Ernährung 2006 International Cachexia Workshop Berlin, June 2006

Transcription

1 Activation Peptides ATP E1 ATP Ubiquitin Proteolysis E2 Proteín Proteasome 26S E2 E3 Conjugation Ernährung 2006 International Cachexia Workshop Berlin, June 2006 Antiproteolytic strategies Prof. Dr. Josep M. Argilés Departamento de Bioquímica y Biología Molecular Universidad de Barcelona, Spain

2 Hippocrates of Kos: ( BC) The flesh is consumed and becomes water,, the shoulders, clavicles, chest and thights melt away. The illness is fatal

3 Multiorgan syndrome Systemic disorder

4 T h e C a c h e x i a P y r a m i d T r e a t m e n t T u m o u r F o o d i n t a k e M e t a b o l i c a b n o r m a l i t i e s T u m o u r f a c t o r s C y t o k i n e s H o r m o n e s B r a i n I m m u n e s y s t e m S k e l e t a l A d i p o s e L i v e r m u s c l e t i s s u e B l o o d G u t I m m o b i l i t y Q u a l i t y W e i g h t o f l i f e l o s s A n e m i a O e d e m a W e a k n e s s

5 Skeletal muscle

6

7 MUSCLES AA LIVER Acute-phase proteins Gluconeogenesis

8 Skeletal muscle - Decreased AA uptake - Increased AA oxidation - Decreased glucose transport - Alterations in mitochondrial function (uncoupling) - Apoptosis - Alterations in satellite cell proliferation/differentiation - Increased proteolysis

9 ESTIMATION OF PROTEIN TURNOVER IN VIVO 14 C-PROTEIN LOADING 400mC i /kg body weight NaH 14 CO 3

10 SKELETAL MUSCLE (GASTROCNEMIUS) Ks Kd Ka Control AH Costelli et al., J Clin Invest. 1993;92(6):

11 PROTEINS synthesis degradation c y c l ohe x im i de ( - ) TYROSINE TYROSINE TOTAL PRQTEOLYSIS = DEGRADATION NET PROTEOLYSIS = DEGRADATION - SYNTHESIS

12 Tyrosine released by isolated soleus rat muscles (nmoles/g.hr) PAIR-FED TUMOUR *** (Martínez et al, 1994)

13 CANCER CACHEXIA PROTEIN Kd Ks AMINO ACIDS

14 Proteolytic systems in muscle Lysosomal Cathepsins Non-lysosomal Ca ++ -dependent Calpains ATP-dependent Ubiquitin

15 In vitro proteolysis (nmol Tyr released/g/h) CONTROL TUMOR lisosomal Ca 2+ -dependent ubiquitin-dependent

16 Activation Peptides ATP E1 ATP Ubiquitin Proteolysis E2 Proteín Proteosome 26S E2 E3 Conjugation

17 Muscle-specific ubiquitin ligases MAFbx (atrogin-5) MURF-1

18 Ubiquitin mrna levels in skeletal muscle of gastric cancer patients Total Ub mrna levels (arbitrary units) Control subjects Stage I-II Stage III Stage IV Patients lost 5.57% of body weight (n= 20) Bossola et al. American Journal of Physiology 280: R1518-R1523 (2001)

19 Cytokine network Wasting TUMOUR Neuroendocrine response Muscle proteolysis Tumour-specific products Treatment

20 Therapeutic approaches

21 Pharmacological strategies MUSCLE WASTING Nutritional approaches

22 Anticatabolic + Anabolic

23 Using nutrition Leu β-hydroxy-β-methylbutyrate

24 Busquets et al., J Cell Physiol (3):283-9.

25 Chymotrypsin-like activity in proteasome Smith et al., Cancer Res. 2005;65(1):277-83

26 Smith et al., Cancer Res. 2005;65(1):277-83

27 Using nutraceuticals EPA Resveratrol

28 Whitehouse et al., Cancer Res. 2001;61(9):

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30 ω-3 FATTY ACIDS Wigmore et al., 1996 Treated a group of pancreatic cancer patients with fish oil capsules (containing 18% EPA and 12% DHA) for three months and observed an increase in body weight, a reduction of acute-phase proteins (C-reactive protein) and a stabilization of the resting energy expenditure. Fearon et al., 2003 A randomized double blind trial in pancreatic cancer patients using a protein and energy dense supplement enriched with ω-3 fatty acids and antioxidants. The trial demonstrates weight and LBM gain and improved quality of life. Gut. 52(10):

31 Resveratrol Diphenol found in grapes, peanuts nf-κb inhibitor COX-2 inhibitor Br J Cancer (9): Wyke SM, Russell ST, Tisdale MJ. Induction of proteasome expression in skeletal muscle is attenuated by inhibitors of NFkappaB activation.

32 Using drugs β2 agonists Anticachectic cytokines

33 BETA-2 ADRENERGIC AGONISTS OH HO CH - CH 2 - NH - CH 3 ADRENALINE (EPINEPHRINE) HO Cl OH CH 3 H 2 N CH - CH 2 - NH - C - CH 3 CLENBUTEROL Cl CH 3 HOCH 2 OH CH 3 HO CH - CH 2 - NH - C - CH 3 SALBUTAMOL CH 3 HOCH 2 OH HO CH - CH 2 - NH - (CH 2 ) 6 - O - (CH 2 ) 4 SALM ETEROL HO OH CH 3 CH - CH 2 - NH - CH - CH 2 OH FENOTEROL HO O CH HN OH CH 3 HO CH - CH 2 - NH - CH - CH 2 OCH 3 FORMOTEROL

34 EFFECT OF FORMOTEROL TREATMENT ON SKELETAL MUSCLE WEIGHTS OF TUMOUR-BEARING RATS 1000 GASTROCNEMIUS ** 400 TIBIALIS 750 ** 300 ** ** mg / 100 g IBW SOLEUS EDL control formoterol ** *** control tumour control tumour Busquets et al., 2005

35 EFFECT OF FORMOTEROL TREATMENT ON GENE EXPRESSION OF PROTEOLYTIC SYSTEMS IN RAT GASTROCNEMIUS ubiquitin 2.4 kb ubiquitin 1.2 kb 200 proteasome C8 subunit arbitrary units * control tumour m-calpain * control tumour cathepsin B * control *** tumour control 200 *** formoterol control tumour 0 control tumour Busquets et al., 2005

36 EDL or Soleus Krebs-Henseleit buffer 35ºC

37 EFFECTS OF BETA-AGONISTS ON IN VITRO PROTEOLYTIC RATE IN ISOLATED EDL MUSCLES nmol tyrosine released / g. 2 hours *** *** control formoterol clenbuterol Busquets et al., 2005

38 Anticachectic cytokines: IL-15

39 70 Protein degradation in C2 myotubes % of total protein degradation * Control IL-15 (20ng/ml) 0 Busquets et al., 2005

40 Proteolytic rate in isolated EDL rat muscles Control IL-15 nmoles tyr/g x h * 20 0 Busquets et al., 2005

41 EFFECTS OF IL-15 TREATMENT ON SKELETAL MUSCLE FROM TUMOUR-BEARING RATS MUSCLE WEIGHTS (% of control) PROT. DEGRADATION RATE (% / day) mrna EXPRESSION (% of control) * ** ** 6 4 * ** * ** GSN SOL TIB 0 CONTROL TUMOUR 0 UB 2.4 UB 1.2 C8 Non-treated Treated Carbó et al., 2000

42 Using proteolytic inhibitors Proteasome inhibitors Lactacystin Bortezomib (PS-341) MG-132 Calpain inhibitors Calpeptin BN82270

43 Chymotrypsin-like activity in proteasome 10mg /kg body weight MG-132 Lolezek et al., Biochem. Biophys. Res. Commun. 345:

44 Fareed et al., Am. J. Physiol. 290: R , 2006

45 Fareed et al., Am. J. Physiol. 290: R , 2006

46 Molecular mechanisms potentially involved in muscle wasting Preproteasomal Paraproteasomal Proteasomal Postproteasomal

47 Cancer Myofibrils Ca ++ /Calpain dependent release of myofilaments Reincorporation Myofilaments Substrate modification Ub/proteasome dependent proteolysis COP9 signalosome CHIP VCP Peptides TPP, aminopeptidases other exopeptidases Amino acids

48 CACHEXIA TREATMENT ANTIPROTEOLYTIC STRATEGIES Nutrition + Nutraceuticals + Drugs Anabolic +Anticatabolic

49 Thank you. Danke.