Myokines in treatment-naïve patients with cancer-associated cachexia

Clin Nutr. 2021 Apr;40(4):2443-2455. doi: 10.1016/j.clnu.2020.10.050. Epub 2020 Nov 2.

Abstract

Cancer-associated cachexia is a complex metabolic syndrome characterized by weight loss and systemic inflammation. Muscle loss and fatty infiltration into muscle are associated with poor prognosis in cancer patients. Skeletal muscle secretes myokines, factors with autocrine, paracrine and/or endocrine action, which may be modified by or play a role in cachexia. This study examined myokine content in the plasma, skeletal muscle and tumor homogenates from treatment-naïve patients with gastric or colorectal stages I-IV cancer with cachexia (CC, N = 62), or not (weight stable cancer, WSC, N = 32). Myostatin, interleukin (IL) 15, follistatin-like protein 1 (FSTL-1), fatty acid binding protein 3 (FABP3), irisin and brain-derived neurotrophic factor (BDNF) protein content in samples was measured with Multiplex technology; body composition and muscle lipid infiltration were evaluated in computed tomography, and quantification of triacylglycerol (TAG) in the skeletal muscle. Cachectic patients presented lower muscle FSTL-1 expression (p = 0.047), higher FABP3 plasma content (p = 0.0301) and higher tumor tissue expression of FABP3 (p = 0.0182), IL-15 (p = 0.007) and irisin (p = 0.0110), compared to WSC. Neither muscle TAG content, nor muscle attenuation were different between weight stable and cachectic patients. Lumbar adipose tissue (AT) index, visceral AT index and subcutaneous AT index were lower in CC (p = 0.0149, p = 0.0455 and p = 0.0087, respectively), who also presented lower muscularity in the cohort (69.2% of patients; p = 0.0301), compared to WSC. The results indicate the myokine profile in skeletal muscle, plasma and tumor is impacted by cachexia. These findings show that myokines eventually affecting muscle wasting may not solely derive from the muscle itself (as the tumor also may contribute to the systemic scenario), and put forward new perspectives on cachexia treatment targeting myokines and associated receptors and pathways.

Keywords: Cachexia; Cancer; Myokines; Skeletal muscle; Tumor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain-Derived Neurotrophic Factor / blood
  • Brain-Derived Neurotrophic Factor / metabolism
  • Cachexia / blood
  • Cachexia / etiology*
  • Cachexia / metabolism
  • Carrier Proteins / blood
  • Carrier Proteins / metabolism*
  • Colonic Neoplasms / blood
  • Colonic Neoplasms / metabolism
  • Fatty Acid Binding Protein 3 / blood
  • Fatty Acid Binding Protein 3 / metabolism
  • Female
  • Fibronectins / blood
  • Fibronectins / metabolism*
  • Follistatin-Related Proteins / blood
  • Follistatin-Related Proteins / metabolism
  • Gastrointestinal Neoplasms / blood
  • Gastrointestinal Neoplasms / complications
  • Gastrointestinal Neoplasms / metabolism*
  • Humans
  • Intercellular Signaling Peptides and Proteins / metabolism*
  • Interleukin-15 / blood
  • Interleukin-15 / metabolism
  • Male
  • Middle Aged
  • Muscle, Skeletal / metabolism*
  • Myostatin / blood
  • Myostatin / metabolism
  • Rectal Neoplasms / blood
  • Rectal Neoplasms / metabolism
  • Rectus Abdominis / metabolism
  • Stomach Neoplasms / blood
  • Stomach Neoplasms / metabolism

Substances

  • Brain-Derived Neurotrophic Factor
  • Carrier Proteins
  • FABP3 protein, human
  • FNDC5 protein, human
  • Fatty Acid Binding Protein 3
  • Fibronectins
  • Follistatin-Related Proteins
  • IL15 protein, human
  • Intercellular Signaling Peptides and Proteins
  • Interleukin-15
  • MSTN protein, human
  • Myostatin
  • FSTL1 protein, human
  • BDNF protein, human