Cancer cachexia is a multifactorial syndrome in which a progressive reduction of body mass is characterized by loss of adipose tissue and skeletal muscle mass and metabolic disorders. Its etiology is unknown, it is believed that cachexia is the result of a variety of interactions between host and tumor. Thus, scientific evidence shows that this syndrome is associated with systemic inflammation. In this context, the white adipose tissue (WAT) has a central role in metabolic changes, the depletion of lipid and adipokine dysregulation in the synthesis of pro- and anti-inflammatory. The group of Dr. Seelaender recently demonstrated that cachectic rats bearing the Walker 256 tumor have an increased population of macrophages infiltrating the adipose tissue in the process of cachexia, with great capacity to produce TNF alpha and prostaglandin E2. It was also found that aerobic physical training (PT) was capable of reduce inflitrates in WAT with concomitant abolition of local and systemic inflammation. In cachectic patients with cancer, we recently demonstrated the presence of infiltrating immune cells in WAT, however, it is necessary to implement phenotypic characterization of these cells. In turn, the encouraging results obtained in animal models with the adoption of chronic endurance exercise urged in, 1 year, to implement a protocol to the PT case cachectic patients, University Hospital (UH). After informed consent, patients of the UH shall be enrolled into 4 groups- cachectic cancer patients, non-cachectic cancer patients, cachectic patients, and controls. The groups shall be further divided into sedentary (1st. Phase) and trained (2nd. Phase). The latter will be submitted to 6-week endurance exercise (the protocol has been already tested and standardized for HU patients, after approval by the Ethics Committee). Plasma and tissue samples of both Sedentary and Trained patients will be collected during surgical procedure for tumour excision. The objectives of this study are to investigate and characterize the infiltrating cells in WAT cachectic patients and test the hypothesis of attenuation of infiltration by PT through its anti-inflammatory effect.
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