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      IGF-1 treatment reduces weight loss and improves outcome in a rat model of cancer cachexia

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          Abstract

          Background

          A hallmark symptom of cancer cachexia is the loss of skeletal muscle. This is at least partially due to a deregulation of the growth hormone/IGF-1 axis and a subsequently impaired protein synthesis in skeletal muscle. Here, we investigated the effect of IGF-1 supplementation in a rat model of cancer cachexia.

          Methods

          Juvenile rats were inoculated with the Yoshida AH-130 hepatoma and treated once daily with 0.3 mg kg −1 day −1 (low dose) or 3 mg kg −1 day −1 (high dose) IGF-1 or placebo for a period of maximal 16 days. Body weight and body composition (by NMR) were assessed at baseline and at the end of the study or day of death. Locomotor activity and food intake were assessed at baseline and day 10/11 after tumour inoculation for 24 h.

          Results

          Untreated tumour-bearing rats lost 55.3 ± 2.14 g body weight, which was reduced by low-dose to −39.6 ± 11.1 g ( p = 0.0434) and high-dose IGF-1 to −42.7 ± 8.8 g ( p = 0.057). Placebo-treated rats lost 41.4 ± 2.0-g lean mass, which was attenuated by low-dose IGF-1 (−28.8 ± 8.3 g, p = 0.041) and high-dose IGF-1 (−30.9 ± 7.4, p = 0.067). Spontaneous activity and food intake were improved by low-dose IGF-1 only. No effect on fat mass was observed. Low-dose IGF-1 significantly reduced mortality (HR = 0.45, 95%CI = 0.21–0.93, p = 0.0315), whilst the high dose did not reach significance (HR = 0.68, 95%CI = 0.26–1.74, p = 0.42).

          Conclusion

          Low-dose IGF-1 reduced mortality and attenuated loss of body weight as well as muscle mass in the Yoshida hepatoma rat model. Moreover, an improved quality of life was observed in these animals. Further experiments using different doses are necessary.

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          Most cited references18

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          Reversal of cancer cachexia and muscle wasting by ActRIIB antagonism leads to prolonged survival.

          Muscle wasting and cachexia have long been postulated to be key determinants of cancer-related death, but there has been no direct experimental evidence to substantiate this hypothesis. Here, we show that in several cancer cachexia models, pharmacological blockade of ActRIIB pathway not only prevents further muscle wasting but also completely reverses prior loss of skeletal muscle and cancer-induced cardiac atrophy. This treatment dramatically prolongs survival, even of animals in which tumor growth is not inhibited and fat loss and production of proinflammatory cytokines are not reduced. ActRIIB pathway blockade abolished the activation of the ubiquitin-proteasome system and the induction of atrophy-specific ubiquitin ligases in muscles and also markedly stimulated muscle stem cell growth. These findings establish a crucial link between activation of the ActRIIB pathway and the development of cancer cachexia. Thus ActRIIB antagonism is a promising new approach for treating cancer cachexia, whose inhibition per se prolongs survival. Copyright 2010 Elsevier Inc. All rights reserved.
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            Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training.

            Skeletal muscle is the most abundant tissue in the human body, and the maintenance of its mass is essential to ensure basic function as locomotion, strength and respiration. The decision to synthesize or to break down skeletal muscle proteins is regulated by a network of signaling pathways that transmit external stimuli to intracellular factors regulating gene transcription. The tightly regulated balance of muscle protein breakdown and synthesis is disturbed in several distinct myopathies, but also in two pathologies: sarcopenia and cachexia. In recent years, it became evident that in these two muscle wasting disorders specific regulating molecules are increased in expression (e.g. members of the ubiquitin-proteasome system, myostatin, apoptosis inducing factors), whereas other factors (e.g. insulin-like growth factor 1) are down-regulated. So far, not many treatment options to fight the muscle loss are available. One of the most promising approaches is exercise training that, due to its multifactorial effects, can act on several signaling pathways. Therefore, this review will concentrate on specific alterations discussed in the current literature that are present in the skeletal muscle of both muscle wasting disorders. In addition, we will focus on exercise training as an intervention strategy.
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              Ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle

              The principles of ethical authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle (JCSM) are: all authors listed on the manuscript have approved its submission and publication as provided to JCSM; no person who has a right to be recognized as author has been omitted from the list of authors; each author has made an independent material contribution to the work submitted for publication; the submitted work is original and is neither under consideration elsewhere nor has it been published previously in whole or in part other than in abstract form; all original research work is approved by the relevant bodies such as institutional review boards or ethics committees; all conflicts of interest, financial or otherwise, that may affect the authors’ ability to present data objectively have been duly declared in the manuscript; the manuscript in its published form will be maintained on the servers of JCSM as a valid publication only as long as all statements in the guidelines on ethical publishing remain true; if any of the aforementioned statements ceases to be true, the authors have a duty to notify the editors of JCSM as soon as possible so that the information available online can be updated and/or the manuscript can be withdrawn.
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                Author and article information

                Contributors
                +49-30-450525023 , +49-30-450525978 , jochen.springer@charite.de
                Journal
                J Cachexia Sarcopenia Muscle
                Journal of Cachexia, Sarcopenia and Muscle
                Springer-Verlag (Berlin/Heidelberg )
                2190-5991
                2190-6009
                8 May 2011
                8 May 2011
                June 2011
                : 2
                : 2
                : 105-109
                Affiliations
                [1 ]Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany
                [2 ]Center for Cardiovascular Research, Charité Medical School, Campus Mitte, Hessische Str. 3-4, 10115 Berlin, Germany
                [3 ]Center for Stroke Research Berlin, Charité Medical School, Berlin, Germany
                [4 ]Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy
                [5 ]Norwich Medical School, University of East Anglia, Norwich, UK
                Article
                29
                10.1007/s13539-011-0029-3
                3117996
                21766056
                0c103740-d368-4161-b07e-c2478a715be8
                © The Author(s) 2011
                History
                : 2 February 2011
                : 25 April 2011
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag 2011

                Orthopedics
                cancer cachexia,insulin like growth factor-1,weight loss,body composition,wasting,survival
                Orthopedics
                cancer cachexia, insulin like growth factor-1, weight loss, body composition, wasting, survival

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