Abstract

Simple SummaryPancreatic cancer (PC) is a highly fatal malignancy. A major reason for the poor prognosis of patients with PC is the insensitivity to most oncological treatment approaches. It is known that regular exercise reduces the cancer risk. We have already shown that serum from advanced prostate and colon cancer patients after exercise reduces growth and viability of cancer cells. The aim of this study was to identify exercise-induced cytokines in serum from patients with advanced-stage PC that regulate cancer cell proliferation and apoptosis. Our data suggest that a mild resistance exercise training in advanced PC patients induces the release of CXCL1, IL10 and CCL4 from contracting skeletal muscle. We demonstrate that these myokines inhibit growth and migration of PC cells, and induce PC cell death. With this report we provide new knowledge on the cancer-protective function of exercise in PC. Our data strongly support sport therapies for cancer patients.The evidence that regular physical exercise reduces the risk of developing cancer is well described. However, the interaction between physical exercise and cancer is not fully clarified yet. Several myokines released by skeletal muscle appear to have a direct anti-tumour function. There are few data on myokine secretion after exercise in patients with advanced tumours. Pancreatic cancer (PC) is a very aggressive and usually fatal cancer. To investigate the effects of exercise in PC, the blood of advanced-stage PC patients was analysed after 12 weeks of resistance training using whole-body electromyostimulation. After the 12-week training period, the patient serum inhibited the proliferation and the motility of PC cells and enhanced PC cell apoptosis. The impact of exercise training was also investigated in an exercise-mimicking in vitro model using electric pulse stimulation of human myotubes and revealed similar anti-tumour effects on PC cells, clearly indicating direct cancer-protective properties of activated skeletal muscle. Protein and gene expression analyses in plasma from exercise-trained patients and in myotube cultures after in vitro exercise showed that interleukin 10 (IL10), C-X-C motif ligand 1 (CXCL1) and C-C motif chemokine ligand 4 (CCL4) are myokines released from activated skeletal muscle. In accordance with the effects of serum from exercise-trained patients, the supplementation with recombinant IL10, CXCL1 and CCL4 impaired growth and migration of PC cells. Treatment of PC cells with these myokines upregulated caspase 3/7 expression and the cleavage of poly(ADP-ribose) polymerase, leading to enhanced PC cell death. The identification of myokines with anti-tumour properties in advanced-stage PC patients after exercise opens a new perspective in supportive therapy with sports and exercise for cancer patients.

Highlights

  • Regular exercise reduces the risk of cancer development, and in cancer survivors lowers the risk of cancer recurrence and mortality [1,2]

  • We examined the effect of recombinant human C-C motif chemokine ligand 22 (CCL22) and lymphotoxin α (LTA), proteins which were increased in the plasma of Pancreatic cancer (PC) patients doing exercise but not in the Electric pulse stimulation (EPS) myotube medium, but found no significant suppressive effect on PC cell growth (Figure 4D)

  • The results suggest that C-X-C motif ligand 1 (CXCL1), interleukin 10 (IL10) and C motif chemokine ligand 4 (CCL4), which were induced by Whole-body electromyostimulation (WB-EMS) resistance exercise, decreased the mobility of PC cells

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Summary

Introduction

Regular exercise reduces the risk of cancer development, and in cancer survivors lowers the risk of cancer recurrence and mortality [1,2]. It is reported that specific exercise-related myokines provide health benefits mainly by metabolic improvement in muscle and fat tissue, and by anti-inflammatory action; some of these mechanisms have an indirect impact on cancer [4,6,7]. IL6 is secreted by the tumour-immune system axis and has pro-inflammatory effects, and is a myokine that is quickly released by skeletal muscle itself in response to contraction and attenuates inflammation [6]. Over the last 10 years, researchers found significant evidence that myokines can influence cancer cell growth and viability, e.g., via the induction of apoptosis or the stimulation of the immune system to fight the tumour [2,6,11,12]

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