We have previously demonstrated that parathyroid hormone-related protein (PTHrP) is a cachexia inducer, but it is still not
known what PTHrP effects on target tissues induce the cachexia. Therefore, we examined the effects of anti-PTHrP antibody
and osteoprotegerin (OPG) on PTHrP-producing tumor-induced cachexia. Nude mice bearing PTHrP-producing human lung cancer cells
(HARA-B) exhibited cachexia with hypercalcemia 3–4 weeks after inoculation, accompanied by losses in body, adipose tissue,
and muscle weight. OPG ameliorated hypercalcemia, as did neutralization of PTHrP with antibody; and it increased both body
and adipose tissue weights. These increases in body and adipose tissue weight, however, were significantly less than those
in mice treated with anti-PTHrP antibody. Simultaneous administration of OPG and anti-PTHrP antibody caused significant increases
in body, adipose tissue, and muscle weight, along with an immediate decrease in blood ionized calcium levels. The increase
in body weight was similar to that observed in mice treated with anti-PTHrP antibody alone, and the decrease in the blood
ionized calcium levels was significantly greater than that in mice treated with OPG or anti-PTHrP antibody alone. These results
suggest that an effect of PTHrP on target tissues other than hypercalcemia is involved in the development of cachexia. Expression
of cachexia-inducing proinflammatory cytokines (interleukin-6 and leukemia inhibitory factor) is stimulated by PTHrP. This
might be a mechanism by which PTHrP produces tumor-induced cachexia. It is also suggested that OPG and anti-PTHrP antibody
synergistically act to ameliorate hypercalcemia, although the mechanism responsible for this is unclear.
Key words PTHrP - cachexia - hypercalcemia - osteoprotegerin - anti-PTHrP antibody