+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer



Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer



Annals of Surgery 219(4): 325-331



To determine whether resting energy expenditure (REE) is increased in cachectic patients with pancreatic cancer and to define the relation of tumor necrosis factor (TNF) and interleukin-6 (IL-6) production to the acute-phase response and to REE. Measurement of REE (indirect calorimetry) and assessment of body composition (bioelectrical impedance analysis) were done in 21 patients with unresectable pancreatic cancer and on 16 age-related controls. The systemic inflammatory response in peripheral blood of the cancer patients was assessed using the acute-phase protein, C-reactive protein, and the cytokines TNF and IL-6. Production of these cytokines by peripheral blood mononuclear cells in vitro was also measured. Patients with pancreatic cancer had an elevated REE when compared with controls (73.4 +/- 5.0 vs. 53.5 +/- 1.6 kcal/kg body cell mass; p < 0.003). Resting energy expenditure was significantly greater in cancer patients with an acute-phase response (C-reactive protein > 10 mg/L) than in those who did not have such a response (85.5 +/- 10.0 [n = 9] vs. 64.3 +/- 3.0 [n = 12] kcal/kg body cell mass; p < 0.04). Tumor necrosis factor was not detected in the serum of any of the cancer patients. Serum IL-6 was detected but levels were not significantly different among cancer patients with or without an acute-phase response. In contrast, spontaneous production of TNF and IL-6 by isolated peripheral blood mononuclear cells was significantly greater in cancer patients with an acute-phase response that in those without (TNF: 1231 +/- 244 vs. 210 +/- 54 pg/ml/10(5) cells; p < 0.001; IL-6: 11.5 +/- 1.7 vs. 3.6 +/- 1.4 ng/mL/10(5) cells; p < 0.003). In pancreatic cancer at least a component of weight loss is due to increased REE. Furthermore, the presence of an acute-phase response identifies a group of patients who are markedly hypermetabolic. The serum concentration of TNF of IL-6 does not correlate with the presence of an acute-phase response, whereas rates of cytokine production by peripheral blood mononuclear cells are significantly greater in patients with such a response. This suggests that local rather than systemic cytokine production may be important in regulating the acute-phase response.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 042725973

Download citation: RISBibTeXText

PMID: 7512810

DOI: 10.1097/00000658-199404000-00001


Related references

An acute-phase protein response is associated with increased resting energy expenditure in weight-losing patients with either benign or malignant pancreatic disease. Proceedings of the Nutrition Society 52(3): 240A, 1993

The relationship among acute-phase response proteins, cytokines and hormones in cachectic patients with colon cancer. World Journal of Surgical Oncology 8: 85, 2011

Weight loss and low body cell mass in males with lung cancer: Relationship with systemic inflammation, acute-phase response, resting energy expenditure, and catabolic and anabolic hormones. Clinical Science (London) 97(2): 215-223, 1999

Ibuprofen reduces energy expenditure and acute-phase protein production compared with placebo in pancreatic cancer patients. British Journal of Cancer 72(1): 185-188, 1995

The relationship among acute-phase responce proteins, cytokines, and hormones in various gastrointestinal cancer types patients with cachectic. Human and Experimental Toxicology 31(2): 117-125, 2012

The agreement between measured and predicted resting energy expenditure in patients with pancreatic cancer: a pilot study. Jop 5(1): 32-40, 2004

Resting energy expenditure in patients undergoing pylorus preserving pancreatoduodenectomies for bile duct cancer or pancreatic tumors. Journal of Clinical Biochemistry and Nutrition 48(3): 183-186, 2011

Albumin synthesis rates in cachectic cancer patients with an ongoing acute-phase protein response. Annals of Surgery 228(5): 720, 1998

Albumin synthesis rates are not decreased in hypoalbuminemic cachectic cancer patients with an ongoing acute-phase protein response. Annals of Surgery 227(2): 249-254, 1998

Increased resting energy expenditure and weight loss are related to a systemic inflammatory response in lung cancer patients. Journal of Clinical Oncology 13(10): 2600-2605, 1995

Resting energy expenditure during the acute phase of spinal cord injury. Anesthesiology (Hagerstown) 79(3A): A193, 1993

Insulin resistance in patients with cancer: relationships with tumor site, tumor stage, body-weight loss, acute-phase response, and energy expenditure. Nutrition 17(7/8): 590-593 + viii, 2001

Resting energy expenditure and skeletal muscle uncoupling protein-3 mRNA expression in early pancreatic cancer. Clinical Nutrition (Edinburgh) 19(Supplement 1): 6, August, 2000