A TGF-β/KLF10 signaling axis regulates atrophy-associated genes to induce muscle wasting in pancreatic cancer

Abstract

Cancer cachexia, and its associated complications, represent a large and currently untreatable roadblock to effective cancer management. Many potential therapies have been proposed and tested—including appetite stimulants, targeted cytokine blockers, and nutritional supplementation—yet highly effective therapies are lacking. Innovative approaches to treating cancer cachexia are needed. Members of the Kruppel-like factor (KLF) family play wide-ranging and important roles in the development, maintenance, and metabolism of skeletal muscle. Within the KLF family, we identified KLF10 upregulation in a multitude of wasting contexts—including in pancreatic, lung, and colon cancer mouse models as well as in human patients. We subsequently interrogated loss-of-function of KLF10 as a potential strategy to mitigate cancer associated muscle wasting. In vivo studies leveraging orthotopic implantation of pancreas cancer cells into wild-type and KLF10 KO mice revealed significant preservation of lean mass and robust suppression of pro-atrophy muscle-specific ubiquitin ligases Trim63 and Fbxo32, as well as other factors implicated in atrophy, calcium signaling, and autophagy. Bioinformatics analyses identified Transforming growth factor beta (TGF-β), a known inducer of KLF10 and cachexia promoting factor, as a key upstream regulator of KLF10. We provide direct in vivo evidence that KLF10 KO mice are resistant to the atrophic effects of TGF-β. ChIP-based binding studies demonstrated direct binding to Trim63 , a known wasting-associated atrogene. Taken together, we report a critical role for the TGF-β/KLF10 axis in the etiology of pancreatic cancer–associated muscle wasting and highlight the utility of targeting KLF10 as a strategy to prevent muscle wasting and limit cancer-associated cachexia.

Molecular Mechanisms of Cachexia: A Review

“…The overexpression of KLF10, a member of the KLF family, may be involved in the pathogenesis of cachexia relative to the induction of TGF-β [67,68]. Hence, the loss-of-function of KLF10 has been identified as a promising approach to mitigate cancer-induced muscle atrophy [69]. Furthermore, the activation of the TNF-α/TAK-1 signaling pathway leads to a rise in Activin A levels in skeletal muscle, in addition to myostatin [70].…”

In Vitro Models for Cancer-Associated Cachexia: The Complex Modelling of a Multiorgan Syndrome

“…TGF-β is a driver of cancer-associated muscle wasting, it has a direct catabolic effect on the tissue inducing the ubiquitin-mediated proteasome degradation (UPR) of muscle proteins [110,111]. TNF-α is also reported to play in the loss of adipose tissue by increasing gluconeogenesis and proteolysis, simultaneously decreasing protein, lipid and glycogen synthesis [2,111].…”