Cancer Anorexia and the Central Nervous System
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Purpose
The pathogenesis of cancer anorexia is complex and multifactorial. However, a number of consistent and robust evidence point to a prominent role for the central nervous system. In particular, the hyperactivation of the immune system, due to tumour growth, causes a systemic inflammatory response primarily mediated by pro-inflammatory cytokines. At the central level, inflammatory response profoundly alters the activity of the hypothalamic nuclei, which are involved in the regulation of energy homeostasis. In particular, pro-inflammatory cytokines inhibit prophagic neurons activity, while enhance the activation of the anorexigenic neurons. Although supported by compelling experimental evidence, it should be acknowledged that this pathogenic hypothesis has not been confirmed yet by human studies.
Aim of the present study is to determine the specific pattern(s) of the brain activation after assumption of a standard meal in both anorexic and non-anorexic cancer patients to reveal potential differences, which will be correlated with the levels of concurrently measured circulating pro-inflammatory cytokines. The results obtained would help in assessing the role of the central nervous system and, in particular of the hypothalamus, in the pathogenesis of cancer anorexia.
| Condition |
|---|
|
Cancer Cachexia |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Cross-Sectional |
| Official Title: | Neuroimaging of Hypothalamic Activity During Cancer Anorexia |
- ACTIVATION/NON ACTIVATION OF SPECIFIC BRAIN AREAS, EVALUATED BY FUNCTIONAL MAGNETIC RESONANCE [ Time Frame: TIME 0 AND AFTER 15 AND 45 MINUTES FROM A STANDARD MEAL ASSUMPTION ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples Without DNA
serum
| Estimated Enrollment: | 3 |
| Study Start Date: | April 2010 |
| Estimated Study Completion Date: | June 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
| ANOREXIC CANCER PATIENTS |
| NON-ANOREXIC CANCER PATIENTS |
| CONTROL GROUP |
Detailed Description:
After approval of the study protocol by the Ethical Committee of our Institution (Azienda Policlinico Umberto I, Sapienza University, Rome, Italy), 4 anorexic cancer patients, 4 non-anorexic cancer patients and 8 healthy individuals will be studied. The sample size is based on studies of neuroimaging already published and available on international journals.
Patients with confirmed cancer diagnosis will be enrolled before the initiation of any anti-cancer treatments. The presence/absence of anorexia will be investigated using a specific questionnaire (Cangiano et al., 1990) and a visual analogue scale (VAS). After an overnight fasting, blood samples will be collected from cancer patients and control subjects and interleukin(IL)-1, IL-6 and Tumor Necrosis Factor-α (TNF-α) levels will be measured by a commercially available ELISA kit.
On the same day, hypothalamic activation pattern(s) will be evaluated in patients and in control subjects by fMRI. After basal evaluation, all the groups will receive a standard oral meal, i.e., a 200 mL hypercaloric oral nutritional supplement providing 300 Kcal, and then a second fMRI scan will be performed. Using a computerized software, the average value of the grey for the hypothalamus will be calculated, and normalized for the one obtained in the basal condition, to obtain the percentage (%) of activation (or inhibition) of the hypothalamus.
Data obtained will be statistically analyzed using the t-Student and Bonferroni tests.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Probability Sample |
Lung cancer patients with confirmed cancer diagnosis before the initiation of any anti-cancer treatments will be enrolled. Four anorexic cancer patients, 4 non-anorexic cancer patients and 4 healthy individuals will be studied.
Inclusion Criteria:
- Lung cancer patients at diagnosis
Exclusion Criteria:
- Patients treated with immunosuppressors, with concomitant wasting diseases (e.g. AIDS, trauma, end-stage renal disease)
Contacts and Locations| Italy | |
| Department of Clinical Medicine, Sapienza University of Rome | Recruiting |
| Rome, Italy, 00185 | |
| Contact: Alessandro Laviano, MD +390649973902 alessandro.laviano@uniroma1.it | |
| Principal Investigator: | Alessandro Laviano, MD | Sapienza University of Rome |
More Information
No publications provided
| Responsible Party: | Alessandro Laviano, MD, Associate Professor, University of Roma La Sapienza |
| ClinicalTrials.gov Identifier: | NCT01564693 History of Changes |
| Other Study ID Numbers: | FRFLAV |
| Study First Received: | March 14, 2012 |
| Last Updated: | February 19, 2013 |
| Health Authority: | Italy: Ethics Committee |
Keywords provided by University of Roma La Sapienza:
|
anorexia cancer hypothalamus inflammation |
Additional relevant MeSH terms:
|
Anorexia Cachexia Signs and Symptoms, Digestive Signs and Symptoms |
Emaciation Weight Loss Body Weight Changes Body Weight |
ClinicalTrials.gov processed this record on June 18, 2013