Identification of neutrophil-derived proteases and angiotensin II as biomarkers of cancer cachexia

• Published in: British journal of cancer Vol. 114; no. 6; pp. 680 - 687
• Main Authors: Penafuerte, Claudia A, Gagnon, Bruno, Sirois, Jacinthe, Murphy, Jessica, MacDonald, Neil, Tremblay, Michel L
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 15.03.2016
• Subjects: Angiotensin II - blood; Biomarkers, Tumor - blood; Cachexia - blood; Cachexia - enzymology; Case-Control Studies; Cohort Studies; Cytokines - blood; Female; Humans; Male; Middle Aged; Molecular Diagnostics; Neoplasms - blood; Neoplasms - enzymology; Neutrophils - enzymology; Peptide Hydrolases - blood; RNA, Messenger - blood
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2016.3

Cachexia is a metabolic disorder characterised by muscle wasting, diminished response to anti-cancer treatments and poor quality of life. Our objective was to identify blood-based biomarkers of cachexia in advanced cancer patients. Hence, we characterised the plasma cytokine and blood cell mRNA profiles of patients grouped in three cohorts: patients with cachexia, pre-cachexia (no cachexia but high CRP levels: ⩾ 5 mg l⁻¹) and no cachexia (no cachexia and CRP: < 5 mg l⁻¹). A total of 122 newly diagnosed cancer patients with seven cancer types were studied prior to their initial therapy. Plasma levels of 22 cytokines were quantified using the bio-plex technology. mRNAs isolated from whole blood and expression profiles were determined by the chip array technology and Ingenuity Pathway Analysis (IPA) software. In comparison with non-cachectic individuals, both pre-cachectic and cachectic patients showed an increase (⩾ 1.5-folds) in mRNA expression of neutrophil-derived proteases (NDPs) and significantly elevated angiotensin II (Ang II) (P = 0.005 and P = 0.02, respectively), TGFβ1 (P = 0.042 and P < 0.0001, respectively) and CRP (both P < 0.0001) in the plasma. Moreover, cachectic patients displayed a significant increase in IL-6 (P = 0.005), IL-8 (P = 0.001) and absolute neutrophil counts (P = 0.007). Ang II, TGFβ1, CRP and NDP are blood biomarkers for cancer cachexia. These findings contribute to early diagnosis and prevention of cachexia.