HNE-37506 Metabolic Consequences of Chronic Disease; Nutritional and Pharmacological Intervention


Credits 6.00

Teaching methodContact hours
Group work32
Independent study
Course coordinator(s)dr. K van Norren
Lecturer(s)prof. dr. RF Witkamp
dr. K van Norren
MSc RLC Plas
dr. LM Janssen Duijghuijsen
PS Vinke
prof. dr. ir. J Keijer
Examiner(s)dr. K van Norren
prof. dr. RF Witkamp

Language of instruction:


Assumed knowledge on:

Human Physiology Preferred: General medicine, human pathology, Nutrition and Pharmacology, at least basic knowledge of nutrition and health, immunology The course has a mechanistic and molecular focus.
This course might be attended by students from different disciplines, however to be able to apply the obtained knowledge mechanistically, some general background information on these topics is strongly advised.
To find out more about this course and to self-asses if you have the proper background, please watch the introduction movie and do the self-assessment


Note: This course has a maximum number of participants. The deadline for registration is one week earlier than usual. See Academic Year.( -> Registration for Courses.

During chronic disease (cancer, COPD, metabolic syndrome, heart failure) but also during normal ageing progressive changes in homeostasis and metabolism occur. These changes may significantly contribute to impaired quality of life and (or) disease burden. Increasing evidence indicates that next to intervention strategies directed towards the primary (disease-) process it makes sense to target these associated disorders. Combinations of nutritional and pharmacological intervention can often provide feasible and relevant strategies to improve a persons' health status or quality of life.
During this course different aspects of metabolic changes that affect nutritional status, treatment-ability and outcome of the patient with chronic disease will be discussed. The focus will be on disease or treatment-induced loss of muscle mass and function. The course focuses on 1) inflammation as a general common inducer of muscle loss, 2) tissues of inflammatory origin: adipose tissue, gut and tumour, 3) disease or treatment specific mechanisms (e.g. disease induced anorexia , hypoxia / ischemia or ischemia/reperfusion induced muscle protein breakdown (COPD, cancer, heart failure, surgery)), 4) how interaction between the sources of inflammation can enhance the effect. 5) Moreover, the metabolism linking inflammation-induced muscle loss and patient outcome (infectious complications and drug toxicities) will be discussed in depth as well as 6) current evidence on multi-target treatment interventions in this process with nutrition, pharma or exercise and 7) the knowledge gap that is still there on treatment of muscle wasting that is crucial to be filled in, to be able to interfere.

Learning outcomes:

After successful completion of this course students are expected to be able to:
- explain the main mechanisms involved in disease-related changes in homeostasis and metabolism;
- define cachexia and its main characteristics;
- interpret and analyse the different pathways involved in disease or treatment induced muscle loss;
- integrate the consequences of increased intestinal permeability to inflammatory responses of the body;
- present a conference-worth oral presentation based on the concept 'take on the role of one of the presenters of the two-yearly world cachexia conference' combined with a bibliographic and pathway-specific literature search;
- apply the basic concepts of networking at conferences;
- apply knowledge on the concepts how a change in body composition as present in cachexia can influence treatment efficacy and treatment toxicity of drugs to recommendations for future research on drug treatment regimens;
- integrate and apply the discussed and self-analysed pathways to outcomes of the intensive practical training and outcomes (cell metabolic experiments) of the computer animated outcomes (simulation of animal cachexia models);
- discuss in depth above mentioned outcomes in context with current status of literature.


Apart from lectures (including some invited lecturers) a mini conference will be organized by the students based on the two-yearly world cachexia conference.
The practical is used to illustrate and practice interpretation of results in the context of pathway analysis from literature.
It will be split in two research approaches:
- inflammatory cell metabolic experiments;
- computer animated simulations of animal cachexia models.


The acquired knowledge will be tested by an exam that consists of 10 to 14 essay questions (equivalent to max 70 points).
The practical report accounts for an equivalent of max 15 points as does the conference-worth oral presentation.
When 55 or more points have been acquired for the exam plus report and presentation, the student has passed the course successfully.


To be announced.

Restricted Optional for: MNHNutrition and HealthMScC: Molecular Nutrition and Toxicology6MO