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[心脏肿瘤学——阐明癌症治疗和癌症恶病质所致心脏功能障碍的机制]

[Cardio-oncology - elucidation of the mechanism of cardiac dysfunction caused by cancer therapy and cancer cachexia].

作者信息

Nonaka Miki, Ueno Susumu, Uezono Yasuhito

机构信息

Division of Cancer Pathophysiology, National Cancer Center Research Institute.

Department of Pain Control Research, The Jikei University School of Medicine.

出版信息

Nihon Yakurigaku Zasshi. 2020;155(3):165-170. doi: 10.1254/fpj.19123.

Abstract

Cardiovascular disorders in cancer patients with cachexia have recently become a great concern. However, the relationship between cancer cachexia and cardiac dysfunction remains unclear, due to lack of suitable models. We established a novel murine model of cancer cachexia by implantation of 85As2 cells, a cell line derived from human gastric cancer cells, presenting anorexia, weight loss and low fat-free mass similar to those observed in patients. Moreover, cardiac dysfunction is expected in this model, which has not been yet examined. In the present study, we firstly evaluated cardiac functions with the model. Secondly, we investigated effects of voluntary wheel running (VWR) on cachexia-induced cardiac dysfunction using this model, as the exercise is considered to be one of therapies for chronic heart failure. 85As2 cells were transplanted subcutaneously into mice, which observed a symptomatic cachexia; decrease in body, skeletal muscle weight, and food intake. In addition, this cachexia mouse developed severe cardiac atrophy and left ventricular ejection fraction (LVEF) also markedly reduced with cachexia progression. Moreover, VWR suppressed the decrease in food intake and skeletal muscle weight loss in this model, and improved LVEF with suppression of heart weight loss. These results imply that our 85As2-cachexia mice models show cardiac dysfunction and VWR may improve not only cachexia symptoms but also cardiac dysfunction. As exercise therapy is generally introduced for the purpose of improving heart failure symptoms, this study suggests a possible therapeutic effect of exercise on cardiac dysfunction induced by cancer cachexia.

摘要

恶病质癌症患者的心血管疾病近来备受关注。然而,由于缺乏合适的模型,癌症恶病质与心脏功能障碍之间的关系仍不明确。我们通过植入85As2细胞建立了一种新型的癌症恶病质小鼠模型,该细胞系源自人胃癌细胞,呈现出与患者相似的厌食、体重减轻和低去脂体重。此外,预计该模型会出现心脏功能障碍,但尚未进行检测。在本研究中,我们首先用该模型评估心脏功能。其次,我们研究了自愿轮转运动(VWR)对使用该模型的恶病质诱导的心脏功能障碍的影响,因为运动被认为是慢性心力衰竭的治疗方法之一。将85As2细胞皮下移植到小鼠体内,这些小鼠出现了有症状的恶病质;体重、骨骼肌重量和食物摄入量下降。此外,这种恶病质小鼠出现了严重的心脏萎缩,随着恶病质进展,左心室射血分数(LVEF)也显著降低。而且,VWR抑制了该模型中食物摄入量的下降和骨骼肌重量的减轻,并通过抑制心脏重量减轻改善了LVEF。这些结果表明,我们的85As2-恶病质小鼠模型显示出心脏功能障碍,VWR不仅可以改善恶病质症状,还可以改善心脏功能障碍。由于运动疗法通常是为了改善心力衰竭症状而引入的,本研究提示运动对癌症恶病质诱导的心脏功能障碍可能具有治疗作用。

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