Abstract

Cancer cachexia is a complex metabolic syndrome affecting approximately 527,100 cancer patients in the US. It results from adaptation to cancer and is characterized by loss of muscle mass with or without loss of fat mass. The two main aims of this research are to investigate the combined effect of resistance training (RT) and citrulline supplementation (CS) on muscle mass and to determine whether this combined regime alter plasma circulating cell free mitochondrial DNA level and mitochondrial respiratory capacity (MRC) in cancer cachexia patients. Eligible participants (Males and Females: Age ≥50 years diagnosed with cancer cachexia) will be divided into four groups (I-IV). Groups III and IV will be supplemented with citrulline (10 g/day × 12 weeks), and Groups II and IV will perform 12 weeks of RT. The outcome variables include muscle mass (muscle hypertrophy and fat free mass using ultrasound), MRC (muscle biopsy using Oxygraph-2K), and quantification of plasma circulating cell free mitochondrial DNA level (using polymerase chain reaction [PCR]). Coupling of RT with CS will provide an innovative intervention to maximize the potential for lean mass increase by mitigating inflammation and protein degradation while concomitantly enhancing protein synthesis and mitochondrial function.