Pathophysiologic Basis of Anorexia: Focus on the Interaction between Ghrelin Dynamics and the Serotonergic System

Hiroshi Takeda, Koji Nakagawa, Naoto Okubo, Mie Nishimura, Shuichi Muto, Shunsuke Ohnishi, Naoya Sakamoto, Hidetaka Hosono, Masahiro Asaka
2013 Biological and Pharmaceutical Bulletin  
Anorexia is an important issue in the management of elderly patients with cancer because it contributes to the development of malnutrition, increases morbidity and mortality, and negatively affects patients' quality of life. This review summarizes the potential mechanisms of the development of anorexia in three animal models that mimic the situations commonly seen in elderly patients receiving chemotherapy. Cisplatin-induced anorexia is attributable to a decrease in peripheral and central
more » ... l and central ghrelin secretion caused by the stimulation of serotonin (5-hydroxytryptamine; 5-HT) 2B and 5-HT 2C receptors via 5-HT secretion. Age-associated anorexia is caused by an increase in plasma leptin, which results from disturbed reactivity of ghrelin in the hypothalamus and regulation of ghrelin secretion. Environmental change causes the activation of central 5-HT 1B and 5-HT 2C receptors and the melanocortin-4 receptor system, resulting in a decrease in circulat- ing ghrelin levels which lowers food intake. New therapeutic approaches based on these pathophysiological mechanisms are warranted for the treatment of anorexia in cancer patients, especially elderly ones.
doi:10.1248/bpb.b13-00364 pmid:23995649 fatcat:3c7u6b35cjfuxi6re7xaf3audy