Pancreatic cancer cachexia: three dimensions of a complex syndrome.


Journal

British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635

Informations de publication

Date de publication:
05 2021
Historique:
received: 29 11 2019
accepted: 02 02 2021
revised: 18 01 2021
pubmed: 21 3 2021
medline: 16 12 2021
entrez: 20 3 2021
Statut: ppublish

Résumé

Cancer cachexia is a multifactorial syndrome that is characterised by a loss of skeletal muscle mass, is commonly associated with adipose tissue wasting and malaise, and responds poorly to therapeutic interventions. Although cachexia can affect patients who are severely ill with various malignant or non-malignant conditions, it is particularly common among patients with pancreatic cancer. Pancreatic cancer often leads to the development of cachexia through a combination of distinct factors, which, together, explain its high prevalence and clinical importance in this disease: systemic factors, including metabolic changes and pathogenic signals related to the tumour biology of pancreatic adenocarcinoma; factors resulting from the disruption of the digestive and endocrine functions of the pancreas; and factors related to the close anatomical and functional connection of the pancreas with the gut. In this review, we conceptualise the various insights into the mechanisms underlying pancreatic cancer cachexia according to these three dimensions to expose its particular complexity and the challenges that face clinicians in trying to devise therapeutic interventions.

Identifiants

pubmed: 33742145
doi: 10.1038/s41416-021-01301-4
pii: 10.1038/s41416-021-01301-4
pmc: PMC8110983
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1623-1636

Références

Fearon, K., Strasser, F., Anker, S. D., Bosaeus, I., Bruera, E., Fainsinger, R. L. et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 12, 489–495 (2011).
pubmed: 21296615 doi: 10.1016/S1470-2045(10)70218-7
Baracos, V. E., Martin, L., Korc, M., Guttridge, D. C. & Fearon, K. C. H. Cancer-associated cachexia. Nat. Rev. Dis. Primers 4, 17105 (2018).
pubmed: 29345251 doi: 10.1038/nrdp.2017.105
Martin, L., Birdsell, L., MacDonald, N., Reiman, T., Clandinin, M. T., McCargar, L. J. et al. Cancer cachexia in the age of obesity: skeletal muscle depletion Is a powerful prognostic factor, independent of body mass index. J. Clin. Oncol. 31, 1539–1547 (2013).
pubmed: 23530101 doi: 10.1200/JCO.2012.45.2722
Minicozzi, P., Cassetti, T., Vener, C. & Sant, M. Analysis of incidence, mortality and survival for pancreatic and biliary tract cancers across Europe, with assessment of influence of revised European age standardisation on estimates. Cancer Epidemiol. 55, 52–60 (2018).
pubmed: 29777994 doi: 10.1016/j.canep.2018.04.011
Hendifar, A. E., Chang, J. I., Huang, B. Z., Tuli, R. & Wu, B. U. Cachexia, and not obesity, prior to pancreatic cancer diagnosis worsens survival and is negated by chemotherapy. J. Gastrointest. Oncol. 9, 17–23 (2018).
pubmed: 29564167 pmcid: 5848037 doi: 10.21037/jgo.2017.11.10
Mitsunaga S., Kasamatsu E. & Machii K. Incidence and frequency of cancer cachexia during chemotherapy for advanced pancreatic ductal adenocarcinoma. Support Care Cancer 28, 5271–5279 (2020)
Kays, J. K., Shahda, S., Stanley, M., Bell, T. M., O’Neill, B. H., Kohli, M. D. et al. Three cachexia phenotypes and the impact of fat-only loss on survival in FOLFIRINOX therapy for pancreatic cancer. J. Cachexia Sarcopenia Muscle 9, 673–684 (2018).
pubmed: 29978562 pmcid: 6104116 doi: 10.1002/jcsm.12307
Choi, Y., Oh, D. Y., Kim, T. Y., Lee, K. H., Han, S. W., Im, S. A. et al. Skeletal muscle depletion predicts the prognosis of patients with advanced pancreatic cancer undergoing palliative chemotherapy, independent of body mass index. PLoS ONE 10, e0139749 (2015).
pubmed: 26437072 pmcid: 4593598 doi: 10.1371/journal.pone.0139749
Bachmann, J., Heiligensetzer, M., Krakowski-Roosen, H., Buchler, M. W., Friess, H. & Martignoni, M. E. Cachexia worsens prognosis in patients with resectable pancreatic cancer. J. Gastrointest. Surg. 12, 1193–1201 (2008).
pubmed: 18347879 doi: 10.1007/s11605-008-0505-z
Bauer, M. R., Bright, E. E., MacDonald, J. J., Cleary, E. H., Hines, O. J. & Stanton, A. L. Quality of life in patients with pancreatic cancer and their caregivers. Pancreas 47, 368–375 (2018).
pubmed: 29521939 doi: 10.1097/MPA.0000000000001025
Hagensen, A., London, A. E., Phillips, J. J., Helton, W. S., Picozzi, V. J. & Blackmore, C. C. Using experience-based design to improve the care experience for patients with pancreatic cancer. J. Oncol. Pract. 12, e1035–e1041 (2016).
pubmed: 27624947 doi: 10.1200/JOP.2016.011213
Waddell, N., Pajic, M., Patch, A. M., Chang, D. K., Kassahn, K. S., Bailey, P. et al. Whole genomes redefine the mutational landscape of pancreatic cancer. Nature 518, 495–501 (2015).
pubmed: 25719666 pmcid: 4523082 doi: 10.1038/nature14169
Ying, H., Kimmelman, A. C., Lyssiotis, C. A., Hua, S., Chu, G. C., Fletcher-Sananikone, E. et al. Oncogenic Kras maintains pancreatic tumors through regulation of anabolic glucose metabolism. Cell 149, 656–670 (2012).
pubmed: 22541435 pmcid: 3472002 doi: 10.1016/j.cell.2012.01.058
Guillaumond, F., Leca, J., Olivares, O., Lavaut, M.-N., Vidal, N., Berthezène, P. et al. Strengthened glycolysis under hypoxia supports tumor symbiosis and hexosamine biosynthesis in pancreatic adenocarcinoma. Proc. Natl Acad. Sci. USA 110, 3919–3924 (2013).
pubmed: 23407165 doi: 10.1073/pnas.1219555110 pmcid: 3593894
Chen, Y., Cairns, R., Papandreou, I., Koong, A. & Denko, N. C. Oxygen consumption can regulate the growth of tumors, a new perspective on the Warburg effect. PLoS ONE 4, e7033 (2009).
pubmed: 19753307 pmcid: 2737639 doi: 10.1371/journal.pone.0007033
Wang, F., Liu, H., Hu, L., Liu, Y., Duan, Y., Cui, R. et al. The Warburg effect in human pancreatic cancer cells triggers cachexia in athymic mice carrying the cancer cells. BMC Cancer 18, 360 (2018).
pubmed: 29609556 pmcid: 5880080 doi: 10.1186/s12885-018-4271-3
Son, J., Lyssiotis, C. A., Ying, H., Wang, X., Hua, S., Ligorio, M. et al. Glutamine supports pancreatic cancer growth through a KRAS-regulated metabolic pathway. Nature 496, 101–105 (2013).
pubmed: 23535601 pmcid: 3656466 doi: 10.1038/nature12040
Roux, C., Riganti, C., Borgogno, S. F., Curto, R., Curcio, C., Catanzaro, V. et al. Endogenous glutamine decrease is associated with pancreatic cancer progression. Oncotarget 8, 95361–95376 (2017).
pubmed: 29221133 pmcid: 5707027 doi: 10.18632/oncotarget.20545
Vasseur, S., Tomasini, R., Tournaire, R. & Iovanna, J. L. Hypoxia induced tumor metabolic switch contributes to pancreatic cancer aggressiveness. Cancers (Basel) 2, 2138–2152 (2010).
doi: 10.3390/cancers2042138
Sousa, C. M., Biancur, D. E., Wang, X., Halbrook, C. J., Sherman, M. H., Zhang, L. et al. Pancreatic stellate cells support tumour metabolism through autophagic alanine secretion. Nature 536, 479–483 (2016).
pubmed: 27509858 pmcid: 5228623 doi: 10.1038/nature19084
Mayers, J. R., Wu, C., Clish, C. B., Kraft, P., Torrence, M. E., Fiske, B. P. et al. Elevation of circulating branched-chain amino acids is an early event in human pancreatic adenocarcinoma development. Nat. Med. 20, 1193–1198 (2014).
pubmed: 25261994 pmcid: 4191991 doi: 10.1038/nm.3686
Neinast, M. D., Jang, C., Hui, S., Murashige, D. S., Chu, Q., Morscher, R. J. et al. Quantitative analysis of the whole-body metabolic fate of branched-chain amino acids. Cell Metabolism 29, 417–429.e414 (2019).
pubmed: 30449684 doi: 10.1016/j.cmet.2018.10.013
Mayers, J. R., Torrence, M. E., Danai, L. V., Papagiannakopoulos, T., Davidson, S. M., Bauer, M. R. et al. Tissue of origin dictates branched-chain amino acid metabolism in mutant Kras-driven cancers. Science 353, 1161–1165 (2016).
pubmed: 27609895 pmcid: 5245791 doi: 10.1126/science.aaf5171
Lee, J. H., Cho, Y. R., Kim, J. H., Kim, J., Nam, H. Y., Kim, S. W. et al. Branched-chain amino acids sustain pancreatic cancer growth by regulating lipid metabolism. Exp. Mol. Med. 51, 1–11 (2019).
pubmed: 31827068 pmcid: 6881327 doi: 10.1038/s12276-019-0299-y
Das, S. K., Eder, S., Schauer, S., Diwoky, C., Temmel, H., Guertl, B. et al. Adipose triglyceride lipase contributes to cancer-associated cachexia. Science 333, 233–238 (2011).
pubmed: 21680814 doi: 10.1126/science.1198973
Ryden, M., Agustsson, T., Laurencikiene, J., Britton, T., Sjolin, E., Isaksson, B. et al. Lipolysis–not inflammation, cell death, or lipogenesis–is involved in adipose tissue loss in cancer cachexia. Cancer 113, 1695–1704 (2008).
pubmed: 18704987 doi: 10.1002/cncr.23802
Shaw, J. H. & Wolfe, R. R. Fatty acid and glycerol kinetics in septic patients and in patients with gastrointestinal cancer. The response to glucose infusion and parenteral feeding. Ann. Surg. 205, 368–376 (1987).
pubmed: 3105476 pmcid: 1492741 doi: 10.1097/00000658-198704000-00005
Wang, F., Kumagai-Braesch, M., Herrington, M. K., Larsson, J. & Permert, J. Increased lipid metabolism and cell turnover of MiaPaCa2 cells induced by high-fat diet in an orthotopic system. Metabolism 58, 1131–1136 (2009).
pubmed: 19493551 doi: 10.1016/j.metabol.2009.03.027
Agustsson, T., Ryden, M., Hoffstedt, J., van Harmelen, V., Dicker, A., Laurencikiene, J. et al. Mechanism of increased lipolysis in cancer cachexia. Cancer Res. 67, 5531–5537 (2007).
pubmed: 17545636 doi: 10.1158/0008-5472.CAN-06-4585
Russell, S. T. & Tisdale, M. J. Effect of a tumour-derived lipid-mobilising factor on glucose and lipid metabolism in vivo. Br. J. Cancer 87, 580–584 (2002).
pubmed: 12189560 pmcid: 2376149 doi: 10.1038/sj.bjc.6600493
Russell, S. T., Zimmerman, T. P., Domin, B. A. & Tisdale, M. J. Induction of lipolysis in vitro and loss of body fat in vivo by zinc-alpha2-glycoprotein. Biochim. Biophys. Acta 59–68, 2004 (1636).
Bao, Y., Bing, C., Hunter, L., Jenkins, J. R. & Wabitsch, M. Trayhurn P. Zinc-α2-glycoprotein, a lipid mobilizing factor, is expressed and secreted by human (SGBS) adipocytes. FEBS Lett. 579, 41–47 (2005).
pubmed: 15620688 doi: 10.1016/j.febslet.2004.11.042
Bing, C., Bao, Y., Jenkins, J., Sanders, P., Manieri, M., Cinti, S. et al. Zinc-α2-glycoprotein, a lipid mobilizing factor, is expressed in adipocytes and is up-regulated in mice with cancer cachexia. Proc. Natl Acad. Sci. USA 101, 2500–2505 (2004).
pubmed: 14983038 doi: 10.1073/pnas.0308647100 pmcid: 356979
Kulyte, A., Lorente-Cebrian, S., Gao, H., Mejhert, N., Agustsson, T., Arner, P. et al. MicroRNA profiling links miR-378 to enhanced adipocyte lipolysis in human cancer cachexia. Am. J. Physiol. Endocrinol. Metab. 306, E267–E274 (2014).
pubmed: 24326420 doi: 10.1152/ajpendo.00249.2013
Sagar, G., Sah, R. P., Javeed, N., Dutta, S. K., Smyrk, T. C., Lau, J. S. et al. Pathogenesis of pancreatic cancer exosome-induced lipolysis in adipose tissue. Gut 65, 1165–1174 (2016).
pubmed: 26061593 doi: 10.1136/gutjnl-2014-308350
Rohm M., Zeigerer A., Machado J. & Herzig S. Energy metabolism in cachexia. EMBO Rep. 20, e47258 (2019)
Mitsunaga, S., Ikeda, M., Shimizu, S., Ohno, I., Furuse, J., Inagaki, M. et al. Serum levels of IL-6 and IL-1beta can predict the efficacy of gemcitabine in patients with advanced pancreatic cancer. Br. J. Cancer 108, 2063–2069 (2013).
pubmed: 23591198 pmcid: 3670479 doi: 10.1038/bjc.2013.174
Petruzzelli, M., Schweiger, M., Schreiber, R., Campos-Olivas, R., Tsoli, M., Allen, J. et al. A switch from white to brown fat increases energy expenditure in cancer-associated cachexia. Cell Metab. 20, 433–447 (2014).
pubmed: 25043816 doi: 10.1016/j.cmet.2014.06.011
Sah, R. P., Sharma, A., Nagpal, S., Patlolla, S. H., Sharma, A., Kandlakunta, H. et al. Phases of metabolic and soft tissue changes in months preceding a diagnosis of pancreatic ductal adenocarcinoma. Gastroenterology 156, 1742–1752 (2019).
pubmed: 30677401 doi: 10.1053/j.gastro.2019.01.039
Bing, C., Russell, S. T., Beckett, E. E., Collins, P., Taylor, S., Barraclough, R. et al. Expression of uncoupling proteins-1, -2 and -3 mRNA is induced by an adenocarcinoma-derived lipid-mobilizing factor. Br. J. Cancer 86, 612–618 (2002).
pubmed: 11870545 pmcid: 2375279 doi: 10.1038/sj.bjc.6600101
Falconer, J. S., Fearon, K. C., Plester, C. E., Ross, J. A. & Carter, D. C. Cytokines the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer. Ann. Surg. 219, 325–331 (1994).
pubmed: 7512810 pmcid: 1243147 doi: 10.1097/00000658-199404000-00001
Gonzalez-Bulnes, A., Fujiwara, Y., Kobayashi, T., Chayahara, N., Imamura, Y., Toyoda, M. et al. Metabolomics evaluation of serum markers for cachexia and their intra-day variation in patients with advanced pancreatic cancer. PLoS ONE 9, e113259 (2014).
doi: 10.1371/journal.pone.0113259
Bye, A., Wesseltoft-Rao, N., Iversen, P. O., Skjegstad, G., Holven, K. B., Ulven, S. et al. Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer. Med. Oncol. 33, 54 (2016).
pubmed: 27119533 doi: 10.1007/s12032-016-0768-2
Bachmann, J., Buchler, M. W., Friess, H. & Martignoni, M. E. Cachexia in patients with chronic pancreatitis and pancreatic cancer: impact on survival and outcome. Nutr. Cancer 65, 827–833 (2013).
pubmed: 23909726 doi: 10.1080/01635581.2013.804580
Talar-Wojnarowska, R., Gasiorowska, A., Smolarz, B., Romanowicz-Makowska, H., Kulig, A. & Malecka-Panas, E. Clinical significance of interleukin-6 (Il-6) gene polymorphism and Il-6 serum level in pancreatic adenocarcinoma and chronic pancreatitis. Dig. Dis. Sci. 54, 683–689 (2008).
pubmed: 18661238 doi: 10.1007/s10620-008-0390-z
Miura, T., Mitsunaga, S., Ikeda, M., Shimizu, S., Ohno, I., Takahashi, H. et al. Characterization of patients with advanced pancreatic cancer and high serum interleukin-6 levels. Pancreas 44, 756–763 (2015).
pubmed: 25931255 doi: 10.1097/MPA.0000000000000335
Talbert, E. E., Lewis, H. L., Farren, M. R., Ramsey, M. L., Chakedis, J. M., Rajasekera, P. et al. Circulating monocyte chemoattractant protein-1 (MCP-1) is associated with cachexia in treatment-naive pancreatic cancer patients. J. Cachexia Sarcopenia Muscle 9, 358–368 (2018).
pubmed: 29316343 pmcid: 5879958 doi: 10.1002/jcsm.12251
Hou, Y.-C., Wang, C.-J., Chao, Y.-J., Chen, H.-Y., Wang, H.-C., Tung, H.-L. et al. Elevated serum interleukin-8 level correlates with cancer-related cachexia and sarcopenia: An indicator for pancreatic cancer outcomes. J. Clin. Med. 7, 502 (2018).
pmcid: 6306800 doi: 10.3390/jcm7120502
Martignoni, M. E. Role of mononuclear cells and inflammatory cytokines in pancreatic cancer-related cachexia. Clin. Cancer Res. 11, 5802–5808 (2005).
pubmed: 16115919 doi: 10.1158/1078-0432.CCR-05-0185
Zhang, D., Zhou, Y., Wu, L., Wang, S., Zheng, H., Yu, B. et al. Association of IL-6 gene polymorphisms with cachexia susceptibility and survival time of patients with pancreatic cancer. Ann. Clin. Lab. Sci. 38, 113–119 (2008).
pubmed: 18469355
Egberts, J. H., Cloosters, V., Noack, A., Schniewind, B., Thon, L., Klose, S. et al. Anti-tumor necrosis factor therapy inhibits pancreatic tumor growth and metastasis. Cancer Res. 68, 1443–1450 (2008).
pubmed: 18316608 doi: 10.1158/0008-5472.CAN-07-5704
de Matos-Neto, E. M., Lima, J. D. C. C., de Pereira, W. O., Figuerêdo, R. G., Riccardi, D. M. D. R., Radloff, K. et al. Systemic inflammation in cachexia - Is tumor cytokine expression profile the culprit? Front. Immunol. 6, 629–629 (2015).
pubmed: 26732354 pmcid: 4689790
Shimada, M., Andoh, A., Araki, Y., Fujiyama, Y. & Bamba, T. Ligation of the Fas antigen stimulates chemokine secretion in pancreatic cancer cell line PANC-11. J. Gastroenterol. Hepatol. 16, 1060–1067 (2001).
pubmed: 11595074 doi: 10.1046/j.1440-1746.2001.02583.x
Delitto, D., Judge, S. M., Delitto, A. E., Nosacka, R. L., Rocha, F. G., DiVita, B. B. et al. Human pancreatic cancer xenografts recapitulate key aspects of cancer cachexia. Oncotarget 8, 1177–1189 (2017).
pubmed: 27901481 doi: 10.18632/oncotarget.13593
Gerber, M. H., Underwood, P. W., Judge, S. M., Delitto, D., Delitto, A. E., Nosacka, R. L. et al. Local and systemic cytokine profiling for pancreatic ductal adenocarcinoma to study cancer cachexia in an era of precision medicine. Int. J. Mol. Sci. 19, 3836 (2018).
pmcid: 6321633 doi: 10.3390/ijms19123836
Haugen, F., Labori, K. J., Noreng, H. J., Buanes, T., Iversen, P. O. & Drevon, C. A. Altered expression of genes in adipose tissues associated with reduced fat mass in patients with pancreatic cancer. Arch. Physiol. Biochem. 117, 78–87 (2011).
pubmed: 21457003 doi: 10.3109/13813455.2011.560609
Bonetto, A., Aydogdu, T., Jin, X., Zhang, Z., Zhan, R., Puzis, L. et al. JAK/STAT3 pathway inhibition blocks skeletal muscle wasting downstream of IL-6 and in experimental cancer cachexia. Am. J. Physiol. Endocrinol. Metab. 303, E410–E421 (2012).
pubmed: 22669242 pmcid: 3423125 doi: 10.1152/ajpendo.00039.2012
Pettersen, K., Andersen, S., Degen, S., Tadini, V., Grosjean, J., Hatakeyama, S. et al. Cancer cachexia associates with a systemic autophagy-inducing activity mimicked by cancer cell-derived IL-6 trans-signaling. Sci. Rep. 7, 2046 (2017).
pubmed: 28515477 pmcid: 5435723 doi: 10.1038/s41598-017-02088-2
Ma, J. F., Sanchez, B. J., Hall, D. T., Tremblay, A. K., Di Marco, S. & Gallouzi, I. E. STAT3 promotes IFNgamma/TNFalpha-induced muscle wasting in an NF-kappaB-dependent and IL-6-independent manner. EMBO Mol. Med. 9, 622–637 (2017).
pubmed: 28264935 pmcid: 5412921 doi: 10.15252/emmm.201607052
Hall, D. T., Ma, J. F., Di Marco, S. & Gallouzi, I.-E. Inducible nitric oxide synthase (iNOS) in muscle wasting syndrome, sarcopenia, and cachexia. Aging 3, 702–715 (2011).
pubmed: 21832306 pmcid: 3184974 doi: 10.18632/aging.100358
Acharyya, S., Ladner, K. J., Nelsen, L. L., Damrauer, J., Reiser, P. J., Swoap, S. et al. Cancer cachexia is regulated by selective targeting of skeletal muscle gene products. J. Clin. Invest. 114, 370–378 (2004).
pubmed: 15286803 pmcid: 484974 doi: 10.1172/JCI200420174
Gilabert, M., Calvo, E., Airoldi, A., Hamidi, T., Moutardier, V., Turrini, O. et al. Pancreatic cancer-induced cachexia Is Jak2-dependent in mice. J. Cell Physiol. 229, 1437–1443 (2014).
pubmed: 24648112 doi: 10.1002/jcp.24580
Zimmers, T. A., Fishel, M. L. & Bonetto, A. STAT3 in the systemic inflammation of cancer cachexia. Semin. Cell. Dev. Biol. 54, 28–41 (2016).
pubmed: 26860754 pmcid: 4867234 doi: 10.1016/j.semcdb.2016.02.009
Lira, F. S., Yamashita, A. S., Rosa, J. C., Tavares, F. L., Caperuto, E., Carnevali, L. C. Jr. et al. Hypothalamic inflammation is reversed by endurance training in anorectic-cachectic rats. Nutr. Metab. 8, 60–60 (2011).
doi: 10.1186/1743-7075-8-60
Plata-Salamán, C. R., Ilyin, S. E. & Gayle, D. Brain cytokine mRNAs in anorectic rats bearing prostate adenocarcinoma tumor cells. Am. J. Physiol. Regul. Integr. Comp. Physiol. 275, R566–R573 (1998).
doi: 10.1152/ajpregu.1998.275.2.R566
Inui, A. & Neuropeptide, Y. a key molecule in anorexia and cachexia in wasting disorders? Mol. Med. Today 5, 79–85 (1999).
pubmed: 10200949 doi: 10.1016/S1357-4310(98)01395-1
Reyes, T. M. & Sawchenko, P. E. Involvement of the arcuate nucleus of the hypothalamus in interleukin-1-induced anorexia. J. Neurosci. 22, 5091–5099 (2002).
pubmed: 12077204 pmcid: 6757734 doi: 10.1523/JNEUROSCI.22-12-05091.2002
Amitani, M., Asakawa, A., Amitani, H. & Inui, A. Control of food intake and muscle wasting in cachexia. Int. J. Biochem. Cell Biol. 45, 2179–2185 (2013).
pubmed: 23911307 doi: 10.1016/j.biocel.2013.07.016
Ji, Y. B., Bo, C. L., Xue, X. J., Weng, E. M., Gao, G. C., Dai, B. B. et al. Association of inflammatory cytokines with the symptom cluster of pain, fatigue, depression, and sleep disturbance in chinese patients with cancer. J. Pain Symptom Manage 54, 843–852 (2017).
pubmed: 28797869 doi: 10.1016/j.jpainsymman.2017.05.003
Breitbart, W., Rosenfeld, B., Tobias, K., Pessin, H., Ku, G. Y., Yuan, J. et al. Depression, cytokines, and pancreatic cancer. Psychooncology 23, 339–345 (2014).
pubmed: 24136882 doi: 10.1002/pon.3422
Yaskin, J. C. Nervous symptoms as earliest manifestations of carcinoma of the pancreas. JAMA 96, 1664–1668 (1931).
doi: 10.1001/jama.1931.02720460010003
Morley, J. E. Anorexia of aging: physiologic and pathologic. Am. J. Clin. Nutr. 66, 760–773 (1997).
pubmed: 9322549 doi: 10.1093/ajcn/66.4.760
Moo-Young, T. A., Larson, J. W., Belt, B. A., Tan, M. C., Hawkins, W. G., Eberlein, T. J. et al. Tumor-derived TGF-beta mediates conversion of CD4+Foxp3+ regulatory T cells in a murine model of pancreas cancer. J. Immunother. 32, 12–21 (2009).
pubmed: 19307989 doi: 10.1097/CJI.0b013e318189f13c
Löhr, M., Schmidt, C., Ringel, J., Kluth, M., Müller, P., Nizze, H. et al. Transforming Growth Factor-β1 induces desmoplasia in an experimental model of human pancreatic carcinoma. Cancer Res. 61, 550–555 (2001).
pubmed: 11212248
Zugmaier, G., Paik, S., Wilding, G., Knabbe, C., Bano, M., Lupu, R. et al. Transforming Growth Factor β1 induces cachexia and szystemic fibrosis without an antitumor effect in nude mice. Cancer Res. 51, 3590–3594 (1991).
pubmed: 2054795
Mendias, C. L., Gumucio, J. P., Davis, M. E., Bromley, C. W., Davis, C. S. & Brooks, S. V. Transforming growth factor-beta induces skeletal muscle atrophy and fibrosis through the induction of atrogin-1 and scleraxis. Muscle Nerve 45, 55–59 (2012).
pubmed: 22190307 pmcid: 3245632 doi: 10.1002/mus.22232
Greco, S. H., Tomkotter, L., Vahle, A. K., Rokosh, R., Avanzi, A., Mahmood, S. K. et al. TGF-beta blockade reduces mortality and metabolic changes in a validated murine model of pancreatic cancer cachexia. PLoS ONE 10, e0132786 (2015).
pubmed: 26172047 pmcid: 4501823 doi: 10.1371/journal.pone.0132786
Zimmers, T. A., Davies, M. V., Koniaris, L. G., Haynes, P., Esquela, A. F., Tomkinson, K. N. et al. Induction of cachexia in mice by systemically administered myostatin. Science 296, 1486–1488 (2002).
pubmed: 12029139 doi: 10.1126/science.1069525
Chen, J. L., Walton, K. L., Winbanks, C. E., Murphy, K. T., Thomson, R. E., Makanji, Y. et al. Elevated expression of activins promotes muscle wasting and cachexia. FASEB J. 28, 1711–1723 (2014).
pubmed: 24378873 doi: 10.1096/fj.13-245894
Zhong, X., Pons, M., Poirier, C., Jiang, Y., Liu, J., Sandusky, G. E. et al. The systemic activin response to pancreatic cancer: implications for effective cancer cachexia therapy. J. Cachexia Sarcopenia Muscle 10, 1083–1101 (2019).
pubmed: 31286691 pmcid: 6818463 doi: 10.1002/jcsm.12461
Koopmann, J., Buckhaults, P., Brown, D. A., Zahurak, M. L., Sato, N., Fukushima, N. et al. Serum macrophage inhibitory cytokine 1 as a marker of pancreatic and other periampullary cancers. Clin. Cancer Res. 10, 2386–2392 (2004).
pubmed: 15073115 doi: 10.1158/1078-0432.CCR-03-0165
Johnen, H., Lin, S., Kuffner, T., Brown, D. A., Tsai, V. W., Bauskin, A. R. et al. Tumor-induced anorexia and weight loss are mediated by the TGF-beta superfamily cytokine MIC-1. Nat. Med. 13, 1333–1340 (2007).
pubmed: 17982462 doi: 10.1038/nm1677
Todorov, P., Cariuk, P., McDevitt, T., Coles, B., Fearon, K. & Tisdale, M. Characterization of a cancer cachectic factor. Nature 379, 739–742 (1996).
pubmed: 8602222 doi: 10.1038/379739a0
Whitehouse, A. S. & Tisdale, M. J. Increased expression of the ubiquitin-proteasome pathway in murine myotubes by proteolysis-inducing factor (PIF) is associated with activation of the transcription factor NF-kappaB. Br. J. Cancer 89, 1116–1122 (2003).
pubmed: 12966435 pmcid: 2376944 doi: 10.1038/sj.bjc.6601132
Wyke, S. M. & Tisdale, M. J. NF-κB mediates proteolysis-inducing factor induced protein degradation and expression of the ubiquitin–proteasome system in skeletal muscle. Br. J. Cancer 92, 711–721 (2005).
pubmed: 15714207 pmcid: 2361865 doi: 10.1038/sj.bjc.6602402
Eley, H. L. & Tisdale, M. J. Skeletal muscle atrophy, a link between depression of protein synthesis and increase in degradation. J. Biol. Chem. 282, 7087–7097 (2007).
pubmed: 17213191 doi: 10.1074/jbc.M610378200
Wigmore, S. J., Todorov, P. T., Barber, M. D., Ross, J. A., Tisdale, M. J. & Fearon, K. C. H. Characteristics of patients with pancreatic cancer expressing a novel cancer cachectic factor. Br. J. Surg. 87, 53–58 (2000).
pubmed: 10606911 doi: 10.1046/j.1365-2168.2000.01317.x
Watchorn, T. M., Waddell, I. D., Dowidar, N. & Ross, J. A. Proteolysis-inducing factor regulates hepatic gene expression via the transcription factors NF-κΒ and STAT3. FASEB J. 15, 562–564 (2001).
pubmed: 11259367 doi: 10.1096/fj.00-0534fje
Huang, X.-Y., Huang, Z.-L., Yang, J.-H., Xu, Y.-H., Sun, J.-S., Zheng, Q. et al. Pancreatic cancer cell-derived IGFBP-3 contributes to muscle wasting. J Exp. Clin. Cancer Res. 35, 46 (2016).
pubmed: 26975989 pmcid: 4791758 doi: 10.1186/s13046-016-0317-z
He, W. A., Calore, F., Londhe, P., Canella, A., Guttridge, D. C. & Croce, C. M. Microvesicles containing miRNAs promote muscle cell death in cancer cachexia via TLR7. Proc. Natl Acad. Sci USA 111, 4525–4529 (2014).
pubmed: 24616506 doi: 10.1073/pnas.1402714111 pmcid: 3970508
Zhang, G., Liu, Z., Ding, H., Zhou, Y., Doan, H. A., Sin, K. W. T. et al. Tumor induces muscle wasting in mice through releasing extracellular Hsp70 and Hsp90. Nat. Commun 8, 589 (2017)
Sikkens, E. C. M., Cahen, D. L., de Wit, J., Looman, C. W. N., van Eijck, C. & Bruno, M. J. A prospective assessment of the natural course of the exocrine pancreatic function in patients with a pancreatic head tumor. J. Clin. Gastroenterol. 48, e43–e46 (2014).
pubmed: 24717227 doi: 10.1097/MCG.0b013e31829f56e7
Permert, J., Ihse, I., Jorfeldt, L., von Schenck, H., Arnqvist, H. J. & Larsson, J. Pancreatic cancer is associated with impaired glucose metabolism. Eur. J. Surg. 159, 101–107 (1993).
pubmed: 8098623
Lim, P.-W., Dinh, K. H., Sullivan, M., Wassef, W. Y., Zivny, J., Whalen, G. F. et al. Thirty-day outcomes underestimate endocrine and exocrine insufficiency after pancreatic resection. HPB (Oxford) 18, 360–366 (2016).
doi: 10.1016/j.hpb.2015.11.003
Maignan, A., Ouaissi, M., Turrini, O., Regenet, N., Loundou, A., Louis, G. et al. Risk factors of exocrine and endocrine pancreatic insufficiency after pancreatic resection: A multi-center prospective study. J. Visc. Surg. 155, 173–181 (2018).
pubmed: 29396112 doi: 10.1016/j.jviscsurg.2017.10.007
Speicher, J. E. & Traverso, L. W. Pancreatic exocrine function is preserved after distal pancreatectomy. J. Gastroenterol. Surg. 14, 1006–1011 (2010).
doi: 10.1007/s11605-010-1184-0
Beger, H. G., Poch, B., Mayer, B. & Siech, M. New onset of diabetes and pancreatic exocrine insufficiency after pancreaticoduodenectomy for benign and malignant tumors. Ann. Surg. 267, 259–270 (2018).
pubmed: 28834847 doi: 10.1097/SLA.0000000000002422
Kang, M. J., Jung, H. S., Jang, J.-Y., Jung, W., Chang, J., Shin, Y. C. et al. Metabolic effect of pancreatoduodenectomy: resolution of diabetes mellitus after surgery. Pancreatology 16, 272–277 (2016).
pubmed: 26899541 doi: 10.1016/j.pan.2016.01.006
Wu, J.-M., Kuo, T.-C., Yang, C.-Y., Chiang, P.-Y., Jeng, Y.-M., Huang, P.-H. et al. Resolution of diabetes after pancreaticoduodenectomy in patients with and without pancreatic ductal cell adenocarcinoma. Ann. Surg. Oncol. 20, 242–249 (2013).
pubmed: 22864799 doi: 10.1245/s10434-012-2577-y
Vujasinovic, M., Valente, R., Del Chiaro, M., Permert, J. & Löhr, J.-M. Pancreatic exocrine insufficiency in pancreatic cancer. Nutrients 9, 183 (2017).
pmcid: 5372846 doi: 10.3390/nu9030183
Schober, M., Jesenofsky, R., Faissner, R., Weidenauer, C., Hagmann, W., Michl, P. et al. Desmoplasia and chemoresistance in pancreatic cancer. Cancers (Basel) 6, 2137–2154 (2014).
doi: 10.3390/cancers6042137
Brune, K., Abe, T., Canto, M., O’Malley, L., Klein, A. P., Maitra, A. et al. Multifocal neoplastic precursor lesions associated with lobular atrophy of the pancreas in patients having a strong family history of pancreatic cancer. Am. J. Surg. Pathol. 30, 1067–1076 (2006).
pubmed: 16931950 pmcid: 2746409
Anagnostides, A., Chadwick, V., Selden, A. & Maton, P. Sham feeding and pancreatic secretion: evidence for direct vagal stimulation of enzyme output. Gastroenterology 87, 109–114 (1984).
pubmed: 6724252 doi: 10.1016/0016-5085(84)90132-X
White, T., McAlexander, R. & Magee, D. The effect of gastric distension on duodenal aspirates in man. Gastroenterology 44, 48–51 (1963).
pubmed: 14000362 doi: 10.1016/S0016-5085(63)80117-1
Watanabe, S., Shiratori, K., Takeuchi, T., Chey, W., You, C. & Chang, T.-M. Release of cholecystokinin and exocrine pancreatic secretion in response to an elemental diet in human subjects. Dig. Dis. Sci. 31, 919–924 (1986).
pubmed: 3731983 doi: 10.1007/BF01303211
Bapat, A. A., Hostetter, G., Von Hoff, D. D. & Han, H. Perineural invasion and associated pain in pancreatic cancer. Nat. Rev. Cancer. 11, 695–707 (2011).
pubmed: 21941281 doi: 10.1038/nrc3131
Ceyhan, G. O., Demir, I. E., Rauch, U., Bergmann, F., Muller, M. W., Buchler, M. W. et al. Pancreatic neuropathy results in “neural remodeling” and altered pancreatic innervation in chronic pancreatitis and pancreatic cancer. Am. J. Gastroenterol. 104, 2555–2565 (2009).
pubmed: 19568227 doi: 10.1038/ajg.2009.380
Körner, M., Hayes, G. M., Rehmann, R., Zimmermann, A., Friess, H., Miller, L. J. et al. Secretin receptors in normal and diseased human pancreas: marked reduction of receptor binding in ductal neoplasia. Am. J. Patho. 167, 959–968 (2005).
doi: 10.1016/S0002-9440(10)61186-8
Weinberg, D. S., Ruggeri, B., Barber, M. T., Biswas, S., Miknyocki, S., Waldman, S. A. & Cholecystokinin, A. and B receptors are differentially expressed in normal pancreas and pancreatic adenocarcinoma. J. Clin. Invest. 100, 597–603 (1997).
pubmed: 9239407 pmcid: 508227 doi: 10.1172/JCI119570
Weinberg, D. S., Heyt, G. J., Cavanagh, M., Pitchon, D., McGlynn, K. A. & London, W. T. Cholecystokinin and gastrin levels are not elevated in human pancreatic adenocarcinoma. Cancer Epidemiol. Biomarkers Prev. 10, 721–722 (2001).
pubmed: 11401926
Ji, B., Bi, Y., Simeone, D., Mortensen, R. M. & Logsdon, C. D. Human pancreatic acinar cells lack functional responses to cholecystokinin and gastrin. Gastroenterology 121, 1380–1390 (2001).
pubmed: 11729117 doi: 10.1053/gast.2001.29557
Shintakuya, R., Uemura, K., Murakami, Y., Kondo, N., Nakagawa, N., Urabe, K. et al. Sarcopenia is closely associated with pancreatic exocrine insufficiency in patients with pancreatic disease. Pancreatology 17, 70–75 (2017).
pubmed: 27743711 doi: 10.1016/j.pan.2016.10.005
Danai, L. V., Babic, A., Rosenthal, M. H., Dennstedt, E. A., Muir, A., Lien, E. C. et al. Altered exocrine function can drive adipose wasting in early pancreatic cancer. Nature 558, 600–604 (2018).
pubmed: 29925948 pmcid: 6112987 doi: 10.1038/s41586-018-0235-7
Gooden, H. M. & White, K. J. Pancreatic cancer and supportive care—pancreatic exocrine insufficiency negatively impacts on quality of life. Support Care Cancer 21, 1835–1841 (2013).
pubmed: 23397095 doi: 10.1007/s00520-013-1729-3
Zuijdgeest-Van Leeuwen, S. D., Van Der Heijden, M. S., Rietveld, T., Van Den Berg, J. W. O., Tilanus, H. W., Burgers, J. A. et al. Fatty acid composition of plasma lipids in patients with pancreatic, lung and oesophageal cancer in comparison with healthy subjects. Clin. Nutr. 21, 225–230 (2002).
pubmed: 12127931 doi: 10.1054/clnu.2001.0530
Matejcic, M., Lesueur, F., Biessy, C., Renault, A. L., Mebirouk, N., Yammine, S. et al. Circulating plasma phospholipid fatty acids and risk of pancreatic cancer in a large European cohort. Int. J. Cancer 143, 2437–2448 (2018).
pubmed: 30110135 doi: 10.1002/ijc.31797
Murphy, R. A., Yeung, E., Mazurak, V. C. & Mourtzakis, M. Influence of eicosapentaenoic acid supplementation on lean body mass in cancer cachexia. Br. J. Cancer 105, 1469–1473 (2011).
pubmed: 21970879 pmcid: 3242518 doi: 10.1038/bjc.2011.391
Dewey, A., Baughan, C., Dean, T. P., Higgins, B. & Johnson I. Eicosapentaenoic acid (EPA, an omega‐3 fatty acid from fish oils) for the treatment of cancer cachexia. Cochrane Database Syst. Rev. CD004597 (2007)
Haaber, A. B., Rosenfalck, A. M., Hansen, B., Hilsted, J. & Larsen, S. Bone mineral metabolism, bone mineral density, and body composition in patients with chronic pancreatitis and pancreatic exocrine insufficiency. Int. J. Pancreatol. 27, 21–27 (2000).
pubmed: 10811020 doi: 10.1385/IJGC:27:1:21
Nakamura, T., Takebe, K., Imamura, K., Tando, Y., Yamada, N., Arai, Y. et al. Fat-soluble vitamins in patients with chronic pancreatitis (pancreatic insufficiency). Acta Gastroenterol. Belg. 59, 10–14 (1996).
pubmed: 8686411
Klapdor, S., Richter, E. & Klapdor, R. Vitamin D status and per-oral vitamin D supplementation in patients suffering from chronic pancreatitis and pancreatic cancer disease. Anticancer Res. 32, 1991–1998 (2012).
pubmed: 22593477
Dev, R., Del Fabbro, E., Schwartz, G. G., Hui, D., Palla, S. L., Gutierrez, N. et al. Preliminary report: vitamin D deficiency in advanced cancer patients with symptoms of fatigue or anorexia. Oncologist 16, 1637–1641 (2011).
pubmed: 21964001 pmcid: 3233299 doi: 10.1634/theoncologist.2011-0151
Garcia, M., Seelaender, M., Sotiropoulos, A., Coletti, D. & Lancha, A. H. Vitamin D, muscle recovery, sarcopenia, cachexia, and muscle atrophy. Nutrition 60, 66–69 (2019).
pubmed: 30529188 doi: 10.1016/j.nut.2018.09.031
Camperi, A., Pin, F., Costamagna, D., Penna, F., Menduina, M. L., Aversa, Z. et al. Vitamin D and VDR in cancer cachexia and muscle regeneration. Oncotarget 8, 21778–21793 (2017).
pubmed: 28423519 pmcid: 5400623 doi: 10.18632/oncotarget.15583
Mantovani, G., Madeddu, C. & Maccio, A. Cachexia and oxidative stress in cancer: an innovative therapeutic management. Curr. Pharm. Des. 18, 4813–4818 (2012).
pubmed: 22632861 doi: 10.2174/138161212803216889
Huang, B. Z., Pandol, S. J., Jeon, C. Y., Chari, S. T., Sugar, C. A., Chao, C. R. et al. New-onset diabetes, longitudinal trends in metabolic markers, and risk of pancreatic cancer in a heterogeneous population. J. Gastroenterol. Hepatol. 18, 1812–1821.e7 (2019).
Sah, R. P., Nagpal, S. J. S., Mukhopadhyay, D. & Chari, S. T. New insights into pancreatic cancer-induced paraneoplastic diabetes. Nat. Rev. Gastroenterol. Hepatol. 10, 423–433 (2013).
pubmed: 23528347 pmcid: 3932322 doi: 10.1038/nrgastro.2013.49
Aggarwal, G., Ramachandran, V., Javeed, N., Arumugam, T., Dutta, S., Klee, G. G. et al. Adrenomedullin is up-regulated in patients with pancreatic cancer and causes insulin resistance in beta cells and mice. Gastroenterology 143, 1510–1517.e1511 (2012).
pubmed: 22960655 doi: 10.1053/j.gastro.2012.08.044
Armstrong, E. A., Beal, E. W., Chakedis, J., Paredes, A. Z., Moris, D., Pawlik, T. M. et al. Exosomes in Pancreatic Cancer: from Early Detection to Treatment. J. Gastrointest. Surg. 22, 737–750 (2018).
pubmed: 29423813 doi: 10.1007/s11605-018-3693-1
Wang, W. S., Liu, X. H., Liu, L. X., Jin, D. Y., Yang, P. Y. & Wang, X. L. Identification of proteins implicated in the development of pancreatic cancer-associated diabetes mellitus by iTRAQ-based quantitative proteomics. J. Proteomics 84, 52–60 (2013).
pubmed: 23571023 doi: 10.1016/j.jprot.2013.03.031
Basso, D., Greco, E., Fogar, P., Pucci, P., Flagiello, A., Baldo, G. et al. Pancreatic cancer-associated diabetes mellitus: an open field for proteomic applications. Clin. Chim. Acta 357, 184–189 (2005).
pubmed: 15946661 doi: 10.1016/j.cccn.2005.03.025
Basso, D., Greco, E., Fogar, P., Pucci, P., Flagiello, A., Baldo, G. et al. Pancreatic cancer-derived S-100A8 N-terminal peptide: a diabetes cause? Clin. Chim. Acta 372, 120–128 (2006).
pubmed: 16678810 doi: 10.1016/j.cca.2006.03.027
Permert, J., Larsson, J., Westermark, G. T., Herrington, M. K., Christmanson, L., Pour, P. M. et al. Islet amyloid polypeptide in patients with pancreatic cancer and diabetes. N. Engl. J. Med. 330, 313–318 (1994).
pubmed: 8277951 doi: 10.1056/NEJM199402033300503
Ding, X., Flatt, P. R., Permert, J. & Adrian, T. E. Pancreatic cancer cells selectively stimulate islet β cells to secrete amylin. Gastroenterology 114, 130–138 (1998).
pubmed: 9428227 doi: 10.1016/S0016-5085(98)70641-9
Liu, J., Knezetic, J. A., Strömmer, L., Permert, J., Larsson, J. R. & Adrian, T. E. The intracellular mechanism of insulin resistance in pancreatic cancer patients. J. Clin. Endocrinol. Metab. 85, 1232–1238 (2000).
pubmed: 10720068
Yoshikawa, T., Noguchi, Y., Doi, C., Makino, T., Okamoto, T. & Matsumoto, A. Insulin resistance was connected with the alterations of substrate utilization in patients with cancer. Cancer Lett. 141, 93–98 (1999).
pubmed: 10454248 doi: 10.1016/S0304-3835(99)00086-5
Watanapa, P. & Williamson, R. C. Surgical palliation for pancreatic cancer: developments during the past two decades. Br. J. Surg. 79, 8–20 (1992).
pubmed: 1371087 doi: 10.1002/bjs.1800790105
Wong, Y. T., Brams, D. M., Munson, L., Sanders, L., Heiss, F., Chase, M. et al. Gastric outlet obstruction secondary to pancreatic cancer: surgical vs endoscopic palliation. Surgical Endosc. 16, 310–312 (2002).
doi: 10.1007/s00464-001-9061-2
Dzutsev, A., Badger, J. H., Perez-Chanona, E., Roy, S., Salcedo, R., Smith, C. K. et al. Microbes and cancer. Annu. Rev. Immunol. 35, 199–228 (2017).
pubmed: 28142322 doi: 10.1146/annurev-immunol-051116-052133
Torres, P. J., Fletcher, E. M., Gibbons, S. M., Bouvet, M., Doran, K. S. & Kelley, S. T. Characterization of the salivary microbiome in patients with pancreatic cancer. Peer J. 3, e1373 (2015).
pubmed: 26587342 doi: 10.7717/peerj.1373 pmcid: 4647550
Farrell, J. J., Zhang, L., Zhou, H., Chia, D., Elashoff, D., Akin, D. et al. Variations of oral microbiota are associated with pancreatic diseases including pancreatic cancer. Gut 61, 582–588 (2012).
pubmed: 21994333 doi: 10.1136/gutjnl-2011-300784
Pushalkar, S., Hundeyin, M., Daley, D., Zambirinis, C. P., Kurz, E., Mishra, A. et al. The pancreatic cancer microbiome promotes oncogenesis by induction of innate and adaptive immune suppression. Cancer Discov. 8, 403–416 (2018).
pubmed: 29567829 pmcid: 6225783 doi: 10.1158/2159-8290.CD-17-1134
Sethi, V., Kurtom, S., Tarique, M., Lavania, S., Malchiodi, Z., Hellmund, L. et al. Gut microbiota promotes tumor growth in mice by modulating immune response. Gastroenterology 155, 33–37 e36 (2018).
pubmed: 29630898 doi: 10.1053/j.gastro.2018.04.001
Geller, L. T., Barzily-Rokni, M., Danino, T., Jonas, O. H., Shental, N., Nejman, D. et al. Potential role of intratumor bacteria in mediating tumor resistance to the chemotherapeutic drug gemcitabine. Science 357, 1156–1160 (2017).
pubmed: 28912244 pmcid: 5727343 doi: 10.1126/science.aah5043
Li, S., Fuhler, G. M., Bn, N., Jose, T., Bruno, M. J., Peppelenbosch, M. P. et al. Pancreatic cyst fluid harbors a unique microbiome. Microbiome 5, 147 (2017).
pubmed: 29122007 pmcid: 5680603 doi: 10.1186/s40168-017-0363-6
Bindels, L. B., Neyrinck, A. M., Loumaye, A., Catry, E., Walgrave, H., Cherbuy, C. et al. Increased gut permeability in cancer cachexia: mechanisms and clinical relevance. Oncotarget 9, 18224–18238 (2018).
pubmed: 29719601 pmcid: 5915068 doi: 10.18632/oncotarget.24804
Pötgens, S. A., Brossel, H., Sboarina, M., Catry, E., Cani, P. D., Neyrinck, A. M. et al. Klebsiella oxytoca expands in cancer cachexia and acts as a gut pathobiont contributing to intestinal dysfunction. Sci. Rep. 8, 12321 (2018).
pubmed: 30120320 pmcid: 6098145 doi: 10.1038/s41598-018-30569-5
Bures, J., Cyrany, J., Kohoutova, D., Forstl, M., Rejchrt, S., Kvetina, J. et al. Small intestinal bacterial overgrowth syndrome. World J. Gastroenterol. 16, 2978–2990 (2010).
pubmed: 20572300 pmcid: 2890937 doi: 10.3748/wjg.v16.i24.2978
Nishiyama, H., Nagai, T., Kudo, M., Okazaki, Y., Azuma, Y., Watanabe, T. et al. Supplementation of pancreatic digestive enzymes alters the composition of intestinal microbiota in mice. Biochem. Biophys. Res. Commun. 495, 273–279 (2018).
pubmed: 29106956 doi: 10.1016/j.bbrc.2017.10.130
Varian, B. J., Gourishetti, S., Poutahidis, T., Lakritz, J. R., Levkovich, T., Kwok, C. et al. Beneficial bacteria inhibit cachexia. Oncotarget 7, 11803–11816 (2016).
pubmed: 26933816 pmcid: 4914249 doi: 10.18632/oncotarget.7730
Routy, B., Le Chatelier, E., Derosa, L., Duong, C. P. M., Alou, M. T., Daillère, R. et al. Gut microbiome influences efficacy of PD-1–based immunotherapy against epithelial tumors. Science 359, 91–97 (2018).
pubmed: 29097494 doi: 10.1126/science.aan3706
Ahuja, M., Schwartz, D. M., Tandon, M., Son, A., Zeng, M., Swaim, W. et al. Orai1-mediated antimicrobial secretion from pancreatic acini shapes the gut microbiome and regulates gut innate immunity. Cell Metab. 25, 635–646 (2017).
pubmed: 28273482 pmcid: 5345693 doi: 10.1016/j.cmet.2017.02.007
Nay, K., Jollet, M., Goustard, B., Baati, N., Vernus, B., Pontones, M. et al. Gut bacteria are critical for optimal muscle function: a potential link with glucose homeostasis. Am. J. Physiol. Endocrinol. Metab. 317, E158–E171 (2019).
pubmed: 31039010 doi: 10.1152/ajpendo.00521.2018
Oliphant, K. & Allen-Vercoe, E. Macronutrient metabolism by the human gut microbiome: major fermentation by-products and their impact on host health. Microbiome 7, 91 (2019).
pubmed: 31196177 pmcid: 6567490 doi: 10.1186/s40168-019-0704-8
Liu, R., Hong, J., Xu, X., Feng, Q., Zhang, D., Gu, Y. et al. Gut microbiome and serum metabolome alterations in obesity and after weight-loss intervention. Nat. Med. 23, 859–868 (2017).
pubmed: 28628112 doi: 10.1038/nm.4358
Biswas, A. K. & Acharyya, S. Understanding cachexia in the context of metastatic progression. Nat. Rev. Cancer 20, 274–284 (2020).
pubmed: 32235902 doi: 10.1038/s41568-020-0251-4
Yakovenko, A., Cameron, M. & Trevino, J. G. Molecular therapeutic strategies targeting pancreatic cancer induced cachexia. World J. Gastrointest. Surg. 10, 95–106 (2018).
pubmed: 30622678 pmcid: 6314860 doi: 10.4240/wjgs.v10.i9.95
Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F. et al. ESPEN guidelines on nutrition in cancer patients. Clin. Nutr. 36, 11–48 (2017).
pubmed: 27637832 doi: 10.1016/j.clnu.2016.07.015
Shukla, S. K., Gebregiworgis, T., Purohit, V., Chaika, N. V., Gunda, V., Radhakrishnan, P. et al. Metabolic reprogramming induced by ketone bodies diminishes pancreatic cancer cachexia. Cancer Metab. 2, 18 (2014).
pubmed: 25228990 pmcid: 4165433 doi: 10.1186/2049-3002-2-18
May, P. E., Barber, A., D’Olimpio, J. T., Hourihane, A. & Abumrad, N. N. Reversal of cancer-related wasting using oral supplementation with a combination of β-hydroxy-β-methylbutyrate, arginine, and glutamine. Am. J. Surg. 183, 471–479 (2002).
pubmed: 11975938 doi: 10.1016/S0002-9610(02)00823-1
Holecek, M. Side effects of long-term glutamine supplementation. JPEN J. Parenter Enteral. Nutr. 37, 607–616 (2012).
pubmed: 22990615 doi: 10.1177/0148607112460682
Smith, H. J., Mukerji, P. & Tisdale, M. J. Attenuation of proteasome-induced proteolysis in skeletal muscle by β-hydroxy-β-methylbutyrate in cancer-induced muscle loss. Cancer Res. 65, 277–283 (2005).
pubmed: 15665304 doi: 10.1158/0008-5472.277.65.1
Wilkinson, D. J., Hossain, T., Hill, D. S., Phillips, B. E., Crossland, H., Williams, J. et al. Effects of leucine and its metabolite β-hydroxy-β-methylbutyrate on human skeletal muscle protein metabolism. J. Physiol. 591, 2911–2923 (2013).
pubmed: 23551944 pmcid: 3690694 doi: 10.1113/jphysiol.2013.253203
Eley Helen, L., Russell Steven, T., Tisdale & Michael, J. Effect of branched-chain amino acids on muscle atrophy in cancer cachexia. Biochem. J. 407, 113–120 (2007).
pubmed: 17623010 pmcid: 2267397 doi: 10.1042/BJ20070651
Tayek, J. A., Bistrian, B. R., Hehir, D. J., Martin, R., Moldawer, L. L. & Blackburn, G. L. Improved protein kinetics and albumin synthesis by branched chain amino acid‐enriched total parenteral nutrition in cancer cachexia: a prospective randomized crossover trial. Cancer 58, 147–157 (1986).
pubmed: 3085914 doi: 10.1002/1097-0142(19860701)58:1<147::AID-CNCR2820580126>3.0.CO;2-I
Deutz, N. E., Safar, A., Schutzler, S., Memelink, R., Ferrando, A., Spencer, H. et al. Muscle protein synthesis in cancer patients can be stimulated with a specially formulated medical food. Clin. Nutr. 30, 759–768 (2011).
pubmed: 21683485 pmcid: 3964623 doi: 10.1016/j.clnu.2011.05.008
Berk, L., James, J., Schwartz, A., Hug, E., Mahadevan, A., Samuels, M. et al. A randomized, double-blind, placebo-controlled trial of a beta-hydroxyl beta-methyl butyrate, glutamine, and arginine mixture for the treatment of cancer cachexia (RTOG 0122). Support Care Cancer 16, 1179–1188 (2008).
pubmed: 18293016 doi: 10.1007/s00520-008-0403-7
Malta, F. A. P. S., Estadella, D. & Gonçalves, D. C. The role of omega 3 fatty acids in suppressing muscle protein catabolism: a possible therapeutic strategy to reverse cancer cachexia? J. Funct. Foods 54, 1–12 (2019).
doi: 10.1016/j.jff.2018.12.033
Wigmore, S. J., Barber, M. D., Ross, J. A., Tisdale, M. J. & Fearon, K. C. H. Effect of oral eicosapentaenoic acid on weight loss in patients with pancreatic cancer. Nutr Cancer 36, 177–184 (2000).
pubmed: 10890028 doi: 10.1207/S15327914NC3602_6
Abe, K., Uwagawa, T., Haruki, K., Takano, Y., Onda, S., Sakamoto, T. et al. Effects of ω-3 fatty acid supplementation in patients with bile duct or pancreatic cancer undergoing chemotherapy. Anticancer Res. 38, 2369–2375 (2018).
pubmed: 29599363
Fearon, K. C. H., von Meyenfeldt, M. F., Moses, A. G. W., van Geenen, R., Roy, A., Gouma, D. J. et al. Effect of a protein and energy dense n-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 52, 1479–1486 (2003).
pubmed: 12970142 pmcid: 1773823 doi: 10.1136/gut.52.10.1479
Hinson, R. M., Williams, J. A. & Shacter, E. Elevated interleukin 6 is induced by prostaglandin E2 in a murine model of inflammation: possible role of cyclooxygenase-2. Proc. Natl Acad. Sci. USA 93, 4885–4890 (1996).
pubmed: 8643498 doi: 10.1073/pnas.93.10.4885 pmcid: 39374
Kunkel, S. L., Spengler, M., May, M. A., Spengler, R., Larrick, J. & Remick, D. Prostaglandin E2 regulates macrophage-derived tumor necrosis factor gene expression. J. Biol. Chem. 263, 5380–5384 (1988).
pubmed: 3162731 doi: 10.1016/S0021-9258(18)60727-6
Thompson, M. G., Pascal, M., Mackie, S. C., Thom, A., Morrison, K. S., Colette Backwell, F. R. et al. Evidence that protein kinase C and mitogen activated protein kinase are not involved in the mechanism by which insulin stimulates translation in L6 myoblasts. Biosci. Rep. 15, 37–46 (1995).
pubmed: 7647290 doi: 10.1007/BF01200213
Mantovani, G., Maccio, A., Madeddu, C., Serpe, R., Antoni, G., Massa, E. et al. Phase II nonrandomized study of the efficacy and safety of COX-2 inhibitor celecoxib on patients with cancer cachexia. J. Mol. Med. (Berl) 88, 85–92 (2010).
doi: 10.1007/s00109-009-0547-z
Lai, V., George, J., Richey, L., Kim, H. J., Cannon, T., Shores, C. et al. Results of a pilot study of the effects of celecoxib on cancer cachexia in patients with cancer of the head, neck, and gastrointestinal tract. Head Neck 30, 67–74 (2008).
pubmed: 17615567 doi: 10.1002/hed.20662
McMillan, D. C., Wigmore, S. J., Wigmore, K. C. H., O’Gorman, P., Wright, C. E. & McArdle, C. S. A prospective randomized study of megestrol acetate and ibuprofen in gastrointestinal cancer patients with weight loss. Br J Cancer 79, 495–500 (1999).
pubmed: 10027319 pmcid: 2362415 doi: 10.1038/sj.bjc.6690077
McMillan, D. C., Simpson, J. M., Preston, T., Watson, W. S., Fearon, K. C. H., Shenkin, A. et al. Effect of megestrol acetate on weight loss, body composition and blood screen of gastrointestinal cancer patients. Clin. Nutr. 13, 85–89 (1994).
pubmed: 16843365 doi: 10.1016/0261-5614(94)90065-5
Gordon, J. N., Trebble, T. M., Ellis, R. D., Duncan, H. D., Johns, T. & Goggin, P. M. Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial. Gut 54, 540–545 (2005).
pubmed: 15753541 pmcid: 1774430 doi: 10.1136/gut.2004.047563
Wiedenmann, B., Malfertheiner, P., Friess, H., Ritch, P., Arseneau, J., Mantovani, G. et al. A multicenter, phase II study of infliximab plus gemcitabine in pancreatic cancer cachexia. J. Support. Oncol. 6, 18–25 (2008).
pubmed: 18257397
Hurwitz, H., Van Cutsem, E., Bendell, J., Hidalgo, M., Li, C.-P., Salvo, M. G. et al. Ruxolitinib + capecitabine in advanced/metastatic pancreatic cancer after disease progression/intolerance to first-line therapy: JANUS 1 and 2 randomized phase III studies. Invest. New Drugs 36, 683–695 (2018).
pubmed: 29508247 pmcid: 6752723 doi: 10.1007/s10637-018-0580-2
Solheim, T. S., Laird, B. J. A., Balstad, T. R., Stene, G. B., Bye, A., Johns, N. et al. A randomized phase II feasibility trial of a multimodal intervention for the management of cachexia in lung and pancreatic cancer. J. Cachexia Sarcopenia Muscle 8, 778–788 (2017).
pubmed: 28614627 pmcid: 5659068 doi: 10.1002/jcsm.12201
Solheim, T. S., Laird, B. J., Balstad, T. R., Bye, A., Stene, G., Baracos, V. et al. Cancer cachexia: rationale for the MENAC (Multimodal—Exercise, Nutrition and Anti-inflammatory medication for Cachexia) trial. BMJ Support. Palliat. Care 8, 258–265 (2018).
Wiskemann, J., Clauss, D., Tjaden, C., Hackert, T., Schneider, L., Ulrich, C. M. et al. Progressive resistance training to impact physical fitness and body weight in pancreatic cancer patients: A randomized controlled trial. Pancreas 48, 257–266 (2019).
pubmed: 30589829 doi: 10.1097/MPA.0000000000001221
Hamauchi, S., Furuse, J., Takano, T., Munemoto, Y., Furuya, K., Baba, H. et al. A multicenter, open-label, single-arm study of anamorelin (ONO-7643) in advanced gastrointestinal cancer patients with cancer cachexia. Cancer 125, 4294–4302 (2019).
pubmed: 31415709 doi: 10.1002/cncr.32406
Koch, M., Varela, L., Kim, J. G., Kim, J. D., Hernández-Nuño, F., Simonds, S. E. et al. Hypothalamic POMC neurons promote cannabinoid-induced feeding. Nature 519, 45–50 (2015).
pubmed: 25707796 pmcid: 4496586 doi: 10.1038/nature14260
Jatoi, A., Windschitl, H. E., Loprinzi, C. L., Sloan, J. A., Dakhil, S. R., Mailliard, J. A. et al. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J. Clin. Oncol. 20, 567–573 (2002).
pubmed: 11786587 doi: 10.1200/JCO.2002.20.2.567
Golan, T., Geva, R., Richards, D., Madhusudan, S., Lin, B. K., Wang, H. T. et al. LY2495655, an antimyostatin antibody, in pancreatic cancer: a randomized, phase 2 trial. J. Cachexia Sarcopenia Muscle 9, 871–879 (2018).
pubmed: 30051975 pmcid: 6204586 doi: 10.1002/jcsm.12331
Riechelmann, R. P., Burman, D., Tannock, I. F., Rodin, G. & Zimmermann, C. Phase II trial of mirtazapine for cancer-related cachexia and anorexia. Am J Hosp. Palliat. Med. 27, 106–110 (2010).
Landers, A., Muircroft, W. & Brown, H. Pancreatic enzyme replacement therapy (PERT) for malabsorption in patients with metastatic pancreatic cancer. BMJ Support. Palliat. Care 6, 75–79 (2016).
Bruno, M., Haverkort, E., Tijssen, G., Tytgat, G., Van & Leeuwen, D. Placebo controlled trial of enteric coated pancreatin microsphere treatment in patients with unresectable cancer of the pancreatic head region. Gut 42, 92–96 (1998).
pubmed: 9505892 pmcid: 1726970 doi: 10.1136/gut.42.1.92
Dominguez-Munoz, J. E., Nieto-Garcia, L., Lopez-Diaz, J., Larino-Noia, J., Abdulkader, I. & Iglesias-Garcia, J. Impact of the treatment of pancreatic exocrine insufficiency on survival of patients with unresectable pancreatic cancer: a retrospective analysis. BMC Cancer 18, 534 (2018).
pubmed: 29728096 pmcid: 5935964 doi: 10.1186/s12885-018-4439-x
Woo, S. M., Joo, J., Kim, S. Y., Park, S. J., Han, S. S., Kim, T. H. et al. Efficacy of pancreatic exocrine replacement therapy for patients with unresectable pancreatic cancer in a randomized trial. Pancreatology 16, 1099–1105 (2016).
pubmed: 27618657 doi: 10.1016/j.pan.2016.09.001
Iglesia, D. D. L., Avci, B., Kiriukova, M., Panic, N., Bozhychko, M., Sandru, V. et al. Pancreatic exocrine insufficiency and pancreatic enzyme replacement therapy in patients with advanced pancreatic cancer: a systematic review and meta-analysis. United European Gastroenterol. J. 8, 1115–1125 (2020).
pubmed: 32631175 pmcid: 7724551 doi: 10.1177/2050640620938987
Johnson, C. Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas. Gut 54, v1–v16 (2005).
doi: 10.1136/gut.2004.057059
Tempero, M. A., Malafa, M. P., Al-Hawary, M., Asbun, H., Bain, A., Behrman, S. W. et al. Pancreatic adenocarcinoma, version 2.2017, NCCN clinical practice guidelines in oncology. J. Natl. Compr. Canc Netw 15, 1028–1061 (2017).
pubmed: 28784865 doi: 10.6004/jnccn.2017.0131
Löhr, J. M., Dominguez-Munoz, E., Rosendahl, J., Besselink, M., Mayerle, J., Lerch, M. M. et al. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United European Gastroenterol. J. 5, 153–199 (2017).
pubmed: 28344786 pmcid: 5349368 doi: 10.1177/2050640616684695
Andersen, D. K., Korc, M., Petersen, G. M., Eibl, G., Li, D., Rickels, M. R. et al. Diabetes, pancreatogenic diabetes, and pancreatic cancer. Diabetes 66, 1103–1110 (2017).
pubmed: 28507210 pmcid: 5399609 doi: 10.2337/db16-1477
Madiraju, A. K., Erion, D. M., Rahimi, Y., Zhang, X. M., Braddock, D. T., Albright, R. A. et al. Metformin suppresses gluconeogenesis by inhibiting mitochondrial glycerophosphate dehydrogenase. Nature 510, 542–546 (2014).
pubmed: 24847880 pmcid: 4074244 doi: 10.1038/nature13270
Oliveira, A. G. & Gomes-Marcondes, M. C. C. Metformin treatment modulates the tumour-induced wasting effects in muscle protein metabolism minimising the cachexia in tumour-bearing rats. BMC Cancer 16, 418 (2016).
pubmed: 27388367 pmcid: 4936094 doi: 10.1186/s12885-016-2424-9
Kordes, S., Pollak, M. N., Zwinderman, A. H., Mathôt, R. A., Weterman, M. J., Beeker, A. et al. Metformin in patients with advanced pancreatic cancer: a double-blind, randomised, placebo-controlled phase 2 trial. Lancet Oncol. 16, 839–847 (2015).
pubmed: 26067687 doi: 10.1016/S1470-2045(15)00027-3
Chen, S.-M., Chieng, W.-W., Huang, S.-W., Hsu, L.-J. & Jan, M.-S. The synergistic tumor growth-inhibitory effect of probiotic Lactobacillus on transgenic mouse model of pancreatic cancer treated with gemcitabine. Sci. Rep. 10, 20319 (2020).
pubmed: 33230218 pmcid: 7683550 doi: 10.1038/s41598-020-77322-5
Riquelme, E., Zhang, Y., Zhang, L., Montiel, M., Zoltan, M., Dong, W. et al. Tumor microbiome diversity and composition influence pancreatic cancer outcomes. Cell 178, 795–806.e712 (2019).
pubmed: 31398337 pmcid: 7288240 doi: 10.1016/j.cell.2019.07.008
Cheng, W. Y., Wu, C.-Y. & Yu, J. The role of gut microbiota in cancer treatment: friend or foe? Gut 69, 1867–1876 (2020).
pubmed: 32759302 doi: 10.1136/gutjnl-2020-321153
Hingorani, S. R., Wang, L., Multani, A. S., Combs, C., Deramaudt, T. B., Hruban, R. H. et al. Trp53R172H and KrasG12D cooperate to promote chromosomal instability and widely metastatic pancreatic ductal adenocarcinoma in mice. Cancer Cell 7, 469–483 (2005).
pubmed: 15894267 doi: 10.1016/j.ccr.2005.04.023
Aguirre, A. J., Bardeesy, N., Sinha, M., Lopez, L., Tuveson, D. A., Horner, J. et al. Activated Kras and Ink4a/Arf deficiency cooperate to produce metastatic pancreatic ductal adenocarcinoma. Genes Dev. 17, 3112–3126 (2003).
pubmed: 14681207 pmcid: 305262 doi: 10.1101/gad.1158703
Talbert, E. E., Cuitiño, M. C., Ladner, K. J., Rajasekerea, P. V., Siebert, M., Shakya, R. et al. Modeling human cancer-induced cachexia. Cell Rep. 28, 1612–1622.e1614 (2019).
pubmed: 31390573 pmcid: 6733019 doi: 10.1016/j.celrep.2019.07.016
Henderson, S. E., Makhijani, N. & Mace, T. A. Pancreatic cancer–induced cachexia and relevant mouse models. Pancreas 47, 937–945 (2018).
pubmed: 30113428 pmcid: 6097247 doi: 10.1097/MPA.0000000000001124

Auteurs

Maximilian Kordes (M)

Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Department of Upper Abdominal Diseases, Cancer Theme, Karolinska University Hospital, Stockholm, Sweden.

Lars Larsson (L)

Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.

Lars Engstrand (L)

Department of Clinical Genetics, Science for Life Laboratory, Stockholm, Sweden.

J-Matthias Löhr (JM)

Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden. matthias.lohr@ki.se.
Department of Upper Abdominal Diseases, Cancer Theme, Karolinska University Hospital, Stockholm, Sweden. matthias.lohr@ki.se.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH