Exploring the molecular mechanisms underlying head and neck cancer cachexia
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Dissertação |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10773/27274 |
Resumo: | Head and neck cancer (HNC) is the sixth most common cancer worldwide, with estimated 630,000 new patients diagnosed annually, resulting in more than 350,000 deaths every year. Patients with HNC usually have large weight loss often associated with cachexia, a syndrome mainly characterized by muscle mass loss. Cachexia has been underdiagnosed in the set of HNC, resulting in increased rates of morbidity and impaired quality of life of patients. There are no effective therapeutic options for the management of this syndrome, which can be justified, at least in part, by its misdiagnosis. The objective of this dissertation was to characterize the body wasting phenotype of HNC patients and identify putative biomarkers to improve the early diagnosis and management of HNC cachexia. Thirty male patients were enrolled in this study and were assigned to one of two groups based on the nutritional risk index: HNC (NRI>97.5; n=16) or HNC+ cachexia (NRI<97.5; n=14). Targeted and nontargeted proteomic approaches were applied to the analysis of blood-derived serum and urine. Data highlighted the contribution of inflammation to the development of cachexia given by the high levels of C-reactive protein (CRP), IL-6 and TNF-α, which were associated to advanced stages of disease. The high circulating levels of myostatin seem to corroborate the occurrence of muscle wasting. The negative correlation observed between CRP and ghrelin suggests that HNC cachectic patients with CRP levels higher than 30 mg/dL may benefit from therapy with ghrelin agonists. Urine proteomics allowed the identification of 18 proteins modulated by cachexia, within the 520 distinct proteins identified by GeLC-MS/MS, such as alpha chain of C4-binding protein, CRP and argininosuccinate synthase, which emphasizes the contribution of inflammation to cachexia pathogenesis. Future studies will be important to validate the diagnosis value of these proteins for the management of cachexia in HNC and, eventually, in other types of cancer |
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Exploring the molecular mechanisms underlying head and neck cancer cachexiaHead and neck cancerCachexiaMuscle wastingBiomarkersUrine proteomicsHead and neck cancer (HNC) is the sixth most common cancer worldwide, with estimated 630,000 new patients diagnosed annually, resulting in more than 350,000 deaths every year. Patients with HNC usually have large weight loss often associated with cachexia, a syndrome mainly characterized by muscle mass loss. Cachexia has been underdiagnosed in the set of HNC, resulting in increased rates of morbidity and impaired quality of life of patients. There are no effective therapeutic options for the management of this syndrome, which can be justified, at least in part, by its misdiagnosis. The objective of this dissertation was to characterize the body wasting phenotype of HNC patients and identify putative biomarkers to improve the early diagnosis and management of HNC cachexia. Thirty male patients were enrolled in this study and were assigned to one of two groups based on the nutritional risk index: HNC (NRI>97.5; n=16) or HNC+ cachexia (NRI<97.5; n=14). Targeted and nontargeted proteomic approaches were applied to the analysis of blood-derived serum and urine. Data highlighted the contribution of inflammation to the development of cachexia given by the high levels of C-reactive protein (CRP), IL-6 and TNF-α, which were associated to advanced stages of disease. The high circulating levels of myostatin seem to corroborate the occurrence of muscle wasting. The negative correlation observed between CRP and ghrelin suggests that HNC cachectic patients with CRP levels higher than 30 mg/dL may benefit from therapy with ghrelin agonists. Urine proteomics allowed the identification of 18 proteins modulated by cachexia, within the 520 distinct proteins identified by GeLC-MS/MS, such as alpha chain of C4-binding protein, CRP and argininosuccinate synthase, which emphasizes the contribution of inflammation to cachexia pathogenesis. Future studies will be important to validate the diagnosis value of these proteins for the management of cachexia in HNC and, eventually, in other types of cancerO cancro da cabeça e pescoço é o sexto tipo de cancro mais comum no mundo, com 630.000 novos casos diagnosticados e mais de 350.000 mortes registados anualmente. Os pacientes com cancro da cabeça e pescoço apresentam, geralmente, uma perda de peso acentuada devida, principalmente, à perda de massa muscular. Estes sinais de catabolismo estão associados a uma síndrome que se designa de caquexia. Esta síndrome compromete o prognóstico e a qualidade de vida do paciente oncológico. Apesar da sua importância clínica, não existem opções terapêuticas eficazes para o tratamento da caquexia associada ao cancro, o que pode ser justificado, pelo menos em parte, pela dificuldade em diagnosticar os pacientes com caquexia. O objetivo desta dissertação foi caracterizar o fenótipo de pacientes com cancro da cabeça e pescoço com e sem perda de peso corporal e identificar possíveis biomarcadores de caquexia em fluidos biológicos para melhorar o diagnóstico e tratamento destes pacientes. Para o efeito estudaram-se 30 pacientes do sexo masculino com cancro da cabeça e pescoço que foram agrupados com base no índice de risco nutricional (NRI, nutritional risk index) em dois grupos: com caquexia (NRI<97,5; n=14) e sem caquexia (NRI>97,5; n=16). A análise de parâmetros séricos destacou a importância da inflamação para a caquexia e a sua associação com o estadio da doença. Os níveis séricos elevados de miostatina observados em doentes com caquexia suportam a ocorrência de catabolismo muscular neste grupo de doentes. Mais ainda, verificou-se uma correlação negativa entre os valores de proteína reativa C (CRP) e a grelina, o que suporta a potencial aplicação terapêutica dos agonistas de grelina no tratamento de doentes com perda de peso e valores de CRP superiores a 30 mg/dL. A análise do proteoma da urina permitiu identificar 18 proteínas moduladas pela caquexia, das 520 das proteínas identificadas por GeLC-MS/MS, sendo de destacar as proteínas envolvidas na inflamação CRP, alpha chain of C4-binding protein, e argininosuccinato sintase. No futuro será importante validar o valor de diagnóstico destas proteínas para o diagnóstico da caquexia associada ao cancro da cabeça e pescoço e, eventualmente, de outros tipos de cancro2020-01-14T09:21:59Z2019-07-26T00:00:00Z2019-07-26info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10773/27274engTavares, Patrícia da Silvainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-02-22T11:52:52Zoai:ria.ua.pt:10773/27274Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:00:06.057980Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Exploring the molecular mechanisms underlying head and neck cancer cachexia |
title |
Exploring the molecular mechanisms underlying head and neck cancer cachexia |
spellingShingle |
Exploring the molecular mechanisms underlying head and neck cancer cachexia Tavares, Patrícia da Silva Head and neck cancer Cachexia Muscle wasting Biomarkers Urine proteomics |
title_short |
Exploring the molecular mechanisms underlying head and neck cancer cachexia |
title_full |
Exploring the molecular mechanisms underlying head and neck cancer cachexia |
title_fullStr |
Exploring the molecular mechanisms underlying head and neck cancer cachexia |
title_full_unstemmed |
Exploring the molecular mechanisms underlying head and neck cancer cachexia |
title_sort |
Exploring the molecular mechanisms underlying head and neck cancer cachexia |
author |
Tavares, Patrícia da Silva |
author_facet |
Tavares, Patrícia da Silva |
author_role |
author |
dc.contributor.author.fl_str_mv |
Tavares, Patrícia da Silva |
dc.subject.por.fl_str_mv |
Head and neck cancer Cachexia Muscle wasting Biomarkers Urine proteomics |
topic |
Head and neck cancer Cachexia Muscle wasting Biomarkers Urine proteomics |
description |
Head and neck cancer (HNC) is the sixth most common cancer worldwide, with estimated 630,000 new patients diagnosed annually, resulting in more than 350,000 deaths every year. Patients with HNC usually have large weight loss often associated with cachexia, a syndrome mainly characterized by muscle mass loss. Cachexia has been underdiagnosed in the set of HNC, resulting in increased rates of morbidity and impaired quality of life of patients. There are no effective therapeutic options for the management of this syndrome, which can be justified, at least in part, by its misdiagnosis. The objective of this dissertation was to characterize the body wasting phenotype of HNC patients and identify putative biomarkers to improve the early diagnosis and management of HNC cachexia. Thirty male patients were enrolled in this study and were assigned to one of two groups based on the nutritional risk index: HNC (NRI>97.5; n=16) or HNC+ cachexia (NRI<97.5; n=14). Targeted and nontargeted proteomic approaches were applied to the analysis of blood-derived serum and urine. Data highlighted the contribution of inflammation to the development of cachexia given by the high levels of C-reactive protein (CRP), IL-6 and TNF-α, which were associated to advanced stages of disease. The high circulating levels of myostatin seem to corroborate the occurrence of muscle wasting. The negative correlation observed between CRP and ghrelin suggests that HNC cachectic patients with CRP levels higher than 30 mg/dL may benefit from therapy with ghrelin agonists. Urine proteomics allowed the identification of 18 proteins modulated by cachexia, within the 520 distinct proteins identified by GeLC-MS/MS, such as alpha chain of C4-binding protein, CRP and argininosuccinate synthase, which emphasizes the contribution of inflammation to cachexia pathogenesis. Future studies will be important to validate the diagnosis value of these proteins for the management of cachexia in HNC and, eventually, in other types of cancer |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-07-26T00:00:00Z 2019-07-26 2020-01-14T09:21:59Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://hdl.handle.net/10773/27274 |
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http://hdl.handle.net/10773/27274 |
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eng |
language |
eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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