J Cachexia Sarcopenia Muscle. 2015 Dec;6(4):317-24. doi: 10.1002/jcsm.12033. Epub 2015 Apr 30.
Plasma growth differentiation factor 15 is associated with weight loss and mortality in cancer patients.
Journal of cachexia, sarcopenia and muscle
Lorena Lerner, Teresa G Hayes, Nianjun Tao, Brian Krieger, Bin Feng, Zhenhua Wu, Richard Nicoletti, M Isabel Chiu, Jeno Gyuris, Jose M Garcia
Affiliations
Affiliations
- AVEO Pharmaceuticals Cambridge, MA, USA.
- Department of Medicine, Center for Translational Research on Inflammatory Diseases (CTRID), Michael E DeBakey Veterans Affairs Medical Center Houston, TX, USA ; Dan L. Duncan Cancer Center, Baylor College of Medicine Houston, TX, USA.
- Department of Medicine, Center for Translational Research on Inflammatory Diseases (CTRID), Michael E DeBakey Veterans Affairs Medical Center Houston, TX, USA ; Dan L. Duncan Cancer Center, Baylor College of Medicine Houston, TX, USA ; Department of Molecular and Cell Biology and Huffington Center on Aging, Baylor College of Medicine Houston, TX, USA.
PMID: 26672741
PMCID: PMC4670740 DOI: 10.1002/jcsm.12033
Abstract
BACKGROUND: Cancer-related weight loss is associated with increased inflammation and decreased survival. The novel inflammatory mediator growth differentiation factor (GDF)15 is associated with poor prognosis in cancer but its role in cancer-related weight loss (C-WL) remains unclear. Our objective was to measure GDF15 in plasma samples of cancer subjects and controls and establish its association with other inflammatory markers and clinical outcomes.
METHODS: We measured body weight, appetite, plasma GDF15, and other inflammatory markers in men with cancer-related weight loss (C-WL, n = 58), weight stable patients with cancer (C-WS, n = 72), and non-cancer controls (Co, n = 59) matched by age and pre-illness body mass index. In a subset of patients we also measured handgrip strength, appendicular lean body mass (aLBM), Eastern Cooperative Oncology Group (ECOG), and Karnofsky performance scores.
RESULTS: GDF15, interleukin (IL)-6 and IL-8 were increased in C-WL versus other groups. IL-1 receptor antagonist, IL-4, interferon-gamma, tumour necrosis factor alpha, and vascular endothelial growth factor A were increased in C-WL versus C-WS, and Activin A was significantly downregulated in Co versus other groups. C-WL patients had lower handgrip strength, aLBM, and fat mass, and Eastern Cooperative Oncology Group and Karnofsky performance scores were lower in both cancer groups. GDF15, IL-6, and IL-8 significantly correlated with weight loss; GDF15 negatively correlated with aLBM, handgrip strength, and fat mass. IL-8 and Activin A negatively correlated with aLBM and fat mass. GDF15 and IL-8 predicted survival adjusting for stage and weight change (Cox regression P < 0.001 for both).
CONCLUSION: GDF15 and other inflammatory markers are associated with weight loss, decreased aLBM and strength, and poor survival in patients with cancer. GDF15 may serve as a prognostic indicator in cancer patients and is being evaluated as a potential therapeutic target for cancer-related weight loss.
Keywords: Activin A; Cachexia; Cytokines; GDF15; IL-6; IL-8; Inflammation; MIC-1
References
- Am J Med. 1980 Oct;69(4):491-7 - PubMed
- J Physiol. 2002 Aug 15;543(Pt 1):379-86 - PubMed
- Cell. 2010 Aug 20;142(4):531-43 - PubMed
- Br J Cancer. 2010 Feb 16;102(4):665-72 - PubMed
- Curr Opin Clin Nutr Metab Care. 2005 May;8(3):265-9 - PubMed
- Am J Physiol. 1997 Oct;273(4 Pt 1):E720-6 - PubMed
- Am J Physiol. 1989 Mar;256(3 Pt 2):R659-65 - PubMed
- J Clin Endocrinol Metab. 2005 May;90(5):2920-6 - PubMed
- Nat Immunol. 2012 Oct;13(10):925-31 - PubMed
- J Cachexia Sarcopenia Muscle. 2012 Dec;3(4):239-43 - PubMed
- Biochem Biophys Res Commun. 2002 Mar 1;291(3):701-6 - PubMed
- Anticancer Res. 2001 Nov-Dec;21(6A):4077-82 - PubMed
- Clin Sci (Lond). 1999 Aug;97(2):215-23 - PubMed
- Nat Med. 2007 Nov;13(11):1333-40 - PubMed
- Med Oncol. 2005;22(4):353-8 - PubMed
- Radiother Oncol. 2011 Oct;101(1):233-6 - PubMed
- Clin Cancer Res. 2009 Nov 1;15(21):6658-64 - PubMed
- J Biol Chem. 1997 May 9;272(19):12575-82 - PubMed
- J Palliat Care. 1991 Summer;7(2):6-9 - PubMed
- Cytokine. 2012 Jan;57(1):9-16 - PubMed
- Cancer. 2004 Sep 1;101(5):1090-8 - PubMed
- Arch Intern Med. 1988 Jul;148(7):1586-91 - PubMed
- Biochem Biophys Res Commun. 2002 Apr 26;293(1):560-5 - PubMed
- J Interferon Cytokine Res. 2010 Jan;30(1):9-14 - PubMed
- J Clin Endocrinol Metab. 2012 May;97(5):E700-9 - PubMed
- J Pain Symptom Manage. 1999 Apr;17(4):240-7 - PubMed
- J Gerontol A Biol Sci Med Sci. 2011 Jan;66(1):122-9 - PubMed
- Science. 2002 May 24;296(5572):1486-8 - PubMed
- J Investig Med. 2000 Jan;48(1):40-8 - PubMed
- Int J Epidemiol. 2007 Feb;36(1):228-35 - PubMed
- Qual Life Res. 1995 Jun;4(3):221-31 - PubMed
- J Cachexia Sarcopenia Muscle. 2012 Dec;3(4):245-51 - PubMed
Publication Types
Grant support