriate. This review examines the prevalence and clinical features of associated comorbid conditions, including atherosclerosis, cardiac failure, diabetes, osteoporosis, cachexia, gastro-esophageal reflux disease and depression. A brief consideration of their management in COPD is also given. In addition evidence for the concept of pulmonary overspill leading to systemic inflammation, the consequences of systemic inflammation, the possibility of accelerated aging, and of how these concepts could relate to shared genetic risk factors for both comorbidity and pulmonary aspects of COPD is discussed.
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PMID:Chronic obstructive pulmonary disease and comorbidity: a review and consideration of pathophysiology. 2019 37

This represents the third clinical update based on presentations at the American Medical Directors Association (AMDA) annual meeting. Topics covered this year include hypertension, heart failure, cachexia, dehydration, falls, depression, constipation, and aspiration pneumonia.
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PMID:Clinical update on nursing home medicine: 2009. 1980 52

Pain threshold (or perception) can increase or decrease according to some factors like gender, depression or individual differences. Also, previous studies showed that pain threshold can change in obesity but, these studies on the effects of obesity on pain threshold have given controversial results. In the obese people who were exposed to pain stimulation to determined pain threshold, an increased pain threshold was observed. Contrarily, in the studies using electrophysiological test had lower pain threshold, which indicates a reverse correlation between degree of overweight and the threshold of the nociceptive reflex. These studies indicate possible interrelationships between the endogenous opioids, nociception and obesity or eating behavior. Nevertheless, its mechanism is still unclear. The endocrine changes that play an important role in obesity can lead an increase or decrease in pain threshold. There are a few researches about these hormonal factors which are related to pain pathways, that they are nociceptive (like leptin) or antinociceptive effect (like ghrelin, orexin A and B). Ghrelin is one of the hormones which is related to obesity. There are studies which prove the relationship between this hormone and the systems that play a role in pain modulation in the brain. However, there is no previous knowledge about the effects of ghrelin on pain threshold in obesity. But, many strong evidence are present to hypothesise that ghrelin may have effects on pain threshold. Obesity and fasting are the two main situations in which ghrelin secretion is mostly modified. Circulating ghrelin levels negatively correlate with BMI, meaning increased ghrelin secretion during fasting, malnutrition, cachexia, and in anorexia nervosa and reduced ghrelin secretion in obesity. Therefore, we have the opinion that ghrelin play an important role in obesity-pain relationship and/or regulate other systems that are related to pain pathway. Based on the above analyses, we propose a hypothesis that the diminution of the susceptibility to pain in lean subjects/animals may be induced by the increase in endogenous ghrelin activity, or increased of the susceptibility to pain in obese subject/animals may be induced by the decrease in endogenous ghrelin activity.
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PMID:Possible involvement of ghrelin on pain threshold in obesity. 1988 81

An 18-year-old, neutered, male Vietnamese pot-bellied pig (Sus scrofa) was treated for chronic, intermittent nasal discharge and sneezing. The animal was diagnosed with severe periodontal disease (grade IV), an oronasal fistula, and multiple tooth root abscesses via dental examination and computed tomography of the skull. Dentistry was performed, including multiple tooth extractions, and antibiotic therapy was initiated. Eighteen months later, the animal was evaluated for lethargy, anorexia, and a firm, 12 cm x 12 cm mass between the 2 rami of the mandible. Laboratory testing revealed moderate anemia, severe leukocytosis, and hyperglobulinemia. Skull radiographs indicated osteomyelitis of the mandible and soft-tissue swelling. A fine-needle aspirate and biopsy were taken, and results were consistent with squamous cell carcinoma. Treatment with piroxicam and antibiotics was initiated as needed to control signs of pain and secondary infection, respectively. Three months after diagnosis, the pig was euthanized due to cachexia and severe depression secondary to squamous cell carcinoma. On postmortem examination, the right mandibular area contained multiple, coalescing, irregular masses extending from the ramus rostrally to the mandibular canine teeth and ventrally within the intermandibular space, completely obliterating the normal anatomy. An open midshaft fracture was present on the right mandible. On histopathology, the masses were confirmed as locally invasive and destructive squamous cell carcinoma. No evidence of metastasis was noted in regional lymph nodes or in any of the distant sites evaluated.
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PMID:Oral squamous cell carcinoma in a Vietnamese pot-bellied pig (Sus scrofa). 1990 1

Male hypogonadism is commonly diagnosed on the basis of subphysiological concentrations of androgen hormones, and is associated with many symptoms present in advanced cancer. Androgen deficiency might be an important cause of muscle wasting in both cancer cachexia and sarcopenia. We did a systematic review of the clinical association of male hypogonadism in advanced cancer. We searched PubMed, Medline, and Embase for publications on the relation between male hypogonadism and functional status, nutritional status, body composition, symptoms, and quality of life in patients with advanced cancer. Of 381 publications identified, six original articles were included. We found no definitive association between nutritional, functional, or quality-of-life characteristics and male hypogonadism. Possible associations between male hypogonadism and weight loss, low albumin, low-body cell mass index, low-peripheral fat and muscle mass, higher inflammation, higher pain, higher opioid consumption, worse scores for anxiety, depression, and emotional and functional well-being need to be confirmed by better designed studies. There is no clear epidemiological data to indicate whether male hypogonadism is independently associated with clinical and biological sequelae of cancer cachexia, such as higher inflammation, fatigue, and body wasting. Standardised kits sensitive to low concentrations of free-testosterone or bioavailable testosterone are needed to diagnose androgen deficiency in women. A clearer epidemiology of androgen deficiencies in advanced cancer will help determine which patients should receive testosterone-replacement therapy for alleviating cancer cachexia symptoms and improving quality of life.
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PMID:Male hypogonadism associated with advanced cancer: a systematic review. 2054 64


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