Editing Cachexia (section)

=== Inflammatory ===
Certain molecules in the body, called [[Inflammatory cytokine]]s, play a big role in causing cachexia. Two important ones are [[tumor necrosis factor|tumor necrosis factor (TNF)]] and [[interleukin 6|interleukin 6 (IL-6)]].<ref name="fearon-2012" />

==== Tumor Necrosis Factor (TNF) ====
TNF breaks down muscle and fat while stopping new muscle and fat cells from forming by activating the [[ubiquitin proteasome pathway]].<ref name="ferrer-2023" /><ref name="fearon-2012" /><ref name="Kumar" /><ref name="petruzzelli-2016">{{Cite journal |last1=Petruzzelli |first1=Michele |last2=Wagner |first2=Erwin F. |date=2016-03-01 |title=Mechanisms of metabolic dysfunction in cancer-associated cachexia |journal=Genes & Development |language=en |volume=30 |issue=5 |pages=489–501 |doi=10.1101/gad.276733.115 |issn=0890-9369 |pmc=4782044 |pmid=26944676}}</ref><ref name="nishikawa-2021" /><ref name="setiawan-2023">{{Cite journal |last1=Setiawan |first1=Tania |last2=Sari |first2=Ita Novita |last3=Wijaya |first3=Yoseph Toni |last4=Julianto |first4=Nadya Marcelina |last5=Muhammad |first5=Jabir Aliyu |last6=Lee |first6=Hyeok |last7=Chae |first7=Ji Heon |last8=Kwon |first8=Hyog Young |date=2023-05-22 |title=Cancer cachexia: molecular mechanisms and treatment strategies |journal=Journal of Hematology & Oncology |language=en |volume=16 |issue=1 |page=54 |doi=10.1186/s13045-023-01454-0 |doi-access=free |issn=1756-8722 |pmc=10204324 |pmid=37217930}}</ref> It also triggers the release of other cytokines that also speed up muscle loss. Since this process is very complex, cachexia is unlikely to be caused by one molecule.<ref name="petruzzelli-2016" /> While it is thought to be produced by immune cells called [[macrophage]]s, scientists are still unsure of exactly where TNF is produced in cachexia.<ref name="fearon-2012" />

==== Interleukin-6 (IL-6) ====
IL-6 is thought to cause muscle loss by starting a pathway called the [[JAK-STAT signaling pathway|JAK/STAT pathway]].<ref name="ferrer-2023" /><ref name="fearon-2012" /><ref name="setiawan-2023" /><ref>{{Cite journal |last1=Moresi |first1=Viviana |last2=Adamo |first2=Sergio |last3=Berghella |first3=Libera |date=2019-04-30 |title=The JAK/STAT Pathway in Skeletal Muscle Pathophysiology |journal=Frontiers in Physiology |volume=10 |page=500 |doi=10.3389/fphys.2019.00500 |doi-access=free |issn=1664-042X |pmc=6502894 |pmid=31114509}}</ref> IL-6 is produced by immune cells called macrophages, potentially producing [[acute phase reactants]] which may worsen muscle loss.<ref name="fearon-2012" /><ref name="petruzzelli-2016" />

Other molecules may include:

* [[Myostatin]] - Prevents muscle growth and is often higher in people with cancer.<ref name="fearon-2012" /><ref name="petruzzelli-2016" /><ref name="argiles-2016">{{cite journal |vauthors=Argilés JM, Campos N, Lopez-Pedrosa JM, Rueda R, Rodriguez-Mañas L |date=September 2016 |title=Skeletal Muscle Regulates Metabolism via Interorgan Crosstalk: Roles in Health and Disease |journal=Journal of the American Medical Directors Association |volume=17 |issue=9 |pages=789–96 |doi=10.1016/j.jamda.2016.04.019 |pmid=27324808 |doi-access=free}}</ref>
* Activin - May contribute to muscle loss when TNF is also active.<ref name="fearon-2012" /><ref name="petruzzelli-2016" />
* Growth Differentiation Factor 15 (GDF-15) - Normally produced during cellular stress. Thought to play a role in food aversion and is associated with reduced food intake.<ref name="ferrer-2023" />