To examine the effects of
aliskiren, a small-molecule
renin inhibitor, on
cancer cachexia and to explore the underlying mechanisms. A
cancer cachexia model was established by subcutaneously injecting C26 mouse colon
carcinoma cells into isogenic BALB/c mice.
Aliskiren was administered intragastrically [10 mg/kg body weight (BW)] on day 5 (as a preventive strategy, AP group) or on day 12 (as a therapeutic strategy, AT group) after C26 injection. Mice that received no C26 injection (healthy controls, HC group) or only C26 injection but not
aliskiren (
cancer, CA group) were used as controls. BW,
tumor growth, whole body functions, and survival were monitored daily in half of the mice in each group, whereas serum,
tumors, and gastrocnemius muscles were harvested from the other mice after sacrifice on day 20 for further analysis.
Aliskiren significantly alleviated multiple cachexia‑associated symptoms, including BW loss,
tumor burden, muscle wasting, muscular dysfunction, and shortened survival. On the molecular level,
aliskiren antagonized cachexia‑induced activation of the renin‑angiotensin system (RAS), systematic and muscular
inflammation, oxidative stress, and autophagy‑lysosome as well as ubiquitin‑proteasome stimulation. In addition, early administration of
aliskiren before
cachexia development (AP group) resulted in more robust effects in alleviating
cachexia or targeting underlying mechanisms than administration after
cachexia development (AT group).
Aliskiren exhibited potent anti‑cachexia activities. These activities were achieved through the targeting of at least four mechanisms underlying
cachexia development: RAS activation, increase in systematic
inflammation, upregulation of oxidative stress, and stimulation of autophagy-lysosome pathway (ALP) and
ubiquitin-
proteasome pathway (UPP).