Die Rolle der Wärmeregulation des menschlichen Organismus bei einer Krebserkrankung und die rote Muskulatur als mögliche Wärmequelle eines antitumoralen Fiebers

Henning M. Schramm
Article-ID: DMS-21162-DE
DOI: https://doi.org/10.14271/DMS-21162-DE

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Die Temperatur im menschlichen Organismus wird durch eine Hierarchie von neuronalen und endokrinen Strukturen reguliert, die im gesamten Gehirnstamm und Rückenmark lokalisiert sind und im präoptischen Bereich des rostralen Hypothalamus koordiniert werden. Störungen im Gleichgewicht zwischen wärme- und kälteempfindlichen Neuronen lösen entsprechende Reaktionen über die neuronalen und endokrinen Strukturen aus. Für die periphere Temperatur spielt hierbei die Durchblutung eine entscheidende Rolle, für die Kerntemperatur dagegen sind neben Bewegungs-, Stoffwechsel- und Verdauungswärme das braune Fettgewebe und die rote Muskulatur die entscheidenden Wärmequellen zur Regulation der Thermohomöostase sowie eines Fieberverlaufes.

Bei einer Krebserkrankung und insbesondere in Verbindung mit der Cancer Fatigue kommt es bei der Regulation der Thermohomöostase in diesen beiden Organen zu tiefgreifenden Veränderungen. Wir werden besonders auf die Rolle der roten Muskulatur eingehen, die zwei verschiedene Funktionen wahrnimmt. Einerseits trägt sie zur Wärmeregulation der Kerntemperatur entscheidend bei, andererseits erfüllt sie posturale und Bewegungsfunktionen im Zusammenhang mit unserer aufrechten Körperhaltung. Ihre Funktionen sind beim Krebspatienten grundlegend gestört und dies spielt bei verminderter Kälteresistenz und bei Cancer Fatigue eine bedeutende Rolle.

The role of temperature regulation in the human organism with cancer and slow oxidative fibres as a possible source of warmth with antitumor pyrexia

In the human organism the temperature is regulated by a hierarchy of neuronal and endocrine structures localized in the whole of the brain stem and spinal marrow that are coordinated in the preoptic region near the rostral hypothalamus. Disorders of the balance between heat and cold sensitive neurones trigger relevant reactions via the neuronal and endocrine structures. The circulation plays a crucial role for the peripheral temperature, but for the core temperature the key sources of warmth to regulate thermohomeostasis and the course taken by pyrexia are warmth due to movement, metabolism and digestion as well as brown fatty tissue and slow oxidative muscle fibres.

In the case of cancer and especially in conjunction with cancer fatigue, thermohomeostasis regulation causes deep-reaching changes in these two organs. We will give special consideration to slow oxidative muscle fibres which have two different functions. On the one hand they make a major contribution to the regulation of the core temperature, on the other they have postural and movement functions in connection with our upright posture. Their functions are seriously affected in cancer patients and that plays a significant role in reduced resistance to cold and cancer fatigue.

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