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Understanding the relationship between cancer associated cachexia and hypoxia-inducible factor-1 - 23/05/23

Doi : 10.1016/j.biopha.2023.114802 
Subramanian Muthamil a, Hyun Yong Kim a, Hyun-Jun Jang a, Ji-Hyo Lyu a, Ung Cheol Shin a, Younghoon Go b, Seong-Hoon Park c, Hee Gu Lee d, Jun Hong Park a, e,
a Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju, Jeollanam-do, 58245, Republic of Korea 
b Korean Medicine (KM)-application Center, Korea Institute of Oriental Medicine, Daegu, Republic of Korea 
c Genetic and Epigenetic Toxicology Research Group, Korea Institute of Toxicology, Daejeon 34141, Republic of Korea 
d Immunotherapy Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon 34141, Republic of Korea 
e University of Science & Technology (UST), KIOM campus, Korean Convergence Medicine Major, Daejeon 34054, Republic of Korea 

Corresponding author at: Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju, Jeollanam-do, 58245, Republic of Korea.Herbal Medicine Resources Research Center, Korea Institute of Oriental MedicineNajuJeollanam-do58245Republic of Korea

Abstract

Cancer-associated cachexia (CAC) is a multifactorial disorder characterized by an unrestricted loss of body weight as a result of muscle and adipose tissue atrophy. Cachexia is influenced by several factors, including decreased metabolic activity and food intake, an imbalance between energy uptake and expenditure, excessive catabolism, and inflammation. Cachexia is highly associated with all types of cancers responsible for more than half of cancer-related mortalities worldwide. In healthy individuals, adipose tissue significantly regulates energy balance and glucose homeostasis. However, in metastatic cancer patients, CAC occurs mainly because of an imbalance between muscle protein synthesis and degradation which are organized by certain extracellular ligands and associated signaling pathways. Under hypoxic conditions, hypoxia-inducible factor-1 (HIF-1α) accumulated and translocated to the nucleus and activate numerous genes involved in cell survival, invasion, angiogenesis, metastasis, metabolic reprogramming, and cancer stemness. On the other hand, the ubiquitination proteasome pathway is inhibited during low O2 levels which promote muscle wasting in cancer patients. Therefore, understanding the mechanism of the HIF-1 pathway and its metabolic adaptation to biomolecules is important for developing a novel therapeutic method for cancer and cachexia therapy. Even though many HIF inhibitors are already in a clinical trial, their mechanism of action remains unknown. With this background, this review summarizes the basic concepts of cachexia, the role of inflammatory cytokines, pathways connected with cachexia with special reference to the HIF-1 pathway and its regulation, metabolic changes, and inhibitors of HIFs.

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Graphical Abstract




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Highlights

Hypoxia inducible factor (HIF-1) pathways associated with metastasis cancer and the multifactorial syndrome ‘cachexia’.
Adipogenesis associated with cachexia by secreting adipokines or cytokines which are the mediators of cachexia pathways.
HIF-1 involved in metabolic reprogramming in tumor cells including glucose, lipid, amino acid metabolism and lactate/H+ efflux.
HIF-1 inhibitors block cachexia associated signalling pathways and promotes the adipogenesis.
HIF-1 inhibitors from natural sources targeting activation of the HIF-1 pathway are important in cachexia pharmacotherapy.

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Keywords : Cancer-associated cachexia, Hypoxia-inducible factor-1, Muscle wasting, Adipogenesis, Metabolism, Signaling pathways


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