University of Texas - MD Anderson Cancer Center, Department of Endocrine, Neoplasia and Hormonal Disorders, Houston, TX, USA.
Indiana University, Department of Physical Therapy, Indianapolis, IN, USA.
Bone. 2021 Sep;150:115998. doi: 10.1016/j.bone.2021.115998. Epub 2021 May 8.
Patients afflicted with or being treated for cancer constitute a distinct and alarming subpopulation who exhibit elevated fracture risk and heightened susceptibility to developing secondary osteoporosis. Cancer cells uncouple the regulatory processes central for the adequate regulation of musculoskeletal tissue. Systemically taxing treatments to target tumors or disrupt the molecular elements driving tumor growth place considerable strain on recovery efforts. Skeletal tissue is inherently sensitive to mechanical forces, therefore attention to exercise and mechanical loading as non-pharmacological means to preserve bone during treatment and in post-treatment rehabilitative efforts have been topics of recent focus. This review discusses the dysregulation that cancers and the ensuing metabolic dysfunction that confer adverse effects on musculoskeletal tissues. Additionally, we describe foundational mechanotransduction pathways and the mechanisms by which they influence both musculoskeletal and cancerous cells. Functional and biological implications of mechanical loading at the tissue and cellular levels will be discussed, highlighting the current understanding in the field. Herein, in vitro, translational, and clinical data are summarized to consider the positive impact of exercise and low magnitude mechanical loading on tumor-bearing skeletal tissue.
患有癌症或正在接受癌症治疗的患者构成了一个独特且令人警惕的亚群，他们表现出骨折风险增加和易发生继发性骨质疏松症的倾向。癌细胞使调节骨骼肌肉组织的调控过程脱耦联。为了靶向肿瘤或破坏驱动肿瘤生长的分子元素而进行的系统治疗会对恢复努力造成相当大的压力。骨骼组织对机械力具有内在的敏感性，因此，关注运动和机械加载作为非药物手段来维持治疗期间和治疗后康复努力中的骨骼，一直是最近的关注焦点。本文讨论了癌症引起的失调以及由此导致的代谢功能障碍对骨骼肌肉组织的不良影响。此外，我们描述了基础的机械转导途径以及它们影响骨骼肌肉组织和癌细胞的机制。将讨论组织和细胞水平的机械加载的功能和生物学意义，强调该领域的当前理解。本文通过总结体外、转化和临床数据，来考虑运动和低幅度机械加载对荷瘤骨骼组织的积极影响。
