title: Adipose tissue pathways involved in weight loss of cancer cachexia.
abstract: BACKGROUND
  The regulatory gene pathways that accompany loss of adipose tissue in cancer cachexia are unknown and were explored using pangenomic transcriptome profiling.
  
  
  METHODS
  Global gene expression profiles of abdominal subcutaneous adipose tissue were studied in gastrointestinal cancer patients with (n=13) or without (n=14) cachexia.
  
  
  RESULTS
  Cachexia was accompanied by preferential loss of adipose tissue and decreased fat cell volume, but not number. Adipose tissue pathways regulating energy turnover were upregulated, whereas genes in pathways related to cell and tissue structure (cellular adhesion, extracellular matrix and actin cytoskeleton) were downregulated in cachectic patients. Transcriptional response elements for hepatic nuclear factor-4 (HNF4) were overrepresented in the promoters of extracellular matrix and adhesion molecule genes, and adipose HNF4 mRNA was downregulated in cachexia.
  
  
  CONCLUSIONS
  Cancer cachexia is characterised by preferential loss of adipose tissue; muscle mass is less affected. Loss of adipose tissue is secondary to a decrease in adipocyte lipid content and associates with changes in the expression of genes that regulate energy turnover, cytoskeleton and extracellular matrix, which suggest high tissue remodelling. Changes in gene expression in cachexia are reciprocal to those observed in obesity, suggesting that regulation of fat mass at least partly corresponds to two sides of the same coin.
authors.affiliation: Department of Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm SE-141 86, Sweden. ingrid.dahlman@ki.se
authors.forename: I
authors.initials: I
authors.lastname: Dahlman
authors.forename: N
authors.initials: N
authors.lastname: Mejhert
authors.forename: K
authors.initials: K
authors.lastname: Linder
authors.forename: T
authors.initials: T
authors.lastname: Agustsson
authors.forename: D M
authors.initials: DM
authors.lastname: Mutch
authors.forename: A
authors.initials: A
authors.lastname: Kulyte
authors.forename: B
authors.initials: B
authors.lastname: Isaksson
authors.forename: J
authors.initials: J
authors.lastname: Permert
authors.forename: N
authors.initials: N
authors.lastname: Petrovic
authors.forename: J
authors.initials: J
authors.lastname: Nedergaard
authors.forename: E
authors.initials: E
authors.lastname: Sjölin
authors.forename: D
authors.initials: D
authors.lastname: Brodin
authors.forename: K
authors.initials: K
authors.lastname: Clement
authors.forename: K
authors.initials: K
authors.lastname: Dahlman-Wright
authors.forename: M
authors.initials: M
authors.lastname: Rydén
authors.forename: P
authors.initials: P
authors.lastname: Arner
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000368:Aged; D002100:Cachexia / Q000209:etiology / Q000235:genetics*; D005260:Female; D015870:Gene Expression; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation / Q000235:genetics; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000235:genetics* / Q000378:metabolism; D009765:Obesity / Q000235:genetics / Q000378:metabolism; D020411:Oligonucleotide Array Sequence Analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015398:Signal Transduction / Q000235:genetics*; D015431:Weight Loss / Q000235:genetics*
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