The sphingolipids are a family of membrane lipids with only a structural role, influencing lipid bilayer properties, but they also act as effector molecules with essential roles in many aspects of cell biology. The sphingolipids ceramide, sphingosine and S1P have shown opposite effects: whereas ceramide and sphingosine usually inhibit proliferation and promote apoptotic responses to different stress stimuli, S1P is known to stimulate cell growth, and promote cell survival. Ceramide can be produced through the de novo synthesis pathway, and by membrane sphingomyelin hydrolysis catalyzed by sphingomyelinases. Both pathways can be activated by the pro-inflammatory cytokine TNFa. Because this cytokine has been shown to promote muscle loss and seems to be crucial in the development of cachexia, we hypothesized that the formation of ceramide, or a metabolite, can be involved in tumor-induced muscle wasting. We investigated the role of ceramide in the in vitro atrophic effects of TNFa on differentiated C2C12 myotubes, by using cell permeant ceramides and inhibitors of sphingolipid metabolism. We observed that TNFa atrophic effects, as evaluated by the reduction in myotube area, are mimicked by exogenous ceramides, supporting the idea that ceramide can participate in muscle atrophy. To verify if ceramide is a mediator of TNFa-induced atrophy, and to identify the metabolites potentially involved, we analyzed the effects of drugs able to block sphingolipid metabolism at different steps: the inhibition of de novo synthesis pathway was unable to restore myotube size in the presence of TNFa whereas the inhibitors of neutral sphingomyelinases reversed TNFa-induced atrophy. Moreover, an accumulation of ceramide and sphingosine induced pro-atrophic effects, whereas sphingosine-1-phosphate had a protective effect. These observations establish that in C2C12 myotubes, ceramide or other downstream metabolites such as sphingosine, produced by the neutral sphingomyelinase pathway in response to TNFa stimulation, participate in cell atrophy. To evaluate the in vivo role of sphingolipids, we treated BalbC mice carrying C26 adenocarcinoma woth Myriocin, an inhibitor of the de novo pathway of ceramide synthesis, that is able to deplete muscle tissue in all sphingolipids, was administered daily to the animals. This treatment partially protected animals against tumor-induced loss of body weight and muscle weight, without affecting the size of tumors. Moreover, myriocin treatment significantly reversed the decrease in myofiber size associated with tumor development, and reduced the expression of atrogenes Foxo3 and Atrogin-1, showing that it was able to protect against muscle atrophy. These results strongly suggest that ceramide, or a downstream sphingolipid metabolite, is involved in tumor-induced muscle atrophy. The sphingolipid pathway thus appears as a new potential target of pharmacological interventions aiming at protecting muscle tissue against atrophy.
