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Blockade of the IL-6 trans-signalling/STAT3 axis suppresses cachexia in Kras-induced lung adenocarcinoma

A Miller^1,2, L McLeod^1,3, S Alhayyani^1,3,4

¹Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia.

|November 29, 2016

Abstract:

Lung cancer is the leading cause of cancer death worldwide, and is frequently associated with the devastating paraneoplastic syndrome of cachexia. The potent immunomodulatory cytokine interleukin (IL)-6 has been linked with the development of lung cancer as well as cachexia; however, the mechanisms by which IL-6 promotes muscle wasting in lung cancer cachexia are ill-defined. In this study, we report that the gp130^F/F knock-in mouse model displaying hyperactivation of the latent transcription factor STAT3 via the common IL-6 cytokine family signalling receptor, gp130, develops cachexia during Kras-driven lung carcinogenesis. Specifically, exacerbated weight loss, early mortality and reduced muscle and adipose tissue mass were features of the gp130^F/F:Kras^G12D model, but not parental Kras^G12D mice in which STAT3 was not hyperactivated. Gene expression profiling of muscle tissue in cachectic gp130^F/F:Kras^G12D mice revealed the upregulation of IL-6 and STAT3-target genes compared with Kras^G12D muscle tissue. These cachectic features of gp130^F/F:Kras^G12D mice were abrogated upon the genetic normalization of STAT3 activation or ablation of IL-6 in gp130^F/F:Kras^G12D:Stat3^-/+ or gp130^F/F:Kras^G12D:Il6^-/- mice, respectively. Furthermore, protein levels of the soluble IL-6 receptor (sIL-6R), which is the central facilitator of IL-6 trans-signalling, were elevated in cachectic muscle from gp130^F/F:Kras^G12D mice, and the specific blockade of IL-6 trans-signalling, but not classical signalling, with an anti-IL-6R antibody ameliorated cachexia-related characteristics in gp130^F/F:Kras^G12D mice. Collectively, these preclinical findings identify trans-signalling via STAT3 as the signalling modality by which IL-6 promotes muscle wasting in lung cancer cachexia, and therefore support the clinical evaluation of the IL-6 trans-signalling/STAT3 axis as a therapeutic target in advanced lung cancer patients presenting with cachexia.

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