- Dasgupta, Aneesha;
- Shukla, Surendra K;
- Vernucci, Enza;
- King, Ryan J;
- Abrego, Jaime;
- Mulder, Scott E;
- Mullen, Nicholas J;
- Graves, Gavin;
- Buettner, Kyla;
- Thakur, Ravi;
- Murthy, Divya;
- Attri, Kuldeep S;
- Wang, Dezhen;
- Chaika, Nina V;
- Pacheco, Camila G;
- Rai, Ibha;
- Engle, Dannielle D;
- Grandgenett, Paul M;
- Punsoni, Michael;
- Reames, Bradley N;
- Teoh-Fitzgerald, Melissa;
- Oberley-Deegan, Rebecca;
- Yu, Fang;
- Klute, Kelsey A;
- Hollingsworth, Michael A;
- Zimmerman, Matthew C;
- Mehla, Kamiya;
- Sadoshima, Junichi;
- Tuveson, David A;
- Singh, Pankaj K
Approximately one third of cancer patients die due to complexities related to cachexia. However, the mechanisms of cachexia and the potential therapeutic interventions remain poorly studied. We observed a significant positive correlation between SIRT1 expression and muscle fiber cross-sectional area in pancreatic cancer patients. Rescuing Sirt1 expression by exogenous expression or pharmacological agents reverted cancer cell-induced myotube wasting in culture conditions and mouse models. RNA-seq and follow-up analyses showed cancer cell-mediated SIRT1 loss induced NF-κB signaling in cachectic muscles that enhanced the expression of FOXO transcription factors and NADPH oxidase 4 (Nox4), a key regulator of reactive oxygen species production. Additionally, we observed a negative correlation between NOX4 expression and skeletal muscle fiber cross-sectional area in pancreatic cancer patients. Knocking out Nox4 in skeletal muscles or pharmacological blockade of Nox4 activity abrogated tumor-induced cachexia in mice. Thus, we conclude that targeting the Sirt1-Nox4 axis in muscles is an effective therapeutic intervention for mitigating pancreatic cancer-induced cachexia.