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YAP disrupts bile acid homeostasis to drive cancer-associated cachexia

Madeline L Webb, Mikaela Wong, Anthony P Karamalakis, Yuchen Liu, View ORCID ProfileKimberley J Evason, Kira X Sun, View ORCID ProfileKristin Brown, View ORCID ProfileJay R Black, View ORCID ProfileYingzi Yang, View ORCID ProfileAndrew G Cox
doi: https://doi.org/10.64898/2026.02.01.702698
Madeline L Webb
1 Peter MacCallum Cancer Centre;
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Mikaela Wong
1 Peter MacCallum Cancer Centre;
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Anthony P Karamalakis
1 Peter MacCallum Cancer Centre;
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Yuchen Liu
2 Harvard School of Dental Medicine;
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Kimberley J Evason
3 University of Utah;
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Kira X Sun
4 BGI-Australia;
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Kristin Brown
1 Peter MacCallum Cancer Centre;
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Jay R Black
5 The University of Melbourne
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Yingzi Yang
2 Harvard School of Dental Medicine;
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Andrew G Cox
1 Peter MacCallum Cancer Centre;
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  • For correspondence: andrew.cox{at}petermac.org
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Abstract

Cancer-associated cachexia is a severe metabolic syndrome marked by dramatic loss of adipose and muscle mass. Although preclinical models have advanced our understanding of cachexia, there are still no approved therapies due to the limited insights into the mechanisms underlying tissue wasting. Here, we utilise a YAP-driven model of liver cancer in zebrafish, which rapidly develops cachexia, to uncover an evolutionarily conserved role for bile acid disruption in the onset of cachexia. Spatial transcriptomic analysis revealed that YAP induces a bi-lineage cholangiocarcinoma phenotype, which was associated with bile acid dysregulation. Mechanistically, we establish that both bile acid synthesis (via CYP7A1) and signalling through the bile acid receptor TGR5 are essential for cachexia induction. Notably, we find that the promotion of bile acid excretion with odevixibat ameliorates cachexia. Together, our findings reveal an evolutionarily conserved mechanism by which YAP promotes cachexia and suggest a potential therapeutic strategy to treat the syndrome.

Competing Interest Statement

The authors have declared no competing interest.

Footnotes

  • https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE317420

Funder Information Declared

National Health and Medical Research Council, https://ror.org/011kf5r70, 1146558, GNT1176650, 2037181
Victorian Cancer Agency, MCRF23013
GESA
Dame Kate Campbell Fellowship
Peter MacCallum Cancer Foundation
Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.
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Posted February 03, 2026.
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YAP disrupts bile acid homeostasis to drive cancer-associated cachexia
Madeline L Webb, Mikaela Wong, Anthony P Karamalakis, Yuchen Liu, Kimberley J Evason, Kira X Sun, Kristin Brown, Jay R Black, Yingzi Yang, Andrew G Cox
bioRxiv 2026.02.01.702698; doi: https://doi.org/10.64898/2026.02.01.702698
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YAP disrupts bile acid homeostasis to drive cancer-associated cachexia
Madeline L Webb, Mikaela Wong, Anthony P Karamalakis, Yuchen Liu, Kimberley J Evason, Kira X Sun, Kristin Brown, Jay R Black, Yingzi Yang, Andrew G Cox
bioRxiv 2026.02.01.702698; doi: https://doi.org/10.64898/2026.02.01.702698

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