The health benefits of exercise against chemotherapy-induced skeletal muscle loss

Detalhes bibliográficos
Autor(a) principal: Pedrosa, Mafalda Barbosa
Data de Publicação: 2022
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10773/37148
Resumo: Paraneoplastic conditions such as cancer-associated cachexia and sarcopenia are often exacerbated by chemotherapy, which affects the patient’s quality of life as well as the response to therapy. In order to prevent or treat the muscle changes underlying these conditions, therapeutic approaches that include physical exercise programs have been suggested. In this thesis we describe the existing knowledge about the chemotherapy induced skeletal wasting, at function, mass and molecular levels, as well as the counteracting effects that exercise have on this condition, namely on increasing protein synthesis and decreasing muscle proteolysis. For that purpose, we performed two reviews: one focused on chemotherapy-induced molecular and functional changes in skeletal muscle and the other focused on the molecular and functional interplay between physical exercise and chemotherapy on skeletal muscle remodeling. Next, to bring more insights about the impact of chemotherapy and physical exercise on skeletal muscle of cancer patients, we explored the effect of a prehabilitation program in gastric cancer treated with FLOT, a recent neoadjuvant regiment. Our data suggests no changes promoted by chemotherapy nor prehabilitation (with WHO recommended physical activity (PA group) or structured exercise program (EXER group)) in anthropometric measures, but handgrip strength was reduced in men from EXER group after neoadjuvant chemotherapy. Albumin was significantly reduced only in the EXER group and HbA1c was increased in both EXER and PA group after neoadjuvant chemotherapy. No significant changes were detected on SkM regarding histological analysis (observational) nor in molecular players involved in SkM protein synthesis or proteolysis. Further pre-clinical and clinical studies with more defined criteria, molecular analysis of muscle samples as well as supervised exercise training to guarantee the fulfilment of protocol are needed to understand if exercise can be an effective strategy against muscle wasting induced by cancer and chemotherapy.
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spelling The health benefits of exercise against chemotherapy-induced skeletal muscle lossGastric cancerChemotherapySkeletal muscleFLOTExerciseMolecular changesParaneoplastic conditions such as cancer-associated cachexia and sarcopenia are often exacerbated by chemotherapy, which affects the patient’s quality of life as well as the response to therapy. In order to prevent or treat the muscle changes underlying these conditions, therapeutic approaches that include physical exercise programs have been suggested. In this thesis we describe the existing knowledge about the chemotherapy induced skeletal wasting, at function, mass and molecular levels, as well as the counteracting effects that exercise have on this condition, namely on increasing protein synthesis and decreasing muscle proteolysis. For that purpose, we performed two reviews: one focused on chemotherapy-induced molecular and functional changes in skeletal muscle and the other focused on the molecular and functional interplay between physical exercise and chemotherapy on skeletal muscle remodeling. Next, to bring more insights about the impact of chemotherapy and physical exercise on skeletal muscle of cancer patients, we explored the effect of a prehabilitation program in gastric cancer treated with FLOT, a recent neoadjuvant regiment. Our data suggests no changes promoted by chemotherapy nor prehabilitation (with WHO recommended physical activity (PA group) or structured exercise program (EXER group)) in anthropometric measures, but handgrip strength was reduced in men from EXER group after neoadjuvant chemotherapy. Albumin was significantly reduced only in the EXER group and HbA1c was increased in both EXER and PA group after neoadjuvant chemotherapy. No significant changes were detected on SkM regarding histological analysis (observational) nor in molecular players involved in SkM protein synthesis or proteolysis. Further pre-clinical and clinical studies with more defined criteria, molecular analysis of muscle samples as well as supervised exercise training to guarantee the fulfilment of protocol are needed to understand if exercise can be an effective strategy against muscle wasting induced by cancer and chemotherapy.Condições paraneoplásicas como a caquexia e a sarcopenia associada ao cancro são comumente exacerbadas pela quimioterapia, o que condiciona a qualidade de vida do paciente bem como a resposta à terapêutica. No sentido de prevenir ou tratar as alterações musculares subjacentes a estas condições, têm sido sugeridas abordagens terapêuticas que incluem programas de exercício físico. Nesta dissertação descrevemos o conhecimento existente sobre a perda de massa muscular induzida pela quimioterapia, a nível funcional e molecular, bem como os efeitos atenuantes que o exercício tem, nomeadamente no aumento da síntese proteica e diminuição da proteólise muscular. Para isso, realizamos duas revisões da literatura: uma focada nas alterações moleculares e funcionais induzidas pela quimioterapia no músculo esquelético e a outra focada na interação molecular e funcional entre exercício físico e quimioterapia na remodelação do músculo esquelético. De forma a compreender melhor o efeito da quimioterapia e do exercício físico no músculo esquelético de pacientes com cancro, exploramos o impacto de um programa de pré-habilitação em pacientes com cancro gástrico tratados com FLOT, um regime neoadjuvante recente. Os nossos resultados não sugerem alterações nem promovidas pela quimioterapia nem pela pré-habilitação (atividade física segundo recomendações da OMS (PA) ou exercício físico, grupo EXER) a nível antropométrico, contudo verificou-se uma redução na força de preensão em homens do grupo EXER após a quimioterapia neoadjuvante. Os níveis de albumina diminuíram significativamente no grupo EXER e a HbA1c aumentou quer no grupo EXER como no grupo de doentes PA após o tratamento. No músculo esquelético não foram detetadas alterações significativas nem a nível histológico (observacional) nem molecular (marcadores de proteólise e de síntese proteica). Para melhor compreender se o exercício pode ser uma estratégia eficaz contra a perda de massa muscular induzida pelo cancro e quimioterapia são necessários mais estudos pré-clínicos e clínicos com critérios bem definidos, análise molecular de biopsias musculares, bem como o supervisionamento dos treinos de forma a garantir o cumprimento do protocolo.2024-12-08T00:00:00Z2022-11-30T00:00:00Z2022-11-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10773/37148engPedrosa, Mafalda Barbosainfo:eu-repo/semantics/embargoedAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-02-22T12:11:14Zoai:ria.ua.pt:10773/37148Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:07:35.939865Repositório 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 The health benefits of exercise against chemotherapy-induced skeletal muscle loss
title The health benefits of exercise against chemotherapy-induced skeletal muscle loss
spellingShingle The health benefits of exercise against chemotherapy-induced skeletal muscle loss
Pedrosa, Mafalda Barbosa
Gastric cancer
Chemotherapy
Skeletal muscle
FLOT
Exercise
Molecular changes
title_short The health benefits of exercise against chemotherapy-induced skeletal muscle loss
title_full The health benefits of exercise against chemotherapy-induced skeletal muscle loss
title_fullStr The health benefits of exercise against chemotherapy-induced skeletal muscle loss
title_full_unstemmed The health benefits of exercise against chemotherapy-induced skeletal muscle loss
title_sort The health benefits of exercise against chemotherapy-induced skeletal muscle loss
author Pedrosa, Mafalda Barbosa
author_facet Pedrosa, Mafalda Barbosa
author_role author
dc.contributor.author.fl_str_mv Pedrosa, Mafalda Barbosa
dc.subject.por.fl_str_mv Gastric cancer
Chemotherapy
Skeletal muscle
FLOT
Exercise
Molecular changes
topic Gastric cancer
Chemotherapy
Skeletal muscle
FLOT
Exercise
Molecular changes
description Paraneoplastic conditions such as cancer-associated cachexia and sarcopenia are often exacerbated by chemotherapy, which affects the patient’s quality of life as well as the response to therapy. In order to prevent or treat the muscle changes underlying these conditions, therapeutic approaches that include physical exercise programs have been suggested. In this thesis we describe the existing knowledge about the chemotherapy induced skeletal wasting, at function, mass and molecular levels, as well as the counteracting effects that exercise have on this condition, namely on increasing protein synthesis and decreasing muscle proteolysis. For that purpose, we performed two reviews: one focused on chemotherapy-induced molecular and functional changes in skeletal muscle and the other focused on the molecular and functional interplay between physical exercise and chemotherapy on skeletal muscle remodeling. Next, to bring more insights about the impact of chemotherapy and physical exercise on skeletal muscle of cancer patients, we explored the effect of a prehabilitation program in gastric cancer treated with FLOT, a recent neoadjuvant regiment. Our data suggests no changes promoted by chemotherapy nor prehabilitation (with WHO recommended physical activity (PA group) or structured exercise program (EXER group)) in anthropometric measures, but handgrip strength was reduced in men from EXER group after neoadjuvant chemotherapy. Albumin was significantly reduced only in the EXER group and HbA1c was increased in both EXER and PA group after neoadjuvant chemotherapy. No significant changes were detected on SkM regarding histological analysis (observational) nor in molecular players involved in SkM protein synthesis or proteolysis. Further pre-clinical and clinical studies with more defined criteria, molecular analysis of muscle samples as well as supervised exercise training to guarantee the fulfilment of protocol are needed to understand if exercise can be an effective strategy against muscle wasting induced by cancer and chemotherapy.
publishDate 2022
dc.date.none.fl_str_mv 2022-11-30T00:00:00Z
2022-11-30
2024-12-08T00:00:00Z
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