SUPPLEMENTARY DATA. Nature Medicine: doi: /nm.4171

Transcription

1 SUPPLEMENTARY DATA

2 Supplementary Figure 1 a b c PF %Change Body weight Lean mass Body fat Tissue weight (g) PF GC iwat awat BAT PF d e f g week 2 week 3 NEFA (mmol/l) PF phsl (Ser565) Hsl pacc (Ser79) Acc pampk alpha 1 (Thr172) Ampk alpha 1 pampk beta 1 (Ser18) Ampk beta 1 Cidea Actin phsl (Ser565)/Hsl (a.u.) week 2 week 3 pacc (Ser79)/Acc (a.u.) week 2 week 3 h i j MC38 Ampk alpha protein (a.u.) week 2 week 3 Ampk beta protein (a.u.) Cidea protein (a.u.) week 2 week 3 week 2 week 3 pacc (Ser79) Acc phsl (Ser565) Hsl pampk alpha 1 (Thr172) Ampk alpha 1 pampk beta 1 (Ser18) Ampk beta 1 phsl (Ser66) Hsl Atgl Plin ppka Targets Cidea Vcp Actin

3 Supplementary Figure 1: Cancer cachexia leads to the loss of Ampk expression in white adipose tissue. (a) Change of body weight, body fat and lean mass in control (), pair-fed (PF) and -induced cachectic () mice measured by ECHO-MRI body composition analysis (, PF n = 5, n = 8). (b) Average tissue weights of gastrocnemius skeletal muscle (GC), inguinal white (iwat), abdominal white (awat) and brown (BAT) adipose tissue depots of the same animals. (c) H&E staining of iwat of the same animals (representative images of n = 5). Scale bar µm. (d) Serum nonesterified fatty acid (NEFA) levels of the same animals. (e) Loss of iwat in - bearing mice over time (n = 8). (f) Immunoblot of the lipolysis, lipogenesis and Ampk signaling pathways in iwat from cachectic and control (ctrl) animals over time. Three representative animals per group are shown. (g) Quantification of phsl(ser565) and pacc(ser79) levels normalized to total protein levels as shown in (f) (n =3). (h) Quantification of Ampk alpha and beta as well as Cidea protein levels as shown in (f) (n = 3). (i) Immunoblot of the lipolysis, lipogenesis and Ampk signaling pathways in awat of non-cachectic MC38 cell injected animals (n = 3). (j) Immunoblot of the lipolysis signaling pathway in iwat of cachectic animals. Total Hsl blot is identical to that in Fig. 2a. All data in the figure are shown as the mean ± s.e.m. n numbers refer to biological replicates. (a,b,d,e,g,h) 1-way ANOVA with Tukey s Multiple Comparison Posttest. P <.5, P <.1, P <.1

4 Supplementary Figure 2 a % Body weight change % Body fat change % Lean mass change b NEFA (mmol/l) NaCl OHDA NaCl 6-OHDA NaCl 6-OHDA NaCl 6-OHDA c d Tissue weight (g) NE (ng/mg tissue) NE (ng/mg tissue) NE (ng/mg tissue) NaCl 6-OHDA NaCl 6-OHDA NaCl 6-OHDA NaCl 6-OHDA e f.15 Relative Ucp1 mrna levels NEFA (mmol/l).1.5 NaCl NaCl 6-OHDA. DMSO H89 22 C 4 C

5 Supplementary Figure 2: Blockade of sympathetic signaling does not ameliorate the cachectic phenotype in WAT. (a) Change of body weight, body fat and lean mass in and Colon 26 () mice injected with 6-OHDA or NaCl, measured by ECHO-MRI body composition analysis ( n = 4, n = 8). (b) Serum NEFA levels, (c) iwat weight, (d) iwat, awat and BAT norepinephrine (NE) levels of the same animals. (e) Ucp1 mrna levels in iwat of male BALB/c mice injected with NaCl or 6-OHDA into the inguinal fat pads and housed at 22 C or 4 C for 24 h (n = 5). (f) NEFA levels in supernatants of cachectic 3T3-L1 adipocytes treated with vehicle (DMSO) or 5 µm H89 for 3 h (n = 4). All data in the figure are shown as the mean ± s.e.m. n numbers refer to biological replicates. (a-d,f) 2-way ANOVA with Bonferroni s Multiple Comparison Posttest. (e) 1-way ANOVA with Tukey s Multiple Comparison Posttest. P <.5, P <.1, P <.1.

6 Supplementary Figure 3 a Body weight (g) b Tissue weight (g) Apc +/+ Apc 58/+ c NEFA (mmol/l) 1..5 d Body weight (g) Apc +/+ Apc 58/+ SW48. GC iwat awat BAT Body weight (g) SW48. +/+ Apc 58/+ Apc f Relative mrna levels SW Time (d) Time (d) 2 1 Murf1 Atrogin1 Bnip3 e g Tissue weight (g).3 SW Tissue weight (g).15 SW48.1 n.s.5 SW48 pacc (Ser79) Acc phsl (Ser565) Hsl pampk alpha 1 (Thr172) Ampk alpha 1. GC iwat awat BAT. GC iwat awat BAT pampk beta 1 (Ser18) Ampk beta 1 Actin

7 Supplementary Figure 3: Loss of Ampk expression is a common feature of various colon cancer mouse models. (a) Body weight, (b) tissue weights and (c) serum NEFA levels of control (Apc +/+ ) and Apc 58/+ cachectic animals (Apc +/+ n = 8, Apc 58/+ n = 4). (d) Body weight of control () and SW48 tumor cell injected cachectic animals. Left panel, SCID Fox Chase background; Right panel, Nude BALB/c background (n = 6). (e) Tissue weights of the same animals. (f) Relative mrna level of the E3 ligases Murf1 and Atrogin-1 as well as autophagy marker Bnip3 in the gastrocnemius (GC) muscle of the same mice (n = 5). (g) Immunoblot of the lipolysis, lipogenesis and Ampk signaling pathways in iwat of Fox Chase SCID mice injected with human SW48 cachexiainducing tumor cells (n = 3). All data in the figure are shown as the mean ± s.e.m. n numbers refer to biological replicates. n.s., non-significant. (a-c,e,f) Student s t-test. (d) 2-way ANOVA with Bonferroni s Multiple Comparison Posttest. P <.5, P <.1, P <.1.

8 Supplementary Figure 4 a b 26 c 8 Relative Cidea mrna levels Relative Cidea mrna levels Body weight (g) Pair-fed control Time (d before sacrifice) RMR (ml/h) Pair-fed control Time (d before sacrifice) d 11 e 1 f 8 VO2 (ml/h) Pair-fed control Time (d before sacrifice) VCO2 (ml/h) Pair-fed control Time (d before sacrifice) BW normalized RMR (ml/h) 6 4 PF g h 8 8 Food intake (g/mouse/day) Pair-fed control Time (d before sacrifice) Activity (counts/h) 6 4 Pair-fed control Time (d before sacrifice) i RER Pair-fed control Time (d before sacrifice)

9 Supplementary Figure 4: Cancer cachexia leads to reduced energy expenditure. (a) Cidea mrna levels in iwat (left) and BAT (right) of control and Colon-26 () cachectic animals ( n = 4, n = 8). (b-i) Indirect calorimetry measurements of -injected cachectic animals and pair-fed PBS injected control animals that received the same maximum amount of food as the animals with 1 h time delay. Measurements were performed using the TSE PhenoMaster system. Body weight (b), resting metabolic rate (RMR) (c), VO2 (d), VCO2 (e), food intake (g), arbitrary movements (h), and respiratory exchange ratio (RER) (i) of and pair-fed control animals. Animals were sacrificed when they had lost > 1% of body weight. Data are shown in time before sacrifice to assure that the degree of cachexia was similar in all mice at any given time point. All values were measured every 12 min and mean values were calculated for 24 h, synchronized to the day of sacrifice. Average hourly values are shown in (c-g) (n = 6). (f) RMR adjusted to body weight at the day of sacrifice, ANCOVA adjusted at g body weight (n = 6). All data in the figure are shown as the mean ± s.e.m. n numbers refer to biological replicates. (a,f) Student s t-test. (b-e,g-i) Repeated measures ANOVA with Bonferroni s Multiple Comparison Posttest. P <.5, P <.1, P <.1.

10 Supplementary Figure 5 a Relative Ucp1 mrna level Relative Prdm16 mrna level 1..5 Relative Dio2 mrna level 1..5 Relative Cox7a1 mrna level week 2. week 3. week. 1. week 2. week 3. week. 1. week 2. week 3. week. 1. week 2. week 3. week b Relative Ucp1 mrna level WT PBS WT LLC KO LLC n.d. Relative Prdm16 mrna level WT PBS WT LLC KO LLC Relative Dio2 mrna level WT PBS WT LLC KO LLC Relative Cox7a1 mrna level WT PBS WT LLC KO LLC c Body weight (g) LLC Body fat (g) LLC Lean mass (g) LLC Time (d) Time (d) Time (d) d LLC Ampk alpha 1 e 1 Ampk beta 1 Cidea Actin VO2 (ml/h) 1 8 WTPBS WT LLC KO LLC Time (d before sacrifice)

11 Supplementary Figure 5: Cancer cachexia does not induce browning marker genes in WAT. (a) Relative mrna levels of different browning markers in iwat of control () and Colon-26 () cachectic animals. Experiment was performed for three weeks. Weekly, a cohort of six and ten -bearing mice was sacrificed. (b) Relative mrna levels of different browning markers in Ucp1 knockout (KO) and wildtype (wt) mice injected with LLC tumor cells or PBS, sacrificed 14 d after tumor cell injection. (c) Body weight, body fat and lean mass of control () and LLC injected mice (n = 6). (d) Immunoblot of Ampk alpha 1 and beta 1 and Cidea in iwat of the same mice as shown in (c) (representative of n = 6). (e) VO2 of Ucp1 KO and wt mice injected with LLC or PBS, respectively. Measurements were performed using the TSE PhenoMaster system. Same mice as shown in (b). All data in the figure are shown as the mean ± s.e.m. n numbers refer to biological replicates. n.d., not detectable. (b) 1-way ANOVA with Tukey s Multiple Comparison Posttest. (c) 2-way ANOVA with Bonferroni s Multiple Comparison Posttest. P <.5, P <.1.

12 Supplementary Figure 6 a 2. CP CP b Relative protein levels 1..5 ACIP ACIP Relative Cidea mrna level Time of CHX treatment (h). sinc sicidea c Final body weight (g) 3 25 GC weight (mg) 35 3 iwat weight (mg) 4 awat weight (mg) WT KO 25 WT KO WT KO WT KO d Relative NEFA levels Relative NEFA levels e NEFA (mmol/l) WT KO. WT KO. DMSO AICAR

13 Supplementary Figure 6: Cidea partly controls the lipolytic response to cancer cachexia in adipocytes. (a) Ampk beta 1 protein levels by immunoblot relative to Ponceau staining from cachectic 3T3-L1 cells transfected with control peptide (CP) or ACIP and treated with 1 mm cycloheximide (CHX) for, 1, 2, 4, 8 and 12 h (n = 3). (b) Relative Cidea mrna level of 3T3-L1 adipocytes treated with a non-specific control sirna (sinc) or a sirna specific for Cidea (n = 4). (c) Body weight and tissue weights of Cidea KO animals and wt littermates, injected with LLC tumor cells, sacrificed on day 21 (wt n = 5, KO n = 7). (d) Relative NEFA levels in supernatants of iwat and awat explants from wild-type (wt) and Cidea KO animals treated with control or mouse serum (n = 3). (e) NEFA levels in supernatants of cachectic 3T3-L1 cells treated with vehicle (DMSO) or 1 µm AICAR for 3 h (n = 4). All data in the figure are shown as the mean ± s.e.m. n numbers refer to biological replicates. (b,d) Student s test. (e) 2- way ANOVA with Bonferroni s Multiple Comparison Posttest. P <.1, P <.1.

14 Supplementary Figure 7 a b iwat Relative mrna levels 3 No virus anti-flag AAV ACIP AAV ACIP AAV 1 c c phsl (Ser565)/Actin (a.u.) C ACIP pacc (Ser79)/Actin (a.u.) C ACIP iwat awat Liver AAV d 6 AAV ACIP AAV e n.s. Relative mrna levels 4 n.s. Tumor weight (g) 1..5 iwat awat BAT GC. ACIP

15 Supplementary Figure 7: ACIP ameliorates the cachectic phenotype in vivo. (a) Flag- ACIP mrna expression in iwat, awat and liver of mice injected with 31 9 ifu AAV (; C) into the left inguinal fat pad and 31 9 ifu Flag-ACIP AAV (ACIP) into the right inguinal fat pad of the same animal (No virus n = 6, and ACIP AAV n = 1). (b) Flag-ACIP peptide expression in iwat of the same animals, shown by immunohistochemistry using anti-flag antibody (representative images of n = 3). (c) Quantitation of phsl(ser565) and pacc(ser79) over Actin in iwat from same animals as in (a). (d) Flag-ACIP mrna levels in iwat, awat, BAT and gastrocnemius muscle (GC) of mice injected with ifu ACIP or AAV, and cells two weeks later. Animals were sacrificed upon 1-15% weight loss or at the latest 21 d after tumor cell injection ( n = 12, ACIP n = 15). (e) Tumor weights of the same animals. All data in the figure are shown as the mean ± s.e.m. n numbers refer to biological replicates. n.s., non-significant. (c) 2-way ANOVA with Bonferroni s Multiple Comparison Posttest. (d) Student s t-test. P <.5. P <.1.

16 Supplementary Table 1: Patient characteristics from human bariatric surgery intervention and cachexia study Parameter Cachexia Weight stability n (Women/Men) 33 (19/14) 3 (16/14) Cancer type (n): Rectal Sigma Colon Gastric Cholecystic Bladder Age (years) 62 ± ± 18 BMI (kg/m 2 ).1 ± 2.6 ± 1.8 Creatinine (µmol/l) 74 ± 31 9 ± 75 C-reactive protein (mg/l) 21 ± ± 27 Chemotherapy none none