Agnès Martin, Josiane Castells, Valentine Allibert, Andréa Emerit, Cindy Zolotoff, Victoire Cardot‐Ruffino, Yann S. Gallot, Barbara Vernus, Véronique Chauvet, Laurent Bartholin, Laurent Schaeffer, Anne‐Cécile Durieux, Christophe Hourdé, François B. Favier, Laetitia Mazelin, Damien Freyssenet, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Institut NeuroMyoGène (INMG), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Laboratoire de Biologie de l'Exercice pour la Performance et la Santé (LBEPS), Université d'Évry-Val-d'Essonne (UEVE)-Université Paris-Saclay-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Dynamique Musculaire et Métabolisme (DMEM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université de Montpellier (UM), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Ligue Nationale contre le Cancer (Comité Saône et Loire), Ministère de l'Enseignement supérieur, de la Recherche et de l'Innovation MESRI, Fondation ARC pour la Recherche sur le Cancer, Université d'Évry-Val-d'Essonne (UEVE)-Université Paris-Saclay-Institut de Recherche Biomédicale des Armées (IRBA), and Raynaud, Christelle
Cancer patients at advanced stages experience a severe depletion of skeletal muscle compartment together with a decrease in muscle function, known as cancer cachexia. Cachexia contributes to reducing quality of life, treatment efficiency, and lifespan of cancer patients. However, the systemic nature of the syndrome is poorly documented. Here, we hypothesize that glucocorticoids would be important systemic mediators of cancer cachexia.To explore the role of glucocorticoids during cancer cachexia, biomolecular analyses were performed on several tissues (adrenal glands, blood, hypothalamus, liver, and skeletal muscle) collected from ApcTwenty-three-week-old Apc mice recapitulated important features of cancer cachexia including body weight loss (-16%, P 0.0001), muscle atrophy (gastrocnemius muscle: -53%, P 0.0001), and weakness (-50% in tibialis anterior muscle force, P 0.0001), increased expression of atrogens (7-fold increase in MuRF1 transcript level, P 0.0001) and down-regulation of Akt-mTOR pathway (3.3-fold increase in 4EBP1 protein content, P 0.0001), together with a marked transcriptional rewiring of hepatic metabolism toward an increased expression of gluconeogenic genes (Pcx: +90%, Pck1: +85%), and decreased expression of glycolytic (Slc2a2: -40%, Gk: -30%, Pklr: -60%), ketogenic (Hmgcs2: -55%, Bdh1: -80%), lipolytic/fatty oxidation (Lipe: -50%, Mgll: -60%, Cpt2: -60%, Hadh: -30%), and lipogenic (Acly: -30%, Acacb: -70%, Fasn: -45%) genes. The hypothalamic pituitary-adrenal axis was activated, as evidenced by the increase in the transcript levels of genes encoding corticotropin-releasing hormone in the hypothalamus (2-fold increase, P 0.01), adrenocorticotropic hormone receptor (3.4-fold increase, P 0.001), and steroid biosynthesis enzymes (Cyp21a1, P 0.0001, and Cyp11b1, P 0.01) in the adrenal glands, as well as by the increase in corticosterone level in the serum (+73%, P 0.05), skeletal muscle (+17%, P 0.001), and liver (+24%, P 0.05) of cachectic 23-week-old Apc mice. A comparative transcriptional analysis with dexamethasone-treated C57BL/6J mice indicated that the activation of the hypothalamic-pituitary-adrenal axis in 23-week-old ApcThese findings highlight the role of the hypothalamic-pituitary-adrenal-glucocorticoid pathway in the transcriptional regulation of skeletal muscle catabolism and hepatic metabolism during cancer cachexia. They also provide the paradigm for the design of new therapeutic strategies.