Why do cancer patients lose weight?

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Photo by National Cancer Institute on Unsplash
Photo by National Cancer Institute on Unsplash

About 20% of cancer deaths can be attributed to weight loss caused by the disease, and international researchers believe they have discovered a way cancer-related weight loss happens. The researchers screened the levels of metabolites - substances created as the body breaks down foods, chemicals or itself - in both humans and mice who were losing weight due to cancer. They say they found elevated lactate levels corresponded with the weight loss, so they looked closer at this by implanting human cancer cells in mice. The researchers say they found the elevated lactate triggered breakdown of fat via a specific receptor, which they believe could in future be targeted with treatments to help reduce weight loss in cancer patients.

Media release

From: Springer Nature

Cancer: Disease-induced weight loss may be driven by lactate

Elevated levels of lactate may lead to the development of cachexia (disease-related weight loss) following the onset of cancer, according to a study including data from mice and humans published in Nature Metabolism.

Cachexia is a metabolic syndrome characterized by the loss of body fat and muscle mass and affects around 50–80% of cancer patients. The condition results in a deterioration in quality of life and poor tolerance to cancer therapies, and accounts for 20% of cancer deaths. Previous research has shown that cancer can significantly alter the host’s metabolism and levels of certain metabolic products, but how and why cachexia occurs and how it can be treated is unknown.

Xinli Hu, Rui-Ping Xiao, and colleagues screened metabolite levels in the blood from patients and mice with cancer cachexia, identifying elevated lactate levels that correlated with the degree of body weight lost. To investigate this further, the authors implanted mice with human cancer cells and found that elevated lactate levels could trigger extensive transformation of white adipose tissue (body fat), including increased browning and lipolysis (breakdown of fat), via the GPR81 receptor on white adipose tissue. They illustrate that lactate can bind to this receptor and activate signals within the cells to increase metabolic activity in adipose tissue, which initiates the loss of fat and muscle mass and eventually body weight. The authors also highlight that inhibiting GPR81 was seen to limit tumour growth in mice.

The authors suggest that their findings indicate that lactate may have a role in cachexia development and that targeted ablation of its receptor GPR81 may be a potential therapeutic strategy for the treatment of cancer cachexia; however they note that further research is necessary.

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Research Springer Nature, Web page The URL will go live after the embargo ends
Journal/
conference:
Nature Metabolism
Research:Paper
Organisation/s: Peking University, China
Funder: We thank W. Leng for support in phosphoproteomics analysis and H. Cheng for the discussion and revision of the manuscript. This work was supported by the National Key R&D Program of China (2018YFA0800701, 2022YFA1303000, 2018YFA0507603 and 2018YFA0800501), the National Natural Science Foundation of China (81770376, 81630008 and 81790621), Beijing Municipal Science & Technology Commission (Z171100000417006) and Beijing Natural Science Foundation (5182010).
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