恶性肿瘤患者中营养不良发生率很高,而肌肉减少是恶性肿瘤相关营养不良的重要特征。 免疫与代谢因素相互作 用共同导致肌肉减少。 炎症被认为是肿瘤相关肌肉减少的关键原因,包括炎症因子和免疫细胞的参与。 炎症因子及其介导 信号通路的激活,导致肌肉组织分解代谢增加。 但多数靶向炎症因子的药物并未展示出较好的治疗肿瘤相关肌肉减少的效 果,说明其他机制参与其中。 近年来有研究发现固有免疫细胞和适应性免疫细胞通过影响摄食行为、代谢重编程和调控肌肉 组织干细胞参与肿瘤相关肌肉减少过程,但具体机制尚未阐明。 此外,肌肉减少所致的循环及局部的代谢底物水平的改变也 影响免疫细胞的激活和信号转导。 因此,分析免疫因素与肌肉组织的相互作用时,应注意系统循环和局部微环境的统一性和 差异性,以找出可施加干预的靶点,为治疗肿瘤相关的肌肉减少提供方向,从而改善肿瘤患者的治疗应答以及临床获益。

The incidence of malnutrition is high in patients with malignant tumors while muscle loss is an important feature of malignancy related malnutrition. Inflammation is thought to be a key cause of tumor-associated muscle loss including the involvement of inflammatory factors and immune cells. The activation of inflammatory factors and their mediated signaling pathways leads to the increase of catabolism in muscle tissue. However most drugs targeting inflammatory factors have not shown a good effect on tumor-related muscle loss suggesting that other mechanisms are involved. In recent years it has been found that innate immune cells and adaptive immune cells participate in tumor-related muscle loss through modulating feeding behavior metabolic reprogramming and regulation of muscle tissue stem cells but the specific mechanism has not been clarified. The interaction of immune and metabolic factors jointly leads to muscle loss. The metabolic changes in systemic circulation and the local microenvironment caused by muscle loss also affect the activation and signal transduction of immune cells. Therefore the analysis of the interaction of immune factors with muscle tissue should pay attention to the unity and variability of the systemic circulation and the local microenvironment in order to identify targets on which interventions can be exerted and to provide direction for the treatment of tumor-related muscle loss thereby to improve treatment response as well as clinical benefit in patients with malignant tumor.