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R-ketorolac ameliorates cancer-associated cachexia and prolongs survival of tumour-bearing mice.
- Source :
-
Journal of cachexia, sarcopenia and muscle [J Cachexia Sarcopenia Muscle] 2024 Apr; Vol. 15 (2), pp. 562-574. Date of Electronic Publication: 2024 Feb 01. - Publication Year :
- 2024
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Abstract
- Background: Cancer-associated cachexia (CAC) is a debilitating syndrome associated with poor quality of life and reduced life expectancy of cancer patients. CAC is characterized by unintended body weight reduction due to muscle and adipose tissue loss. A major hallmark of CAC is systemic inflammation. Several non-steroidal anti-inflammatory drugs (NSAIDs) have been suggested for CAC treatment, yet no single medication has proven reliable. R-ketorolac (RK) is the R-enantiomer of a commonly used NSAID. The effect of RK on CAC has not yet been evaluated.<br />Methods: Ten- to 11-week-old mice were inoculated with C26 or CHX207 cancer cells or vehicle control (phosphate-buffered saline [PBS]). After cachexia onset, 2 mg/kg RK or PBS was administered daily by oral gavage. Body weight, food intake and tumour size were continuously measured. At study endpoints, blood was drawn, mice were sacrificed and tissues were excised. Immune cell abundance was analysed using a Cytek® Aurora spectral flow cytometer. Cyclooxygenase (COX) activity was determined in lung homogenates using a fluorometric kit. Muscle tissues were analysed for mRNA and protein expression by quantitative real-time PCR and western blotting analysis, respectively. Muscle fibre size was determined on histological slides after haematoxylin/eosin staining.<br />Results: Ten-day survival rate of C26-bearing animals was 10% while RK treatment resulted in a 100% survival rate (P = 0.0009). Chemotherapy resulted in a 10% survival rate 14 days after treatment initiation, but all mice survived upon co-medication with RK and cyclophosphamide (P = 0.0001). Increased survival was associated with a protection from body weight loss in C26 (-0.61 ± 1.82 vs. -4.48 ± 2.0 g, P = 0.0004) and CHX207 (-0.49 ± 0.33 vs. -2.49 ± 0.93 g, P = 0.0003) tumour-bearing mice treated with RK, compared with untreated mice. RK ameliorated musculus quadriceps (-1.7 ± 7.1% vs. -27.8 ± 8.3%, P = 0.0007) and gonadal white adipose tissue (-18.8 ± 49% vs. -69 ± 15.6%, P = 0.094) loss in tumour-bearing mice, compared with untreated mice. Mechanistically, RK reduced circulating interleukin-6 (IL-6) concentrations from 334 ± 151 to 164 ± 123 pg/mL (P = 0.047) in C26 and from 93 ± 39 to 35 ± 6 pg/mL (P = 0.0053) in CHX207 tumour-bearing mice. Moreover, RK protected mice from cancer-induced T-lymphopenia (+1.8 ± 42% vs. -49.2 ± 12.1% in treated vs. untreated mice, respectively). RK was ineffective in ameliorating CAC in thymus-deficient nude mice, indicating that the beneficial effect of RK depends on T-cells.<br />Conclusions: RK improved T-lymphopenia and decreased systemic IL-6 concentrations, resulting in alleviation of cachexia and increased survival of cachexigenic tumour-bearing mice, even under chemotherapy and independent of COX inhibition. Considering its potential, we propose that the use of RK should be investigated in patients suffering from CAC.<br /> (© 2024 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.)
- Subjects :
- Humans
Mice
Animals
Cachexia drug therapy
Cachexia etiology
Cachexia metabolism
Ketorolac metabolism
Ketorolac pharmacology
Ketorolac therapeutic use
Interleukin-6 metabolism
Mice, Nude
Quality of Life
Muscle, Skeletal pathology
Body Weight
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Neoplasms complications
Neoplasms drug therapy
Neoplasms metabolism
Lymphopenia complications
Lymphopenia drug therapy
Lymphopenia pathology
Subjects
Details
- Language :
- English
- ISSN :
- 2190-6009
- Volume :
- 15
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of cachexia, sarcopenia and muscle
- Publication Type :
- Academic Journal
- Accession number :
- 38302863
- Full Text :
- https://doi.org/10.1002/jcsm.13422