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cent randomized phase III clinical trial suggested that combination therapy with MA, EPA supplementation, thalidomide, and L-carnitine was significantly more effective in improving lean body mass and appetite than single agents. Combination pharmacological therapy with nutritional supplementation PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19854492 of n-3 PUFAs may be the appropriate approach to cancer BIRB796 chemical information cachexia management. Nutritional supplements of n-3 PUFAs as immuno-modulators have also been studied in several clinical trials for their ability to prevent inflammation and infection. Administration of n-3 PUFAs pre- or post-surgery of major abdominal cancer was shown to decrease inflammatory cytokine levels. In a randomized intervention trial, patients with elective colorectal cancer surgery were given oral nutritional supplements enriched with n-3 PUFAs at dosage of 2.0 g of EPA and 1.0 g of DHA per day for seven days before surgery. n-3 PUFAs increased the levels of anti-inflammatory modulators leukotriene B5 and 5hydroxyeicosapentaenoic acid, and reduced the production of leukotriene B4 Curr Pharmacol Rep. Author manuscript; available in PMC 2016 October 01. Gu et al. Page 13 , a pro-inflammatory modulator. The trial concluded that orally administrated n-3 PUFAs can exert anti-inflammatory effects in surgical patients, while having no effect on reducing the risk of postoperative complications. A clinical phase II trial to improve outcome of chemotherapy in metastatic breast cancer by DHA was based on the finding that compared to normal cells, tumor cells can be more easily sensitized to chemotherapy when membrane lipids contains high level of DHA, because of differential anti-oxidant defense level between normal and tumor cells. After administration of DHA at a dosage of 1.8 g per day to anthracycline-based chemotherapy patients with breast cancer and visceral metastases, DHA level was 5.1% of total fatty acids on average while baseline DHA level was 2.6%. The trial results showed that time to progression was 8.7 months in the high DHA group vs. 3.5 months in the low DHA group. The overall survival was significantly greater in the H-DHA group with a median survival time of 34 months vs 18 months in the L-DHA group. The study concluded that DHA had no adverse side effects, unlike chemotherapy, and improved the outcome of treatment; at high plasma level, DHA has a potential to specifically chemosensitize tumors for better therapeutic effects. Some studies suggested that COX inhibitors, primarily blocking AA metabolism, are effective in the prevention of prostate and colon cancer. However, the severe cardiovascular side effects of COX-2 inhibitors has threatened the clinical application of these inhibitors. Because JAK2 mediates critical physiological functions such as cell proliferation, the kinase activity of JAK2 is tightly regulated via various mechanisms, including trans-acting proteins and by JH2 1215. Both biochemical and clinical evidence have demonstrated an important regulatory function for JH2 in JAKs, and at present, 32 different mutations in JH2 of JAK2 have been shown to cause, or are linked to, hematological diseases16. The most frequent somatic mutation, V617F, results in constitutively active JAK2, and is responsible for >95% of polycythemia vera cases and ~50% of essential thrombocythemia and primary myelofibrosis cases1719. The mechanism by which JH2 negatively regulates the tyrosine kinase activity of JH1 is currently not known, but it is likely to involve an intramo

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