The protective effect of cannabinoids against colorectal cancer cachexia through modulation of inflammation and immune responses.

Cancer cachexia is a multifactorial disorder characterized by weight loss and muscle wasting, and there are currently no FDA-approved medications. In the present study, upregulation of six cytokines was observed in serum samples from patients with colorectal cancer (CRC) and in mouse models. A negative correlation between the levels of the six cytokines and body mass index in CRC patients was seen. Gene Ontology analysis revealed that these cytokines were involved in regulating T cell proliferation. The infiltration of CD8 ⁺ T cells was found to be associated with muscle atrophy in mice with CRC. Adoptive transfer of CD8 ⁺ T cells isolated from CRC mice resulted in muscle wasting in recipients. The Genotype-Tissue Expression database showed that negative correlations between the expression of cachexia markers and cannabinoid receptor 2 (CB2) in human skeletal muscle tissues. Pharmacological treatment with Δ ⁹ -tetrahydrocannabinol (Δ ⁹ -THC), a selective CB2 agonist or overexpression of CB2 attenuated CRC-associated muscle atrophy. In contrast, knockout of CB2 with a CRISPR/Cas9-based strategy or depletion of CD8 ⁺ T cells in CRC mice abolished the Δ ⁹ -THC-mediated effects. This study demonstrates that cannabinoids ameliorate CD8 ⁺ T cell infiltration in CRC-associated skeletal muscle atrophy via a CB2-mediated pathway. Serum levels of the six-cytokine signature might serve as a potential biomarker to detect the therapeutic effects of cannabinoids in CRC-associated cachexia.
Competing Interests: Conflict of interest statement The authors disclose no conflicts of interest.
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