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Sarcopenia versus cancer cachexia: the muscle wasting continuum in healthy and diseased aging

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Abstract

Muscle wasting is one of the major health problems in older adults and is traditionally associated to sarcopenia. Nonetheless, muscle loss may also occur in older adults in the presence of cancer, and in this case, it is associated to cancer cachexia. The clinical management of these conditions is a challenge due to, at least in part, the difficulties in their differential diagnosis. Thus, efforts have been made to better comprehend the pathogenesis of sarcopenia and cancer cachexia, envisioning the improvement of their clinical discrimination and treatment. To add insights on this topic, this review discusses the current knowledge on key molecular players underlying sarcopenia and cancer cachexia in a comparative perspective. Data retrieved from this analysis highlight that while sarcopenia is characterized by the atrophy of fast-twitch muscle fibers, in cancer cachexia an increase in the proportion of fast-twitch fibers appears to happen. The molecular drivers for these specificmuscle remodeling patterns are still unknown; however, among the predominant contributors to sarcopenia is the age-induced neuromuscular denervation, and in cancer cachexia, the muscle disuse experienced by cancer patients seems to play an important role. Moreover, inflammation appears to be more severe in cancer cachexia. Impairment of nutrition-related mediators may also contribute to sarcopenia and cancer cachexia, being distinctly modulated in each condition.

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Acknowledgements

This work was supported by CIAFEL (UIDB/00617/2020), LAQV (UIDB/50006/2020) and CITAB (UIDB/04033/2020) research units and by A.M.P.’s fellowship (SFRH/BD/144396/2019) through national founds by the Portuguese Foundation for Science and Technology (FCT) and co-financed by the European Regional Development Fund (FEDER), within the PT2020 Partnership Agreement.

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AMP conducted the literature search and drafted the manuscript and PAO, RF and JAD critically revised the work.

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Correspondence to Alexandra Moreira-Pais or José A. Duarte.

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Moreira-Pais, A., Ferreira, R., Oliveira, P.A. et al. Sarcopenia versus cancer cachexia: the muscle wasting continuum in healthy and diseased aging. Biogerontology 22, 459–477 (2021). https://doi.org/10.1007/s10522-021-09932-z

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  • DOI: https://doi.org/10.1007/s10522-021-09932-z

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