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Sorafenib induces muscle wasting by disrupting the activity of distinct chromatin regulators

ABSTRACT: n cancer treatment regimens using chemotherapy, adverse effects can outweigh the benefits. Various chemotherapeutic drugs are linked to skeletal muscle wasting, drastically reducing the chance of survivability of cancer patients. Insights into the molecular basis of chemotherapy-induced cachexia is an unmet need to improve the treatment strategies. Here, we investigated tyrosine kinase inhibitor (TKI) class of chemotherapeutic agents for their effects on muscle function. Sorafenib (Sor), but not Nilotinib (Nilo) and Imatinib (Ima), triggered cachexia. Our system-wide analyses revealed that Sor alters the global transcription program and proteostasis in muscle cells. Mechanistically, Sor impeded chromatin association of SET1/MLL histone methyltransferase on distinct muscle-specific genes. Thus, it reduced H3K4 methylation and rendered the chromatin transcriptionally incompetent, as characterized by diminished association of RNA polymerase II. This transcriptional reorientation resulted in disruption of sarcomere organization, drastically perturbed calcium homeostasis, and mitochondrial respiration in muscle cells. Consequently, Sor-treatment severely compromised the contractile ability of muscle cells. Collectively, we identified an unanticipated epigenetic process affected by Sor that led to cachexia. Our findings hold the potential to strategize therapy regimens to minimize chemotherapy-induced muscle wasting and improve treatment outcomes.

INSTRUMENT(S):

ORGANISM(S): Mus Musculus (mouse)

TISSUE(S): Skeletal Muscle Myoblast, C2c12 Cell, Bone Marrow

DISEASE(S): Cachexia

SUBMITTER: Andreas Pich

LAB HEAD: Andreas Pich

PROVIDER: PXD054882 | Pride | 2025-05-07

REPOSITORIES: Pride

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Sorafenib induces cachexia by impeding transcriptional signaling of the SET1/MLL complex on muscle-specific genes.

Khan Bushra B Lanzuolo Chiara C Rosti Valentina V Santarelli Philina P Pich Andreas A Kraft Theresia T Amrute-Nayak Mamta M Nayak Arnab A

iScience 20240910 10

Chemotherapeutics used in cancer therapy are often linked to muscle wasting or cachexia. Insights into the molecular basis of chemotherapy-induced cachexia is essential to improve treatment strategies. Here, we demonstrated that Sorafenib-tyrosine kinase inhibitor (TKI) class of chemotherapeutic agents-induced cachexia. System-wide analyses revealed that Sorafenib alters the global transcriptional program and proteostasis in muscle cells. Mechanistically, Sorafenib treatment reduced active epige ...[more]

PMID: 39386761

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Project description:Background: Cancer cachexia (CAC) reduces patient survival and quality of life. Developments of efficient therapeutic strategies are required for the CAC treatments. This long-term process could be shortened by the drug-repositioning approach which exploits old drugs approved for non-cachexia disease. Amiloride, a diuretic drug, is clinically used for treatments of hypertension and edema due to heart failure. Here, we explored the effects of amiloride for ameliorating muscle wasting in murine models of cancer cachexia. Methods: CT26 and LLC tumor cells were subcutaneously injected into mice to induce cancer cachexia. Amiloride was intraperitoneally injected daily once tumors were formed. Cachexia features of the CT26 and LLC models, respectively, were characterized by phenotypic, histopathologic and biochemical analyses. Plasma exosomes and muscle atrophy-related proteins were quantitatively analyzed. Integrative NMR-based metabolomic and transcriptomic analyses were conducted to identify significantly altered metabolic pathways and distinctly changed metabolism-related biological processes in gastrocnemius. Results: The CT26 and LLC models displayed prominent cachexia features including decreases in body weight, skeletal muscle, adipose tissue and muscle strength. The amiloride treatment in tumor-bearing mice distinctly alleviated muscle atrophy and relieved cachexia-related features without affecting tumor growth. The CT26 and LLC cachexia mice showed increased particle density of plasma exosomes which were largely derived from tumors. Significantly, the amiloride treatment inhibited tumor-derived exosome release, which did not obviously affect exosome secretion from non-neoplastic tissues or induce observable systemic toxicities in normal healthy mice. Integrative-omics revealed significant metabolic impairments in cachectic gastrocnemius, including promoted muscular catabolism, inhibited muscular protein synthesis, blocked glycolysis and impeded ketone body oxidation. The amiloride treatment evidently improved the metabolic impairments in cachectic gastrocnemius. Conclusions: Our results demonstrated the efficacy of amiloride in ameliorating cachectic muscle wasting and elucidated the underlying mechanistic rationale for its use as an alternative strategy to improve CAC treatments.

Project description:Cancer cachexia represents a debilitating muscle wasting condition that is highly prevalent in patients with pancreatic ductal adenocarcinoma (PDAC). Cachexia is estimated to contribute to ~30% of cancer-related deaths, with deterioration of respiratory muscles suspected to be a key contributor to cachexia-associated morbidity and mortality. In recent studies, we identified inflammation and fibrotic remodeling of respiratory accessory muscles as a key feature of human PDAC cachexia. To gain insight into mechanisms driving respiratory muscle wasting and fibrotic remodeling in response to PDAC, we conducted temporal histological and transcriptomic analyses on diaphragm muscles harvested from mice bearing orthotopic murine pancreatic (KPC) tumors at time points reflective of pre-cachexia (D8 and D10), mild-moderate cachexia (D12 and D14) and advanced cachexia (endpoint). Compared to Sham, KPC mice showed progressive diaphragm myofiber atrophy beginning on D12 (-16 to -24% , D12toendpointvs.Sham,P< 0.05), which preceded reductions in breathing frequency (-55%,P= 0.0074) and diaphragm excursion (-43%,P= 0.0006) observed at endpoint. During the pre-cachexia phase, diaphragms showed significantleukocyte infiltration (+3 fold to +13-fold; D8–endpointvs.Sham,P< 0.05) and transcriptomic enrichment of inflammatory processes associated with tissue injury that remained increased through endpoint. Diaphragm inflammation was followed by increases in PDGFR+ fibroadipogenic progenitors (+2.5 to +3.8-fold; D10–endpointvs.Sham,P< 0.05), ECM expansion (+1.5 to +1.8-fold; D14–endpointvs.Sham),P<0.05) and collagen accumulation (+3.8-fold; Endpointvs.Sham,P= 0.0013). These processes were supported by changes in the diaphragm transcriptome. Ingenuity pathway analysis predicted factors involved in inflammatory responses to tissue injury, including TGF-B1, Angiotensin, and PDGF BB, as top upstream regulators activated in diaphragms prior to and throughout cachexia progression, while PGC-1α and the insulin receptor were among the top upstream regulators predicted to be suppressed. The transcriptomic dataset further revealed progressive disturbances to networks involved in lipid, glucose and oxidative metabolism, activation of the unfolded protein response and neuromuscular junction remodeling associated with denervation. In summary, our data support leukocyte infiltration and fibroadipogenic progenitor expansion as early events that precede wasting and fibrotic remodeling of respiratory muscles in response to PDAC that may also underlie metabolic disturbances, weakness and respiratory complications.

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