癌症恶病质是合并症的典型例子，发生在大多数癌症患者中。它是肿瘤生长和相关炎症/免疫反应的直接结果。抗癌治疗可能会加剧恶病质，常常导致剂量限制和/或治疗延迟或停止。癌症恶病质的发病机制仍不清楚，包括营养、代谢、激素和免疫成分。肿瘤塑造免疫反应以使其发挥自身优势的能力现已被广泛接受，而这种改变的免疫反应可能在恶病质发作中发挥作用的可能性仍然是一个不确定的问题。事实上，大多数关于恶病质的免疫相关研究主要集中在促炎介质上，几乎完全忽视了免疫细胞之间的相互作用和周围组织的稳态。本综述概述了癌症恶病质中发生的免疫系统失调，重点关注主要为刺激抗癌免疫反应而开发的免疫调节策略也可能有助于对抗恶病质。癌症和恶病质是衰老过程中常见的合并症。沿着这条线，癌症和衰老相关的肌肉萎缩可能在同一患者中共存。由于这两种疾病具有一些共同的潜在机制，因此讨论了免疫调节对衰老性肌肉减少症的潜在有效性。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Cancer cachexia is the prototypical example of comorbidity, occurring in most of cancer patients. It is a direct consequence of tumor growth and of the associated inflammatory/immune response. Cachexia can be exacerbated by anti-cancer therapies, frequently resulting in dose limitation and/or treatment delay or discontinuation. The pathogenesis of cancer cachexia is still unclear and includes nutritional, metabolic, hormonal and immunological components. Tumor ability to shape the immune response to its own advantage is now well accepted, while the possibility that such an altered immune response could play a role in the onset of cachexia is still an undefined issue. Indeed, most of the immune-related research on cachexia mainly focused on pro-inflammatory mediators, almost totally disregarding the interactions among immune cells and the homeostasis of peripheral tissues. The present review provides an overview of the immune system dysregulations occurring in cancer cachexia, focusing on the possibility that immunomodulating strategies, mainly developed to stimulate the anti-cancer immune response, could be useful to counteract cachexia as well. Cancer and cachexia are frequent comorbidities of aging. Along this line, cancer- and aging-associated muscle wasting likely coexist in the same patients. Since both conditions share some of the underlying mechanisms, the potential effectiveness of immunomodulation on sarcopenia of aging is discussed.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.