Patients with aggressive cancer, e.g., gastrointestinal cancer, are prone (≥50% chance) to developing cancer cachexia (CC). Little is known about the effects of CC on the biomechanical function of muscle. A promising prevention strategy was found in the form of a multi-modal therapy combining mild resistance exercise (e.g., whole-body electro-myostimulation, WB-EMS) and a protein-rich diet. In a previous study of ours, this was effective in counteracting the loss of muscle mass, yet a systematic and comprehensive assessment of active and passive single muscle fibre functions was so far absent. This pilot study investigated the biomechanical function of single muscle fibres (rectus abdominis) from the biopsies of conventionally treated (pre-)cachectic cancer ((pre-)CC) patients (m = 9), those receiving the multi-modal therapy comprising WB-EMS training and protein-rich nutrition (m = 3), and a control group (m = 5). Our findings not only align with previous findings showing the absolute force loss in CC that is accelerated by atrophy but also speak in favour of a different, potentially energy- and Ca2+-homeostasis-related effect that compromises muscle contraction (F ~0.9 mN vs. F ~0.6 mN in control patients). However, myofibrillar Ca2+sensitivity and the quality of contraction were unaltered (pCa50: 5.6–5.8). Single fibres from the (pre-)CC patients receiving WB-EMS training and protein supplementation were significantly more compliant (p< 0.001 at ≥130% of resting length L0). Those fibres displayed a similar softness to the ones from the control patients (axial compliance ~15 m/N at ≥130% L0), while single fibres from the patients with (developing) cachexia were significantly stiffer (axial compliance ~7 m/N,p< 0.001 at ≥130% L0). Adjuvant multi-modal therapy (WB-EMS training and nutritional support) contributes to maintaining the axial compliance of single fibres and potentially improves the quality of life for patients at risk of developing CC.
侵袭性癌症（如胃肠道癌症）患者发生癌性恶病质（CC）的风险较高（概率≥50%）。目前关于CC对肌肉生物力学功能影响的研究尚不充分。一种结合轻度抗阻运动（如全身电肌肉刺激，WB-EMS）与高蛋白饮食的多模式疗法显示出良好的预防潜力。我们前期的研究表明该疗法能有效减缓肌肉质量流失，但迄今缺乏对活性与被动性单肌纤维功能的系统全面评估。本试点研究通过活检样本，分析了常规治疗的（前期）恶病质癌症患者（m=9）、接受WB-EMS训练联合高蛋白营养多模式治疗的患者（m=3）及对照组（m=5）腹直肌单肌纤维的生物力学功能。研究结果不仅验证了既往发现的CC患者因肌肉萎缩导致的绝对肌力加速丧失现象，还提示存在另一种可能涉及能量与钙离子稳态的机制损害肌肉收缩功能（恶病质患者F~0.6 mN vs. 对照组F~0.9 mN）。但肌原纤维钙敏感性（pCa50: 5.6–5.8）与收缩质量未发生改变。接受WB-EMS训练与蛋白质补充的（前期）CC患者单肌纤维顺应性显著增强（在≥130%静息长度L0时p<0.001），其柔软度与对照组纤维相近（轴向顺应性~15 m/N），而恶病质（进展期）患者单肌纤维则显著僵硬（轴向顺应性~7 m/N，p<0.001）。辅助性多模式疗法（WB-EMS训练与营养支持）有助于维持单肌纤维轴向顺应性，并可能改善CC风险患者的生活质量。
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