Strategies for potential manipulation of anorexia during acute and chronic disease

Acute and chronic pathologic processes and immunotherapy in humans are frequently accompanied by anorexia and other neurologic manifestations of disease. Various signals (including cytokines such as immunomodulators) are responsible for anorexia during disease or immunotherapy. Anorexia during disease can be beneficial or deleterious to an organism depending on the timing and duration. For example, a restriction in the intake of micronutrients and macronutrients may be part of the biological roles of the temporal anorexia that accompanies infection. However, diseases with long-term anorexia may be associated with cachexia. Present research on anorexia focuses on elucidating the immunochemical and neuronal mechanisms that contribute to anorexia and on developing potential interventions including the following: 1) nutritional substrates; 2) monoclonal antibodies, receptor antagonists, soluble receptors, and other cytokine (including endogenous) inhibitors; 3) glucocorticoids and other steroids; 4) nonsteroidal antiinflammatory agents; 5) neuropeptide inhibitors of cytokine action; and 6) antisense strategies.