Wang Ruizhong, Kumar Brijesh, Bhat-Nakshatri Poornima, Prasad Mayuri S, Jacobsen Max H, Ovalle Gabriela, Maguire Calli, Sandusky George, Trivedi Trupti, Mohammad Khalid S, Guise Theresa, Penthala Narsimha R, Crooks Peter A, Liu Jianguo, Zimmers Teresa, Nakshatri Harikrishna
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
JCSM Rapid Commun. 2021 Jan-Jun;4(1):24-39. doi: 10.1002/rco2.23. Epub 2020 Jul 15.
Loss of skeletal muscle volume and resulting in functional limitations are poor prognostic markers in breast cancer patients. Several molecular defects in skeletal muscle including reduced MyoD levels and increased protein turn over due to enhanced proteosomal activity have been suggested as causes of skeletal muscle loss in cancer patients. However, it is unknown whether molecular defects in skeletal muscle are dependent on tumor etiology.
We characterized functional and molecular defects of skeletal muscle in MMTV-Neu (Neu+) mice (n= 6-12), an animal model that represents HER2+ human breast cancer, and compared the results with well-characterized luminal B breast cancer model MMTV-PyMT (PyMT+). Functional studies such as grip strength, rotarod performance, and ex vivo muscle contraction were performed to measure the effects of cancer on skeletal muscle. Expression of muscle-enriched genes and microRNAs as well as circulating cytokines/chemokines were measured. Since NF-κB pathway plays a significant role in skeletal muscle defects, the ability of NF-κB inhibitor dimethylaminoparthenolide (DMAPT) to reverse skeletal muscle defects was examined.
Neu+ mice showed skeletal muscle defects similar to accelerated aging. Compared to age and sex-matched wild type mice, Neu+ tumor-bearing mice had lower grip strength (202±6.9 vs. 179±6.8 g grip force, p=0.0069) and impaired rotarod performance (108±12.1 vs. 30±3.9 seconds, P<0.0001), which was consistent with reduced muscle contractibility (p<0.0001). Skeletal muscle of Neu+ mice (n=6) contained lower levels of CD82+ (16.2±2.9 vs 9.0±1.6) and CD54+ (3.8±0.5 vs 2.4±0.4) muscle stem and progenitor cells (p<0.05), suggesting impaired capacity of muscle regeneration, which was accompanied by decreased MyoD, p53 and miR-486 expression in muscles (p<0.05). Unlike PyMT+ mice, which showed skeletal muscle mitochondrial defects including reduced mitochondria levels and Pgc1β, Neu+ mice displayed accelerated aging-associated changes including muscle fiber shrinkage and increased extracellular matrix deposition. Circulating "aging factor" and cachexia and fibromyalgia-associated chemokine Ccl11 was elevated in Neu+ mice (1439.56±514 vs. 1950±345 pg/ml, p<0.05). Treatment of Neu+ mice with DMAPT significantly restored grip strength (205±6 g force), rotarod performance (74±8.5 seconds), reversed molecular alterations associated with skeletal muscle aging, reduced circulating Ccl11 (1083.26 ±478 pg/ml), and improved animal survival.
These results suggest that breast cancer subtype has a specific impact on the type of molecular and structure changes in skeletal muscle, which needs to be taken into consideration while designing therapies to reduce breast cancer-induced skeletal muscle loss and functional limitations.
骨骼肌体积减少并导致功能受限是乳腺癌患者预后不良的标志物。骨骼肌中的几种分子缺陷,包括MyoD水平降低以及由于蛋白酶体活性增强导致的蛋白质周转增加,被认为是癌症患者骨骼肌损失的原因。然而,尚不清楚骨骼肌中的分子缺陷是否取决于肿瘤病因。
我们对MMTV-Neu(Neu+)小鼠(n = 6 - 12)骨骼肌的功能和分子缺陷进行了表征,该动物模型代表HER2+人类乳腺癌,并将结果与特征明确的腔面B型乳腺癌模型MMTV-PyMT(PyMT+)进行比较。进行了握力、转棒试验性能和离体肌肉收缩等功能研究,以测量癌症对骨骼肌的影响。测量了肌肉富集基因和微小RNA的表达以及循环细胞因子/趋化因子。由于NF-κB通路在骨骼肌缺陷中起重要作用,因此研究了NF-κB抑制剂二甲基氨基鬼臼毒素(DMAPT)逆转骨骼肌缺陷的能力。
Neu+小鼠表现出类似于加速衰老的骨骼肌缺陷。与年龄和性别匹配的野生型小鼠相比,携带Neu+肿瘤的小鼠握力较低(握力202±6.9 vs. 179±6.8 g,p = 0.0069)且转棒试验性能受损(108±12.1 vs. 30±3.9秒,P < 0.0001),这与肌肉收缩性降低一致(p < 0.0001)。Neu+小鼠(n = 6)的骨骼肌中CD82+(16.2±2.9 vs 9.0±1.6)和CD54+(3.8±0.5 vs 2.4±0.4)肌肉干细胞和祖细胞水平较低(p < 0.05),表明肌肉再生能力受损,同时伴有肌肉中MyoD、p53和miR-486表达降低(p < 0.05)。与显示骨骼肌线粒体缺陷(包括线粒体水平降低和Pgc1β降低)的PyMT+小鼠不同,Neu+小鼠表现出与加速衰老相关的变化,包括肌纤维萎缩和细胞外基质沉积增加。Neu+小鼠中循环“衰老因子”以及恶病质和纤维肌痛相关趋化因子Ccl11升高(1439.56±514 vs. 1950±345 pg/ml,p < 0.05)。用DMAPT治疗Neu+小鼠可显著恢复握力(205±6 g力)、转棒试验性能(74±8.5秒),逆转与骨骼肌衰老相关的分子改变,降低循环Ccl11(1083.26 ±478 pg/ml)并提高动物存活率。
这些结果表明,乳腺癌亚型对骨骼肌分子和结构变化的类型有特定影响,在设计减少乳腺癌诱导的骨骼肌损失和功能受限的治疗方法时需要考虑这一点。