Perturbed BMP signaling and denervation promote muscle wasting in cancer cachexia.

Roberta Sartori; Adam Hagg; Sandra Zampieri; Andrea Armani; Catherine E Winbanks; Laís R Viana; Mouna Haidar; Kevin I Watt; Hongwei Qian; Camilla Pezzini; Pardis Zanganeh; Bradley J Turner; Anna Larsson; Gianpietro Zanchettin; Elisa S Pierobon; Lucia Moletta; Michele Valmasoni; Alberto Ponzoni; Shady Attar; Gianfranco Da Dalt; Cosimo Sperti; Monika Kustermann; Rachel E Thomson; Lars Larsson; Kate L Loveland; Paola Costelli; Aram Megighian; Stefano Merigliano; Fabio Penna; Paul Gregorevic; Marco Sandri
Abstract
Most patients with advanced solid cancers exhibit features of cachexia, a debilitating syndrome characterized by progressive loss of skeletal muscle mass and strength. Because the underlying mechanisms of this multifactorial syndrome are incompletely defined, effective therapeutics have yet to be developed. Here, we show that diminished bone morphogenetic protein (BMP) signaling is observed early in the onset of skeletal muscle wasting associated with cancer cachexia in mouse models and in patients with cancer. Cancer-mediated factors including Activin A and IL-6 trigger the expression of the BMP inhibitor Noggin in muscle, which blocks the actions of BMPs on muscle fibers and motor nerves, subsequently causing disruption of the neuromuscular junction (NMJ), denervation, and muscle wasting. Increasing BMP signaling in the muscles of tumor-bearing mice by gene delivery or pharmacological means can prevent muscle wasting and preserve measures of NMJ function. The data identify perturbed BMP signaling and denervation of muscle fibers as important pathogenic mechanisms of muscle wasting associated with tumor growth. Collectively, these findings present interventions that promote BMP-mediated signaling as an attractive strategy to counteract the loss of functional musculature in patients with cancer.
Journal
ISSN 1946-6242
Published 04 Aug 2021
Volume 13
Issue 605
Pages
DOI 10.1126/scitranslmed.aay9592
Type Journal Article | Research Support, Non-U.S. Gov't
Sponsorship