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Complement pathway activation mediates pancreatic cancer–induced muscle wasting and pathological remodeling
Andrew C. D’Lugos, … , Sarah M. Judge, Andrew R. Judge
Andrew C. D’Lugos, … , Sarah M. Judge, Andrew R. Judge
Published April 8, 2025
Citation Information: J Clin Invest. 2025;135(12):e178806. https://doi.org/10.1172/JCI178806.
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Research Article Muscle biology Oncology

Complement pathway activation mediates pancreatic cancer–induced muscle wasting and pathological remodeling

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Abstract

Cancer cachexia is a multifactorial condition characterized by skeletal muscle wasting that impairs quality of life and longevity for many cancer patients. A greater understanding of the molecular etiology of this condition is needed for effective therapies to be developed. We performed a quantitative proteomic analysis of skeletal muscle from cachectic pancreatic ductal adenocarcinoma (PDAC) patients and non-cancer controls, followed by immunohistochemical analyses of muscle cross sections. These data provide evidence of a local inflammatory response in muscles of cachectic PDAC patients, including an accumulation of plasma proteins and recruitment of immune cells into muscle that may promote the pathological remodeling of muscle. Our data further support the complement system as a potential mediator of these processes, which we tested by injecting murine pancreatic cancer cells into wild-type mice and mice with genetic deletion of the central complement component 3 (C3–/– mice). Compared with wild-type mice, C3–/– mice showed attenuated tumor-induced muscle wasting and dysfunction and reduced immune cell recruitment and fibrotic remodeling of muscle. These studies demonstrate that complement activation contributes to the skeletal muscle pathology and dysfunction in PDAC, suggesting that the complement system may possess therapeutic potential in preserving skeletal muscle mass and function.

Authors

Andrew C. D’Lugos, Jeremy B. Ducharme, Chandler S. Callaway, Jose G. Trevino, Carl Atkinson, Sarah M. Judge, Andrew R. Judge

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Figure 1

Skeletal muscle proteome is dysregulated in cachectic PDAC patients.

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Skeletal muscle proteome is dysregulated in cachectic PDAC patients.
(A)...
(A) Rectus abdominis biopsies acquired from cachectic PDAC patients (n = 8) and non-cancer controls (CTRL; n = 6) were subjected to 10-plex tandem mass tag proteomics. Biopsies were enzymatically digested to isolate peptides, which were labeled with 10 distinct isobaric tags (8 PDAC plus 2 pooled CTRL [n = 6 total]), and combined for liquid chromatography tandem mass spectrometry analysis. Differentially expressed proteins (DEPs) between PDAC and CTRL were analyzed through a bioinformatics pipeline, followed by IHC analyses of skeletal muscle cross sections. (B) Heatmap displays the relative expression (vs. CTRL) of proteins that met differential expression criteria (≥2 peptides; –1.25 ≥ median fold change ≥ 1.25; FDR-adjusted P value ≤ 0.05) between PDAC and CTRL. (C) Among the DEPs (n = 383) in PDAC skeletal muscle, most are downregulated relative to CTRL. (D and E) The top 15 cellular components enriched by upregulated (D) and downregulated (E) proteins were identified through DAVID Functional Annotation. (F and G) The top 15 biological processes enriched by upregulated (F) and downregulated (G) proteins were identified through DAVID Function Annotations, Kyoto Encyclopedia of Genes and Genomes, and Reactome pathway databases. (H and I) The top 15 activated (H) and inhibited (I) functions were identified through IPA analysis of up- and downregulated proteins, combined. Annotations with fewer than 3 proteins or a P value greater than 0.05 were excluded.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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