Review
Highlights of the mechanistic and therapeutic cachexia and sarcopenia research 2010 to 2012 and their relevance for cardiology

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Abstract

Sarcopenia and cachexia are significant medical problems with a high disease related burden in cardiovascular illness. Muscle wasting and weight loss are very frequent particularly in chronic heart failure and they relate to poor prognosis. Although clinically largely underestimated, the fields of cachexia and sarcopenia are of great relevance to cardiologists.

In cachexia and sarcopenia a significant number of research publications related to basic science questions of muscle wasting and lipolysis were published between 2010 and 2012. Recently, the two processes of muscle wasting and lipolysis were found to be closely linked. Treatment research in pre-clinical models involves studies on a number of different therapeutic entities, including ghrelin, selective androgen receptor modulators (SARMs), as well as drugs targeting myostatin or melanocortin-4. In the human setting, studies using enobosarm (a SARM) and anamorelin (ghrelin) are in phase III.

The last 3 years has seen significant efforts to define the field using consensus statements. In the future, these definitions should also be considered for guidelines and treatment trials in cardiovascular medicine. The current review aims to summarize important information and development in the fields of muscle wasting, sarcopenia and cachexia focussing on findings in cardiovascular research, in order for cardiologists to have a better understanding of the progress in the still not well enough known field.

Introduction

The last decades has seen increasing interest in muscle wasting [1], [2], [3], [4], [5] and cachexia [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16] research in chronic diseases and ageing. Indeed, both are significant medical problems with a high disease related burden on symptoms, quality of life and prognosis of patients [17], [18], [19] and with high socioeconomic expense [20]. Muscle wasting in general, sarcopenia, lipolysis and cachexia are very active research fields with great medical relevance [21], [22], [23]. New research is abundant and many comprehensive review articles are written to cover the new findings on mechanisms and pathophysiology [24], [25] as well as symptoms [26], [27], nutritional issues [28], [29], and new therapeutic options [30], [31], [32], [33]. In this review we aimed to summarize the most important information on muscle wasting, sarcopenia and cachexia focussing on findings in cardiovascular research, in order for cardiologists to have a better understanding of the progress in this still not well enough known field. In order to reach the wide group of physicians and researchers we have decided to publish this review simultaneously in two renowned journals (wide-scope and cardiologist ones).

Section snippets

Search strategy

We searched the electronic databases MEDLINE, EMBASE and SCOPUS (January 2010 to October 2012). Additionally, abstracts from national and international cardiovascular meetings were searched. The main search terms were: cachexia, sarcopenia, muscle wasting, mechanism, therapy, cardiovascular illness, and heart failure.

Muscle wasting is not only seen in chronically ill patients, but is also prominent in acute and critical illnesses, including sepsis and septic shock [34], and in hospitalised

Journal and conference activities

Finally, the field of cachexia, sarcopenia and muscle wasting research is characterised by the development of several new scientific journals. In 2010, we founded the Journal of Cachexia, Sarcopenia and Muscle (JCSM). In 2011, the journal Skeletal Muscle, and in 2012 The Journal of Frailty & Aging (JFA) were founded. All these journals are free access or open access. Since 2000, six international cachexia conferences have taken place and reported extensively. Since 2000, the number of attendees

Acknowledgment

SvH is a consultant and has received honoraria for speaking from Professional Dietetics, Vifor, and Pfizer. SDA is a consultant, has received honoraria for speaking and/or has attended advisory boards for Amgen Inc., Professional Dietetics, Psioxus Therapeutics, GTx, Helsinn, GSK, Sanofi, Regeneron, Novartis, Takeda, Servier, Chugai and Vifor. All other authors report no conflict of interest. The authors of this manuscript have certified that they comply with the Principles of Ethical

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