Histidine decarboxylase inhibition attenuates cancer-associated muscle wasting

J Exp Med. 2025 Sep 1;222(9):e20242239. doi: 10.1084/jem.20242239. Epub 2025 Jul 2.

Abstract

Cancer cachexia is a multifactorial syndrome involving muscle and fat wasting, inflammation, and metabolic dysfunction. Across cancer subtypes, pancreatic cancer has one of the highest cachexia incidence rates at ∼80%. Given the advanced age of most pancreatic cancer patients, we sought to query cancer-associated muscle wasting using an age-matched murine model. We found that histamine and histamine decarboxylase (HDC) activity were specifically elevated in the muscles of aged tumor-bearing mice. We further found that (1) wasting stimuli induced histamine production and enhanced HDC activity; (2) exogenous histamine was sufficient to induce atrophy-associated gene expression; (3) inhibition of HDC activity by α-fluoromethylhistidine (FMH) protected against atrophy; (4) treatment of tumor-bearing mice with FMH rescued muscle wasting; and (5) a calcineurin inhibitor was able to rescue histamine-associated increases in calcium/atrogene signaling. In summary, we present a novel metabolic pathway that has significant implications for the treatment of cachectic cancer patients.

MeSH terms

  • Animals
  • Cachexia* / drug therapy
  • Cachexia* / etiology
  • Histamine / metabolism
  • Histidine Decarboxylase* / antagonists & inhibitors
  • Histidine Decarboxylase* / metabolism
  • Humans
  • Male
  • Methylhistidines / pharmacology
  • Mice
  • Mice, Inbred C57BL
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / metabolism
  • Muscle, Skeletal / pathology
  • Muscular Atrophy* / drug therapy
  • Muscular Atrophy* / enzymology
  • Muscular Atrophy* / etiology
  • Muscular Atrophy* / pathology
  • Neoplasms* / complications
  • Pancreatic Neoplasms* / complications
  • Pancreatic Neoplasms* / pathology

Substances

  • Histidine Decarboxylase
  • Histamine
  • Methylhistidines