Circulating Carnosine Dipeptidase 1 Associates with Weight Loss and Poor Prognosis in Gastrointestinal Cancer

• Published in: PloS one Vol. 10; no. 4; p. e0123566
• Main Authors: Arner, Peter, Henjes, Frauke, Schwenk, Jochen M., Darmanis, Spyros, Dahlman, Ingrid, Iresjö, Britt-Marie, Naredi, Peter, Agustsson, Thorhallur, Lundholm, Kent, Nilsson, Peter, Rydén, Mikael
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21.04.2015; Public Library of Science (PLoS)
• Subjects: Adenocarcinoma - blood; Adenocarcinoma - mortality; Adenocarcinoma - pathology; adult; Aged; albumin; Amino acids; Analysis; Antibodies; Apolipoproteins; Biomarkers; Biomarkers, Tumor - blood; Biotechnology; blood analysis; Cachexia; Cachexia - blood; Cachexia - mortality; Cachexia - pathology; Cancer; cancer prognosis; Carnosine; carnosine dipeptidase 1; Catabolism; clinical article; cohort analysis; Cohort Studies; controlled study; Design factors; Diabetes; digestive system cancer; Dipeptidase; Dipeptidases - blood; Disease; disease association; enzyme blood level; enzyme immunoassay; Female; Gallbladder diseases; Gastrointestinal cancer; Glioblastoma; Health aspects; Hospitals; human; Humans; Immunoassay; Insulin-like growth factor I; Kirurgi; Laboratories; Male; Malnutrition; Medical diagnosis; Medical prognosis; Metastases; Metastasis; Middle Aged; outcome assessment; Ovarian cancer; Oxidation; Pancreas; Pancreatic cancer; Pancreatitis; Patients; Plasma levels; Prognosis; Prostate cancer; Proteins; Proteomics; Quality of life; Rodents; Science; Screening; somatomedin C; Stomach Neoplasms - blood; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Surgery; Survival Analysis; unclassified drug; validation process; Weight loss; weight reduction
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0123566

Cancer cachexia (CC) is linked to poor prognosis. Although the mechanisms promoting this condition are not known, several circulating proteins have been proposed to contribute. We analyzed the plasma proteome in cancer subjects in order to identify factors associated with cachexia. Plasma was obtained from a screening cohort of 59 patients, newly diagnosed with suspected gastrointestinal cancer, with (n = 32) or without (n = 27) cachexia. Samples were subjected to proteomic profiling using 760 antibodies (targeting 698 individual proteins) from the Human Protein Atlas project. The main findings were validated in a cohort of 93 patients with verified and advanced pancreas cancer. Only six proteins displayed differential plasma levels in the screening cohort. Among these, Carnosine Dipeptidase 1 (CNDP1) was confirmed by sandwich immunoassay to be lower in CC (p = 0.008). In both cohorts, low CNDP1 levels were associated with markers of poor prognosis including weight loss, malnutrition, lipid breakdown, low circulating albumin/IGF1 levels and poor quality of life. Eleven of the subjects in the discovery cohort were finally diagnosed with non-malignant disease but omitting these subjects from the analyses did not have any major influence on the results. In gastrointestinal cancer, reduced plasma levels of CNDP1 associate with signs of catabolism and poor outcome. These results, together with recently published data demonstrating lower circulating CNDP1 in subjects with glioblastoma and metastatic prostate cancer, suggest that CNDP1 may constitute a marker of aggressive cancer and CC.