Effects of Adjuvant Exercise and Nutrition Therapy on Muscle Fibre Biomechanics in Gastrointestinal Cancer Patients

• Published in: Cancers Vol. 16; no. 8; p. 1608
• Main Authors: Haug, Michael, Schwappacher, Raphaela, Pollmann, Charlotte, Ritter, Paul, Michael, Mena, Hermann, Hans Joachim, Grützmann, Robert, Mittelstädt, Anke, Neurath, Markus Friedrich, Zopf, Yurdagül, Friedrich, Oliver
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.04.2024
• Subjects: Adjuvant treatment; Analysis; Atrophy; Biomechanics; Biopsy; Cachexia; Caffeine; Calcium homeostasis; Cancer; Cancer patients; Cancer therapies; Chemotherapy; Chronic illnesses; Colorectal cancer; Development and progression; Diet; Diet therapy; Exercise; Force; Health aspects; Homeostasis; Inflammation; Kinases; Muscle contraction; Musculoskeletal system; Nutrition therapy; Oncology, Experimental; Pancreatic cancer; Physical fitness; Physiology; Proteins; Quality of life; Resveratrol; Stomach cancer; Surgery; Tumors; Germany; multi-modal therapy; protein-rich diet; resistance training; single fibres; skeletal muscle; cancer cachexia
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16081608

Patients with aggressive cancer, e.g., gastrointestinal cancer, are prone (≥50% chance) to developing cancer cachexia (CC). Little is known about the effects of CC on the biomechanical function of muscle. A promising prevention strategy was found in the form of a multi-modal therapy combining mild resistance exercise (e.g., whole-body electro-myostimulation, WB-EMS) and a protein-rich diet. In a previous study of ours, this was effective in counteracting the loss of muscle mass, yet a systematic and comprehensive assessment of active and passive single muscle fibre functions was so far absent. This pilot study investigated the biomechanical function of single muscle fibres ( ) from the biopsies of conventionally treated (pre-)cachectic cancer ((pre-)CC) patients (m = 9), those receiving the multi-modal therapy comprising WB-EMS training and protein-rich nutrition (m = 3), and a control group (m = 5). Our findings not only align with previous findings showing the absolute force loss in CC that is accelerated by atrophy but also speak in favour of a different, potentially energy- and Ca -homeostasis-related effect that compromises muscle contraction (F ~0.9 mN vs. F ~0.6 mN in control patients). However, myofibrillar Ca sensitivity and the quality of contraction were unaltered (pCa50: 5.6-5.8). Single fibres from the (pre-)CC patients receiving WB-EMS training and protein supplementation were significantly more compliant ( < 0.001 at ≥130% of resting length L ). Those fibres displayed a similar softness to the ones from the control patients (axial compliance ~15 m/N at ≥130% L ), while single fibres from the patients with (developing) cachexia were significantly stiffer (axial compliance ~7 m/N, < 0.001 at ≥130% L ). Adjuvant multi-modal therapy (WB-EMS training and nutritional support) contributes to maintaining the axial compliance of single fibres and potentially improves the quality of life for patients at risk of developing CC.