Exercise as a modulator of purinergic signaling and inflammation in cancer-associated sarcopenia: a narrative review.

BACKGROUND: Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, is highly prevalent among cancer patients and is strongly associated with poor prognosis. Increasing evidence indicates that overactivation of the purinergic system contributes to a chronic inflammatory state that promotes tumor progression and exacerbates muscle wasting. PURPOSE: This narrative review examines how physical exercise may modulate purinergic signaling and inflammation, potentially improving the quality of life of cancer patients with sarcopenia. METHODS: A literature search was conducted in the MEDLINE database via PubMed, including articles published between 2008 and 2025, using descriptors such as "purinergic signaling", "CD39", "CD73", "P2X7 receptor", "adenosine", "sarcopenia", "skeletal muscle metabolism", "cancer", "inflammation", and "extracellular ATP". RESULTS: Original studies and review articles in English addressing the relationship between purinergic pathways, inflammation, muscle metabolism, and cancer were included. CONCLUSIONS: Findings suggest that cancer-related sarcopenia is closely linked to systemic inflammation mediated by purinergic pathways, and evidence indicates that exercise may play a pivotal role in mitigating muscle loss and improving patient outcomes.