Possible mediators of anorexia-cachesia syndrome are hormones, cytokines, and leptin at the peripheral tissues, and neuropeptides, cytokines, and hormones in the hypothalamus. Insulin resistance and relative hyper-glucagonemia might stimulate anorexia. Interleukin(IL)-6, and tumor necrosis factor(TNF)-alpha as well as IL-1 and leukemia inhibitory factor(LIF) are some of those cytokines. Although leptin in the adipose tissue is an attractive addition, changes in the tumor-bearing state does not support its active role in the induction of anorexia. Newer neuropeptides related with anorexia and oxygenia have been found in the hypothalamus. Hypothalamic neuropeptide Y(NPY) and ciliary neurotropic factor(CNTF) are some of those promising mediators. Although current trend has been progestational drugs, newer drugs such as anticytokines, anabolic agents, and neuropeptide agonists/antagonists are now under investigations.
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