A conundrum for use v. non-use of specific amino acids in muscle atrophy and immune support for CLL patients

[Higsby]

CLL and cancer patients, particularly those over 70, are often concerned about muscle wasting or muscle atrophy. Sarcopenia is characterized as the progressive loss of muscle mass that is typically associated with aging.

These patients are frequently advised to increase their intake of dietary proteins [amino acids] and to increase their participation in resistance exercises. Some cancer and CLL patients experience chronic fatigue and don’t or can’t always adhere to an exercise regimen.

Those patients who really want to increase their muscle mass will exercise regularly and may consume body-building proteins, like the branched-chained amino acids - leucine, isoleucine, and valine; arginine; lysine; methionine; and glutamine. [ harcourthealth.com/5-of-the... ]. Others have suggested the inclusion the other 9 essential amino acids [ fitnesshacks.org/9-essentia... ] as well as a diet that includes dairy, eggs, meat, and fish - animal protein. Still other observers include beta-alanine; creatine monohydrate; and, HMB, a metabolite of leucine, among the top bodybuilding supplements.

It should be noted that there is a strong similarity of foods which are high in methionine, glutamine, and the peptide hormone IGF-1, which is purportedly a promoter of cell growth. The similar foods for the three proteins include lean beef, lamb, turkey, chicken, pork, fish, eggs and dairy. Foods high in casein, the protein found in the milk of mammals, is contained in similar dairy foods.

Here is the issue! There have been a number of articles, some anecdotal advocacy, but some in peer-reviewed journals that suggest that glutamine, methionine, and IGF-1 may promote the growth of cancerous and non-cancerous cells. Some sources [ nutritionfacts.org/ ] advocate a plant-based diet; and, avoid eggs, dairy, processed meats, and cooking meat at high temperatures, such as in outdoor grilling.

It is recognized that glucose is the primary “fuel” for glycolysis metabolism of cancerous cells, but that if a patient avoids glucose [sugars] to lessen the speed of growth of CLL cells, the CLL cells may likely adapt to metabolizing amino acids such as glutamine or serine for its fuel needed for cell proliferation.

So the conundrum is “should the aging CLL patient who wants to minimize muscle atrophy and/or increase their lean muscle mass avoid these animal and dairy protein foods as well as bodybuilding supplements, or is there a middle ground”? Three relatively recent peer-reviewed articles, cited below, shed some light on the questions poised herein, but do not provide definitive guidance.

• Targeting Glucose Metabolism and Compensatory Metabolic Resistance in CLL, Nov. 16, 2012, Blood ashpublications.org/blood/a...

• Metabolic rewiring beyond Warburg in chronic lymphocytic leukemia: How much do we actually know, Critical Reviews in Oncology/Hematology, Volume 134, February 2019, Pages 65-70 sciencedirect.com/science/a...

• The role of mTOR-mediated signaling in the regulation of cellular migration, Immunology Letters, Vol. 196, April 2018, pp. 74-79. sciencedirect.com/science/a...

Maybe one of you geniuses can shed some light on this issue in a clear easy to understand manner.

Higsby

[PlanetaryKim]

Thank you! Very interesting question. I have wondered about this.

[seelel]

The Warburg Effect has been kicked around for a long time now and I think that some CLL research was done that demonstrated that the cell's primary energy source was not through glycolysis as with solid tumours.

I think CLL cells are extremely adaptive to changing conditions so they may have a few energy producing tricks up their sleeve.

I'm pushing 73 and have experienced a loss of muscle mass. However, it doesn't seem to affect me doing manual work around the house and garden. So much that is published is based on standardisation of the human body, so I'm not sure what age and what muscle mass is used as the median in these discussions. Naturally a body past 70 must differ from a body past 50.

I've been a vegetarian for 50 years of which the past 5 years have been plant based only. I feel fine, and all the research papers in the world may not convince me that I shouldn't be.

I guess I have a love / hate relationship with science. It can be so good yet sometimes soooo vague as to being worthless.

Anyway, I'll be pleased to see whether anyone answers your questions. I'd also like to know the answers.

[Jm954 Administrator]

This is very complex and there are a great many unknowns in terms of metabolic pathways and their alternatives in CLL cell. These may also be specific to certain genetic lesions such as 11qdel and TP53 as discussed in one of these papers.

Perhaps the old mantra of ‘moderation in all things’ applies as much to this as anything else. So, specific supplements may be best avoided whilst maintaining a diet and exercise plan aimed at general well-being.

Jackie