劫持稳态:肿瘤恶液质中的脑-体神经回路与治疗机遇OA

Cancer cachexia is a multifactorial syndrome characterized by progressive skeletal muscle wasting(with or without loss of adipose tissue)that cannot be fully reversed by conventional nutritional support.Traditionally viewed as a peripheral disorder driven by tumor-induced systemic inflammation and metabolic dysregulation,emerging evidence now highlights the central nervous system,particularly the hypothalamus,as a pivotal target in tumor-mediated systemic disruption.This review proposed a"homeostatic hijack-ing"model,systematically elaborating on how tumors release signaling molecules—such as exosomes,inflam-matory cytokines and metabolites—to hijack brain-body neural circuits,thereby reprogramming energy alloca-tion and feeding behavior,and ultimately driving the vicious cycle of cachexia.We analyzed the neuroimmun-emetabolic mechanisms underlying cachexia from two interconnected dimensions:"brain-to-body"(central command dysregulation)and"body-to-brain"(peripheral signal feedback).Furthermore,we prospectively discussed novel therapeutic strategies targeting the brain-body interface,offering a refreshed framework for intervening in this intractable syndrome.