Les cardiolipines (CL), phospholipides spécifiques des membranes mitochondriales, sont impliquées dans différentes fonctions mitochondriales. Il a été précédemment démontré que l’accumulation des CL entraînait une augmentation du gaspillage énergétique mitochondrial hépatique et une réduction du rendement de la synthèse d’ATP. Ces travaux de thèse montrent qu’à l’inverse, une diminution modérée de la quantité de CL (- 45 %) induit une réduction des capacités oxydatives mitochondriales sans diminuer la synthèse d’ATP et donc une augmentation de l’efficacité de la synthèse d’ATP. Nous démontrons également les mécanismes conduisant à l’accumulation des cardiolipines hépatiques en situation de cachexie cancéreuse. Le TNFa, cytokine proinflammatoire impliquée dans la cachexie cancéreuse, induit une surexpression spécifique de la phosphatidylglycérolphosphate synthase. La surexpression de cette enzyme impliquée dans la synthèse de novo des CL entraîne une accumulation de CL, responsable du gaspillage énergétique mitochondrial. / Cardiolipin (CL), a specific mitochondrial phospholipid, is involved in various mitochondrial functions. It has been shown that CL accumulation led to increased mitochondrial hepatic energy wasting and reduced ATP synthesis efficiency. This work showed, on the opposite, that moderate reduction in CL content (-45%) induced a decrease in mitochondrial oxidative capacity without decreasing ATP synthesis rate and thus an increased ATP synthesis efficiency. Then we demonstrated mechanisms responsible for hepatic cardiolipin accumulation during cancer cachexia. TNFa, proinflammatory cytokine involved in cancer cachexia, induced a specific overexpression of phosphatidylglycerolphosphate synthase. Overexpression of this enzyme involved into CL de novo biosynthesis led to CL accumulation, responsible for energy wasting during cancer.

Orientador: Robson Francisco Carvalho / Resumo: A caquexia associada ao câncer é uma síndrome caracterizada pela grave perda de tecido musculo esquelético; que se estima que afeta mais de 50% de todos os pacientes com câncer e resulta em menor qualidade de vida devido a fadiga, fraqueza, redução da função imune, resistência à insulina e baixa tolerância e resposta à quimioterapia. Notavelmente, 20% das mortes relacionadas ao câncer são diretamente causadas pela caquexia. A principal limitação de que atualmente não há terapia direcionada, é o uso de abordagens tradicionais que não tratam a complexidade em sistemas biológicos, caracterizada por interações não-lineares de redes de regulação genética (GRN, do inglês Gene Regulatory Networks). Por esse motivo, ainda é necessária uma identificação dos componentes da GRN e uma compreensão quantitativa de sua integração temporal no controle das respostas celulares. Adquirir tal conhecimento é fundamental para capturar detalhes mecanicistas essenciais para direcionar estratégias terapêuticas para uma doença complexa, como a caquexia do câncer. Neste trabalho, examinamos a expressão genética do músculo esquelético em dois abordagens metodológicos diferentes: usando dados de expressão de genes estáticos e dinâmicos. Estruturamos nosso trabalho da seguinte maneira: o Capítulo 1 apresenta uma caracterização quantitativa das vias de sinalização e uma reconstrução de GRN no tecido musculo esquelético em ratos portadores de carcinoma de pulmão de Lewis (LLC, do inglês Lewis lung carcinoma... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Cancer cachexia is a syndrome characterized by the severe skeletal muscle wasting tissue; that affects more than 50% of all cancer patients and results in lower quality of life due to compromised fatigue, weakness, decreased immune function, insulin resistance and poor tolerance and response to radio and chemotherapy. Remarkably, approximately 20% of cancer-related deaths are estimated to be directly caused by cachexia. There is currently no effective targeted therapy and the main limitation lays on the traditional approaches that not deal with the inherent complexity, characterized by non-linear interactions, of gene regulatory networks (GRN). Thus, a clear identification of the components of gene regulation, and a quantitative understanding of their temporal integration to control cellular responses is fundamental for capture essential mechanistic details that will ultimately enable the development of direct therapeutic strategies for the treatment of cancer cachexia. Here, we examine genome-wide gene expression of muscle wasting under two different frameworks, using static and dynamic gene expression data. We structure this approach as follow: Chapter 1 presents a quantitative characterization of the signaling pathways and a GRN reconstruction of muscle wasting in Lewis Lung Carcinoma (LLC) tumor-bearing mice by integrating static mRNAs and microRNAs expression profiles. The results show that LLC mice reduced body weight in 20% and presented muscle and fat tissue wasting a... (Complete abstract click electronic access below) / Doutor

A ausência de terapias eficazes para a caquexia permanece como um problema central para o tratamento do câncer no mundo. Em contrapartida, o treinamento de força (i.e. também conhecido como treinamento resistido) tem sido amplamente utilizado como uma estratégia não farmacológica anticatabólica, prevenindo a perda da massa e da função da musculatura esquelética. Entretanto, o papel terapêutico do treinamento de força na caquexia do câncer permanece apenas especulativo. Portanto, nesse estudo avaliamos se o treinamento de força poderia atenuar a perda da massa e da função da musculatura esquelética em um severo modelo de caquexia do câncer em ratos. Para isso, ratos machos da linhagem Wistar foram randomizados em quatro grupos experimentais: 1) ratos sedentários injetados com solução salina na medula óssea (Controle); 2) ratos injetados com solução salina na medula óssea e submetidos ao treinamento de força (Controle + T); 3) ratos sedentários injetados com células do tumor Walker 256 na medula óssea (Tumor); e 4) ratos injetados com células do tumor Walker 256 na medula óssea e submetidos ao treinamento de força (Tumor + T). Foram avaliados a massa e a área de secção transversa da musculatura esquelética, marcadores de disfunção metabólica e do turnover proteico, a função da musculatura esquelética in vivo e ex vivo, o consumo alimentar, o crescimento tumoral e a sobrevida dos grupos experimentais com tumor. O grupo Tumor apresentou atrofia muscular após quinze dias da injeção das células tumorais como pode ser observado pela redução na massa dos músculos Plantaris (- 20,5%) e EDL (-20%). A atrofia no músculo EDL foi confirmada por análises histológicas, demonstrando uma redução de 43,8% na área de secção transversa. Embora o treinamento de força tenha aumentado o conteúdo proteico da lactato desidrogenase e revertido totalmente o conteúdo da forma fosforilada de 4EBP-1 (i.e. repressor da transcrição de mRNA), ele não atuou na morfologia da musculatura esquelética nos animais com tumor. Além disso, o treinamento de força não atenuou a perda de função da musculatura esquelética, a anorexia, o crescimento tumoral ou a taxa de mortalidade. Contudo, a força muscular, avaliada pelo teste de 1RM, apresentou uma correlação negativa com a sobrevida dos animais (p = 0,02), sugerindo que a perda de força prediz a mortalidade nesse modelo experimental de caquexia do câncer. Em suma, a injeção de células do tumor Walker 256 na medula óssea induz caquexia do câncer em ratos. O treinamento de força não foi eficaz em atenuar a perda de massa e função da musculatura esquelética nesse modelo. Entretanto, a força muscular prediz a sobrevida dos animais, sugerindo que novos estudos são necessários para elucidar o possível efeito terapêutico do treinamento de força para atenuar a caquexia do câncer e a progressão tumoral / The lack of therapies for cachexia is a key problem in cancer treatment. In contrast, resistance exercise training (RET) has been adopted as nonpharmacological anti-catabolic strategy, preventing muscle wasting and muscle dysfunction. However, the role of RET to counteract cancer cachexia is still speculative. Presently, we test whether RET would counteract skeletal muscle wasting in a severe cancer cachexia rat model. Methods: Male Wistar rats were randomly assigned into four experimental groups; 1) untrained control rats injected with saline solution in the bone marrow (control), 2) rats injected with saline solution in the bone marrow and submitted to RET (control + RET), 3) untrained rats injected with Walker 256 tumor cells in the bone marrow (tumor) and 4) rats injected with Walker 256 tumor cells in the bone marrow and submitted to RET (tumor + RET). Skeletal muscle mass and fiber cross sectional area, markers of metabolic and protein turnover impairment, in vivo and ex vivo skeletal muscle function, food intake, tumor growth and mortality rate were assessed. Results: Tumor group displayed skeletal muscle atrophy fifteen days post tumor cells injection as assessed by Plantaris (-20.5%) and EDL (-20.0%) muscle mass. EDL atrophy was confirmed by histological analysis, showing 43.8% decline in the fiber cross sectional area. Even though RET increased the lactate dehydrogenase protein content and fully restored phosphorylated form of 4EBP-1 (i.e. a repressor of mRNA translation) to the control levels in skeletal muscle, it failed to rescue muscle morphology in tumorbearing rats. Indeed, RET has not mitigated loss of muscle function, anorexia, tumor growth or mortality rate. However, loss of strength capacity (assessed by 1-RM test performance) demonstrated a negative correlation with rats´ survival (p = 0.02), suggesting that loss of strength capacity predicts cancer mortality. Conclusions: Bone marrow injection of Walker 256 tumor cells in rats induces cancer cachexia. RET is ineffective to mitigate cancer-induced skeletal muscle wasting in this rat model. However, strength capacity predicts cancer survival, suggesting that new studies are needed to elucidate the putative therapeutic role of different exercise training regimens in counteracting cancer cachexia and tumor progression

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Skeletal muscle associated disorders are correlated with significant morbidity, including frailty, fatigue, reduced mobility and poor resistance to treatments as well as mental health repercussions resulting from a loss of independence. Thus, conditions affecting skeletal muscle put considerable pressure on the health care system. In response to injury, skeletal muscle can regenerate and the molecular mechanisms underlying this unique process has been the subject of intense research with the goal of developing better treatment modalities for muscle-related diseases. Our laboratory has previously demonstrated that C/EBPβ is a negative regulator of postnatal myogenic differentiation. Expressed in muscle satellite cells (MuSCs), the primary source of regenerative potential in skeletal muscle, C/EBPβ inhibits entry into the myogenic differentiation program and is required for MuSC self-renewal after injury. Despite the important role of C/EBPβ in muscle homeostasis, little is known about the genes it regulates. To better understand how C/EBPβ regulates these processes, I used both a candidate-based approach to identify the inhibitor of DNA binding and differentiation protein ID3 as a C/EBPβ target gene that mediates inhibition of myogenic differentiation, and an unbiased approach using RNA-seq. I compared gene expression profiles from C2C12 myoblasts overexpressing C/EBPβ to control cells under growth and differentiation conditions. I observed that more than 20% of the molecular signature found in quiescent MuSCs is regulated by C/EBPβ. Caveolin- 1 was implicated as a direct target of C/EBPβ and part of the molecular mechanism by which C/EBPβ maintains MuSCs quiescence. Interestingly, the RNA-seq data identified numerous C/EBPβ-regulated secreted proteins including growth factors and cytokines. Co-culture experiments indicate that secreted proteins mediate the inhibition of cell differentiation and fusion, suggesting that C/EBPβ functions in an autocrine and paracrine fashion to influence activation of myoblasts in the absence of cell-to-cell contact. Given the role of C/EBPβ in regulating secretory proteins that inhibit myogenic differentiation, I examined the requirement of C/EBPβ in the expression of anti myogenic proteins secreted by cancer cells that affect MuSCs function and drive the development of cancer cachexia. Indeed, the expression of C/EBPβ in cancer cells was found to be required for the production of a cachexia-inducing secretome by tumours in vitro and in vivo. Furthermore, C/EBPβ was found to be sufficient to convert non-cachectic tumours into cachexia-inducing ones. In comparing differentially expressed C/EBPβ-regulated secreted protein transcripts from our RNA-seq data to that from 27 different types of human cancers revealed an ~18% similarity between C/EBPβ-regulated secreted proteins and those enriched in cachectic tumours including pancreatic, gastric and brain cancers. Three of these C/EBPβ-regulated secreted proteins (SERPINF1, TNFRSF11B and CD93) were tested further and found to be inducers of muscle atrophy. This work provides molecular insight into the role of C/EBPβ in the regulation of MuSC function and the regulation of cachexia-inducing factors by tumours, placing C/EBPβ as a novel therapeutic target for the treatment of cancer cachexia and other muscle-related diseases.

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La cachexie est un syndrome complexe caractérisé par une balance énergétique négative. Le rôle joué par le métabolisme énergétique mitochondrial dans ce syndrome est peu connu. Nos précédents travaux montraient une diminution de la synthèse de l’ATP dans les mitochondries hépatiques en stade de cachexie cancéreuse sévère. Dans ce travail, nous démontrons, in vitro, que l’augmentation de la production d’espèce réactive de l’oxygène et du contenu en cardiolipine dans des mitochondries hépatiques saines, mime partiellement les mécanismes observés lors d’un stade cachexie sévère. Nous observons cependant que l’altération du métabolisme mitochondrial hépatique apparait à un stade tardif du développement de la cachexie. En stade sévère les mitochondries musculaires ne développent pas d’altération de leur efficacité de synthèse d’ATP mais une diminution des leurs capacités oxydatives. / Cancer cachexia is a composite syndrome, characterized by a negative energetic balance. The role played by mitochondrial energetic metabolism in this syndrome is poor known. Our past work showed a decrease of ATP synthesis efficiency in hepatic mitochondria in severe state of cancer cachexia. In this work, we demonstrate, in vitro, that increase of reactive oxygen species and cardiolipine content, in healthy mitochondria, can partly mimic the mechanisms observed in severe state of cancer cachexia. We observe that alteration of hepatic mitochondrial metabolism appear last during the development of cancer cachexia. In sever state of cancer cachexia, skeletal muscle mitochondria don’t develop this alteration but demonstrated a decrease of oxidative capacities.

Aims: The aim of this work was to determine whether a increased resting energy expenditure contributes to the nutritional risk for patients with pancreatic cancer. What the variability of resting energy expenditure is and whether it predicts weight loss. Another aim was to verify that lower protein-energy intake also has an impact on weight loss. Methods: Data for the diploma thesis were obtained from the project "Pancreatic Cancer: Metabolic Derangements Associated With Insulin Resistance", which takes place at the Department of Clinical Physiology of Metabolism at 2nd Department of internal medicine in the University Hospital Královské Vinohrady. The project includes 40 - 50 patients with pancreatic tumor resection per year. Data were collected from the beginning of December 2019 until the end of April 2020. The project is funded by the grant AZV NV19-01-00101. 10 consecutive patients (4 women and 6 men) with pancreatic cancer who had a complete dataset for analysis were selected for the research set for the diploma thesis. The patients underwent anthropometric examination, blood tests were taken, and indirect calorimetry was performed. Results: The first part of the research was focused on anthropometric parameters, parameters of nutritional status and the presence of cancer cachexia. The second...

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