Cancer cachexia induces senescent reprogramming of brown adipose tissue and pro-cachectic S100A9 secretion by adipocytes

Biagio, C. di; Tortolici, F.; Gaudioso, F.; Ninni, A.; Annina, F.G.; Ranieri, C. de; Zaccaria, F.; Sciarretta, F.; Luca, V.; Arciprete, F.; Carotti, S.; Vries, A.A.F. de; Kooijman, S.; Pacello, F.; Battistoni, A.; Lettieri-Barbato, D.; Aquilano, K.

doi:doi:10.1038/s41419-026-08806-x

Cancer-associated cachexia (CAC) is a multifactorial wasting syndrome characterized by progressive loss of fat and lean mass, systemic inflammation, and poor therapeutic responsiveness. While brown adipose tissue (BAT) is traditionally considered a protective, energy-dissipating organ, its qualitative remodeling in CAC remains poorly characterized.Here, we demonstrate that CAC induces a senescent conversion of BAT, marked by thermogenic failure, fibrosis, inflammation, and acquisition of a senescence-associated secretory phenotype (SASP). Through integrative transcriptomic, proteomic, and secretomic analyses in a murine model of lung cancer-induced cachexia, we identify S100A9 as a key factor selectively upregulated and secreted by brown adipocytes. Functional assays reveal that the BAT secretome exerts deleterious paracrine effects on white adipocytes and skeletal myotubes, promoting lipolysis and atrophy, while also impairing brown adipocyte identity in an autocrine manner. Co...Show moreCancer-associated cachexia (CAC) is a multifactorial wasting syndrome characterized by progressive loss of fat and lean mass, systemic inflammation, and poor therapeutic responsiveness. While brown adipose tissue (BAT) is traditionally considered a protective, energy-dissipating organ, its qualitative remodeling in CAC remains poorly characterized.Here, we demonstrate that CAC induces a senescent conversion of BAT, marked by thermogenic failure, fibrosis, inflammation, and acquisition of a senescence-associated secretory phenotype (SASP). Through integrative transcriptomic, proteomic, and secretomic analyses in a murine model of lung cancer-induced cachexia, we identify S100A9 as a key factor selectively upregulated and secreted by brown adipocytes. Functional assays reveal that the BAT secretome exerts deleterious paracrine effects on white adipocytes and skeletal myotubes, promoting lipolysis and atrophy, while also impairing brown adipocyte identity in an autocrine manner. Co-culture and gain-of-function experiments with S100A9 recapitulate these phenotypes in vitro in mouse and human brown adipocytes, whereas pharmacological blockade of S100A9 signaling partially restores thermogenic and metabolic features. Collectively, our findings reveal that BAT undergoes functional reprogramming into a senescent and secretory tissue in cancer cachexia, with adipocyte-derived S100A9 acting as a novel pro-cachectic mediator. This work redefines the role of BAT in CAC and identifies S100A9 as a potential therapeutic target within the adipose-muscle crosstalk.Show less

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Cancer cachexia induces senescent reprogramming of brown adipose tissue and pro-cachectic S100A9 secretion by adipocytes