BNIP3 Downregulation Ameliorates Muscle Atrophy in Cancer Cachexia.

Simple Summary: Cancer patients frequently develop a syndrome named cachexia that causes severe muscle loss and frailty, eventually representing the cause of death. Muscle atrophy and muscle weakness are characterized by massive degradation of endogenous proteins, potentially consequent to excessive disposal of mitochondria through the selective autophagic process of mitophagy. This study explored whether selectively silencing BNIP3, a mitophagy-related protein upregulated in the muscle of both mouse and human cancer hosts, could help in preventing muscle loss. Two distinct methodological silencing approaches were tested, either by electroporation of a plasmid or via adenoviral particle injection. Although the first method was ineffective in tumor-bearing mice, the adenovirus-based approach significantly reduced BNIP3 levels and moderately increased muscle fiber size, suggesting partial prevention of muscle atrophy. BNIP3 silencing also maintained mitochondrial mass without disrupting oxidative balance, highlighting BNIP3's central role in cancer cachexia and suggesting that targeting BNIP3 may help in supporting muscle health in cancer patients. Background and Aims: Cancer cachexia is a complex syndrome affecting most cancer patients and is directly responsible for about 20% of cancer-related deaths. Previous studies showed muscle proteolysis hyper-activation and mitophagy induction in tumor-bearing animals. While basal mitophagy is required for maintaining muscle mass and quality, excessive mitophagy promotes uncontrolled protein degradation, muscle loss and impaired function. BNIP3, a key mitophagy-related protein, is significantly increased in the muscles of both mice and human cancer hosts. This study aimed to define the potential of mitigating mitophagy via BNIP3 downregulation in preserving mitochondrial integrity, counteracting skeletal muscle loss in experimental cancer cachexia. Methods: Two in vivo gene delivery methods were performed to knock down muscle BNIP3: electroporation of a BNIP3-specific shRNA expression vector or adenovirus injection. Results: The electroporation effectively reduced muscle BNIP3 in healthy mice but was ineffective in C26 tumor-bearing mice. In contrast, adenovirus-mediated BNIP3 knockdown successfully decreased BNIP3 levels also in tumor hosts. Although BNIP3 knockdown did not impact overall on body or muscle mass, it improved muscle fiber size in C26-bearing miceh2, suggesting partial prevention of muscle atrophy. Mitochondrial respiratory chain complexes (OxPhos) and TOM20 protein levels were consistently rescued, indicating improvements in mitochondrial mass, while H2O2 levels were unchanged among the groups, suggesting that BNIP3 downregulation does not impair the endogenous control of oxidative balance. Conclusions: These findings suggest that a fine balance between mitochondrial disposal and biogenesis is fundamental for preserving muscle homeostasis and highlight a potential role for BNIP3 modulation against cancer-induced muscle wasting. [ABSTRACT FROM AUTHOR]