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Djurhuus SS, Simonsen C, Toft BG, Thomsen SN, Wielsøe S, Røder MA, Hasselager T, Østergren PB, Jakobsen H, Pedersen BK, Hojman P, Brasso K, Christensen JF. Exercise training to increase tumour natural killer-cell infiltration in men with localised prostate cancer: a randomised controlled trial. BJU Int 2023; 131:116-124. [PMID: 35753072 PMCID: PMC10084118 DOI: 10.1111/bju.15842] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To explore the effects of preoperative high-intensity interval training (HIIT) compared to usual care on tumour natural killer (NK)-cell infiltration in men with localised prostate cancer (PCa), as NK-cell infiltration has been proposed as one of the key mechanisms whereby exercise can modulate human tumours. PATIENTS AND METHODS A total of 30 patients with localised PCa undergoing radical prostatectomy (RP) were randomised (2:1) to either preoperative aerobic HIIT four-times weekly (EX; n = 20) or usual care (CON; n = 10) from time of inclusion until scheduled surgery. Tumour NK-cell infiltration was assessed by immunohistochemistry (CD56+ ) in diagnostic core needle biopsies and corresponding prostatic tissue from the RP. Changes in cardiorespiratory fitness, body composition, blood biochemistry, and health-related quality of life were also evaluated. RESULTS The change in tumour NK-cell infiltration did not differ between the EX and CON groups (between-group difference: -0.09 cells/mm2 , 95% confidence interval [CI] -1.85 to 1.66; P = 0.913) in the intention-to-treat analysis. The total number of exercise sessions varied considerably from four to 30 sessions. The per-protocol analysis showed a significant increase in tumour NK-cell infiltration of 1.60 cells/mm2 (95% CI 0.59 to 2.62; P = 0.004) in the EX group. Further, the total number of training sessions was positively correlated with the change in NK-cell infiltration (r = 0.526, P = 0.021), peak oxygen uptake (r = 0.514, P = 0.035) and peak power output (r = 0.506, P = 0.038). CONCLUSION Preoperative HIIT did not result in between-group differences in tumour NK-cell infiltration. Per-protocol and exploratory analyses demonstrate an enhanced NK-cell infiltration in PCa. Future studies are needed to test the capability of exercise to increase tumour immune cell infiltration.
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Affiliation(s)
| | - Casper Simonsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Birgitte Grønkaer Toft
- Department of Pathology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Simon Nørskov Thomsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Sabrina Wielsøe
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Martin Andreas Røder
- Department of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Hasselager
- Department of Pathology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Peter Busch Østergren
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Urology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Henrik Jakobsen
- Department of Urology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Bente Klarlund Pedersen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hojman
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Klaus Brasso
- Department of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Frank Christensen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
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Djurhuus SS, Schauer T, Simonsen C, Toft BG, Jensen ARD, Erler JT, Røder MA, Hojman P, Brasso K, Christensen JF. Effects of acute exercise training on tumor outcomes in men with localized prostate cancer: A randomized controlled trial. Physiol Rep 2022; 10:e15408. [PMID: 36199257 PMCID: PMC9535256 DOI: 10.14814/phy2.15408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/28/2022] [Accepted: 07/14/2022] [Indexed: 06/16/2023] Open
Abstract
Postdiagnosis physical activity is associated with improved cancer outcomes, but biological mechanisms mediating anticancer effects remain unclear. Recent findings suggest that physiological adaptations to acute exercise comprise potential anticancer effects, but these remain poorly explored in clinical settings. The objective of this study was to explore the effects of a single exercise bout on tumor oxygenation and immune cell infiltration in patients with prostate cancer. Thirty patients with localized prostate cancer were randomized (2:1) to either one high-intensity interval training bout or no exercise on the day before radical prostatectomy. Immunohistochemical analyses were performed on prostatic tissue from surgery and assessed for tumor hypoxia, natural killer (NK) cell infiltration, and microvessel density (MVD). Acute systemic response in blood lymphocytes, epinephrine, norepinephrine, IL-6, tumor necrosis factor, cortisol, lactate, and glucose was also evaluated. We did not find between-group differences in tumor hypoxia (Mann-Whitney U test, U = 83.5, p = 0.604) or NK cell infiltration (U = 77.0, p = 0.328). Also, no significant correlation was found between MVD and tumor hypoxia or NK cell infiltration. One exercise bout is likely insufficient to modulate tumor hypoxia or NK cell infiltration. Future studies may elucidate if an accumulation of several exercise bouts can impact these outcomes (NCT03675529, www.clinicaltrials.gov).
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Affiliation(s)
| | - Tim Schauer
- Centre for Physical Activity ResearchCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Casper Simonsen
- Centre for Physical Activity ResearchCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Birgitte Grønkær Toft
- Department of PathologyCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | | | - Janine Terra Erler
- Biotech Research and Innovation Centre (BRIC)University of Copenhagen (UCPH)CopenhagenDenmark
| | - Martin Andreas Røder
- Department of UrologyCopenhagen Prostate Cancer Center, Copenhagen University Hospital –RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Pernille Hojman
- Centre for Physical Activity ResearchCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Klaus Brasso
- Department of UrologyCopenhagen Prostate Cancer Center, Copenhagen University Hospital –RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Jesper Frank Christensen
- Centre for Physical Activity ResearchCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
- The Department of Sports Science and Clinical BiomechanicsFaculty of Health Sciences at the University of Southern DenmarkDenmark
- Digestive Disease CenterBispebjerg HospitalCopenhagenDenmark
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3
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Bay ML, Unterrainer N, Stagaard R, Pedersen KS, Schauer T, Staffeldt MM, Christensen JF, Hojman P, Pedersen BK, Gehl J. Voluntary wheel running can lead to modulation of immune checkpoint molecule expression. Acta Oncol 2020; 59:1447-1454. [PMID: 32935602 DOI: 10.1080/0284186x.2020.1817550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Exercise and physical activity (PA) are associated with reduced tumor growth and enhanced intra-tumoral immune cell infiltration in mice. We aimed to investigate the role of PA achieved by voluntary wheel running in promoting the immunogenic profile across several murine tumor models, and to explore the potential of checkpoint blockade and PA in the form of voluntary wheel running as combination therapy. MATERIAL AND METHODS The experiments were performed with C57BL/6 mice bearing subcutaneous tumors while having access to running wheels in their cages, where key immunoregulatory molecules expressed in the tumor tissue were measured by qPCR. Furthermore, we tested the hypothesis that wheel running combined with PD-L1 -or PD-1 inhibitor treatment could lead to an additive effect on tumor growth in mice bearing B16 melanoma tumors. RESULTS Wheel running increased immune checkpoint expression (PD-1, PD-L1, PD-L2, CD28, B7.1 and B7.2) in B16 tumor-bearing mice, while induction of only PD-L2 was found in E0771 breast cancer and Lewis Lung Cancer. In studies combining voluntary wheel running with PD-1 -and PD-L1 inhibitors we found significant effects of wheel running on attenuating B16 melanoma tumor growth, in line with previous studies. We did, however, not find an additive effect of combining either of the two immunotherapeutic treatments with access to running wheels. CONCLUSION B16 tumors displayed upregulated expression of immune regulatory molecules and decreased tumor growth in response to PA. However, combining PA with PD-1 or PD-L1 blockade did not lead to a further augmented inhibition of tumor growth.
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Affiliation(s)
- Marie Lund Bay
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Nicole Unterrainer
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Stagaard
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Seide Pedersen
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Tim Schauer
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Mie Marienhof Staffeldt
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jesper Frank Christensen
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hojman
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Bente Klarlund Pedersen
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, 7641, University of Copenhagen, Copenhagen, Denmark
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Schauer T, Hojman P, Gehl J, Christensen JF. Exercise training as prophylactic strategy in the management of neutropenia during chemotherapy. Br J Pharmacol 2020; 179:2925-2937. [DOI: 10.1111/bph.15141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Tim Schauer
- Centre for Physical Activity Research, RigshospitaletUniversity of Copenhagen Copenhagen Denmark
| | - Pernille Hojman
- Centre for Physical Activity Research, RigshospitaletUniversity of Copenhagen Copenhagen Denmark
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative CareZealand University Hospital Køge Denmark
- Faculty of Health and Medical Sciences, Department of Clinical MedicineUniversity of Copenhagen Copenhagen Denmark
| | - Jesper Frank Christensen
- Centre for Physical Activity Research, RigshospitaletUniversity of Copenhagen Copenhagen Denmark
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Pedersen KS, Gatto F, Zerahn B, Nielsen J, Pedersen BK, Hojman P, Gehl J. Exercise-Mediated Lowering of Glutamine Availability Suppresses Tumor Growth and Attenuates Muscle Wasting. iScience 2020; 23:100978. [PMID: 32240949 PMCID: PMC7114859 DOI: 10.1016/j.isci.2020.100978] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 01/15/2020] [Accepted: 03/09/2020] [Indexed: 01/01/2023] Open
Abstract
Glutamine is a central nutrient for many cancers, contributing to the generation of building blocks and energy-promoting signaling necessary for neoplastic proliferation. In this study, we hypothesized that lowering systemic glutamine levels by exercise may starve tumors, thereby contributing to the inhibitory effect of exercise on tumor growth. We demonstrate that limiting glutamine availability, either pharmacologically or physiologically by voluntary wheel running, significantly attenuated the growth of two syngeneic murine tumor models of breast cancer and lung cancer, respectively, and decreased markers of atrophic signaling in muscles from tumor-bearing mice. In continuation, wheel running completely abolished tumor-induced loss of weight and lean body mass, independently of the effect of wheel running on tumor growth. Moreover, wheel running abolished tumor-induced upregulation of muscular glutamine transporters and myostatin signaling. In conclusion, our data suggest that voluntary wheel running preserves muscle mass by counteracting muscular glutamine release and tumor-induced atrophic signaling.
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Affiliation(s)
- Katrine S Pedersen
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, University of Copenhagen, 7641, 2200 Copenhagen, Denmark
| | - Francesco Gatto
- Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden; Elypta AB, Stockholm, Sweden
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte University Hospital, 2730 Herlev, Denmark
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden
| | - Bente K Pedersen
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, University of Copenhagen, 7641, 2200 Copenhagen, Denmark
| | - Pernille Hojman
- The Centre for Physical Activity Research (CFAS) and Centre of Inflammation and Metabolism (CIM), Copenhagen University Hospital, University of Copenhagen, 7641, 2200 Copenhagen, Denmark
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C∗EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark; Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, 2730 Herlev, Denmark.
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Christensen JF, Sundberg A, Osterkamp J, Thorsen-Streit S, Nielsen AB, Olsen CK, Djurhuus SS, Simonsen C, Schauer T, Ellingsgaard H, Østerlind K, Krarup PM, Mosgaard C, Vistisen K, Tolver A, Pedersen BK, Hojman P. Interval Walking Improves Glycemic Control and Body Composition After Cancer Treatment: A Randomized Controlled Trial. J Clin Endocrinol Metab 2019; 104:3701-3712. [PMID: 31220283 DOI: 10.1210/jc.2019-00590] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/05/2019] [Indexed: 12/14/2022]
Abstract
CONTEXT Patients with colorectal cancer have increased risk of metabolic diseases including diabetes. Exercise training may counteract metabolic dysregulation, but the impact of exercise training on glycemic control, including postprandial glycemia, has never been explored in patients with colorectal cancer. OBJECTIVE To examine the effects of home-based interval walking on aerobic and metabolic fitness and quality of life in patients with colorectal cancer. DESIGN Randomized controlled trial. SETTING Clinical research center. PARTICIPANTS Thirty-nine sedentary (<150 minutes moderate-intensity exercise per week) patients with stage I to III colorectal cancer who had completed primary treatment. INTERVENTION Home-based interval walking 150 min/wk or usual care for 12 weeks. MAIN OUTCOME MEASURES Changes from baseline to week 12 in maximum oxygen uptake (VO2peak) by cardiopulmonary exercise test, glycemic control by oral glucose tolerance test (OGTT), body composition by dual-energy x-ray absorptiometry scan, blood biochemistry, and quality of life. RESULTS Compared with control, interval walking had no effect on VO2peak [mean between-group difference: -0.32 mL O2 · kg-1 · min-1 (-2.09 to 1.45); P = 0.721] but significantly improved postprandial glycemic control with lower glucose OGTT area under the curve [-126 mM · min (-219 to -33); P = 0.009], 2-hour glucose concentration [-1.1 mM (-2.2 to 0.0); P = 0.056], and improved Matsuda index [1.94 (0.34; 3.54); P = 0.01]. Also, interval walking counteracted an increase in fat mass in the control group [-1.47 kg (-2.74 to -0.19); P = 0.025]. CONCLUSION A home-based interval-walking program led to substantial improvements in postprandial glycemic control and counteracted fat gain in posttreatment patients with colorectal cancer, possibly providing an effective strategy for prevention of secondary metabolic diseases.
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Affiliation(s)
- Jesper F Christensen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
| | - Anna Sundberg
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Jens Osterkamp
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
| | | | - Anette B Nielsen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Cecilie K Olsen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Sissal S Djurhuus
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Casper Simonsen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Tim Schauer
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Helga Ellingsgaard
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Kell Østerlind
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Peter-Martin Krarup
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
- Center for Surgical Science, Zealand University Hospital, Roskilde, Denmark
| | - Camilla Mosgaard
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Kirsten Vistisen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Anders Tolver
- Data Science Laboratory, Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bente K Pedersen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
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8
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Hojman P, Brolin C, Nørgaard-Christensen N, Dethlefsen C, Lauenborg B, Olsen CK, Åbom MM, Krag T, Gehl J, Pedersen BK. IL-6 release from muscles during exercise is stimulated by lactate-dependent protease activity. Am J Physiol Endocrinol Metab 2019; 316:E940-E947. [PMID: 30779630 DOI: 10.1152/ajpendo.00414.2018] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IL-6 is secreted from muscles to the circulation during high-intensity and long-duration exercise, where muscle-derived IL-6 works as an energy sensor to increase release of energy substrates from liver and adipose tissues. We investigated the mechanism involved in the exercise-mediated surge in IL-6 during exercise. Using interval-based cycling in healthy young men, swimming exercise in mice, and electrical stimulation of primary human muscle cells, we explored the role of lactate production in muscular IL-6 release during exercise. First, we observed a tight correlation between lactate production and IL-6 release during both strenuous bicycling and electrically stimulated muscle cell cultures. In mice, intramuscular injection of lactate mimicked the exercise-dependent release of IL-6, and pH buffering of lactate production during exercise attenuated IL-6 secretion. Next, we used in vivo bioimaging to demonstrate that intrinsic intramuscular proteases were activated in mice during swimming, and that blockade of protease activity blunted swimming-induced IL-6 release in mice. Last, intramuscular injection of the protease hyaluronidase resulted in dramatic increases in serum IL-6 in mice, and immunohistochemical analyses showed that intramuscular lactate and hyaluronidase injections led to release of IL-6-containing intramyocellular vesicles. We identified a pool of IL-6 located within vesicles of skeletal muscle fibers, which could be readily secreted upon protease activity. This protease-dependent release of IL-6 was initiated by lactate production, linking training intensity and lactate production to IL-6 release during strenuous exercise.
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Affiliation(s)
- Pernille Hojman
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Camilla Brolin
- Department of Cellular and Molecular Medicine, University of Copenhagen , Copenhagen , Denmark
| | - Nynne Nørgaard-Christensen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Christine Dethlefsen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Britt Lauenborg
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Cecilie Køllner Olsen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Mette Marie Åbom
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Thomas Krag
- Copenhagen Neuromuscular Center, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology and Palliative Care, Zealand University Hospital , Roskilde , Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Bente Klarlund Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Copenhagen University Hospital, University of Copenhagen , Copenhagen , Denmark
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Herrstedt A, Bay ML, Simonsen C, Sundberg A, Egeland C, Thorsen-Streit S, Djurhuus SS, Magne Ueland P, Midttun Ø, Pedersen BK, Bo Svendsen L, de Heer P, Christensen JF, Hojman P. Exercise-mediated improvement of depression in patients with gastro-esophageal junction cancer is linked to kynurenine metabolism. Acta Oncol 2019; 58:579-587. [PMID: 30696326 DOI: 10.1080/0284186x.2018.1558371] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Exercise may improve depression in cancer patients, yet the molecular mechanism behind this protection is poorly understood. Here, we aimed to explore the link between exercise and regulation of kynurenine (Kyn) metabolism and inflammation in patients with operable gastro-esophageal junction (GEJ) cancer patients, who improved significantly in depression score with exercise training. Material and Methods: Fifty GEJ cancer patients were allocated to 12 weeks of supervised training twice weekly including interval-based aerobic exercise and resistance training, or standard care. Depression score was evaluated by HADS, and blood samples and muscle biopsies were collected for determination of Kyn metabolism and inflammation across the intervention. Results: Depression scores decreased by -1.3 points in the exercise group (p < 0.01), whereas no changes were observed in the control group. Plasma 3-hydroxykynurenine (HK), a Kyn metabolite giving rise to other neurotoxic metabolites, increased by 48% (p <0.001) in the control group, while exercise training attenuated this accumulation. The production of HK is induced by inflammation, and while we observed no differences in systemic pro-inflammatory cytokines, exercise training ameliorated the treatment-induced intramuscular inflammation. Moreover, exercise has been suggested to convert Kyn to the neuroprotective metabolite, kynurenic acid (KA), but despite marked functional and muscular exercise-mediated adaptations, we did not observe any enhancement of KA production and related enzyme expression in the muscles of GEJ cancer patients. Conclusion: Exercise training reduced symptoms of depression in patients with GEJ cancer, and this effect was associated with an exercise-dependent attenuation of the inflammation-induced conversion of Kyn to neurotoxic metabolites.
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Affiliation(s)
- Anita Herrstedt
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Marie L. Bay
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Casper Simonsen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anna Sundberg
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Egeland
- Department of Surgical Gastroenterology C, Rigshospitalet, Copenhagen, Denmark
| | - Sarah Thorsen-Streit
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sissal S. Djurhuus
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Per Magne Ueland
- Department of Clinical Science, University of Bergen; Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | | | - Bente K. Pedersen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lars Bo Svendsen
- Department of Surgical Gastroenterology C, Rigshospitalet, Copenhagen, Denmark
| | - Pieter de Heer
- Department of Surgical Gastroenterology C, Rigshospitalet, Copenhagen, Denmark
| | - Jesper F. Christensen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
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Abstract
Exercise training is playing an increasing role in cancer care, as accumulating evidence demonstrates that exercise may prevent cancer, control disease progression, interact with anti-cancer therapies, and improve physical functioning and psychosocial outcomes. In this overview article, we present the current state of the field of exercise oncology, which currently comprises of nearly 700 unique exercise intervention trials with more than 50,000 cancer patients. First, we summarize the range of these interventions with regard to diagnoses, clinical setting, timing, and type of intervention. Next, we provide a detailed discussion of the 292 trials, which have delivered structured exercise programs, outlining the impact of exercise training on cancer-specific, physiological, and psychosocial outcomes in the light of the challenges and physiological limitations cancer patients may experience. In summary, the safety and feasibility of exercise training is firmly established across the cancer continuum, and a wide range of beneficial effects on psychosocial and physiological outcomes are well documented. Many of these beneficial effects are linked to the general health-promoting properties of exercise. However, it is becoming increasing evident that exercise training can have direct effects on cancer and its treatment. This calls for future exercise oncology initiatives, which aim to target cancer-specific outcomes, and which are integrated into the concurrent cancer trajectory. Here, the field must bridge extensive knowledge of integrative exercise physiology with clinical oncology and cancer biology to provide a basis of individualized targeted approaches, which may place exercise training as an integrated component of standard cancer care. © 2019 American Physiological Society. Compr Physiol 9:165-205, 2019.
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Affiliation(s)
- Jesper Frank Christensen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, Copenhagen, Denmark
| | - Casper Simonsen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Copenhagen University Hospital, Copenhagen, Denmark
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Unterrainer N, Pedersen KS, Bay ML, Pedersen BK, Gehl K, Hojman P. PO-364 Effect of exercise and immunotherapy on tumour immunogenicity and growth. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dethlefsen C, Hansen LS, Lillelund C, Andersen C, Gehl J, Christensen JF, Pedersen BK, Hojman P. Exercise-Induced Catecholamines Activate the Hippo Tumor Suppressor Pathway to Reduce Risks of Breast Cancer Development. Cancer Res 2017; 77:4894-4904. [PMID: 28887324 DOI: 10.1158/0008-5472.can-16-3125] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 04/19/2017] [Accepted: 06/27/2017] [Indexed: 11/16/2022]
Abstract
Strong epidemiologic evidence documents the protective effect of physical activity on breast cancer risk, recurrence, and mortality, but the underlying mechanisms remain to be identified. Using human exercise-conditioned serum for breast cancer cell incubation studies and murine exercise interventions, we aimed to identify exercise factors and signaling pathways involved in the exercise-dependent suppression of breast cancer. Exercise-conditioned serum from both women with breast cancer (n = 20) and healthy women (n = 7) decreased MCF-7 (hormone-sensitive) and MDA-MB-231 (hormone-insensitive) breast cancer cell viability in vitro by 11% to 19% and reduced tumorigenesis by 50% when preincubated MCF-7 breast cancer cells were inoculated into NMRI-Foxn1nu mice. This exercise-mediated suppression of cell viability and tumor formation was completely blunted by blockade of β-adrenergic signaling in MCF-7 cells, indicating that catecholamines were the responsible exercise factors. Both epinephrine (EPI) and norepinephrine (NE) could directly inhibit breast cancer cell viability, as well as tumor growth in vivo EPI and NE activate the tumor suppressor Hippo signaling pathway, and the suppressive effect of exercise-conditioned serum was found to be mediated through phosphorylation and cytoplasmic retention of YAP and reduced expression of downstream target genes, for example, ANKRD1 and CTGF. In parallel, tumor-bearing mice with access to running wheels showed reduced growth of MCF-7 (-36%, P < 0.05) and MDA-MB-231 (-66%, P < 0.01) tumors and, for the MCF-7 tumor, increased regulation of the Hippo signaling pathway. Taken together, our findings offer a mechanistic explanation for exercise-dependent suppression of breast cancer cell growth. Cancer Res; 77(18); 4894-904. ©2017 AACR.
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Affiliation(s)
- Christine Dethlefsen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark
| | - Louise S Hansen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark
| | - Christian Lillelund
- The University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark
| | - Christina Andersen
- The University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark
| | - Julie Gehl
- Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Jesper F Christensen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark
| | - Bente K Pedersen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark. .,Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
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13
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Bay ML, Gehl J, Pedersen BK, Hojman P. Voluntary Wheel Running Reduces the Acute Inflammatory Response to Liver Carcinogen in a Sex-specific Manner. Cancer Prev Res (Phila) 2017; 10:719-728. [PMID: 28951483 DOI: 10.1158/1940-6207.capr-17-0075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/31/2017] [Accepted: 09/21/2017] [Indexed: 11/16/2022]
Abstract
Inflammation contributes to the development of cancer, yet acute inflammatory responses are also needed to eradicate tumorigenic cells and activate adaptive immune responses to combat cancer. Physical exercise has direct immunomodulatory effects, and in line with this, exercise has been demonstrated to inhibit tumor growth, including diethylnitrosamine-(DEN)-induced hepatocarcinoma. Having observed a sex-dependent development of DEN-induced hepatocarcinoma, we aimed to evaluate the effect of exercise and sex on the acute inflammatory response to DEN. Thus, we randomized male and female mice to cages with or without running wheels for 6 weeks, whereafter DEN was administered and the inflammatory response was evaluated for up to 96 hours. DEN administration caused marked acute inflammatory responses in female mice with weight loss, reduced food intake, release of liver enzymes, and increased systemic levels of IL6. Moreover, DEN caused increased hepatic expression of cytokines, immune cell markers, and components of the toll-like receptor signaling pathway. In male mice, DEN administration provoked similar physiologic effects with weight loss and reduced food intake, but less systemic and hepatic acute inflammation, which was associated with a higher baseline expression of the detoxifying enzyme glutathione S-transferase and lower expression of ERα in male mice. Voluntary wheel running attenuated systemic and hepatic inflammation, in particular in the female mice, and shifted the peak time of the inflammatory response. In conclusion, DEN elicited an acute inflammatory response in particular in female mice, and this response was attenuated by prior exercise. Cancer Prev Res; 10(12); 719-28. ©2017 AACR.
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Affiliation(s)
- M L Bay
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark
| | - Julie Gehl
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Bente Klarlund Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Denmark.
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14
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Lonkvist CK, Vinther A, Zerahn B, Rosenbom E, Deshmukh AS, Hojman P, Gehl J. Progressive resistance training in head and neck cancer patients undergoing concomitant chemoradiotherapy. Laryngoscope Investig Otolaryngol 2017; 2:295-306. [PMID: 29094074 PMCID: PMC5654939 DOI: 10.1002/lio2.88] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 04/23/2017] [Accepted: 06/12/2017] [Indexed: 12/12/2022] Open
Abstract
Objectives Patients with head and neck squamous cell carcinoma undergoing concomitant chemoradiotherapy (CCRT) frequently experience weight loss, especially loss of lean body mass (LBM), and reduced functional performance. This study investigated whether a 12‐week hospital‐based progressive resistance training (PRT) program during CCRT is feasible in the clinical setting before planning initiation of a larger randomized study which is the long‐term goal. Study design Prospective pilot study. Methods Twelve patients receiving CCRT were planned to attend a 12‐week PRT program. Primary endpoint was feasibility measured as attendance to training sessions. Secondary endpoints included changes in functional performance, muscle strength, and body composition measured by Dual‐energy X‐ray Absorptiometry (DXA) scans. Furthermore, sarcomeric protein content, pentose phosphate pathway (PPP) activity, and glycolysis were determined in muscle biopsies. Results Twelve patients with p16 positive oropharyngeal cancer were enrolled. The primary endpoint was met with 9 of the 12 patients completing at least 25 of 36 planned training sessions. The mean attendance rate was 77%. Functional performance was maintained during the treatment period and increased during follow‐up (p < 0.01). Strength was regained after an initial dip during treatment, paralleling responses in LBM and sarcomeric protein content. LBM began to increase immediately after treatment. The PPP was upregulated after the treatment period, whilst glycolysis remained unchanged. No adverse events were related to PRT and in questionnaires, patients emphasized the social and psychological benefits of attendance. Conclusion Progressive resistance training is feasible and safe during CCRT for head and neck cancer, and is associated with high patient satisfaction. Level of Evidence 2C.
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Affiliation(s)
| | - Anders Vinther
- Department of Rehabilitation, University of Copenhagen Herlev Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, University of Copenhagen Herlev Denmark
| | - Eva Rosenbom
- Nutritional Research Unit, Herlev and Gentofte Hospital, University of Copenhagen Herlev Denmark
| | - Atul S Deshmukh
- Proteomics Program, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen Copenhagen Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research , Rigshospitalet, University of Copenhagen Copenhagen Denmark
| | - Julie Gehl
- Department of Oncology, University of Copenhagen Herlev Denmark
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15
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Bandak M, Jørgensen N, Juul A, Lauritsen J, Kier MGG, Mortensen MS, Oturai PS, Mortensen J, Hojman P, Helge JW, Daugaard G. Reproductive hormones and metabolic syndrome in 24 testicular cancer survivors and their biological brothers. Andrology 2017; 5:718-724. [PMID: 28598554 DOI: 10.1111/andr.12355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/30/2017] [Accepted: 02/07/2017] [Indexed: 01/22/2023]
Abstract
Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III) criteria comprised the main outcome measures of the study. Median age was similar in testicular cancer survivors and their biological brothers [44 years (IQR 39-50) vs. 46 (40-53) years respectively (p = 0.1)]. In testicular cancer survivors, follow-up since treatment was 12 years (7-19). Serum levels of luteinizing hormone and follicle-stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti-Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart from HDL-cholesterol, which was lower in testicular cancer survivors (p = 0.01); there were no differences in the individual components of the metabolic syndrome between testicular cancer survivors and their brothers. In conclusion, gonadal function was impaired in testicular cancer survivors, while we did not detect any difference in the prevalence of metabolic syndrome between testicular cancer survivors and their biological brothers.
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Affiliation(s)
- M Bandak
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - N Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Copenhagen, Denmark
| | - A Juul
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Copenhagen, Denmark
| | - J Lauritsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - M G G Kier
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Unit of Survivorship, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - M S Mortensen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - P S Oturai
- Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J Mortensen
- Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - P Hojman
- Centre of Physical Activity Research, Centre of Inflammation and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J W Helge
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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16
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Lonkvist CK, Lønbro S, Vinther A, Zerahn B, Rosenbom E, Primdahl H, Hojman P, Gehl J. Progressive resistance training in head and neck cancer patients during concomitant chemoradiotherapy -- design of the DAHANCA 31 randomized trial. BMC Cancer 2017; 17:400. [PMID: 28578654 PMCID: PMC5457597 DOI: 10.1186/s12885-017-3388-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 05/25/2017] [Indexed: 02/06/2023] Open
Abstract
Background Head and neck cancer patients undergoing concomitant chemoradiotherapy (CCRT) frequently experience loss of muscle mass and reduced functional performance. Positive effects of exercise training are reported for many cancer types but biological mechanisms need further elucidation. This randomized study investigates whether progressive resistance training (PRT) may attenuate loss of muscle mass and functional performance. Furthermore, biochemical markers and muscle biopsies will be investigated trying to link biological mechanisms to training effects. Methods At the Departments of Oncology at Herlev and Aarhus University Hospitals, patients with stage III/IV squamous cell carcinoma of the head and neck, scheduled for CCRT are randomized 1:1 to either a 12-week PRT program or control group, both with 1 year follow-up. Planned enrollment is 72 patients, and stratification variables are study site, sex, p16-status, and body mass index. Primary endpoint is difference in change in lean body mass (LBM) after 12 weeks of PRT, assessed by dual-energy X-ray absorptiometry (DXA). The hypothesis is that 12 weeks of PRT can attenuate the loss of LBM by at least 25%. Secondary endpoints include training adherence, changes in body composition, muscle strength, functional performance, weight, adverse events, dietary intake, self-reported physical activity, quality of life, labor market affiliation, blood biochemistry, plasma cytokine concentrations, NK-cell frequency in blood, sarcomeric protein content in muscles, as well as muscle fiber type and fiber size in muscle biopsies. Muscle biopsies are optional. Discussion This randomized study investigates the impact of a 12-week progressive resistance training program on lean body mass and several other physiological endpoints, as well as impact on adverse events and quality of life. Furthermore, a translational approach is integrated with extensive biological sampling and exploration into cytokines and mechanisms involved. The current paper discusses decisions and methods behind exercise in head and neck cancer patients undergoing concomitant chemoradiotherapy. Trial registration Approved by the Regional Ethics Committee for the Capital Region of Denmark (protocol id: H-15003725) and registered retrospectively at ClinicalTrials.gov (NCT02557529) September 11th 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3388-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Camilla K Lonkvist
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Simon Lønbro
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Section for Sports Science, Aarhus University, Aarhus, Denmark
| | - Anders Vinther
- Department of Rehabilitation, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Eva Rosenbom
- Nutritional Research Unit, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Hanne Primdahl
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Julie Gehl
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
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17
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Berntsen S, Aaronson NK, Buffart L, Börjeson S, Demmelmaier I, Hellbom M, Hojman P, Igelström H, Johansson B, Pingel R, Raastad T, Velikova G, Åsenlöf P, Nordin K. Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome. BMC Cancer 2017; 17:218. [PMID: 28347291 PMCID: PMC5368942 DOI: 10.1186/s12885-017-3197-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 03/14/2017] [Indexed: 12/16/2022] Open
Abstract
Background Cancer-related fatigue is a common problem in persons with cancer, influencing health-related quality of life and causing a considerable challenge to society. Current evidence supports the beneficial effects of physical exercise in reducing fatigue, but the results across studies are not consistent, especially in terms of exercise intensity. It is also unclear whether use of behaviour change techniques can further increase exercise adherence and maintain physical activity behaviour. This study will investigate whether exercise intensity affects fatigue and health related quality of life in persons undergoing adjuvant cancer treatment. In addition, to examine effects of exercise intensity on mood disturbance, adherence to oncological treatment, adverse effects from treatment, activities of daily living after treatment completion and return to work, and behaviour change techniques effect on exercise adherence. We will also investigate whether exercise intensity influences inflammatory markers and cytokines, and whether gene expressions following training serve as mediators for the effects of exercise on fatigue and health related quality of life. Methods/design Six hundred newly diagnosed persons with breast, colorectal or prostate cancer undergoing adjuvant therapy will be randomized in a 2 × 2 factorial design to following conditions; A) individually tailored low-to-moderate intensity exercise with or without behaviour change techniques or B) individually tailored high intensity exercise with or without behaviour change techniques. The training consists of both resistance and endurance exercise sessions under the guidance of trained coaches. The primary outcomes, fatigue and health related quality of life, are measured by self-reports. Secondary outcomes include fitness, mood disturbance, adherence to the cancer treatment, adverse effects, return to activities of daily living after completed treatment, return to work as well as inflammatory markers, cytokines and gene expression. Discussion The study will contribute to our understanding of the value of exercise and exercise intensity in reducing fatigue and improving health related quality of life and, potentially, clinical outcomes. The value of behaviour change techniques in terms of adherence to and maintenance of physical exercise behaviour in persons with cancer will be evaluated. Trial registration NCT02473003, October, 2014.
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Affiliation(s)
- Sveinung Berntsen
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden.,Dept. of Public Health, Sport and Nutrition, University of Agder, Gimlemoen 25, 4604, Kristiansand, Norway
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands
| | - Laurien Buffart
- Departments of Epidemiology & Biostatistics and Medical Oncology, VU University Medical Center, PO Box 7057, 7007 MB, Amsterdam, the Netherlands
| | - Sussanne Börjeson
- Dept. of Medical and Health Sciences, Division of Nursing Science, Linköping University Campus Valla, 581 83, Linköping, Sweden
| | - Ingrid Demmelmaier
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Maria Hellbom
- Division of Oncology and Pathology, Dept. of Clinical Sciences, Lund University, Box 117, 221 00, Lund, Sweden
| | - Pernille Hojman
- Centre of Inflammation and Metabolism, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helena Igelström
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Birgitta Johansson
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden.,Experimental and Clinical Oncology, Dept. of Immunology, Genetics and Pathology, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Ronnie Pingel
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Truls Raastad
- Dept. of Physical Performance, Norwegian School of Sport Science, Sognsveien 220, 0863, Oslo, Norway
| | - Galina Velikova
- Leeds Institute of Cancer and Pathology, St James's University Hospital LEEDS LS9 7TF University of Leeds, Leeds, UK
| | - Pernilla Åsenlöf
- Dept. of Neuro Science, Physiotherapy, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Karin Nordin
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden. .,Dept. of Public Health, Sport and Nutrition, University of Agder, Gimlemoen 25, 4604, Kristiansand, Norway.
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18
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Falk H, Forde PF, Bay ML, Mangalanathan UM, Hojman P, Soden DM, Gehl J. Calcium electroporation induces tumor eradication, long-lasting immunity and cytokine responses in the CT26 colon cancer mouse model. Oncoimmunology 2017. [PMID: 28638724 DOI: 10.1080/2162402x.2017.1301332] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Electroporation is used in cancer treatment because of its ability to increase local cytotoxicity of e.g. bleomycin (electrochemotherapy) and calcium (calcium electroporation). Calcium electroporation is a novel anticancer treatment that selectively kills cancer cells by necrosis, a cell death pathway that stimulates the immune system due to high release of antigens and "danger signals." In this exploratory study, we aimed to investigate whether calcium electroporation could initiate an anticancer immune response similar to electrochemotherapy. To this end, we treated immunocompetent balb/c mice with CT26 colon tumors with calcium electroporation, electrochemotherapy, or ultrasound-based delivery of calcium or bleomycin. High treatment efficiency was observed with 100% complete remission in all four groups (12/12 with complete remission in each treatment group). In addition, none of the surviving mice from these groups formed new tumors when re-challenged with CT26 cancer cells 100-d post treatment, whereas mice challenged with different cancer cells (4T1 breast cancer) all developed tumors. Treatment of immunodeficient mice with calcium electroporation and electrochemotherapy showed no long-lasting tumor response. Calcium electroporation and electrochemotherapy was associated with a release of High Mobility Group Box 1 protein (HMGB1) in vitro (p = 0.029) and a significant increase of the overall systemic level of pro-inflammatory cytokines in serum from the treated mice (p < 0.003). These findings indicate that calcium electroporation as well as electrochemotherapy could have a role as immune stimulators in future treatments.
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Affiliation(s)
- Hanne Falk
- Center for Experimental Drug and Gene Electrotransfer (CEDGE), Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej, Herlev, Denmark
| | - Patrick F Forde
- Cork Cancer Research Center, Western Gateway Building, University College Cork, Western road, Cork, Ireland
| | - Marie Lund Bay
- Centre of Physical Activity Research, Center of Inflammation and Metabolism, Copenhagen University Hospital, Blegdamsvej, København, Denmark
| | - Uma Maheswari Mangalanathan
- Center for Experimental Drug and Gene Electrotransfer (CEDGE), Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej, Herlev, Denmark
| | - Pernille Hojman
- Centre of Physical Activity Research, Center of Inflammation and Metabolism, Copenhagen University Hospital, Blegdamsvej, København, Denmark
| | - Declan M Soden
- Cork Cancer Research Center, Western Gateway Building, University College Cork, Western road, Cork, Ireland
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (CEDGE), Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej, Herlev, Denmark
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19
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Dethlefsen C, Pedersen KS, Hojman P. Every exercise bout matters: linking systemic exercise responses to breast cancer control. Breast Cancer Res Treat 2017; 162:399-408. [PMID: 28138894 DOI: 10.1007/s10549-017-4129-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 01/20/2017] [Indexed: 12/27/2022]
Abstract
Cumulative epidemiological evidence shows that regular exercise lowers the risk of developing breast cancer and decreases the risk of disease recurrence. The causality underlying this relation has not been fully established, and the exercise recommendations for breast cancer patients follow the general physical activity guidelines, prescribing 150 min of exercise per week. Thus, elucidations of the causal mechanisms are important to prescribe and implement the most optimal training regimen in breast cancer prevention and treatment. The prevailing hypothesis on the positive association within exercise oncology has focused on lowering of the basal systemic levels of cancer risk factors with exercise training. However, another rather overlooked systemic exercise response is the marked acute increases in several potential anti-cancer components during each acute exercise bout. Here, we review the evidence of the exercise-mediated changes in systemic components with the ability to influence breast cancer progression. In the first part, we focus on systemic risk factors for breast cancer, i.e., sex hormones, insulin, and inflammatory markers, and their adaptation to long-term training. In the second part, we describe the systemic factors induced acutely during exercise, including catecholamines and myokines. In conclusion, we propose that the transient increases in exercise factors during acute exercise appear to be mediating the positive effect of regular exercise on breast cancer progression.
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Affiliation(s)
- Christine Dethlefsen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Katrine Seide Pedersen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
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20
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Dethlefsen C, Lillelund C, Midtgaard J, Andersen C, Pedersen BK, Christensen JF, Hojman P. Exercise regulates breast cancer cell viability: systemic training adaptations versus acute exercise responses. Breast Cancer Res Treat 2016; 159:469-79. [PMID: 27601139 DOI: 10.1007/s10549-016-3970-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 08/29/2016] [Indexed: 01/28/2023]
Abstract
PURPOSE Exercise decreases breast cancer risk and disease recurrence, but the underlying mechanisms are unknown. Training adaptations in systemic factors have been suggested as mediating causes. We aimed to examine if systemic adaptations to training over time, or acute exercise responses, in breast cancer survivors could regulate breast cancer cell viability in vitro. METHODS Blood samples were collected from breast cancer survivors, partaking in either a 6-month training intervention or across a 2 h acute exercise session. Changes in training parameters and systemic factors were evaluated and pre/post exercise-conditioned sera from both studies were used to stimulate breast cancer cell lines (MCF-7, MDA-MB-231) in vitro. RESULTS Six months of training increased VO2peak (16.4 %, p < 0.001) and muscle strength, and reduced resting levels of plasma cholesterol (-18.2 %, p = 0.003) and cytokines. Yet, these systemic adaptations had no effect on breast cancer cell viability in vitro. During 2 h of acute exercise, increases in serum lactate (6-fold, p < 0.001), epinephrine (2.9-fold, p = 0.009), norepinephrine (2.2-fold, p < 0.001), and cytokines, including IL-6 (2.1-fold, p < 0.001) were detected. Incubation with serum obtained after exercise reduced viability by -9.2 % in MCF-7 (p = 0.04) and -9.4 % in MDA-MB-231 (p < 0.001) compared to resting serum. CONCLUSION Systemic changes to a 2 h exercise session reduced breast cancer viability, while adaptations to 6 months of training had no impact. Our data question the prevailing dogma that training-dependent baseline reductions in risk factors mediate the protective effect of exercise on breast cancer. Instead, we propose that the cancer protection is driven by accumulative effects of repeated acute exercise responses.
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Affiliation(s)
- Christine Dethlefsen
- The Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Christian Lillelund
- The University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark
| | - Julie Midtgaard
- The University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christina Andersen
- The University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark
| | - Bente Klarlund Pedersen
- The Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Jesper Frank Christensen
- The Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Pernille Hojman
- The Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
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21
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Hvid T, Akerstrom T, Nielsen S, Yfanti C, Juul A, Lindegaard B, Pedersen BK, Hojman P. Pre-training levels of testosterone and sex hormone-binding globulin are not correlated with training adaptations in fat mass and insulin sensitivity in healthy young men. Endocrine 2016; 52:660-3. [PMID: 26481474 DOI: 10.1007/s12020-015-0771-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Thine Hvid
- Department of Infectious Disease, Centre of Physical Activity Research, The Centre of Inflammation and Metabolism, Rigshospitalet 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Thorbjorn Akerstrom
- Department of Infectious Disease, Centre of Physical Activity Research, The Centre of Inflammation and Metabolism, Rigshospitalet 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Søren Nielsen
- Department of Infectious Disease, Centre of Physical Activity Research, The Centre of Inflammation and Metabolism, Rigshospitalet 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Christina Yfanti
- Department of Infectious Disease, Centre of Physical Activity Research, The Centre of Inflammation and Metabolism, Rigshospitalet 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction 6 EDMaRC, Faculty of Health and Medical Sciences, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Lindegaard
- Department of Infectious Disease, Centre of Physical Activity Research, The Centre of Inflammation and Metabolism, Rigshospitalet 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Bente K Pedersen
- Department of Infectious Disease, Centre of Physical Activity Research, The Centre of Inflammation and Metabolism, Rigshospitalet 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Pernille Hojman
- Department of Infectious Disease, Centre of Physical Activity Research, The Centre of Inflammation and Metabolism, Rigshospitalet 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark.
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22
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Loenkvist C, Vinther A, Zerahn B, Rosenbom E, Deshmukh AS, Hojman P, Gehl J. Progressive resistance training in head and neck cancer patients undergoing concomitant chemoradiotherapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e17534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Camilla Loenkvist
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Anders Vinther
- Department of Rehabilitation, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Eva Rosenbom
- Nutritional Research Unit, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Atul S. Deshmukh
- Department of Proteomics, The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Julie Gehl
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
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23
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Pedersen L, Idorn M, Olofsson GH, Lauenborg B, Nookaew I, Hansen RH, Johannesen HH, Becker JC, Pedersen KS, Dethlefsen C, Nielsen J, Gehl J, Pedersen BK, Thor Straten P, Hojman P. Voluntary Running Suppresses Tumor Growth through Epinephrine- and IL-6-Dependent NK Cell Mobilization and Redistribution. Cell Metab 2016; 23:554-62. [PMID: 26895752 DOI: 10.1016/j.cmet.2016.01.011] [Citation(s) in RCA: 476] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/27/2015] [Accepted: 01/20/2016] [Indexed: 02/07/2023]
Abstract
Regular exercise reduces the risk of cancer and disease recurrence. Yet the mechanisms behind this protection remain to be elucidated. In this study, tumor-bearing mice randomized to voluntary wheel running showed over 60% reduction in tumor incidence and growth across five different tumor models. Microarray analysis revealed training-induced upregulation of pathways associated with immune function. NK cell infiltration was significantly increased in tumors from running mice, whereas depletion of NK cells enhanced tumor growth and blunted the beneficial effects of exercise. Mechanistic analyses showed that NK cells were mobilized by epinephrine, and blockade of β-adrenergic signaling blunted training-dependent tumor inhibition. Moreover, epinephrine induced a selective mobilization of IL-6-sensitive NK cells, and IL-6-blocking antibodies blunted training-induced tumor suppression, intratumoral NK cell infiltration, and NK cell activation. Together, these results link exercise, epinephrine, and IL-6 to NK cell mobilization and redistribution, and ultimately to control of tumor growth.
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Affiliation(s)
- Line Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, DK-2100, Denmark
| | - Manja Idorn
- Centre for Cancer Immune Therapy, Department of Hematology, Copenhagen University Hospital, Herlev, DK-2730, Denmark
| | - Gitte H Olofsson
- Centre for Cancer Immune Therapy, Department of Hematology, Copenhagen University Hospital, Herlev, DK-2730, Denmark
| | - Britt Lauenborg
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, DK-2100, Denmark
| | - Intawat Nookaew
- Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, SE-412, Sweden; Comparative Genomics Group, Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - Rasmus Hvass Hansen
- Department of Radiology, University Hospital Copenhagen, Herlev, DK-2730, Denmark
| | | | - Jürgen C Becker
- Department for Translational Skin Cancer Research (TSCR) within the German Cancer Consortium (DKTK), Westdeutsches Tumorzentrum, University Hospital Essen, 45117, Essen, Germany
| | - Katrine S Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, DK-2100, Denmark
| | - Christine Dethlefsen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, DK-2100, Denmark
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, SE-412, Sweden
| | - Julie Gehl
- Department of Oncology, Copenhagen University Hospital, Herlev, DK-2730, Denmark
| | - Bente K Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, DK-2100, Denmark
| | - Per Thor Straten
- Centre for Cancer Immune Therapy, Department of Hematology, Copenhagen University Hospital, Herlev, DK-2730, Denmark; Department of Immunology and Microbiology, University of Copenhagen, DK-2200, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Faculty of Health Science, University of Copenhagen, DK-2100, Denmark; Department of Oncology, Copenhagen University Hospital, Herlev, DK-2730, Denmark.
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24
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Brolin C, Shiraishi T, Hojman P, Krag TO, Nielsen PE, Gehl J. Electroporation Enhanced Effect of Dystrophin Splice Switching PNA Oligomers in Normal and Dystrophic Muscle. Mol Ther Nucleic Acids 2015; 4:e267. [PMID: 26623939 PMCID: PMC5014535 DOI: 10.1038/mtna.2015.41] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/09/2015] [Indexed: 01/16/2023]
Abstract
Peptide nucleic acid (PNA) is a synthetic DNA mimic that has shown potential for discovery of novel splice switching antisense drugs. However, in vivo cellular delivery has been a limiting factor for development, and only few successful studies have been reported. As a possible modality for improvement of in vivo cellular availability, we have investigated the effect of electrotransfer upon intramuscular (i.m.) PNA administration in vivo. Antisense PNA targeting exon 23 of the murine dystrophin gene was administered by i.m. injection to the tibialis anterior (TA) muscle of normal NMRI and dystrophic mdx mice with or without electroporation. At low, single PNA doses (1.5, 3, or 10 µg/TA), electroporation augmented the antisense exon skipping induced by an unmodified PNA by twofold to fourfold in healthy mouse muscle with optimized electric parameters, measured after 7 days. The PNA splice switching was detected at the RNA level up to 4 weeks after a single-dose treatment. In dystrophic muscles of the MDX mouse, electroporation increased the number of dystrophin-positive fibers about 2.5-fold at 2 weeks after a single PNA administration compared to injection only. In conclusion, we find that electroporation can enhance PNA antisense effects in muscle tissue.
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Affiliation(s)
- Camilla Brolin
- Center for Experimental Drug and Gene Electrotransfer (CEDGE), Department of Oncology, Copenhagen University Hospital Herlev, Denmark.,Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, The Panum Institute, University of Copenhagen, Denmark
| | - Takehiko Shiraishi
- Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, The Panum Institute, University of Copenhagen, Denmark
| | - Pernille Hojman
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - Thomas O Krag
- Neuromuscular Research Unit, Department of Neurology Rigshospitalet, University of Copenhagen, Denmark
| | - Peter E Nielsen
- Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, The Panum Institute, University of Copenhagen, Denmark.,Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, The Panum Institute, University of Copenhagen, Denmark
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (CEDGE), Department of Oncology, Copenhagen University Hospital Herlev, Denmark
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25
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Hvid T, Lindegaard B, Winding K, Iversen P, Brasso K, Solomon TPJ, Pedersen BK, Hojman P. Effect of a 2-year home-based endurance training intervention on physiological function and PSA doubling time in prostate cancer patients. Cancer Causes Control 2015; 27:165-74. [PMID: 26573844 DOI: 10.1007/s10552-015-0694-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/31/2015] [Indexed: 10/22/2022]
Abstract
AIM Physical activity after prostate cancer diagnosis has been shown to reduce the risk of disease progression. Here, we aimed to evaluate the effect of a 2-year home-based endurance training intervention on body composition, biomarkers levels, and prostate-specific antigen (PSA) doubling time as a surrogate end-point for progressing disease. METHODS Out-clinic patients with either biochemical recurrence following radical prostatectomy or patients managed on active surveillance were randomized to either 24 months (3 times/week) of home-based endurance training or usual care. Aerobic fitness, body composition, insulin sensitivity, and biomarkers were measured at 0, 6, and 24 months of intervention. PSA doubling time (PSADT) was calculated based on monthly PSA measurements. RESULTS Twenty-five patients were enrolled, and 19 patients completed the study. PSADT increased in the training group from 28 to 76 months (p < 0.05) during the first 6 months and was correlated with changes in VO2max (p < 0.01, r (2) = 0.41). The training group lost 3.6 ± 1.0 kg (p < 0.05) exclusively as fat mass, yet the changes in body composition were not associated with the increased PSADT. The training group showed significant improvements in plasma triglycerides, adiponectin, IGF-1, IGFBP-1, and fasting glucose levels, but no changes in insulin sensitivity (measured as Matsuda index), testosterone, cholesterols, fasting insulin, plasma TNF-alpha, IL-6, or leptin levels. The control group showed no changes in any of the evaluated parameters across the 2-year intervention. CONCLUSION In this small randomized controlled trial, we found that improvements in fitness levels correlated with increasing PSADT, suggesting a link between training and disease progression.
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Affiliation(s)
- Thine Hvid
- The Centre of Inflammation and Metabolism, Centre of Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet M7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Birgitte Lindegaard
- The Centre of Inflammation and Metabolism, Centre of Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet M7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Kamilla Winding
- The Centre of Inflammation and Metabolism, Centre of Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet M7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Peter Iversen
- Department of Urology, Copenhagen Prostate Cancer Center, Rigshospitalet, Copenhagen, Denmark
| | - Klaus Brasso
- Department of Urology, Copenhagen Prostate Cancer Center, Rigshospitalet, Copenhagen, Denmark
| | - Thomas P J Solomon
- The Centre of Inflammation and Metabolism, Centre of Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet M7641, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Bente K Pedersen
- The Centre of Inflammation and Metabolism, Centre of Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet M7641, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Pernille Hojman
- The Centre of Inflammation and Metabolism, Centre of Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet M7641, Blegdamsvej 9, 2100, Copenhagen, Denmark.
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26
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Akerstrom T, Vedel K, Needham J, Hojman P, Kontou E, Hellsten Y, Wojtaszewski JF. Optimizing hyaluronidase dose and plasmid DNA delivery greatly improves gene electrotransfer efficiency in rat skeletal muscle. Biochem Biophys Rep 2015; 4:342-350. [PMID: 29124223 PMCID: PMC5669402 DOI: 10.1016/j.bbrep.2015.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 10/12/2015] [Accepted: 10/20/2015] [Indexed: 11/18/2022] Open
Abstract
Transfection of rat skeletal muscle in vivo is a widely used research model. However, gene electrotransfer protocols have been developed for mice and yield variable results in rats. We investigated whether changes in hyaluronidase pre-treatment and plasmid DNA delivery can improve transfection efficiency in rat skeletal muscle. We found that pre-treating the muscle with a hyaluronidase dose suitable for rats (0.56 U/g b.w.) prior to plasmid DNA injection increased transfection efficiency by >200% whereas timing of the pre-treatment did not affect efficiency. Uniformly distributing plasmid DNA delivery across the muscle by increasing the number of plasmid DNA injections further enhanced transfection efficiency whereas increasing plasmid dose from 0.2 to 1.6 µg/g b.w. or vehicle volume had no effect. The optimized protocol resulted in ~80% (CI95%: 79–84%) transfected muscle fibers with a homogenous distribution. We also show that transfection was stable over five weeks of regular exercise or inactivity. Our findings show that species-specific plasmid DNA delivery and hyaluronidase pre-treatment greatly improves transfection efficiency in rat skeletal muscle. Parameters for effective in vivo skeletal muscle transfection are species specific. Pre-treatment with a rat-specific hyaluronidase dose greatly improves transfection efficiency. Delivering plasmid DNA more uniformly enhances transfection efficiency in rat skeletal muscle. Transfection efficiency is not improved by increasing plasmid DNA dose. Exercise training does not affect transfection stability.
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Affiliation(s)
- Thorbjorn Akerstrom
- The August Krogh Centre, Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Correspondence to: The August Krogh Centre, Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Universitetsparken 13, DK-2100 Copenhagen, Denmark. Fax: +4535320870.The August Krogh Centre, Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of CopenhagenUniversitetsparken 13CopenhagenDK-2100Denmark
| | - Kenneth Vedel
- The August Krogh Centre, Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Josefine Needham
- The August Krogh Centre, Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism, Centre for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eftychia Kontou
- The August Krogh Centre, Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- The August Krogh Centre, Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen F.P. Wojtaszewski
- The August Krogh Centre, Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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27
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Loenkvist C, Vinther A, Zerahn B, Rosenbom E, Hojman P, Andersen E, Gehl J. Feasibility of progressive resistance training in patients undergoing concurrent chemoradiotherapy for head and neck cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e17015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Camilla Loenkvist
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Anders Vinther
- Department of Internal Medicine, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Eva Rosenbom
- Nutrition Unit, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elo Andersen
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Julie Gehl
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
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28
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Matthews VB, Åström MB, Chan MHS, Bruce CR, Krabbe KS, Prelovsek O, Åkerström T, Yfanti C, Broholm C, Mortensen OH, Penkowa M, Hojman P, Zankari A, Watt MJ, Bruunsgaard H, Pedersen BK, Febbraio MA. Erratum to: Brain-derived neurotrophic factor is produced by skeletal muscle cells in response to contraction and enhances fat oxidation via activation of AMP-activated protein kinase. Diabetologia 2015; 58:854-5. [PMID: 25693750 DOI: 10.1007/s00125-015-3502-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V B Matthews
- Cellular and Molecular Metabolism Laboratory, Diabetes and Metabolism Division, Baker Heart Research Institute, PO Box 6492, St Kilda Road Central, Melbourne, VIC, 8008, Australia
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29
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Brandt C, Hansen RH, Hansen JB, Olsen CH, Galle P, Mandrup-Poulsen T, Gehl J, Pedersen BK, Hojman P. Over-expression of Follistatin-like 3 attenuates fat accumulation and improves insulin sensitivity in mice. Metabolism 2015; 64:283-95. [PMID: 25456456 DOI: 10.1016/j.metabol.2014.10.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 09/21/2014] [Accepted: 10/08/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Follistatin-like 3 (fstl3), a natural inhibitor of members of the TGF-β family, increases during resistance training in human plasma. Fstl3 primarily binds myostatin and activin A, and thereby inhibits their functions. We hypothesize that blocking myostatin and activin A signalling through systemic fstl3 over-expression protects against diet-induced obesity and insulin resistance. METHODS Fstl3 was over-expressed by DNA electrotransfer in tibialis anterior, quadriceps and gastrocnemius muscles in female C57BL/C mice, and the mice were subsequently randomized to chow or high-fat feeding. Body weight, food intake, fat accumulation by MR scanning, and glucose, insulin and glucagon tolerance were evaluated, as was the response in body weight and metabolic parameters to 24h fasting. Effects of fstl3 on pancreatic insulin and glucagon content, and pancreatic islet morphology were determined. RESULTS Fstl3 over-expression reduced fat accumulation during high-fat feeding by 16%, and liver fat by 50%, as determined by MRI. No changes in body weight were observed, while the weight of the transfected muscles increased by 10%. No transcriptional changes were found in the subcutaneous adipose tissue. Fstl3 mice displayed improved insulin sensitivity and muscle insulin signalling. In contrast, glucose tolerance was impaired in high-fat fed fstl3 mice, which was explained by increased hepatic glucagon sensitivity and glucose output, as well as a decrease in the pancreatic insulin/glucagon ratio. Accordingly, fstl3 transfection improved counter-regulation to 24h fasting. CONCLUSION Fstl3 over-expression regulates insulin and glucagon sensitivities through increased muscular insulin action, as well as increased hepatic glucagon sensitivity and pancreatic glucagon content.
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Affiliation(s)
- Claus Brandt
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Rasmus Hvass Hansen
- Research Group, Dept. of Radiology, Copenhagen University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark
| | - Jakob Bondo Hansen
- Immunoendocrinology lab, Section of Endocrinological Research, Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Caroline Holkmann Olsen
- Department of Pathology, Copenhagen University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark
| | - Pia Galle
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Thomas Mandrup-Poulsen
- Immunoendocrinology lab, Section of Endocrinological Research, Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark; Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76, Stockholm, Sweden
| | - Julie Gehl
- Department of Oncology, Copenhagen University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark
| | - Bente Klarlund Pedersen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Pernille Hojman
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
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30
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Pedersen L, Idorn M, Olofsson G, Nookaew I, Hansen R, Johannesen H, Becker JC, Lauenborg B, Pedersen KS, Dethlefsen C, Nielsen JB, Gehl J, Pedersen B, thor Straten P, Hojman P. Exercise suppresses tumor growth through epinephrine- and IL-6-dependent mobilization and redistribution of NK cells. J Immunother Cancer 2015. [PMCID: PMC4649414 DOI: 10.1186/2051-1426-3-s2-p246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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31
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Hojman P, Fjelbye J, Zerahn B, Christensen JF, Dethlefsen C, Lonkvist CK, Brandt C, Gissel H, Pedersen BK, Gehl J. Voluntary exercise prevents cisplatin-induced muscle wasting during chemotherapy in mice. PLoS One 2014; 9:e109030. [PMID: 25268807 PMCID: PMC4182656 DOI: 10.1371/journal.pone.0109030] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/28/2014] [Indexed: 11/18/2022] Open
Abstract
Loss of muscle mass related to anti-cancer therapy is a major concern in cancer patients, being associated with important clinical endpoints including survival, treatment toxicity and patient-related outcomes. We investigated effects of voluntary exercise during cisplatin treatment on body weight, food intake as well as muscle mass, strength and signalling. Mice were treated weekly with 4 mg/kg cisplatin or saline for 6 weeks, and randomized to voluntary wheel running or not. Cisplatin treatment induced loss of body weight (29.8%, P < 0.001), lean body mass (20.6%, P = 0.001), as well as anorexia, impaired muscle strength (22.5% decrease, P < 0.001) and decreased glucose tolerance. In addition, cisplatin impaired Akt-signalling, induced genes related to protein degradation and inflammation, and reduced muscle glycogen content. Voluntary wheel running during treatment attenuated body weight loss by 50% (P < 0.001), maintained lean body mass (P < 0.001) and muscle strength (P < 0.001), reversed anorexia and impairments in Akt and protein degradation signalling. Cisplatin-induced muscular inflammation was not prevented by voluntary wheel running, nor was glucose tolerance improved. Exercise training may preserve muscle mass in cancer patients receiving cisplatin treatment, potentially improving physical capacity, quality of life and overall survival.
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Affiliation(s)
- Pernille Hojman
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jonas Fjelbye
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Jesper F. Christensen
- Copenhagen University Hospital, The University Hospitals Centre for Health Care Research (UCSF), Copenhagen, Denmark
| | - Christine Dethlefsen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Camilla K. Lonkvist
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Claus Brandt
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Gissel
- Institute of Biomedicine, University of Aarhus, Aarhus C, Denmark
| | - Bente Klarlund Pedersen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Julie Gehl
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
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Christensen JF, Tolver A, Andersen JL, Rørth M, Daugaard G, Hojman P. Resistance training does not protect against increases in plasma cytokine levels among germ cell cancer patients during and after chemotherapy. J Clin Endocrinol Metab 2014; 99:2967-76. [PMID: 25050898 DOI: 10.1210/jc.2013-4495] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Testicular germ cell cancer (GCC) patients treated with cisplatin-etoposide-bleomycin chemotherapy (BEP) have excellent prognosis but have an increased risk of late-occurring morbidities, which may be associated with changes in the inflammatory profile. OBJECTIVE The objective of the study was to explore plasma cytokine concentrations in GCC patients randomized to resistance training or usual care during BEP, in comparison with healthy controls. DESIGN/SETTING This was a randomized controlled trial in GCC patients enrolled from an oncology clinic, including a healthy reference group for comparison purposes. OUTCOME MEASURES Plasma granulocyte macrophage colony-stimulating factor, interferon-γ, IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12, and TNF-α were measured in fasting blood samples from GCC patients randomized to resistance training (INT; n = 15) or usual care (CON; n = 15) and healthy age-matched controls (REF; n = 19). Clinical toxicity assessments and patient-reported end points were also recorded. RESULTS CON and INT were balanced at baseline. Compared with REF, CON had higher concentrations of IL-10, IL-6, and interferon-γ, and INT had higher concentrations of IL-6, IL-8 and TNF-α (all P < .05). At the end of therapy, concentrations of IL-6, IL-8, and IL-10 increased in both GCC groups (all P < .01). Three months after therapy, all cytokine concentrations were comparable with the pretreatment levels in both GCC-groups but remained elevated compared with REF (P < .05). Changes in TNF-α correlated with pulmonary toxicity (P < .01). At the end of therapy, IL-6 concentrations correlated with quality of life (P < .05) and fatigue (P < .01). CONCLUSION GCC patients treated with BEP display consistently elevated levels of systemic inflammatory markers compared with healthy controls. Resistance training during therapy has no impact on plasma cytokine concentrations.
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Affiliation(s)
- Jesper F Christensen
- University Hospital Centre for Health Research (J.F.C., M.R.), Department of Oncology (J.F.C., M.R., G.D.), and Centre of Inflammation and Metabolism (P.H.), Centre of Physical Activity Research, Copenhagen University Hospital, Blegdamsvej 9, Department of Mathematical Sciences (A.T.), University of Copenhagen, Universitetsparken 5, and Centre for Healthy Ageing (J.L.A.), Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; and Institute of Sports Medicine (J.L.A.), Department of Orthopaedic Surgery M, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark
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Casla S, Hojman P, Cubedo R, Calvo I, Sampedro J, Barakat R. Integrative exercise and lifestyle intervention increases leisure-time activity in breast cancer patients. Integr Cancer Ther 2014; 13:493-501. [PMID: 24997174 DOI: 10.1177/1534735414541962] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physical activity has been demonstrated to increase survival in breast cancer patients, but few breast cancer patients meet the general recommendations for physical activity. The aim of this pilot study was to investigate if a supervised integrated counseling and group-based exercise program could increase leisure-time activity in women with breast cancer. METHODS This pilot project, designed as a single-arm study with pre-post testing, consisted of 24 classes of combined aerobic and strength exercise training as well as classes on dietary and health behavior. A total of 48 women with breast cancer who were undergoing or had recently completed anticancer treatment completed the study. Leisure-time physical activity, grip strength, functional capacity, quality of life (QoL), and depression were assessed at baseline, after intervention, and at the 12-week follow-up after intervention. RESULTS The breast cancer patients increased their leisure-time physical activity (P = .004), global strength (P = .004), functional capacity (P = .001), and QoL (P = .009), and their depression score (P = .004) significantly decreased. These improvements were independent of whether the patients were in ongoing therapy or had completed their treatment. CONCLUSION This integrated intervention may produce lifestyle changes in breast cancer patients and survivors using the teachable moment to increase their leisure-time physical activity and, thereby, their QoL.
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Frandsen SK, Gissel H, Hojman P, Eriksen J, Gehl J. Calcium electroporation in three cell lines: a comparison of bleomycin and calcium, calcium compounds, and pulsing conditions. Biochim Biophys Acta Gen Subj 2013; 1840:1204-8. [PMID: 24342489 DOI: 10.1016/j.bbagen.2013.12.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/15/2013] [Accepted: 12/09/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Electroporation with calcium (calcium electroporation) can induce ATP depletion-associated cellular death. In the clinical setting, the cytotoxic drug bleomycin is currently used with electroporation (electrochemotherapy) for palliative treatment of tumors. Calcium electroporation offers several advantages over standard treatment options: calcium is inexpensive and may readily be applied without special precautions, as is the case with cytostatic drugs. Therefore, details on the use of calcium electroporation are essential for carrying out clinical trials comparing calcium electroporation and electrochemotherapy. METHODS The effects of calcium electroporation and bleomycin electroporation (alone or in combination) were compared in three different cell lines (DC-3F, transformed Chinese hamster lung fibroblast; K-562, human leukemia; and murine Lewis Lung Carcinoma). Furthermore, the effects of electrical pulsing parameters and calcium compound on treatment efficacy were determined. RESULTS Electroporation with either calcium or bleomycin significantly reduced cell survival (p<0.0001), without evidence of a synergistic effect. Cellular death following calcium or bleomycin treatment occurred at similar applied voltages, suggesting that similar parameters should be applied. At equimolar concentrations, calcium chloride and calcium glubionate resulted in comparable decreases in cell viability. CONCLUSIONS Calcium electroporation and bleomycin electroporation significantly reduce cell survival at similar applied voltage parameters. The effect of calcium electroporation is independent of calcium compound. GENERAL SIGNIFICANCE This study strongly supports the use of calcium electroporation as a potential cancer therapy and the results may aid in future clinical trials.
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Affiliation(s)
- Stine Krog Frandsen
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730 Herlev, Denmark
| | - Hanne Gissel
- Institute of Biomedicine, Aarhus University, Building 1160, Ole Worms Allé 4, 8000 Aarhus C, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism, Department of Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Jens Eriksen
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730 Herlev, Denmark; Department of Pathology, Naestved Sygehus, Ringstedgade 61, 4700 Naestved, Denmark
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730 Herlev, Denmark.
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Lindegaard B, Matthews VB, Brandt C, Hojman P, Allen TL, Estevez E, Watt MJ, Bruce CR, Mortensen OH, Syberg S, Rudnicka C, Abildgaard J, Pilegaard H, Hidalgo J, Ditlevsen S, Alsted TJ, Madsen AN, Pedersen BK, Febbraio MA. Interleukin-18 activates skeletal muscle AMPK and reduces weight gain and insulin resistance in mice. Diabetes 2013; 62:3064-74. [PMID: 23670974 PMCID: PMC3749341 DOI: 10.2337/db12-1095] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Circulating interleukin (IL)-18 is elevated in obesity, but paradoxically causes hypophagia. We hypothesized that IL-18 may attenuate high-fat diet (HFD)-induced insulin resistance by activating AMP-activated protein kinase (AMPK). We studied mice with a global deletion of the α-isoform of the IL-18 receptor (IL-18R(-/-)) fed a standard chow or HFD. We next performed gain-of-function experiments in skeletal muscle, in vitro, ex vivo, and in vivo. We show that IL-18 is implicated in metabolic homeostasis, inflammation, and insulin resistance via mechanisms involving the activation of AMPK in skeletal muscle. IL-18R(-/-) mice display increased weight gain, ectopic lipid deposition, inflammation, and reduced AMPK signaling in skeletal muscle. Treating myotubes or skeletal muscle strips with IL-18 activated AMPK and increased fat oxidation. Moreover, in vivo electroporation of IL-18 into skeletal muscle activated AMPK and concomitantly inhibited HFD-induced weight gain. In summary, IL-18 enhances AMPK signaling and lipid oxidation in skeletal muscle implicating IL-18 in metabolic homeostasis.
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Affiliation(s)
- Birgitte Lindegaard
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, University of Copenhagen, Copenhagen, Denmark
- Cellular and Molecular Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Vance B. Matthews
- Cellular and Molecular Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- University of Western Australia Centre for Medical Research, Western Australian Institute for Medical Research, Perth, Australia
| | - Claus Brandt
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hojman
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, University of Copenhagen, Copenhagen, Denmark
| | - Tamara L. Allen
- Cellular and Molecular Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Emma Estevez
- Cellular and Molecular Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Matthew J. Watt
- Department of Physiology, Monash University, Clayton, Australia
| | - Clinton R. Bruce
- Cellular and Molecular Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Physiology, Monash University, Clayton, Australia
| | - Ole H. Mortensen
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Syberg
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Osteoporosis Unit, Hvidovre Hospital, Hvidovre, Denmark
| | - Caroline Rudnicka
- University of Western Australia Centre for Medical Research, Western Australian Institute for Medical Research, Perth, Australia
| | - Julie Abildgaard
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
| | - Henriette Pilegaard
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Juan Hidalgo
- Institute of Neurosciences, Department of Cellular Biology, Physiology, and Immunology, Animal Physiology Unit, Faculty of Sciences, Autonomous University of Barcelona, Barcelona, Spain
| | - Susanne Ditlevsen
- Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas J. Alsted
- Department of Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Andreas N. Madsen
- Department of Molecular Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Bente K. Pedersen
- The Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, University of Copenhagen, Copenhagen, Denmark
| | - Mark A. Febbraio
- Cellular and Molecular Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Corresponding author: Mark A. Febbraio, , or Bente K. Pedersen,
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Højfeldt GW, Dethlefsen C, Pedersen BK, Hojman P. Abstract 5400: Exercise activates AMP-activated protein kinase in breast cancer cells. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-5400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective: Cancer cells are characterized by a changed cellular metabolism, favoring glycolysis. AMPK, a serine/threonine kinase regulates cellular metabolism, and induces fatty acid oxidation and has in regard to this, been shown to suppress tumor cell growth. During physical activity, which is associated with a reduced cancer risk, working muscles secrete myokines, known to activate AMPK. This could indicate a connection between AMPK activity, myokine release from the working muscle, and an anti-cancer response. We hypothesize that exercise-induced myokine secretion causes an anti-cancer response via AMPK activation. Methods: Exercise-induced AMPK activation was studied in two models, 1) A cell study using the two breast cancer cell lines, MDA-MB-231 and MCF-7, incubated with exercise-conditioned serum, representing a myokine pool. Serum was collected from 9 females during a 2 hours cycling bout, and during a subsequent 3 hours rest. Following incubation, cell viability and AMPK phosphorylation was determined in the cells. 2) An In Vivo model, where the two cell lines were injected into nude mice. When the tumors reached 6 mm in diameter, the mice were subjected to 1 hour forced swimming bout, after which the tumors were dissected and analyzed for pAMPK content. Results: 1) Cell study: Two hours of cycling induced a 6-fold increase in serum IL-6, as expected. Incubating cancer cells with this post-exercise serum resulted in a significant reduction in the viability of MCF-7 cells, while no effect on the viability of MDA-MB-231 cells were observed. Preliminary data show increased AMPK phosphorylation in both MDA-MB-231 and MCF-7 cells after incubation with 5% exercise-conditioned serum. 2) In vivo study: 1 hour of swimming resulted in significantly increased AMPK phosphorylation in the MCF-7 tumors. Conclusion: Our preliminary data indicate that exercise-induced factors can cause decreased viability and increased AMPK activity in MCF-7 cells, while MDA-MB-231 cells need further investigation. Acknowledgement: The Centre of Inflammation and Metabolism (CIM) is supported by a grant from the Danish National research Foundation (#02-512-55). This study was further supported by the Danish Medical Research Council and the Lundbeck Foundation.
Citation Format: Grith W. Højfeldt, Christine Dethlefsen, Bente K. Pedersen, Pernille Hojman. Exercise activates AMP-activated protein kinase in breast cancer cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5400. doi:10.1158/1538-7445.AM2013-5400
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Lindegaard B, Hvid T, Grøndahl T, Frosig C, Gerstoft J, Hojman P, Pedersen BK. Expression of fibroblast growth factor-21 in muscle is associated with lipodystrophy, insulin resistance and lipid disturbances in patients with HIV. PLoS One 2013; 8:e55632. [PMID: 23533568 PMCID: PMC3606412 DOI: 10.1371/journal.pone.0055632] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 12/28/2012] [Indexed: 01/04/2023] Open
Abstract
Background Fibroblast growth factor (FGF)-21 is a novel regulator of glucose and lipid metabolism. Recently, increased FGF-21 mRNA expression in muscle was found in patients with type 2 diabetes, but the role for FGF-21 in muscle is not well understood. Patients with HIV-infection and lipodystrophy are characterised by various degree of lipid-driven insulin resistance. We hypothesized that muscle FGF-21 mRNA would be altered in HIV patients with lipodystrophy. Design Twenty-five HIV-infected men with lipodystrophy (LD) and 15 age-matched healthy controls, received an oral glucose tolerance test and a euglycemic-hyperinsulinemic clamp (50 mU/m2/min) combined with 6,6-H2 glucose infusion. Muscle biopsies were obtained and FGF-21 mRNA and glycogen synthase (GS) activity were measured. Results Subjects with HIV were insulin resistant compared with non-HIV subjects. Compared to controls, HIV subjects demonstrated a twofold increase of plasma FGF-21 from 70.4±56.8 pg/ml vs 109.1±71.8 pg/ml, respectively (p = 0.04) and an eight-fold increase in muscular FGF-21 mRNA expression (p = 0.001). Muscle FGF-21 mRNA correlated inversely with the rate of disappearance of glucose during insulin clamp (r = −0.54, p = 0.0009), and the GS fractional velocity in muscle (r = −0.39, p = 0.03), and directly with fasting insulin (r = 0.50, p = 0.0022), HOMA-IR (r = 0.47, p = 0.004), triglycerides (r = 0.60. P = 0.0001), waist-to-hip ratio (r = 0.51, p = 0.0001) and limb fat mass (−0.46, p = 0.004), but not to plasma FGF-21. Conclusion FGF-21 mRNA is increased in skeletal muscle in HIV patients and correlates to whole-body (primarily reflecting muscle) insulin resistance, but not to plasma FGF-21. Those findings add to the evidence that FGF-21 is a myokine and may suggest that muscle FGF-21 is working in a local manner.
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Affiliation(s)
- Birgitte Lindegaard
- Centre of Inflammation and Metabolism, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
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Spanggaard I, Corydon T, Hojman P, Gissel H, Dagnaes-Hansen F, Jensen TG, Gehl J. Spatial Distribution of Transgenic Protein After Gene Electrotransfer to Porcine Muscle. Hum Gene Ther Methods 2012; 23:387-92. [DOI: 10.1089/hgtb.2012.173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Iben Spanggaard
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, 2730 Herlev, Denmark
| | - Thomas Corydon
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Pernille Hojman
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, 2730 Herlev, Denmark
- Centre of Inflammation and Metabolism, Department of Infectious Diseases, Copenhagen University, 2100 Copenhagen, Denmark
| | - Hanne Gissel
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | | | - Thomas G. Jensen
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, 2730 Herlev, Denmark
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Abstract
Cytokines and other peptides are secreted from skeletal muscles in response to exercise and function as hormones either locally within the muscle or by targeting distant organs. Such proteins are recognized as myokines, with the prototype myokine being IL-6. Several studies have established a role of these muscle-derived factors as important contributors of the beneficial effects of exercise, and the myokines are central to our understanding of the cross talk during and after exercise between skeletal muscles and other organs. In a study into the mechanisms of a newly defined myokine, CXCL-1, we found that CXCL-1 overexpression increases muscular fatty acid oxidation with concomitant attenuation of diet-induced fat accumulation in the adipose tissue. Clearly this study adds to the concept of myokines playing an important role in mediating the whole-body adaptive effects of exercise through the regulation of skeletal muscle metabolism. Yet, myokines also contribute to whole-body metabolism by directly signaling to distant organs, regulating metabolic processes in liver and adipose tissue. Thus accumulating data shows that myokines play an important role in restoring a healthy cellular environment, reducing low-grade inflammation and thereby preventing metabolic related diseases like insulin resistance and cancer.
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Brandt C, Jakobsen AH, Adser H, Olesen J, Iversen N, Kristensen JM, Hojman P, Wojtaszewski JFP, Hidalgo J, Pilegaard H. IL-6 regulates exercise and training-induced adaptations in subcutaneous adipose tissue in mice. Acta Physiol (Oxf) 2012; 205:224-35. [PMID: 21991887 DOI: 10.1111/j.1748-1716.2011.02373.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIM The aim of this study was to test the hypothesis that IL-6 regulates exercise-induced gene responses in subcutaneous adipose tissue in mice. METHODS Four-month-old male IL-6 whole body knockout (KO) mice and C57B wild-type (WT) mice performed 1 h of treadmill exercise, where subcutaneous adipose tissue (AT) was removed either immediately after, 4 h or 10 h after exercise as well as from mice not running acutely. Moreover, AT was sampled at resting conditions after 5 weeks of exercise training. RESULTS AT leptin mRNA decreased immediately after a single running exercise bout in both genotypes and returned to baseline within 10 h of recovery in IL-6 KO mice, but not WT mice. Leptin mRNA content decreased in WT and increased in IL-6 KO mice with training, but without significant alterations in leptin protein. Acute exercise induced a decrease in the AT TNFα mRNA content in WT, but not in IL-6-KO mice, while training lowered resting levels of TNFα mRNA in both genotypes. In addition, an exercise-induced decline in AT PPARγ mRNA content was absent in IL-6 KO mice and in line training increased PPARγ mRNA only in IL-6 KO mice. CONCLUSION The present findings indicate a role of IL-6 in regulating exercise- and training-induced leptin and PPARγ expression in adipose tissue. In addition, while IL-6 is required for TNF-α mRNA reduction in response to acute exercise, IL-6 does not appear to be mandatory for anti-inflammatory effects of exercise training in adipose tissue.
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Affiliation(s)
- C Brandt
- Centre of Inflammation and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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Pedersen L, Olsen CH, Pedersen BK, Hojman P. Muscle-derived expression of the chemokine CXCL1 attenuates diet-induced obesity and improves fatty acid oxidation in the muscle. Am J Physiol Endocrinol Metab 2012; 302:E831-40. [PMID: 22275756 DOI: 10.1152/ajpendo.00339.2011] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Serum levels and muscle expression of the chemokine CXCL1 increase markedly in response to exercise in mice. Because several studies have established muscle-derived factors as important contributors of metabolic effects of exercise, this study aimed at investigating the effect of increased expression of muscle-derived CXCL1 on systemic and intramuscular metabolic parameters, with focus on fatty acid oxidation and oxidative metabolism in skeletal muscle. By overexpression of CXCL1 in the tibialis cranialis muscle in mice, significant elevations in muscle and serum CXCL1 within a physiological range were obtained. At 3 mo of high-fat feeding, visceral and subcutaneous fat mass were 32.4 (P < 0.01) and 22.4% (P < 0.05) lower, respectively, in CXCL1-overexpressing mice compared with control mice. Also, chow-fed CXCL-transfected mice had 35.4% (P < 0.05) lower visceral fat mass and 33.4% (P < 0.05) lower subcutaneous fat mass compared with chow-fed control mice. These reductions in accumulation of adipose tissue were accompanied by improved glucose tolerance and insulin sensitivity. Furthermore, in CXCL1-transfected muscles, muscular ex vivo fatty acid oxidation was significantly enhanced compared with control muscles (chow fed: 2.2-fold, P < 0.05; high-fat fed: 2-fold, P < 0.05) and also showed increased expression levels of major fatty acid oxidation genes (CD36, CPT I, and HADH). Finally, CXCL1 expression was associated with increased muscle mRNA expression of VEGF and CD31, suggesting a role for CXCL1 in muscle angiogenesis. In conclusion, our data show that overexpression of CXCL1 within a physiological range attenuates diet-induced obesity, likely mediated through a CXCL1-induced improvement of fatty acid oxidation and oxidative capacity in skeletal muscle tissue.
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Affiliation(s)
- Line Pedersen
- Centre of Inflammation and Metabolism, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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Frandsen SK, Gissel H, Hojman P, Tramm T, Eriksen J, Gehl J. Direct therapeutic applications of calcium electroporation to effectively induce tumor necrosis. Cancer Res 2012; 72:1336-41. [PMID: 22282658 DOI: 10.1158/0008-5472.can-11-3782] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Electroporation of cells with short, high-voltage pulses causes a transient permeabilization of cell membranes that permits passage of otherwise nonpermeating ions and molecules. In this study, we illustrate how electroporation with isotonic calcium can achieve highly effective cancer cell kill in vivo. Calcium electroporation elicited dramatic antitumor responses in which 89% of treated tumors were eliminated. Histologic analyses indicated complete tumor necrosis. Mechanistically, calcium electroporation caused acute ATP depletion likely due to a combination of increased cellular use of ATP, decreased production of ATP due to effects on the mitochondria, as well as loss of ATP through the permeabilized cell membrane. Taken together, our findings offer a preclinical proof of concept for the use of electroporation to load cancer cells with calcium as an efficient anticancer treatment. Electroporation equipment is already used clinically to enhance the delivery of chemotherapy to superficial tumors, with trials on internal tumors in progress, enabling the introduction of calcium electroporation to clinical use. Moreover, the safety profile, availability, and low cost of calcium facilitate access to this technology for many cancer patients in developed and developing countries.
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Affiliation(s)
- Stine Krog Frandsen
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Denmark
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Abstract
Cell membrane permeabilization by electric pulses (electropermeabilization), results in free exchange of ions across the cell membrane. The role of electrotransfer-mediated Ca2+-influx on muscle signaling pathways involved in degeneration (β-actin and MurF), inflammation (IL-6 and TNF-α), and regeneration (MyoD1, myogenin, and Myf5) was investigated, using pulse parameters of both electrochemotherapy (8 HV) and DNA delivery (HVLV). Three pulsing conditions were used: 8 high-voltage pulses (8 HV), resulting in large permeabilization and ion flux, and a combination of one high-voltage pulse and one low-voltage pulse (HVLV), either alone or in combination with injection of DNA. Mice and rats were anesthetized before pulsing. At the times given, animals were killed, and intact tibialis cranialis muscles were excised for analysis. Uptake of Ca2+ was assessed using 45Ca as a tracer. Using gene expression analyses and histology, we showed a clear association between Ca2+ influx and muscular response. Moderate Ca2+ influx induced by HVLV pulses results in activation of pathways involved in immediate repair and hypertrophy. This response could be attenuated by intramuscular injection of EGTA reducing Ca2+ influx. Larger Ca2+ influx as induced by 8-HV pulses leads to muscle damage and muscle fiber regeneration through recruitment of satellite cells. The extent of Ca2+ influx determines the muscular response to electrotransfer and, thus, the success of a given application. In the case of electrochemotherapy, in which the objective is cell death, a large influx of Ca2+ may be beneficial, whereas for DNA electrotransfer, muscle recovery should occur without myofiber loss to ensure preservation of plasmid DNA.
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Affiliation(s)
- Pernille Hojman
- The Centre of Inflammation and Metabolism, Department of Infectious Diseases and Copenhagen Muscle Research Centre, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen
- Department of Oncology 5405, Copenhagen University Hospital Herlev, Denmark; and
| | - Camilla Brolin
- Department of Oncology 5405, Copenhagen University Hospital Herlev, Denmark; and
| | - Hanne Gissel
- Department of Biomedicine, University of Aarhus, Aarhus, Denmark
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Abstract
Regular physical activity protects against the development of breast and colon cancer, since it reduces the risk of developing these by 25-30%. During exercise, humoral factors are released from the working muscles for endocrinal signaling to other organs. We hypothesized that these myokines mediate some of the inhibitory effects of exercise on mammary cancer cell proliferation. Serum and muscles were collected from mice after an exercise bout. Incubation with exercise-conditioned serum inhibited MCF-7 cell proliferation by 52% and increased caspase activity by 54%. A similar increase in caspase activity was found after incubation of MCF-7 cells with conditioned media from electrically stimulated myotubes. PCR array analysis (CAPM-0838E; SABiosciences) revealed that seven genes were upregulated in the muscles after exercise, and of these oncostatin M (OSM) proved to inhibit MCF-7 proliferation by 42%, increase caspase activity by 46%, and induce apoptosis. Blocking OSM signaling with anti-OSM antibodies reduced the induction of caspase activity by 51%. To verify that OSM was a myokine, we showed that it was significantly upregulated in serum and in three muscles, tibialis cranialis, gastronemius, and soleus, after an exercise bout. In contrast, OSM expression remained unchanged in subcutaneous and visceral adipose tissue, liver, and spleen (mononuclear cells). We conclude that postexercise serum inhibits mammary cancer cell proliferation and induces apoptosis of these cells. We suggest that one or more myokines secreted from working muscles may be mediating this effect and that OSM is a possible candidate. These findings emphasize that role of physical activity in cancer treatment, showing a direct link between exercise-induced humoral factors and decreased tumor cell growth.
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Affiliation(s)
- Pernille Hojman
- Centre of Inflammation and Metabolism, Dept. of Infectious Diseases, Rigshospitalet, Univ. of Copenhagen, Denmark.
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46
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Abstract
Gene electrotransfer is expanding in clinical use, thus we have searched for an emergency procedure to stop transgene expression in case of serious adverse events. Calcium is cytotoxic at high intracellular levels, so we tested effects of calcium electrotransfer on transgene expression in muscle. A clinical grade calcium solution (20 μl, 168 mM) was injected into transfected mouse or rat tibialis cranialis muscle. Ca(2+) uptake was quantified using calcium 45 ((45)Ca), and voltage and time between injection and pulsation were varied. Extinction of transgene expression was investigated by using both in vivo imaging of infrared fluorescent "Katushka" and erythropoietin evaluated by ELISA and hemoglobin. Histology was performed. Electrotransfer of Katushka and erythropoietin yielded significant expression. Maximal calcium uptake occurred after injection of Ca(2+) before electropulsing using eight high voltage pulses of 1000 V/cm. Using these parameters, in vivo imaging showed that transgene expression significantly decreased 4 hr after Ca(2+) electrotransfer and was eliminated within 24 hr. Similarly, serum erythropoietin was reduced by 46% at 4 hr and to control levels at 2 days. Histological analyses showed muscle damage and subsequent regeneration. Electrotransfer of isotonic CaCl(2) terminates transgenic protein expression in muscles and may be used for contingency elimination of transgene expression.
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Affiliation(s)
- Pernille Hojman
- Department of Oncology, Copenhagen University Hospital Herlev, DK-2730 Copenhagen, Denmark
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Pedersen L, Pilegaard H, Hansen J, Brandt C, Adser H, Hidalgo J, Olesen J, Pedersen BK, Hojman P. Exercise-induced liver chemokine CXCL-1 expression is linked to muscle-derived interleukin-6 expression. J Physiol 2011; 589:1409-20. [PMID: 21224226 DOI: 10.1113/jphysiol.2010.200733] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The chemokine CXC ligand-1 (CXCL-1) is a small cytokine that elicits effects by signalling through the chemokine receptor CXCR2. CXCL-1 has neutrophil chemoattractant activity, is involved in the processes of angiogenesis, inflammation and wound healing, and may possess neuroprotective effects. The aim of this study was to unravel the mechanisms whereby CXCL-1 is regulated by exercise inmice. After a single bout of exercise, CXCL-1 protein increased in serum(2.4-fold), and CXCL-1 mRNA in muscle (6.5-fold) and liver (41-fold). These increases in CXCL-1 were preceded by increases in serum interleukin-6 (IL-6) and muscle IL-6 mRNA. In contrast, exercise-induced regulation of liver CXCL-1 mRNA expression was completely blunted in IL-6 knockout mice. Based on these findings, we examined the possible existence of a muscle-to-liver axis by overexpressing IL-6 in muscles. This resulted in increases in serum CXCL-1 (5-fold) and liver CXCL-1 mRNA expression (24-fold) compared with control. Because IL-6 expression and release are known to be augmented during exercise in glycogen-depleted animals, CXCL-1 and IL-6 expression were examined after exercise in overnight-fasted mice.We found that fasting significantly augmented serum CXCL-1, and CXCL-1 expression in liver and muscle. Taken together, these data indicate that liver is the main source of serum CXCL-1 during exercise in mice, and that the CXCL-1 expression in the liver is regulated by muscle-derived IL-6.
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Affiliation(s)
- Line Pedersen
- Centre of Inflammation and Metabolism at Department of Infectious Diseases and Copenhagen Muscle Research Centre, Rigshospitalet and Faculty of Health Sciences, University of Copenhagen, Denmark
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48
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Hansen J, Brandt C, Nielsen AR, Hojman P, Whitham M, Febbraio MA, Pedersen BK, Plomgaard P. Exercise induces a marked increase in plasma follistatin: evidence that follistatin is a contraction-induced hepatokine. Endocrinology 2011; 152:164-71. [PMID: 21068158 DOI: 10.1210/en.2010-0868] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Follistatin is a member of the TGF-β super family and inhibits the action of myostatin to regulate skeletal muscle growth. The regulation of follistatin during physical exercise is unclear but may be important because physical activity is a major intervention to prevent age-related sarcopenia. First, healthy subjects performed either bicycle or one-legged knee extensor exercise. Arterial-venous differences were assessed during the one-legged knee extensor experiment. Next, mice performed 1 h of swimming, and the expression of follistatin was examined in various tissues using quantitative PCR. Western blotting assessed follistatin protein content in the liver. IL-6 and epinephrine were investigated as drivers of follistatin secretion. After 3 h of bicycle exercise, plasma follistatin increased 3 h into recovery with a peak of 7-fold. No net release of follistatin could be detected from the exercising limb. In mice performing a bout of swimming exercise, increases in plasma follistatin as well as follistatin mRNA and protein expression in the liver were observed. IL-6 infusion to healthy young men did not affect the follistatin concentration in the circulation. When mice were stimulated with epinephrine, no increase in the hepatic mRNA of follistatin was observed. This is the first study to demonstrate that plasma follistatin is increased during exercise and most likely originates from the liver. These data introduce new perspectives regarding muscle-liver cross talk during exercise and during recovery from exercise.
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Affiliation(s)
- Jakob Hansen
- Centre of Inflammation and Metabolism, Faculty of Health Sciences, University of Copenhagen, Denmark
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49
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Kelly M, Nielsen SA, Scheele C, Brandt C, Hansen J, Hojman P, Plomgaard P, Pedersen BK. Cardiotrophin-1 activates AMP-activated Protein Kinase (AMPK) in Human Skeletal Muscle Cells from Healthy Control, but not Type II Diabetic, Subjects. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000389444.00374.2a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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50
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Hojman P, Dethlefsen C, Pedersen BK. Exercise-induced Muscle-derived Cytokines Inhibit Mammary Cancer Cell Growth. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000389488.85057.d5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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