Abstract

Cancer cachexia is a syndrome characterized by profound cardiac and diaphragm muscle wasting, which increase the risk of morbidity in cancer patients due to failure of the cardiorespiratory system. In this regard, muscle relies greatly on mitochondria to meet energy requirements for contraction and mitochondrial dysfunction can result in muscle weakness and fatigue. In addition, mitochondria are a major source of reactive oxygen species (ROS) production, which can stimulate increased rates of muscle protein degradation. Therefore, it has been suggested that mitochondrial dysfunction may be an underlying factor that contributes to the pathology of cancer cachexia. To determine if pharmacologically targeting mitochondrial dysfunction via treatment with the mitochondria-targeting peptide SS-31 would prevent cardiorespiratory muscle dysfunction, colon 26 (C26) adenocarcinoma tumor-bearing mice were administered either saline or SS-31 daily (3 mg/kg/day) following inoculation. C26 mice treated with saline demonstrated greater ROS production and mitochondrial uncoupling compared to C26 mice receiving SS-31 in both the heart and diaphragm muscle. In addition, saline-treated C26 mice exhibited a decline in left ventricular function which was significantly rescued in C26 mice treated with SS-31. In the diaphragm, muscle fiber cross-sectional area of C26 mice treated with saline was significantly reduced and force production was impaired compared to C26, SS-31-treated animals. Finally, ventilatory deficits were also attenuated in C26 mice treated with SS-31, compared to saline treatment. These data demonstrate that C26 tumors promote severe cardiac and respiratory myopathy, and that prevention of mitochondrial dysfunction is sufficient to preclude cancer cachexia-induced cardiorespiratory dysfunction.

Highlights

  • Cachexia is a debilitating consequence of cancer, most prevalent in patients with gastrointestinal, pancreatic, lung and colorectal cancers [1]

  • The decline in body weight in the TB-SALINE mice was accompanied by a reduction in heart, gastrocnemius, plantaris and extensor digitorum longus (EDL) weight compared to non-tumor-bearing mice

  • Muscle weight in the TB-SS-31 group was preserved for all muscles except the final heart weight, which was significantly reduced compared to the CON-SALINE mice

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Summary

Introduction

Cachexia is a debilitating consequence of cancer, most prevalent in patients with gastrointestinal, pancreatic, lung and colorectal cancers [1]. This condition adversely affects patient outcomes as a result of the continuous loss of fat and muscle mass, leading to compromised physical function, independence and quality of life [2]. The underlying mechanisms driving cancer-induced cardiorespiratory muscle weakness remain unknown, emerging evidence reveals that cancer promotes mitochondrial damage, resulting in alterations to electron transport chain complex activity, impaired ATP synthesis and the production of reactive oxygen species (ROS) [6]. Targeting early changes in mitochondrial function and ROS production could be instrumental in preserving cardiac and skeletal muscle mass and function

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