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      Metabolic reprogramming induced by ketone bodies diminishes pancreatic cancer cachexia.

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          Abstract

          Aberrant energy metabolism is a hallmark of cancer. To fulfill the increased energy requirements, tumor cells secrete cytokines/factors inducing muscle and fat degradation in cancer patients, a condition known as cancer cachexia. It accounts for nearly 20% of all cancer-related deaths. However, the mechanistic basis of cancer cachexia and therapies targeting cancer cachexia thus far remain elusive. A ketogenic diet, a high-fat and low-carbohydrate diet that elevates circulating levels of ketone bodies (i.e., acetoacetate, β-hydroxybutyrate, and acetone), serves as an alternative energy source. It has also been proposed that a ketogenic diet leads to systemic metabolic changes. Keeping in view the significant role of metabolic alterations in cancer, we hypothesized that a ketogenic diet may diminish glycolytic flux in tumor cells to alleviate cachexia syndrome and, hence, may provide an efficient therapeutic strategy.

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          Most cited references30

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          Identification of c-MYC as a target of the APC pathway.

          The adenomatous polyposis coli gene (APC) is a tumor suppressor gene that is inactivated in most colorectal cancers. Mutations of APC cause aberrant accumulation of beta-catenin, which then binds T cell factor-4 (Tcf-4), causing increased transcriptional activation of unknown genes. Here, the c-MYC oncogene is identified as a target gene in this signaling pathway. Expression of c-MYC was shown to be repressed by wild-type APC and activated by beta-catenin, and these effects were mediated through Tcf-4 binding sites in the c-MYC promoter. These results provide a molecular framework for understanding the previously enigmatic overexpression of c-MYC in colorectal cancers.
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            Cancer cachexia: mediators, signaling, and metabolic pathways.

            Cancer cachexia is characterized by a significant reduction in body weight resulting predominantly from loss of adipose tissue and skeletal muscle. Cachexia causes reduced cancer treatment tolerance and reduced quality and length of life, and remains an unmet medical need. Therapeutic progress has been impeded, in part, by the marked heterogeneity of mediators, signaling, and metabolic pathways both within and between model systems and the clinical syndrome. Recent progress in understanding conserved, molecular mechanisms of skeletal muscle atrophy/hypertrophy has provided a downstream platform for circumventing the variations and redundancy in upstream mediators and may ultimately translate into new targeted therapies. Copyright © 2012 Elsevier Inc. All rights reserved.
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              • Article: found

              Targeting metabolic transformation for cancer therapy.

              Cancer therapy has long relied on the rapid proliferation of tumour cells for effective treatment. However, the lack of specificity in this approach often leads to undesirable side effects. Many reports have described various 'metabolic transformation' events that enable cancer cells to survive, suggesting that metabolic pathways might be good targets. There are currently several drugs under development or in clinical trials that are based on specifically targeting the altered metabolic pathways of tumours. This Review highlights pathways against which there are already drugs in different stages of development and also discusses additional druggable targets.
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                Author and article information

                Journal
                Cancer Metab
                Cancer & metabolism
                Springer Science and Business Media LLC
                2049-3002
                2049-3002
                2014
                : 2
                Affiliations
                [1 ] The Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE 68198, USA.
                [2 ] Department of Chemistry, University of Nebraska-Lincoln, Lincoln, NE 68588, USA.
                [3 ] The Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE 68198, USA ; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198, USA.
                [4 ] Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE 68198, USA ; Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA.
                [5 ] Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE 68198, USA.
                [6 ] The Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE 68198, USA ; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198, USA ; Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA ; Department of Genetic Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE 68198, USA.
                Article
                2049-3002-2-18
                10.1186/2049-3002-2-18
                4165433
                25228990
                d20bdf48-7b10-4c8d-be78-0da884be000d
                History

                Cancer cachexia,Cancer metabolism,Ketone bodies,Pancreatic cancer

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