Bonetto Andrea, Kays Joshua K, Parker Valorie A, Matthews Ryan R, Barreto Rafael, Puppa Melissa J, Kang Kyung S, Carson James A, Guise Theresa A, Mohammad Khalid S, Robling Alexander G, Couch Marion E, Koniaris Leonidas G, Zimmers Teresa A
Department of Surgery, Indiana University School of MedicineIndianapolis, IN, USA; Department of Otolaryngology, Head and Neck Surgery, Indiana University School of MedicineIndianapolis, IN, USA; Simon Cancer Center, Indiana University School of MedicineIndianapolis, IN, USA; Indiana University-Purdue University at Indianapolis, Center for Cachexia Research, Innovation and Therapy, Indiana University School of MedicineIndianapolis, IN, USA.
Department of Surgery, Indiana University School of Medicine Indianapolis, IN, USA.
Front Physiol. 2017 Jan 11;7:679. doi: 10.3389/fphys.2016.00679. eCollection 2016.
Cachexia is a distinctive feature of colorectal cancer associated with body weight loss and progressive muscle wasting. Several mechanisms responsible for muscle and fat wasting have been identified, however it is not known whether the physiologic and molecular crosstalk between muscle and bone tissue may also contribute to the cachectic phenotype in cancer patients. The purpose of this study was to clarify whether tumor growth associates with bone loss using several experimental models of colorectal cancer cachexia, namely C26, HT-29, and Apc. The effects of cachexia on bone structure and strength were evaluated with dual energy X-ray absorptiometry (DXA), micro computed tomography (μCT), and three-point bending test. We found that all models showed tumor growth consistent with severe cachexia. While muscle wasting in C26 hosts was accompanied by moderate bone depletion, no loss of bone strength was observed. However, HT-29 tumor bearing mice showed bone abnormalities including significant reductions in whole-body bone mineral density (BMD), bone mineral content (BMC), femoral trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th), but no declines in strength. Similarly, cachexia in the Apc mice was associated with significant decreases in BMD, BMC, BV/TV, Tb.N, and Tb.Th as well as decreased strength. Our data suggest that colorectal cancer is associated with muscle wasting and may be accompanied by bone loss dependent upon tumor type, burden, stage and duration of the disease. It is clear that preserving muscle mass promotes survival in cancer cachexia. Future studies will determine whether strategies aimed at preventing bone loss can also improve outcomes and survival in colorectal cancer cachexia.
恶病质是结直肠癌的一个显著特征,与体重减轻和进行性肌肉消耗有关。已经确定了几种导致肌肉和脂肪消耗的机制,然而,肌肉和骨组织之间的生理和分子相互作用是否也会导致癌症患者的恶病质表型尚不清楚。本研究的目的是使用几种结直肠癌恶病质实验模型,即C26、HT-29和Apc,来阐明肿瘤生长是否与骨质流失有关。通过双能X线吸收法(DXA)、微型计算机断层扫描(μCT)和三点弯曲试验评估恶病质对骨结构和强度的影响。我们发现所有模型均显示肿瘤生长与严重恶病质一致。虽然C26宿主中的肌肉消耗伴随着中度骨质流失,但未观察到骨强度的损失。然而,携带HT-29肿瘤的小鼠出现了骨骼异常,包括全身骨矿物质密度(BMD)、骨矿物质含量(BMC)、股骨小梁骨体积分数(BV/TV)、小梁数量(Tb.N)和小梁厚度(Tb.Th)显著降低,但强度未下降。同样,Apc小鼠的恶病质与BMD、BMC、BV/TV、Tb.N和Tb.Th显著降低以及强度降低有关。我们的数据表明,结直肠癌与肌肉消耗有关,并且可能伴有骨质流失,这取决于肿瘤类型、负担、疾病阶段和持续时间。显然,保持肌肉质量可提高癌症恶病质患者的生存率。未来的研究将确定旨在预防骨质流失的策略是否也能改善结直肠癌恶病质的治疗效果和生存率。