Naslov
AUTOIMMUNE SARCOPENIA - CURRENT KNOWLEDGE AND PERSPECTIVE

Autori
Radic, M

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Skup
World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2018)

Mjesto i datum
Kraków, Poljska, 19.04.2018. - 22.04.2018

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
AUTOIMMUNE, SARCOPENIA

Sažetak
Objective: Sarcopenia is defined as age-associated loss of muscle mass, strength and function with profound impact on functionality as well as on mortality. “Secondary sarcopenia” has now been described in the context of severe and chronic disease such as malignant disease or inflammatory disorders and has been linked to poor clinical outcome. There is currently no widely accepted definition of sarcopenia in autoimmune diseases. Methods: A systematic literature search was carried out in MEDLINE ; EMBASE ; Cochrane Library and ACR/EULAR meeting abstracts. Results: Inflammatory signaling is highly associated with sarcopenia. Mechanistically, increased tumor necrosis factor -α levels lead to inflammation via nuclear factor kappa B activation and finally result in muscle wasting. In rheumatoid arthritis (RA), there are many factors able to increase the risk of sarcopenia. Among them: decrease in physical activity, elevated tumor necrosis factor α and interleukin 1 β levels, increased energy expenditure during rest, high C-reactive protein levels, immobility secondary to stiffness, and pain. Previous studies have shown that unhealthy body composition—especially rheumatoid cachexia, sarcopenic obesity— were related to disease activity, disability scores and rheumatoid factors. Furthermore, there is a high prevalence of sarcopenia in patients with systemic sclerosis (SSc) even among younger patients. Taking a higher number of immunosuppressive or other drugs was identified as a risk factor for sarcopenia in SSc patients. In SSc the prevalence of autoimmune sarcopenia is increased which is associated with inflammation and impaired strength of upper and lower extremities. However, a significantly high proportion of systemic lupus erythematosus (SLE) patients could be classified as sarcopenic, as compared with non-inflammatory controls. The excessive waste of fat-free mass found in SLE could contribute to disease activity and decreased physical activity. Additionally, the catabolic effect of high corticosteroid doses, such as those used in severe lupus, might have contributed to the more frequent sarcopenia observed in SLE patients. Controversy exists whether cardiovascular risk is increased in rheumatic patients with autoimmune sarcopenia. Conclusion: Autoimmune sarcopenia affects the quality of life and promotes the increasing of morbidity in SLE, RA and SSc. Several pro- inflammatory cytokines, a reduction in protein synthesis in myocytes, insulin resistance, inadequate protein intake and deficiencies in muscle regeneration, may play a role in autoimmune sarcopenia.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA