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Muscle weakness and mitochondrial stress occur before severe metastasis in a novel mouse model of ovarian cancer cachexia
A high proportion of women with advanced epithelial ovarian cancer (EOC) experience weakness and cachexia. This relationship is associated with increased morbidity and mortality. EOC is the most lethal gynecological cancer, yet no preclinical cachexia model has demonstrated the combined hallmark fea...
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Published in: | Molecular metabolism (Germany) 2024-08, Vol.86, p.101976, Article 101976 |
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creator | Delfinis, Luca J. Ogilvie, Leslie M. Khajehzadehshoushtar, Shahrzad Gandhi, Shivam Garibotti, Madison C. Thuhan, Arshdeep K. Matuszewska, Kathy Pereira, Madison Jones, Ronald G. Cheng, Arthur J. Hawke, Thomas J. Greene, Nicholas P. Murach, Kevin A. Simpson, Jeremy A. Petrik, Jim Perry, Christopher G.R. |
description | A high proportion of women with advanced epithelial ovarian cancer (EOC) experience weakness and cachexia. This relationship is associated with increased morbidity and mortality. EOC is the most lethal gynecological cancer, yet no preclinical cachexia model has demonstrated the combined hallmark features of metastasis, ascites development, muscle loss and weakness in adult immunocompetent mice.
Here, we evaluated a new model of ovarian cancer-induced cachexia with the advantages of inducing cancer in adult immunocompetent C57BL/6J mice through orthotopic injections of EOC cells in the ovarian bursa. We characterized the development of metastasis, ascites, muscle atrophy, muscle weakness, markers of inflammation, and mitochondrial stress in the tibialis anterior (TA) and diaphragm ∼45, ∼75 and ∼90 days after EOC injection.
Primary ovarian tumour sizes were progressively larger at each time point while severe metastasis, ascites development, and reductions in body, fat and muscle weights occurred by 90 Days. There were no changes in certain inflammatory (TNFα), atrogene (MURF1 and Atrogin) or GDF15 markers within both muscles whereas IL-6 was increased at 45 and 90 Day groups in the diaphragm. TA weakness in 45 Day preceded atrophy and metastasis that were observed later (75 and 90 Day, respectively). The diaphragm demonstrated both weakness and atrophy in 45 Day. In both muscles, this pre-severe-metastatic muscle weakness corresponded with considerable reprogramming of gene pathways related to mitochondrial bioenergetics as well as reduced functional measures of mitochondrial pyruvate oxidation and creatine-dependent ADP/ATP cycling as well as increased reactive oxygen species emission (hydrogen peroxide). Remarkably, muscle force per unit mass at 90 days was partially restored in the TA despite the presence of atrophy and severe metastasis. In contrast, the diaphragm demonstrated progressive weakness. At this advanced stage, mitochondrial pyruvate oxidation in both muscles exceeded control mice suggesting an apparent metabolic super-compensation corresponding with restored indices of creatine-dependent adenylate cycling.
This mouse model demonstrates the concurrent development of cachexia and metastasis that occurs in women with EOC. The model provides physiologically relevant advantages of inducing tumour development within the ovarian bursa in immunocompetent adult mice. Moreover, the model reveals that muscle weakness in both TA and diaphragm precedes s |
doi_str_mv | 10.1016/j.molmet.2024.101976 |
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Here, we evaluated a new model of ovarian cancer-induced cachexia with the advantages of inducing cancer in adult immunocompetent C57BL/6J mice through orthotopic injections of EOC cells in the ovarian bursa. We characterized the development of metastasis, ascites, muscle atrophy, muscle weakness, markers of inflammation, and mitochondrial stress in the tibialis anterior (TA) and diaphragm ∼45, ∼75 and ∼90 days after EOC injection.
Primary ovarian tumour sizes were progressively larger at each time point while severe metastasis, ascites development, and reductions in body, fat and muscle weights occurred by 90 Days. There were no changes in certain inflammatory (TNFα), atrogene (MURF1 and Atrogin) or GDF15 markers within both muscles whereas IL-6 was increased at 45 and 90 Day groups in the diaphragm. TA weakness in 45 Day preceded atrophy and metastasis that were observed later (75 and 90 Day, respectively). The diaphragm demonstrated both weakness and atrophy in 45 Day. In both muscles, this pre-severe-metastatic muscle weakness corresponded with considerable reprogramming of gene pathways related to mitochondrial bioenergetics as well as reduced functional measures of mitochondrial pyruvate oxidation and creatine-dependent ADP/ATP cycling as well as increased reactive oxygen species emission (hydrogen peroxide). Remarkably, muscle force per unit mass at 90 days was partially restored in the TA despite the presence of atrophy and severe metastasis. In contrast, the diaphragm demonstrated progressive weakness. At this advanced stage, mitochondrial pyruvate oxidation in both muscles exceeded control mice suggesting an apparent metabolic super-compensation corresponding with restored indices of creatine-dependent adenylate cycling.
This mouse model demonstrates the concurrent development of cachexia and metastasis that occurs in women with EOC. The model provides physiologically relevant advantages of inducing tumour development within the ovarian bursa in immunocompetent adult mice. Moreover, the model reveals that muscle weakness in both TA and diaphragm precedes severe metastasis while weakness also precedes atrophy in the TA. An underlying mitochondrial bioenergetic stress corresponded with this early weakness. Collectively, these discoveries can direct new research towards the development of therapies that target pre-atrophy and pre-severe-metastatic weakness during EOC in addition to therapies targeting cachexia.
•This is the first inducible orthotopic model of metastatic ovarian cancer cachexia in adult immunocompetent mice.•Diaphragm and limb muscle weakness precedes severe metastasis and atrophy during ovarian cancer.•Skeletal muscle mitochondrial oxidative and redox stress occur during pre-severe-metastatic stages of ovarian cancer.•Specific muscle force, mitochondrial pyruvate oxidation and creatine metabolism demonstrate compensation in later stages.•Ovarian cancer has heterogeneous effects on distinct muscle types across time.</description><identifier>ISSN: 2212-8778</identifier><identifier>EISSN: 2212-8778</identifier><identifier>DOI: 10.1016/j.molmet.2024.101976</identifier><identifier>PMID: 38925248</identifier><language>eng</language><publisher>Germany: Elsevier GmbH</publisher><subject>Animals ; Cachexia - etiology ; Cachexia - metabolism ; Cachexia - pathology ; Carcinoma, Ovarian Epithelial - metabolism ; Carcinoma, Ovarian Epithelial - pathology ; Cell Line, Tumor ; Disease Models, Animal ; Female ; Metastasis ; Mice ; Mice, Inbred C57BL ; Mitochondria ; Mitochondria - metabolism ; Mitochondria - pathology ; Muscle Weakness - etiology ; Muscle Weakness - metabolism ; Muscle, Skeletal - metabolism ; Muscle, Skeletal - pathology ; Muscular Atrophy - etiology ; Muscular Atrophy - metabolism ; Muscular Atrophy - pathology ; Neoplasm Metastasis ; Ovarian cancer cachexia ; Ovarian Neoplasms - complications ; Ovarian Neoplasms - metabolism ; Ovarian Neoplasms - pathology ; Skeletal muscle</subject><ispartof>Molecular metabolism (Germany), 2024-08, Vol.86, p.101976, Article 101976</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c287t-a3b78c548f69abbce54e7441e8eef1ff27e37621495e581a9c5e2a96167c35503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2212877824001078$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3549,27924,27925,45780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38925248$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Delfinis, Luca J.</creatorcontrib><creatorcontrib>Ogilvie, Leslie M.</creatorcontrib><creatorcontrib>Khajehzadehshoushtar, Shahrzad</creatorcontrib><creatorcontrib>Gandhi, Shivam</creatorcontrib><creatorcontrib>Garibotti, Madison C.</creatorcontrib><creatorcontrib>Thuhan, Arshdeep K.</creatorcontrib><creatorcontrib>Matuszewska, Kathy</creatorcontrib><creatorcontrib>Pereira, Madison</creatorcontrib><creatorcontrib>Jones, Ronald G.</creatorcontrib><creatorcontrib>Cheng, Arthur J.</creatorcontrib><creatorcontrib>Hawke, Thomas J.</creatorcontrib><creatorcontrib>Greene, Nicholas P.</creatorcontrib><creatorcontrib>Murach, Kevin A.</creatorcontrib><creatorcontrib>Simpson, Jeremy A.</creatorcontrib><creatorcontrib>Petrik, Jim</creatorcontrib><creatorcontrib>Perry, Christopher G.R.</creatorcontrib><title>Muscle weakness and mitochondrial stress occur before severe metastasis in a novel mouse model of ovarian cancer cachexia</title><title>Molecular metabolism (Germany)</title><addtitle>Mol Metab</addtitle><description>A high proportion of women with advanced epithelial ovarian cancer (EOC) experience weakness and cachexia. This relationship is associated with increased morbidity and mortality. EOC is the most lethal gynecological cancer, yet no preclinical cachexia model has demonstrated the combined hallmark features of metastasis, ascites development, muscle loss and weakness in adult immunocompetent mice.
Here, we evaluated a new model of ovarian cancer-induced cachexia with the advantages of inducing cancer in adult immunocompetent C57BL/6J mice through orthotopic injections of EOC cells in the ovarian bursa. We characterized the development of metastasis, ascites, muscle atrophy, muscle weakness, markers of inflammation, and mitochondrial stress in the tibialis anterior (TA) and diaphragm ∼45, ∼75 and ∼90 days after EOC injection.
Primary ovarian tumour sizes were progressively larger at each time point while severe metastasis, ascites development, and reductions in body, fat and muscle weights occurred by 90 Days. There were no changes in certain inflammatory (TNFα), atrogene (MURF1 and Atrogin) or GDF15 markers within both muscles whereas IL-6 was increased at 45 and 90 Day groups in the diaphragm. TA weakness in 45 Day preceded atrophy and metastasis that were observed later (75 and 90 Day, respectively). The diaphragm demonstrated both weakness and atrophy in 45 Day. In both muscles, this pre-severe-metastatic muscle weakness corresponded with considerable reprogramming of gene pathways related to mitochondrial bioenergetics as well as reduced functional measures of mitochondrial pyruvate oxidation and creatine-dependent ADP/ATP cycling as well as increased reactive oxygen species emission (hydrogen peroxide). Remarkably, muscle force per unit mass at 90 days was partially restored in the TA despite the presence of atrophy and severe metastasis. In contrast, the diaphragm demonstrated progressive weakness. At this advanced stage, mitochondrial pyruvate oxidation in both muscles exceeded control mice suggesting an apparent metabolic super-compensation corresponding with restored indices of creatine-dependent adenylate cycling.
This mouse model demonstrates the concurrent development of cachexia and metastasis that occurs in women with EOC. The model provides physiologically relevant advantages of inducing tumour development within the ovarian bursa in immunocompetent adult mice. Moreover, the model reveals that muscle weakness in both TA and diaphragm precedes severe metastasis while weakness also precedes atrophy in the TA. An underlying mitochondrial bioenergetic stress corresponded with this early weakness. Collectively, these discoveries can direct new research towards the development of therapies that target pre-atrophy and pre-severe-metastatic weakness during EOC in addition to therapies targeting cachexia.
•This is the first inducible orthotopic model of metastatic ovarian cancer cachexia in adult immunocompetent mice.•Diaphragm and limb muscle weakness precedes severe metastasis and atrophy during ovarian cancer.•Skeletal muscle mitochondrial oxidative and redox stress occur during pre-severe-metastatic stages of ovarian cancer.•Specific muscle force, mitochondrial pyruvate oxidation and creatine metabolism demonstrate compensation in later stages.•Ovarian cancer has heterogeneous effects on distinct muscle types across time.</description><subject>Animals</subject><subject>Cachexia - etiology</subject><subject>Cachexia - metabolism</subject><subject>Cachexia - pathology</subject><subject>Carcinoma, Ovarian Epithelial - metabolism</subject><subject>Carcinoma, Ovarian Epithelial - pathology</subject><subject>Cell Line, Tumor</subject><subject>Disease Models, Animal</subject><subject>Female</subject><subject>Metastasis</subject><subject>Mice</subject><subject>Mice, Inbred C57BL</subject><subject>Mitochondria</subject><subject>Mitochondria - metabolism</subject><subject>Mitochondria - pathology</subject><subject>Muscle Weakness - etiology</subject><subject>Muscle Weakness - metabolism</subject><subject>Muscle, Skeletal - metabolism</subject><subject>Muscle, Skeletal - pathology</subject><subject>Muscular Atrophy - etiology</subject><subject>Muscular Atrophy - metabolism</subject><subject>Muscular Atrophy - pathology</subject><subject>Neoplasm Metastasis</subject><subject>Ovarian cancer cachexia</subject><subject>Ovarian Neoplasms - complications</subject><subject>Ovarian Neoplasms - metabolism</subject><subject>Ovarian Neoplasms - pathology</subject><subject>Skeletal muscle</subject><issn>2212-8778</issn><issn>2212-8778</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kF1LwzAUhoMoTub-gUguvdlM0uajN4KIXzDxRq9Dmp6yzLaZSTvdvzejKl4ZAu8h5z0feRA6o2RBCRWX60Xrmxb6BSMs3z8VUhygE8Yomysp1eGfeIJmMa5JOkoIwekxmmSqYJzl6gTtnoZoG8AfYN46iBGbrsKt671d-a4KzjQ49mGf8NYOAZdQ-wA4whaSpA1MTNdF7DpscOe30ODWDzHlfJViX2O_NalPh63pLIQkdgWfzpyio9o0EWbfOkWvd7cvNw_z5fP94831cm6Zkv3cZKVUlueqFoUpSws8B5nnFBRATeuaScikYDQvOHBFTWE5MFMIKqTNOCfZFF2MfTfBvw8Qe926aKFpTAdpUZ0RyRQhlNJkzUerDT7GALXeBNeasNOU6D13vdYjd73nrkfuqez8e8JQtlD9Fv1QToar0QDpn1sHQUfrINGoXADb68q7_yd8AefCl3A</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Delfinis, Luca J.</creator><creator>Ogilvie, Leslie M.</creator><creator>Khajehzadehshoushtar, Shahrzad</creator><creator>Gandhi, Shivam</creator><creator>Garibotti, Madison C.</creator><creator>Thuhan, Arshdeep K.</creator><creator>Matuszewska, Kathy</creator><creator>Pereira, Madison</creator><creator>Jones, Ronald G.</creator><creator>Cheng, Arthur J.</creator><creator>Hawke, Thomas J.</creator><creator>Greene, Nicholas P.</creator><creator>Murach, Kevin A.</creator><creator>Simpson, Jeremy A.</creator><creator>Petrik, Jim</creator><creator>Perry, Christopher G.R.</creator><general>Elsevier GmbH</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202408</creationdate><title>Muscle weakness and mitochondrial stress occur before severe metastasis in a novel mouse model of ovarian cancer cachexia</title><author>Delfinis, Luca J. ; Ogilvie, Leslie M. ; Khajehzadehshoushtar, Shahrzad ; Gandhi, Shivam ; Garibotti, Madison C. ; Thuhan, Arshdeep K. ; Matuszewska, Kathy ; Pereira, Madison ; Jones, Ronald G. ; Cheng, Arthur J. ; Hawke, Thomas J. ; Greene, Nicholas P. ; Murach, Kevin A. ; Simpson, Jeremy A. ; Petrik, Jim ; Perry, Christopher G.R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c287t-a3b78c548f69abbce54e7441e8eef1ff27e37621495e581a9c5e2a96167c35503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Animals</topic><topic>Cachexia - etiology</topic><topic>Cachexia - metabolism</topic><topic>Cachexia - pathology</topic><topic>Carcinoma, Ovarian Epithelial - metabolism</topic><topic>Carcinoma, Ovarian Epithelial - pathology</topic><topic>Cell Line, Tumor</topic><topic>Disease Models, Animal</topic><topic>Female</topic><topic>Metastasis</topic><topic>Mice</topic><topic>Mice, Inbred C57BL</topic><topic>Mitochondria</topic><topic>Mitochondria - metabolism</topic><topic>Mitochondria - pathology</topic><topic>Muscle Weakness - etiology</topic><topic>Muscle Weakness - metabolism</topic><topic>Muscle, Skeletal - metabolism</topic><topic>Muscle, Skeletal - pathology</topic><topic>Muscular Atrophy - etiology</topic><topic>Muscular Atrophy - metabolism</topic><topic>Muscular Atrophy - pathology</topic><topic>Neoplasm Metastasis</topic><topic>Ovarian cancer cachexia</topic><topic>Ovarian Neoplasms - complications</topic><topic>Ovarian Neoplasms - metabolism</topic><topic>Ovarian Neoplasms - pathology</topic><topic>Skeletal muscle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Delfinis, Luca J.</creatorcontrib><creatorcontrib>Ogilvie, Leslie M.</creatorcontrib><creatorcontrib>Khajehzadehshoushtar, Shahrzad</creatorcontrib><creatorcontrib>Gandhi, Shivam</creatorcontrib><creatorcontrib>Garibotti, Madison C.</creatorcontrib><creatorcontrib>Thuhan, Arshdeep K.</creatorcontrib><creatorcontrib>Matuszewska, Kathy</creatorcontrib><creatorcontrib>Pereira, Madison</creatorcontrib><creatorcontrib>Jones, Ronald G.</creatorcontrib><creatorcontrib>Cheng, Arthur J.</creatorcontrib><creatorcontrib>Hawke, Thomas J.</creatorcontrib><creatorcontrib>Greene, Nicholas P.</creatorcontrib><creatorcontrib>Murach, Kevin A.</creatorcontrib><creatorcontrib>Simpson, Jeremy A.</creatorcontrib><creatorcontrib>Petrik, Jim</creatorcontrib><creatorcontrib>Perry, Christopher G.R.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Molecular metabolism (Germany)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Delfinis, Luca J.</au><au>Ogilvie, Leslie M.</au><au>Khajehzadehshoushtar, Shahrzad</au><au>Gandhi, Shivam</au><au>Garibotti, Madison C.</au><au>Thuhan, Arshdeep K.</au><au>Matuszewska, Kathy</au><au>Pereira, Madison</au><au>Jones, Ronald G.</au><au>Cheng, Arthur J.</au><au>Hawke, Thomas J.</au><au>Greene, Nicholas P.</au><au>Murach, Kevin A.</au><au>Simpson, Jeremy A.</au><au>Petrik, Jim</au><au>Perry, Christopher G.R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Muscle weakness and mitochondrial stress occur before severe metastasis in a novel mouse model of ovarian cancer cachexia</atitle><jtitle>Molecular metabolism (Germany)</jtitle><addtitle>Mol Metab</addtitle><date>2024-08</date><risdate>2024</risdate><volume>86</volume><spage>101976</spage><pages>101976-</pages><artnum>101976</artnum><issn>2212-8778</issn><eissn>2212-8778</eissn><abstract>A high proportion of women with advanced epithelial ovarian cancer (EOC) experience weakness and cachexia. This relationship is associated with increased morbidity and mortality. EOC is the most lethal gynecological cancer, yet no preclinical cachexia model has demonstrated the combined hallmark features of metastasis, ascites development, muscle loss and weakness in adult immunocompetent mice.
Here, we evaluated a new model of ovarian cancer-induced cachexia with the advantages of inducing cancer in adult immunocompetent C57BL/6J mice through orthotopic injections of EOC cells in the ovarian bursa. We characterized the development of metastasis, ascites, muscle atrophy, muscle weakness, markers of inflammation, and mitochondrial stress in the tibialis anterior (TA) and diaphragm ∼45, ∼75 and ∼90 days after EOC injection.
Primary ovarian tumour sizes were progressively larger at each time point while severe metastasis, ascites development, and reductions in body, fat and muscle weights occurred by 90 Days. There were no changes in certain inflammatory (TNFα), atrogene (MURF1 and Atrogin) or GDF15 markers within both muscles whereas IL-6 was increased at 45 and 90 Day groups in the diaphragm. TA weakness in 45 Day preceded atrophy and metastasis that were observed later (75 and 90 Day, respectively). The diaphragm demonstrated both weakness and atrophy in 45 Day. In both muscles, this pre-severe-metastatic muscle weakness corresponded with considerable reprogramming of gene pathways related to mitochondrial bioenergetics as well as reduced functional measures of mitochondrial pyruvate oxidation and creatine-dependent ADP/ATP cycling as well as increased reactive oxygen species emission (hydrogen peroxide). Remarkably, muscle force per unit mass at 90 days was partially restored in the TA despite the presence of atrophy and severe metastasis. In contrast, the diaphragm demonstrated progressive weakness. At this advanced stage, mitochondrial pyruvate oxidation in both muscles exceeded control mice suggesting an apparent metabolic super-compensation corresponding with restored indices of creatine-dependent adenylate cycling.
This mouse model demonstrates the concurrent development of cachexia and metastasis that occurs in women with EOC. The model provides physiologically relevant advantages of inducing tumour development within the ovarian bursa in immunocompetent adult mice. Moreover, the model reveals that muscle weakness in both TA and diaphragm precedes severe metastasis while weakness also precedes atrophy in the TA. An underlying mitochondrial bioenergetic stress corresponded with this early weakness. Collectively, these discoveries can direct new research towards the development of therapies that target pre-atrophy and pre-severe-metastatic weakness during EOC in addition to therapies targeting cachexia.
•This is the first inducible orthotopic model of metastatic ovarian cancer cachexia in adult immunocompetent mice.•Diaphragm and limb muscle weakness precedes severe metastasis and atrophy during ovarian cancer.•Skeletal muscle mitochondrial oxidative and redox stress occur during pre-severe-metastatic stages of ovarian cancer.•Specific muscle force, mitochondrial pyruvate oxidation and creatine metabolism demonstrate compensation in later stages.•Ovarian cancer has heterogeneous effects on distinct muscle types across time.</abstract><cop>Germany</cop><pub>Elsevier GmbH</pub><pmid>38925248</pmid><doi>10.1016/j.molmet.2024.101976</doi><oa>free_for_read</oa></addata></record> |
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subjects | Animals Cachexia - etiology Cachexia - metabolism Cachexia - pathology Carcinoma, Ovarian Epithelial - metabolism Carcinoma, Ovarian Epithelial - pathology Cell Line, Tumor Disease Models, Animal Female Metastasis Mice Mice, Inbred C57BL Mitochondria Mitochondria - metabolism Mitochondria - pathology Muscle Weakness - etiology Muscle Weakness - metabolism Muscle, Skeletal - metabolism Muscle, Skeletal - pathology Muscular Atrophy - etiology Muscular Atrophy - metabolism Muscular Atrophy - pathology Neoplasm Metastasis Ovarian cancer cachexia Ovarian Neoplasms - complications Ovarian Neoplasms - metabolism Ovarian Neoplasms - pathology Skeletal muscle |
title | Muscle weakness and mitochondrial stress occur before severe metastasis in a novel mouse model of ovarian cancer cachexia |
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