1
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Abbas AK, Osman AY. Atypical Presentation of Burkitt Lymphoma With Isolated Peritoneal Involvement and Association With Refractory Type B Lactic Acidosis and Hypoglycemia Secondary to the Warburg Effect. Cureus 2023; 15:e35521. [PMID: 37007395 PMCID: PMC10058451 DOI: 10.7759/cureus.35521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/02/2023] Open
Abstract
Lactic acidosis is considered to be one of the most common causes of high anion gap metabolic acidosis in hospitalized patients. Warburg effect can present with type B lactic acidosis and is considered to be a rare but well-known complication of hematological malignancies. Here, we present the case of a 39-year-old male who had type B lactic acidosis and recurrent hypoglycemia secondary to newly diagnosed Burkitt lymphoma. This case highlights the importance of considering malignancy workup in any case of unexplained type B lactic acidosis with vague clinical presentation, which can aid in early diagnosis and management.
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2
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Carson L, Johnston A, Follows GA, Santarsieri A. Relapsed mantle cell lymphoma presenting with lactic acidosis and hypoglycemia: A case report. Clin Case Rep 2023; 11:e6838. [PMID: 36644610 PMCID: PMC9834148 DOI: 10.1002/ccr3.6838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023] Open
Abstract
Lactic acidosis and hypoglycemia are rare presentations of malignancy with a poor prognosis. We present the case of a mantle cell lymphoma patient who relapsed with lactic acidosis and hypoglycemia. Although blood glucose, pH, and lactate normalized following chemotherapy and intensive care support, the patient died from ventilator-associated pneumonia.
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Affiliation(s)
- Lucy Carson
- University of Cambridge School of Clinical MedicineCambridgeUK
| | - Andrew Johnston
- Cambridge University Hospitals NHS Foundation TrustCambridgeUK
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3
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Domingo-Vidal M, Whitaker-Menezes D, Mollaee M, Lin Z, Tuluc M, Philp N, Johnson JM, Zhan T, Curry J, Martinez-Outschoorn U. Monocarboxylate Transporter 4 in Cancer-Associated Fibroblasts Is a Driver of Aggressiveness in Aerodigestive Tract Cancers. Front Oncol 2022; 12:906494. [PMID: 35814364 PMCID: PMC9259095 DOI: 10.3389/fonc.2022.906494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
The most common cancers of the aerodigestive tract (ADT) are non-small cell lung cancer (NSCLC) and head and neck squamous cell carcinoma (HNSCC). The tumor stroma plays an important role in ADT cancer development and progression, and contributes to the metabolic heterogeneity of tumors. Cancer-associated fibroblasts (CAFs) are the most abundant cell type in the tumor stroma of ADT cancers and exert pro-tumorigenic functions. Metabolically, glycolytic CAFs support the energy needs of oxidative (OXPHOS) carcinoma cells. Upregulation of the monocarboxylate transporter 4 (MCT4) and downregulation of isocitrate dehydrogenase 3α (IDH3α) are markers of glycolysis in CAFs, and upregulation of the monocarboxylate transporter 1 (MCT1) and the translocase of the outer mitochondrial membrane 20 (TOMM20) are markers of OXPHOS in carcinoma cells. It is unknown if glycolytic metabolism in CAFs is a driver of ADT cancer aggressiveness. In this study, co-cultures in vitro and co-injections in mice of ADT carcinoma cells with fibroblasts were used as experimental models to study the effects of fibroblasts on metabolic compartmentalization, oxidative stress, carcinoma cell proliferation and apoptosis, and overall tumor growth. Glycolytic metabolism in fibroblasts was modulated using the HIF-1α inhibitor BAY 87-2243, the antioxidant N-acetyl cysteine, and genetic depletion of MCT4. We found that ADT human tumors express markers of metabolic compartmentalization and that co-culture models of ADT cancers recapitulate human metabolic compartmentalization, have high levels of oxidative stress, and promote carcinoma cell proliferation and survival. In these models, BAY 87-2243 rescues IDH3α expression and NAC reduces MCT4 expression in fibroblasts, and these treatments decrease ADT carcinoma cell proliferation and increase cell death. Genetic depletion of fibroblast MCT4 decreases proliferation and survival of ADT carcinoma cells in co-culture. Moreover, co-injection of ADT carcinoma cells with fibroblasts lacking MCT4 reduces tumor growth and decreases the expression of markers of metabolic compartmentalization in tumors. In conclusion, metabolic compartmentalization with high expression of MCT4 in CAFs drives aggressiveness in ADT cancers.
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Affiliation(s)
- Marina Domingo-Vidal
- Sidney Kimmel Cancer Center, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Diana Whitaker-Menezes
- Sidney Kimmel Cancer Center, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Mehri Mollaee
- Lewis Katz School of Medicine, Department of Pathology and Laboratory Medicine, Temple University, Philadelphia, PA, United States
| | - Zhao Lin
- Sidney Kimmel Cancer Center, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Madalina Tuluc
- Sidney Kimmel Cancer Center, Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Nancy Philp
- Sidney Kimmel Cancer Center, Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jennifer M. Johnson
- Sidney Kimmel Cancer Center, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Tingting Zhan
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, United States
| | - Joseph Curry
- Sidney Kimmel Cancer Center, Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Ubaldo Martinez-Outschoorn
- Sidney Kimmel Cancer Center, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
- *Correspondence: Ubaldo Martinez-Outschoorn,
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4
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Choi JW, Lee Y, Kim H, Cho HY, Min SK, Kim YS. Coexpression of MCT1 and MCT4 in ALK-positive Anaplastic Large Cell Lymphoma: Diagnostic and Therapeutic Implications. Am J Surg Pathol 2022; 46:241-248. [PMID: 34619707 DOI: 10.1097/pas.0000000000001820] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In solid tumors, glycolytic cancer or stromal cells export lactates through monocarboxylate transporter (MCT) 4, while oxidative cancer or stromal cells take up lactates as metabolic fuels or signaling molecules through MCT1. CD147 acts as a chaperone of MCT1 or MCT4. Unlike solid tumors, malignant lymphomas have a peculiar tumor microenvironment. To investigate the metabolic phenotype of malignant lymphoma associated with lactate transport, we analyzed immunohistochemical expressions of MCT1, MCT4, and CD147 in 247 cases of various malignant lymphomas. Surprisingly, both MCT1 and MCT4 were diffusely expressed on tumor cell membranes in all cases (11/11, 100%) of anaplastic lymphoma kinase (ALK) (+) anaplastic large cell lymphoma (ALCL). In contrast, only MCT1 was diffusely expressed in tumor cells of ALK(-) ALCL, as well as in B-cell, natural killer/T-cell, T-cell, and classic Hodgkin lymphomas. In these lymphomas, MCT4 expression was mostly localized to adjacent stromal cells. The pattern of diffuse membranous MCT1 and partial MCT4 expressions in tumor cells was observed in 1 case each of peripheral T-cell lymphoma (1/15, 6.7%) and multiple myeloma (1/34, 2.9%). CD147 was diffusely expressed in all types of lymphoma tumor and/or stromal cells. In conclusion, ALK(+) ALCL has a unique metabolism showing high coexpression of MCT1 and MCT4 in tumor cells. Because only ALK(+) ALCL overexpresses MCT4, immunostaining for MCT4 together with ALK is very useful for differential diagnosis from ALK(-) ALCL or peripheral T-cell lymphoma. Moreover, dual targeting against MCT1 and MCT4 would be an appropriate therapeutic approach for ALK(+) ALCL.
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MESH Headings
- Anaplastic Lymphoma Kinase/analysis
- Anaplastic Lymphoma Kinase/genetics
- Basigin/analysis
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Clinical Decision-Making
- Humans
- Immunohistochemistry
- In Situ Hybridization
- Lymphoma, Large-Cell, Anaplastic/enzymology
- Lymphoma, Large-Cell, Anaplastic/genetics
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, Large-Cell, Anaplastic/therapy
- Monocarboxylic Acid Transporters/analysis
- Monocarboxylic Acid Transporters/genetics
- Muscle Proteins/analysis
- Muscle Proteins/genetics
- Predictive Value of Tests
- Prognosis
- Republic of Korea
- Symporters/analysis
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Affiliation(s)
- Jung-Woo Choi
- Department of Pathology, Korea University Ansan Hospital, Ansan
| | - Youngseok Lee
- Department of Pathology, Korea University Anam Hospital, Seoul
| | - Hyunchul Kim
- Department of Pathology, Cha University Ilsan Medical Center, Goyang
| | - Hyun Yee Cho
- Department of Pathology, Korea University Anam Hospital, Seoul
| | - Soo Kee Min
- Department of Pathology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Young-Sik Kim
- Department of Pathology, Korea University Ansan Hospital, Ansan
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5
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Wang C, Lv Z, Zhang Y. Type B lactic acidosis associated with diffuse large B-cell lymphoma and the Warburg effect. J Int Med Res 2022; 50:3000605211067749. [PMID: 34986706 PMCID: PMC8743961 DOI: 10.1177/03000605211067749] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Type B lactic acidosis is a rare complication of non-tissue perfusion abnormalities caused by solid tumors or hematologic malignancies. Herein, we present the case of a 42-year-old man with type B lactic acidosis and hypoglycemia who was found to have a diffuse large B-cell lymphoma. The cause of lactic acidosis and/or hypoglycemia is thought to be the Warburg effect, which is when the metabolic rate of a rapidly growing malignant tumor is very high and dominated by glycolysis. Systemic damage from type B lactic acidosis can occur when the increased rate of glycolysis exceeds the normal muscle and liver lactic acid clearance rate. The Warburg effect is a rare but serious condition that needs to be recognized, not only in diffuse large B-cell lymphoma, but also in other malignancies. The prognosis of lactic acidosis in patients with malignant tumors is very poor. Currently, effective chemotherapy seems to be the only hope for survival.
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Affiliation(s)
- Chunhua Wang
- Department of Gastroenterology, The 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
| | - Zanmei Lv
- Department of Gastroenterology, The 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
| | - Yanwei Zhang
- Department of Diagnostic Radiology, The 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
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6
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Tyagi K, Mandal S, Roy A. Recent advancements in therapeutic targeting of the Warburg effect in refractory ovarian cancer: A promise towards disease remission. Biochim Biophys Acta Rev Cancer 2021; 1876:188563. [PMID: 33971276 DOI: 10.1016/j.bbcan.2021.188563] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023]
Abstract
Epithelial ovarian cancer, the most lethal gynecological malignancy, is diagnosed at advanced stage, recurs and displays chemoresistance to standard chemotherapeutic regimen of taxane/platinum drugs. Despite development of recent therapeutic approaches including poly-ADP ribose polymerase inhibitors, this fatal disease is diagnosed at advanced stage and heralds strategies for early detection and improved treatment. Recent literature suggests that high propensity of ovarian cancer cells to consume and metabolize glucose via glycolysis even in the presence of oxygen (the 'Warburg effect') can significantly contribute to disease progression and chemoresistance and hence, it has been exploited as novel drug target. This review focuses on the molecular cues of aberrant glycolysis as drivers of chemo-resistance and aggressiveness of recurrent ovarian cancer. Furthermore, we discuss the status quo of small molecule inhibition of aerobic glycolysis and significance of metabolic coupling between cancer cells and tumor microenvironment as novel therapeutic interventions against this lethal pathology.
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Affiliation(s)
- Komal Tyagi
- Amity Institute of Molecular Medicine and Stem Cell Research, Amity University, Sector-125, Noida, Uttar Pradesh 201303, India
| | - Supratim Mandal
- Department of Microbiology, Kalyani University, West Bengal 741235, India
| | - Adhiraj Roy
- Amity Institute of Molecular Medicine and Stem Cell Research, Amity University, Sector-125, Noida, Uttar Pradesh 201303, India.
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7
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Hamada T, Kaku T, Mitsu S, Morita Y, Ohno N, Yamaguchi H. Lactic Acidosis and Hypoglycemia in a Patient with Gastric Diffuse Large B-Cell Lymphoma due to the Warburg Effect. Case Rep Oncol 2020; 13:1047-1052. [PMID: 33082747 PMCID: PMC7548916 DOI: 10.1159/000509510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 11/19/2022] Open
Abstract
Lactic acidosis is pathophysiologically classified into type A and type B. The latter is a rare but potentially life-threatening emergency, mainly described in hematological malignancies. The association between Type B lactic acidosis and malignancy is known as the Warburg effect. Patients with the Warburg effect have a very poor prognosis. Herein, we report a case of gastric diffuse large B-cell lymphoma (DLBCL) with severe lactic acidosis and hypoglycemia owing to the Warburg effect that were effectively treated by prompt introduction of chemotherapy. A 73-year-old woman with a 2-month history of abdominal distension was referred to us for suspected peritoneal cancer. Pathological examination revealed gastric DLBCL with peritoneal dissemination. After hospitalization, blood test results revealed prolonged hypoglycemia, with a blood sugar level of 50-70 mg/dL; severe lactic acidosis with pH 7.166; lactate level 12.7 mmol/L; and base excess -21.0 mEq/L, despite continuous administration of glucose and sodium bicarbonate. The cause of lactic acidosis and/or hypoglycemia was considered to be the Warburg effect. We initiated a 50% reduced-dose CHOP (cyclophosphamide, vincristine, doxorubicin, prednisolone) chemotherapy regimen without rituximab until information on the CD20-positive status was available. During chemotherapy, acidosis, hypoglycemia, and impaired consciousness promptly improved. If lactic acidosis or hypoglycemia is present in patients with malignant tumors, it is important to suspect the possibility of the Warburg effect and to introduce cancer treatment as soon as possible.
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Affiliation(s)
- Takafumi Hamada
- Department of General Internal Medicine, Kagoshima Prefectural Oshima Hospital, Kagoshima, Japan
| | - Toshinari Kaku
- Department of General Internal Medicine, Kagoshima Prefectural Oshima Hospital, Kagoshima, Japan
| | - Sumitaka Mitsu
- Department of General Internal Medicine, Kagoshima Prefectural Oshima Hospital, Kagoshima, Japan
| | - Yoshinori Morita
- Department of General Internal Medicine, Kagoshima Prefectural Oshima Hospital, Kagoshima, Japan
| | - Nobuhito Ohno
- Department of Hematology, Ikeda Hospital, Kagoshima, Japan
| | - Hironori Yamaguchi
- Department of Medical Oncology, Jichi Medical University Hospital, Tochigi, Japan
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8
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Li J, Eu JQ, Kong LR, Wang L, Lim YC, Goh BC, Wong ALA. Targeting Metabolism in Cancer Cells and the Tumour Microenvironment for Cancer Therapy. Molecules 2020; 25:molecules25204831. [PMID: 33092283 PMCID: PMC7588013 DOI: 10.3390/molecules25204831] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/12/2022] Open
Abstract
Targeting altered tumour metabolism is an emerging therapeutic strategy for cancer treatment. The metabolic reprogramming that accompanies the development of malignancy creates targetable differences between cancer cells and normal cells, which may be exploited for therapy. There is also emerging evidence regarding the role of stromal components, creating an intricate metabolic network consisting of cancer cells, cancer-associated fibroblasts, endothelial cells, immune cells, and cancer stem cells. This metabolic rewiring and crosstalk with the tumour microenvironment play a key role in cell proliferation, metastasis, and the development of treatment resistance. In this review, we will discuss therapeutic opportunities, which arise from dysregulated metabolism and metabolic crosstalk, highlighting strategies that may aid in the precision targeting of altered tumour metabolism with a focus on combinatorial therapeutic strategies.
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Affiliation(s)
- Jiaqi Li
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK;
| | - Jie Qing Eu
- Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; (J.Q.E.); (L.R.K.); (L.W.); (Y.C.L.); (B.C.G.)
| | - Li Ren Kong
- Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; (J.Q.E.); (L.R.K.); (L.W.); (Y.C.L.); (B.C.G.)
- Medical Research Council Cancer Unit, University of Cambridge, Cambridge CB2 0XZ, UK
| | - Lingzhi Wang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; (J.Q.E.); (L.R.K.); (L.W.); (Y.C.L.); (B.C.G.)
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
| | - Yaw Chyn Lim
- Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; (J.Q.E.); (L.R.K.); (L.W.); (Y.C.L.); (B.C.G.)
- Department of Pathology, National University Health System, Singapore 119074, Singapore
| | - Boon Cher Goh
- Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; (J.Q.E.); (L.R.K.); (L.W.); (Y.C.L.); (B.C.G.)
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Department of Haematology-Oncology, National University Health System, Singapore 119228, Singapore
| | - Andrea L. A. Wong
- Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; (J.Q.E.); (L.R.K.); (L.W.); (Y.C.L.); (B.C.G.)
- Department of Haematology-Oncology, National University Health System, Singapore 119228, Singapore
- Correspondence: ; Tel.: +65-6779-5555
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9
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Baltazar F, Afonso J, Costa M, Granja S. Lactate Beyond a Waste Metabolite: Metabolic Affairs and Signaling in Malignancy. Front Oncol 2020; 10:231. [PMID: 32257942 PMCID: PMC7093491 DOI: 10.3389/fonc.2020.00231] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/11/2020] [Indexed: 12/16/2022] Open
Abstract
To sustain their high proliferation rates, most cancer cells rely on glycolytic metabolism, with production of lactic acid. For many years, lactate was seen as a metabolic waste of glycolytic metabolism; however, recent evidence has revealed new roles of lactate in the tumor microenvironment, either as metabolic fuel or as a signaling molecule. Lactate plays a key role in the different models of metabolic crosstalk proposed in malignant tumors: among cancer cells displaying complementary metabolic phenotypes and between cancer cells and other tumor microenvironment associated cells, including endothelial cells, fibroblasts, and diverse immune cells. This cell metabolic symbiosis/slavery supports several cancer aggressiveness features, including increased angiogenesis, immunological escape, invasion, metastasis, and resistance to therapy. Lactate transport is mediated by the monocarboxylate transporter (MCT) family, while another large family of G protein-coupled receptors (GPCRs), not yet fully characterized in the cancer context, is involved in lactate/acidosis signaling. In this mini-review, we will focus on the role of lactate in the tumor microenvironment, from metabolic affairs to signaling, including the function of lactate in the cancer-cancer and cancer-stromal shuttles, as well as a signaling oncometabolite. We will also review the prognostic value of lactate metabolism and therapeutic approaches designed to target lactate production and transport.
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Affiliation(s)
- Fátima Baltazar
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Guimarães, Portugal
| | - Julieta Afonso
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Guimarães, Portugal
| | - Marta Costa
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Guimarães, Portugal
| | - Sara Granja
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Guimarães, Portugal
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10
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Mangolini M, Ringshausen I. Bone Marrow Stromal Cells Drive Key Hallmarks of B Cell Malignancies. Int J Mol Sci 2020; 21:E1466. [PMID: 32098106 PMCID: PMC7073037 DOI: 10.3390/ijms21041466] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/06/2020] [Accepted: 02/13/2020] [Indexed: 12/11/2022] Open
Abstract
All B cell leukaemias and a substantial fraction of lymphomas display a natural niche residency in the bone marrow. While the bone marrow compartment may only be one of several sites of disease manifestations, the strong clinical significance of minimal residual disease (MRD) in the bone marrow strongly suggests that privileged niches exist in this anatomical site favouring central elements of malignant transformation. Here, the co-existence of two hierarchical systems, originating from haematopoietic and mesenchymal stem cells, has extensively been characterised with regard to regulation of the former (blood production) by the latter. How these two systems cooperate under pathological conditions is far less understood and is the focus of many current investigations. More recent single-cell sequencing techniques have now identified an unappreciated cellular heterogeneity of the bone marrow microenvironment. How each of these cell subtypes interact with each other and regulate normal and malignant haematopoiesis remains to be investigated. Here we review the evidences of how bone marrow stroma cells and malignant B cells reciprocally interact. Evidently from published data, these cell-cell interactions induce profound changes in signalling, gene expression and metabolic adaptations. While the past research has largely focussed on understanding changes imposed by stroma- on tumour cells, it is now clear that tumour-cell contact also has fundamental ramifications for the biology of stroma cells. Their careful characterisations are not only interesting from a scientific biological viewpoint but also relevant to clinical practice: Since tumour cells heavily depend on stroma cells for cell survival, proliferation and dissemination, interference with bone marrow stroma-tumour interactions bear therapeutic potential. The molecular characterisation of tumour-stroma interactions can identify new vulnerabilities, which could be therapeutically exploited.
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Affiliation(s)
- Maurizio Mangolini
- Wellcome Trust/MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 0AH, UK;
| | - Ingo Ringshausen
- Wellcome Trust/MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 0AH, UK;
- Department of Haematology, Addenbrooke’s Hospital, Cambridge University hospital, Cambridge CB2 0AH, UK
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11
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Clinical significance of metabolism-related biomarkers in non-Hodgkin lymphoma – MCT1 as potential target in diffuse large B cell lymphoma. Cell Oncol (Dordr) 2019; 42:303-318. [DOI: 10.1007/s13402-019-00426-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2019] [Indexed: 12/15/2022] Open
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12
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Successful Treatment of Severe Type B Lactic Acidosis in a Patient with HIV/AIDS-Associated High-Grade NHL. Case Reports Immunol 2018; 2018:9093623. [PMID: 30302295 PMCID: PMC6158940 DOI: 10.1155/2018/9093623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 08/29/2018] [Indexed: 11/18/2022] Open
Abstract
Type B lactic acidosis is a rare metabolic complication sometimes associated with hematologic malignancies. When present, this type of lactic acidosis is most commonly seen in patients with high-grade lymphomas or leukemias and is usually indicative of a dismal prognosis. We report a case of a 27-year man with acquired immunodeficiency syndrome (AIDS) that presented with bilateral lower extremity swelling, an abdominal mass, and weight loss. His lab values showed elevated anion gap with lactic acidosis and computed tomography (CT) of the abdomen showed a large soft-tissue mass arising from the left hepatic lobe. Biopsy of the abdominal mass demonstrated a high-grade diffuse large B-cell lymphoma. The patient's lactic acidosis resolved after starting chemotherapy, and a complete response was evident on PET-CT after a third cycle of rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (EPOC-RR). Care-givers should be aware of the implications of lactic acidosis associated with malignancy and the need for prompt diagnosis and treatment.
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13
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Autophagy in cancer: a complex relationship. Biochem J 2018; 475:1939-1954. [DOI: 10.1042/bcj20170847] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 12/27/2022]
Abstract
Macroautophagy is the process by which cells package and degrade cytosolic components, and recycle the breakdown products for future use. Since its initial description by Christian de Duve in the 1960s, significant progress has been made in understanding the mechanisms that underlie this vital cellular process and its specificity. Furthermore, macroautophagy is linked to pathologic conditions such as cancer and is being studied as a therapeutic target. In this review, we will explore the connections between autophagy and cancer, which are tumor- and context-dependent and include the tumor microenvironment. We will highlight the importance of tumor compartment-specific autophagy in both cancer aggressiveness and treatment.
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14
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Metabolic Reprogramming of Cancer Associated Fibroblasts: The Slavery of Stromal Fibroblasts. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6075403. [PMID: 29967776 PMCID: PMC6008683 DOI: 10.1155/2018/6075403] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/02/2018] [Indexed: 12/18/2022]
Abstract
Cancer associated fibroblasts (CAFs) are the main stromal cell type of solid tumour microenvironment and undergo an activation process associated with secretion of growth factors, cytokines, and paracrine interactions. One of the important features of solid tumours is the metabolic reprogramming that leads to changes of bioenergetics and biosynthesis in both tumour cells and CAFs. In particular, CAFs follow the evolution of tumour disease and acquire a catabolic phenotype: in tumour tissues, cancer cells and tumour microenvironment form a network where the crosstalk between cancer cells and CAFs is associated with cell metabolic reprogramming that contributes to CAFs activation, cancer growth, and progression and evasion from cancer therapies. In this regard, the study of CAFs metabolic reprogramming could contribute to better understand their activation process, the interaction between stroma, and cancer cells and could offer innovative tools for the development of new therapeutic strategies able to eradicate the protumorigenic activity of CAFs. Therefore, this review focuses on CAFs metabolic reprogramming associated with both differentiation process and cancer and stromal cells crosstalk. Finally, therapeutic responses and potential anticancer strategies targeting CAFs metabolic reprogramming are reviewed.
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15
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Greer YE, Porat-Shliom N, Nagashima K, Stuelten C, Crooks D, Koparde VN, Gilbert SF, Islam C, Ubaldini A, Ji Y, Gattinoni L, Soheilian F, Wang X, Hafner M, Shetty J, Tran B, Jailwala P, Cam M, Lang M, Voeller D, Reinhold WC, Rajapakse V, Pommier Y, Weigert R, Linehan WM, Lipkowitz S. ONC201 kills breast cancer cells in vitro by targeting mitochondria. Oncotarget 2018; 9:18454-18479. [PMID: 29719618 PMCID: PMC5915085 DOI: 10.18632/oncotarget.24862] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/06/2018] [Indexed: 12/31/2022] Open
Abstract
We report a novel mechanism of action of ONC201 as a mitochondria-targeting drug in cancer cells. ONC201 was originally identified as a small molecule that induces transcription of TNF-related apoptosis-inducing ligand (TRAIL) and subsequently kills cancer cells by activating TRAIL death receptors. In this study, we examined ONC201 toxicity on multiple human breast and endometrial cancer cell lines. ONC201 attenuated cell viability in all cancer cell lines tested. Unexpectedly, ONC201 toxicity was not dependent on either TRAIL receptors nor caspases. Time-lapse live cell imaging revealed that ONC201 induces cell membrane ballooning followed by rupture, distinct from the morphology of cells undergoing apoptosis. Further investigation found that ONC201 induces phosphorylation of AMP-dependent kinase and ATP loss. Cytotoxicity and ATP depletion were significantly enhanced in the absence of glucose, suggesting that ONC201 targets mitochondrial respiration. Further analysis indicated that ONC201 indirectly inhibits mitochondrial respiration. Confocal and electron microscopic analysis demonstrated that ONC201 triggers mitochondrial structural damage and functional impairment. Moreover, ONC201 decreased mitochondrial DNA (mtDNA). RNAseq analysis revealed that ONC201 suppresses expression of multiple mtDNA-encoded genes and nuclear-encoded mitochondrial genes involved in oxidative phosphorylation and other mitochondrial functions. Importantly, fumarate hydratase deficient cancer cells and multiple cancer cell lines with reduced amounts of mtDNA were resistant to ONC201. These results indicate that cells not dependent on mitochondrial respiration are ONC201-resistant. Our data demonstrate that ONC201 kills cancer cells by disrupting mitochondrial function and further suggests that cancer cells that are dependent on glycolysis will be resistant to ONC201.
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Affiliation(s)
- Yoshimi Endo Greer
- Women's Malignancies Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | | | - Kunio Nagashima
- Electron Microscope Laboratory, Leidos Biomedical Research, Inc. Frederick National Laboratory for Cancer Research (FNLCR), Frederick, MD, USA
| | - Christina Stuelten
- Laboratory of Cellular and Molecular Biology, CCR, NCI, NIH, Bethesda, MD, USA
| | - Dan Crooks
- Urologic Oncology Branch, CCR, NCI, NIH, Bethesda, MD, USA
| | - Vishal N. Koparde
- CCR Collaborative Bioinformatics Resource, Leidos Biomedical Research, Inc., FNLCR, Frederick, MD, USA
| | - Samuel F. Gilbert
- Women's Malignancies Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Celia Islam
- Women's Malignancies Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Ashley Ubaldini
- Women's Malignancies Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Yun Ji
- Experimental Transplantation and Immunology Branch, CCR, NCI, NIH, Bethesda, MD, USA
| | - Luca Gattinoni
- Experimental Transplantation and Immunology Branch, CCR, NCI, NIH, Bethesda, MD, USA
| | - Ferri Soheilian
- Electron Microscope Laboratory, Leidos Biomedical Research, Inc. Frederick National Laboratory for Cancer Research (FNLCR), Frederick, MD, USA
| | - Xiantao Wang
- RNA Molecular Biology Group, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD, USA
| | - Markus Hafner
- RNA Molecular Biology Group, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD, USA
| | - Jyoti Shetty
- CCR Sequencing Facility, Leidos Biomedical Research, Inc., FNLCR, Frederick, MD, USA
| | - Bao Tran
- CCR Sequencing Facility, Leidos Biomedical Research, Inc., FNLCR, Frederick, MD, USA
| | - Parthav Jailwala
- CCR Collaborative Bioinformatics Resource, Leidos Biomedical Research, Inc., FNLCR, Frederick, MD, USA
| | - Maggie Cam
- CCR Collaborative Bioinformatics Resource, Leidos Biomedical Research, Inc., FNLCR, Frederick, MD, USA
| | - Martin Lang
- Urologic Oncology Branch, CCR, NCI, NIH, Bethesda, MD, USA
| | - Donna Voeller
- Women's Malignancies Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | | | - Vinodh Rajapakse
- Developmental Therapeutics Branch, CCR, NCI, NIH, Bethesda, MD, USA
| | - Yves Pommier
- Developmental Therapeutics Branch, CCR, NCI, NIH, Bethesda, MD, USA
| | - Roberto Weigert
- Laboratory of Cellular and Molecular Biology, CCR, NCI, NIH, Bethesda, MD, USA
| | | | - Stanley Lipkowitz
- Women's Malignancies Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
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16
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Liu Z, Smith KR, Khong HT, Huang J, Ahn EYE, Zhou M, Tan M. miR-125b regulates differentiation and metabolic reprogramming of T cell acute lymphoblastic leukemia by directly targeting A20. Oncotarget 2018; 7:78667-78679. [PMID: 27637078 PMCID: PMC5346668 DOI: 10.18632/oncotarget.12018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 09/02/2016] [Indexed: 11/25/2022] Open
Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematopoietic malignancy. Although it has been reported that overexpression of miR-125b leads to T-ALL development, the underlying mechanisms of miR-125b action are still unclear. The goal of this study is to delineate the role of miR-125b in T-ALL development. We found that miR-125b is highly expressed in undifferentiated leukemic T cells (CD4-negative) while its expression is low in differentiated T cells (CD4-positive). Overexpression of miR-125b increased the CD4-negative population in T cells, whereas depletion of miR-125b by miR-125b-sponge decreased the CD4-negative cell population. We identified that A20 (TNFAIP3) is a direct target of miR-125b in T cells. Overexpression of miR-125b also increased glucose uptake and oxygen consumption in T cells through targeting A20. Furthermore, restoration of A20 in miR-125b-overexpressing cells decreased the CD4-negative population in T cell leukemia, and decreased glucose uptake and oxygen consumption to the basal level of T cells transfected with vector. In conclusion, our data demonstrate that miR-125b regulates differentiation and reprogramming of T cell glucose metabolism via targeting A20. Since both de-differentiation and dysregulated glucose metabolism contribute to the development of T-cell leukemia, these findings provide novel insights into the understanding and treatment of T-ALL.
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Affiliation(s)
- Zixing Liu
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA
| | - Kelly R Smith
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA
| | - Hung T Khong
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Jingshan Huang
- School of Computing, University of South Alabama, Mobile, AL, USA
| | | | - Ming Zhou
- Cancer Research Institute, Central South University, Changsha, Hunan, China
| | - Ming Tan
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA.,Department of Biochemistry & Molecular Biology, University of South Alabama, Mobile, AL, USA
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17
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Wahab A, Kesari K, J Smith S, Liu Y, Barta SK. Type B lactic acidosis, an uncommon paraneoplastic syndrome. Cancer Biol Ther 2018; 19:101-104. [PMID: 29293400 DOI: 10.1080/15384047.2017.1394550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
A 67-year-old male presented with anasarca and persistent non-pruritic rash of lower extremities. Physical examination was positive for subcutaneous edema with a non-blanching rash of abdomen and lower extremities. Labs showed leukocytosis, lymphocytosis, anemia and thrombocytopenia. He also had acute kidney injury and high anion gap (AG) metabolic acidosis with elevated lactic acid (11.3 mg/dL). Computerized tomography (CT) of abdomen and pelvis showed hepatosplenomegaly, ascites and abdominal lymphadenopathy. Peripheral blood (PB) smear showed blastiod appearing lymphocytes. He was started on bicarbonate infusion due to persistent lactic acidosis (LA), however showed no significant improvement. He was started on IV dexamethasone on 3rd day of hospitalization based on preliminary result of peripheral picture which led to some improvement in LA. Following the confirmation of mantle cell lymphoma (MCL) on bone marrow (BM) biopsy and immunophenotyping, the patient started receiving VR-CAP regimen (bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone) which led to significant improvement in LA and leukocytosis. After discharge, he received further chemotherapy with resolution of the LA and normalization of blood counts. Restaging tests confirmed a complete remission with resolution of the skin rash, resolution of the pathological lymphadenopathy and hepatosplenomegaly on imaging, and absence of lymphoma on a repeat BM biopsy.
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Affiliation(s)
- Ahsan Wahab
- a Department of Internal Medicine , McLaren - Flint Health/Michigan State University , Flint , MI
| | - Kavitha Kesari
- a Department of Internal Medicine , McLaren - Flint Health/Michigan State University , Flint , MI
| | - Susan J Smith
- a Department of Internal Medicine , McLaren - Flint Health/Michigan State University , Flint , MI
| | - Yang Liu
- b Department of Hematology/Oncology , Fox Chase Cancer Center , Philadelphia , PA
| | - Stefan K Barta
- b Department of Hematology/Oncology , Fox Chase Cancer Center , Philadelphia , PA
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18
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Gooptu M, Whitaker-Menezes D, Sprandio J, Domingo-Vidal M, Lin Z, Uppal G, Gong J, Fratamico R, Leiby B, Dulau-Florea A, Caro J, Martinez-Outschoorn U. Mitochondrial and glycolytic metabolic compartmentalization in diffuse large B-cell lymphoma. Semin Oncol 2017; 44:204-217. [PMID: 29248132 DOI: 10.1053/j.seminoncol.2017.10.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/05/2017] [Indexed: 11/11/2022]
Abstract
Metabolic heterogeneity between neoplastic cells and surrounding stroma has been described in several epithelial malignancies; however, the metabolic phenotypes of neoplastic lymphocytes and neighboring stroma in diffuse large B-cell lymphoma (DLBCL) is unknown. We investigated the metabolic phenotypes of human DLBCL tumors by using immunohistochemical markers of glycolytic and mitochondrial oxidative phosphorylation (OXPHOS) metabolism. The lactate importer MCT4 is a marker of glycolysis, whereas the lactate importer MCT1 and TOMM20 are markers of OXPHOS metabolism. Staining patterns were assessed in 33 DLBCL samples as well as 18 control samples (non-neoplastic lymph nodes). TOMM20 and MCT1 were highly expressed in neoplastic lymphocytes, indicating an OXPHOS phenotype, whereas non-neoplastic lymphocytes in the control samples did not express these markers. Stromal cells in DLBCL samples strongly expressed MCT4, displaying a glycolytic phenotype, a feature not seen in stromal elements of non-neoplastic lymphatic tissue. Furthermore, the differential expression of lactate exporters (MCT4) on tumor-associated stroma and lactate importers (MCT1) on neoplastic lymphocytes support the hypothesis that neoplastic cells are metabolically linked to the stroma likely via mutually beneficial reprogramming. MCT4 is a marker of tumor-associated stroma in neoplastic tissue. Our findings suggest that disruption of neoplastic-stromal cell metabolic heterogeneity including MCT1 and MCT4 blockade should be studied to determine if it could represent a novel treatment target in DLBCL.
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Affiliation(s)
- Mahasweta Gooptu
- Department of Medical Oncology, Dana Farber Cancer Institute, Harvard University Medical School, Boston, MA
| | - Diana Whitaker-Menezes
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - John Sprandio
- Consultants in Medical Oncology and Hematology, Broomall, PA
| | - Marina Domingo-Vidal
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Zhao Lin
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Guldeep Uppal
- Department of Pathology, Anatomy and Cell Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Jerald Gong
- Department of Pathology, Anatomy and Cell Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Roberto Fratamico
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Benjamin Leiby
- Department of Clinical Pharmacology, Division of Biostatistics, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alina Dulau-Florea
- Department of Laboratory Medicine, Hematology, National Institutes of Health, Bethesda, MD
| | - Jaime Caro
- Department of Medicine, Cardeza Foundation for Hematological Research, Thomas Jefferson University, Philadelphia, PA USA
| | - Ubaldo Martinez-Outschoorn
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA.
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19
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Fu Y, Liu S, Yin S, Niu W, Xiong W, Tan M, Li G, Zhou M. The reverse Warburg effect is likely to be an Achilles' heel of cancer that can be exploited for cancer therapy. Oncotarget 2017; 8:57813-57825. [PMID: 28915713 PMCID: PMC5593685 DOI: 10.18632/oncotarget.18175] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/25/2017] [Indexed: 12/19/2022] Open
Abstract
Although survival outcomes of cancer patients have been improved dramatically via conventional chemotherapy and targeted therapy over the last decades, there are still some tough clinical challenges that badly needs to be overcome, such as anticancer drug resistance, inevitable recurrences, cancer progression and metastasis. Simultaneously, accumulated evidence demonstrates that aberrant glucose metabolism termed ‘the Warburg effect’ in cancer cell is closely associated with malignant phenotypes. In 2009, a novel ‘two-compartment metabolic coupling’ model, also named ‘the reverse Warburg effect’, was proposed and attracted lots of attention. Based on this new model, we consider whether this new viewpoint can be exploited for improving the existent anti-cancer therapeutic strategies. Our review focuses on the paradigm shift from ‘the Warburg effect’ to ‘the reverse Warburg effect’, the features and molecular mechanisms of ‘the reverse Warburg effect’, and then we discuss its significance in fundamental researches and clinical practice.
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Affiliation(s)
- Yaojie Fu
- The Key Laboratory of Carcinogenesis of The Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan 410078, P. R. China.,Cancer Research Institute, Central South University, Changsha, Hunan 410078, P. R. China.,Medical School of Xiangya, Central South University, Changsha, Hunan 410013, P. R. China
| | - Shanshan Liu
- The Key Laboratory of Carcinogenesis of The Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan 410078, P. R. China.,Cancer Research Institute, Central South University, Changsha, Hunan 410078, P. R. China.,Medical School of Xiangya, Central South University, Changsha, Hunan 410013, P. R. China
| | - Shanghelin Yin
- The Key Laboratory of Carcinogenesis of The Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan 410078, P. R. China.,Cancer Research Institute, Central South University, Changsha, Hunan 410078, P. R. China.,Medical School of Xiangya, Central South University, Changsha, Hunan 410013, P. R. China
| | - Weihong Niu
- The Key Laboratory of Carcinogenesis of The Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan 410078, P. R. China.,Cancer Research Institute, Central South University, Changsha, Hunan 410078, P. R. China
| | - Wei Xiong
- The Key Laboratory of Carcinogenesis of The Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan 410078, P. R. China.,Cancer Research Institute, Central South University, Changsha, Hunan 410078, P. R. China
| | - Ming Tan
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA
| | - Guiyuan Li
- The Key Laboratory of Carcinogenesis of The Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan 410078, P. R. China.,Cancer Research Institute, Central South University, Changsha, Hunan 410078, P. R. China
| | - Ming Zhou
- The Key Laboratory of Carcinogenesis of The Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, Hunan 410078, P. R. China.,Cancer Research Institute, Central South University, Changsha, Hunan 410078, P. R. China
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20
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Lee CH, Gundem G, Lee W, Chen YB, Cross JR, Dong Y, Redzematovic A, Mano R, Wei EY, Cheng EH, Srinivasan R, Oschwald D, Hakimi AA, Dunphy MP, Linehan WM, Papaemmanuil E, Hsieh JJ. Persistent Severe Hyperlactatemia and Metabolic Derangement in Lethal SDHB-Mutated Metastatic Kidney Cancer: Clinical Challenges and Examples of Extreme Warburg Effect. JCO Precis Oncol 2017; 1:PO.16.00007. [PMID: 35172488 PMCID: PMC9797236 DOI: 10.1200/po.16.00007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
To describe the unique clinical features, determine the genomics, and investigate the metabolic derangement of an extremely rare form of a hereditary lethal kidney cancer syndrome. Patients and Methods Three patients with lethal kidney cancer (age 19, 20, and 37 years) exhibiting persistent (1 to 3 months) extremely high levels of blood lactate (> 5 mM) despite normal oxygen perfusion, highly avid tumors on [18F]fluorodeoxyglucose positron emission tomography (PET), and pleomorphic histopathologic features were identified and treated in a single institute. Integrated studies including whole-genome sequencing (WGS), targeted sequencing, immunohistochemistry, cell-based assays, and 18F-glutamine PET imaging were performed to investigate this rare kidney cancer syndrome. Results All three patients with kidney cancer were initially given various diagnoses as a result of diverse tumor histopathology and atypical clinical presentations. The correct diagnoses of these SDHB-mutated renal cell carcinomas were first made based on cancer genomics. Genomic studies of the blood and tumors of these patients identified three different kinds of germline loss-of-function mutations in the SDHB gene and the common loss of heterozygosity in the remaining SDHB allele thorough somatic chromosome 1p deletion. In one patient, WGS revealed that a germline mutation of SDHB coupled with loss of heterozygosity was the sole genetic event. Cancer evolution analysis of SDHB tumors based on WGS demonstrated that SDHB in kidney epithelium fulfills the Knudson two-hit criteria as a major tumor suppressor gene. SDHB -/- tumor cells displayed increase in glucose uptake and lactate production, alteration in mitochondrial architecture, and defect in oxidative respiration. 18F-Glutamine PET imaging studies demonstrated increased glutamine metabolism. Conclusion SDHB-deficient metastatic renal cell carcinoma is a rare, aggressive form of kidney cancer that manifests with clinical evidence of a severe Warburg effect, and genomic studies demonstrated two genetic hits at SDHB genes during kidney tumorigenesis.
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Affiliation(s)
- Chung-Han Lee
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Gunes Gundem
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - William Lee
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Ying-Bei Chen
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Justin R. Cross
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Yiyu Dong
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Almedina Redzematovic
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Roy Mano
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Elizabeth Y. Wei
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Emily H. Cheng
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Ramaprasad Srinivasan
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Dayna Oschwald
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - A. Ari Hakimi
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Mark P. Dunphy
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - W. Marston Linehan
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Elli Papaemmanuil
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - James J. Hsieh
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
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21
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Granja S, Tavares-Valente D, Queirós O, Baltazar F. Value of pH regulators in the diagnosis, prognosis and treatment of cancer. Semin Cancer Biol 2017; 43:17-34. [PMID: 28065864 DOI: 10.1016/j.semcancer.2016.12.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/15/2016] [Accepted: 12/29/2016] [Indexed: 02/07/2023]
Abstract
Altered metabolism, associated with acidification of the extracellular milieu, is one of the major features of cancer. As pH regulation is crucial for the maintenance of all biological functions, cancer cells rely on the activity of lactate exporters and proton transporters to regulate their intracellular pH. The major players in cancer pH regulation are proton pump ATPases, sodium-proton exchangers (NHEs), monocarboxylate transporters (MCTs), carbonic anhydrases (CAs) and anion exchangers (AEs), which have been shown to be upregulated in several human malignancies. Thanks to the activity of the proton pumps and transporters, tumours acidify their microenvironment, becoming more aggressive and resistant to therapy. Thus, targeting tumour pH may contribute to more effective anticancer strategies for controlling tumour progression and therapeutic resistance. In the present study, we review the role of the main pH regulators expressed in human cancer cells, including their diagnostic and prognostic value, as well as their usefulness as therapeutic targets.
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Affiliation(s)
- Sara Granja
- Life and Health Sciences Research Institute (ICVS)/School of Medicine/University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Diana Tavares-Valente
- Life and Health Sciences Research Institute (ICVS)/School of Medicine/University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal
| | - Odília Queirós
- IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal; CBMA - Center of Molecular and Environmental Biology/Department of Biology/University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal
| | - Fátima Baltazar
- Life and Health Sciences Research Institute (ICVS)/School of Medicine/University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
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22
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Zhu G, Wang D, Li S, Yang X, Cao Y, Wang Y, Niu H. Acute effect of lactic acid on tumor-endothelial cell metabolic coupling in the tumor microenvironment. Oncol Lett 2016; 12:3478-3484. [PMID: 27900024 DOI: 10.3892/ol.2016.5047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 06/16/2016] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to systematically analyze alterations in the expression of mitochondrial-associated proteins in human bladder cancer T24 cells co-cultured with tumor-associated human umbilical vein endothelial cells (HUVECs), and to investigate the characteristics of bladder cancer cell energy metabolism. The present study used the following techniques: A co-culture system of T24 cells and HUVECs was constructed using a microfluidic chip as a 3D co-culture system; the concentration of lactic acid in the medium of the cells was determined using an automatic microplate reader; a qualitative analysis of mitochondria-associated protein expression was performed by immunofluorescent staining; and a quantitative analysis of mitochondrial-associated protein expression was conducted using western blotting. The present results revealed that between the control groups (monoculture of T24 cells or HUVECs), the mitochondrial-associated protein fluorescence intensity was increased in the HUVECs compared with the T24 cells. The fluorescence intensity of mitochondrial-associated proteins in the HUVEC control group was increased compared with the HUVECs in the experimental co-culture group. In the T24 cells, the protein fluorescence intensity was increased in the experimental co-culture group compared with the control group. In addition, the expression of mitochondria-associated proteins was increased in HUVECs compared with T24 cells in the control groups, while T24 cells in the experimental co-culture group had an increased expression compared with HUVECs in the experimental group (P<0.05). For T24 cells, the expression of mitochondrial-associated proteins was increased in the experimental group compared with the control group, and contrasting results were observed for the HUVECs (P<0.05). Determination of lactic acid concentration demonstrated that lactic acid concentration was highest in the experimental co-culture group, followed by the T24 control group and the HUVEC control group. In conclusion, the present study demonstrated that energy metabolism of the bladder tumor cells does not parallel the 'Warburg effect', since even under sufficient oxygen conditions the tumor cells still undergo glycolysis. Additionally, bladder tumor cells have an efficient oxidative phosphorylation process, wherein tumor cells promote glycolysis in adjacent interstitial cells, thereby causing increased formation of nutritional precursors. These high-energy metabolites are transferred to adjacent tumor cells in a specified direction and enter the Krebs Cycle. Ultimately, oxidative phosphorylation increases, and sufficient ATP is produced.
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Affiliation(s)
- Guanqun Zhu
- Department of Urology, Affiliated Hospital of Qingdao University, Key Laboratory of Urinary System Diseases, Qingdao, Shandong 266003, P.R. China
| | - Degui Wang
- Department of Anatomy, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Shenqian Li
- Department of Urology, Affiliated Hospital of Qingdao University, Key Laboratory of Urinary System Diseases, Qingdao, Shandong 266003, P.R. China
| | - Xuecheng Yang
- Department of Urology, Affiliated Hospital of Qingdao University, Key Laboratory of Urinary System Diseases, Qingdao, Shandong 266003, P.R. China
| | - Yanwei Cao
- Department of Urology, Affiliated Hospital of Qingdao University, Key Laboratory of Urinary System Diseases, Qingdao, Shandong 266003, P.R. China
| | - Yonghua Wang
- Department of Urology, Affiliated Hospital of Qingdao University, Key Laboratory of Urinary System Diseases, Qingdao, Shandong 266003, P.R. China
| | - Haitao Niu
- Department of Urology, Affiliated Hospital of Qingdao University, Key Laboratory of Urinary System Diseases, Qingdao, Shandong 266003, P.R. China
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Abstract
Lactic acidosis is the most common metabolic acidosis in hospitalized patients-the result from an underlying pathogenic process. To successfully manage lactic acid production, its cause needs to be eliminated. Patients with cancer have many risk factors for developing lactic acidosis, including the cancer diagnosis itself. Patients with lactic acidosis are critically ill, requiring an intense level of nursing care with accompanying frequent cardiopulmonary and renal assessments. The mortality rate from lactic acidosis is high. Therefore, appropriate nursing interventions may include end-of-life and palliative care.
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24
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Sengupta D, Pratx G. Imaging metabolic heterogeneity in cancer. Mol Cancer 2016; 15:4. [PMID: 26739333 PMCID: PMC4704434 DOI: 10.1186/s12943-015-0481-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 12/10/2015] [Indexed: 01/01/2023] Open
Abstract
As our knowledge of cancer metabolism has increased, it has become apparent that cancer metabolic processes are extremely heterogeneous. The reasons behind this heterogeneity include genetic diversity, the existence of multiple and redundant metabolic pathways, altered microenvironmental conditions, and so on. As a result, methods in the clinic and beyond have been developed in order to image and study tumor metabolism in the in vivo and in vitro regimes. Both regimes provide unique advantages and challenges, and may be used to provide a picture of tumor metabolic heterogeneity that is spatially and temporally comprehensive. Taken together, these methods may hold the key to appropriate cancer diagnoses and treatments in the future.
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Affiliation(s)
- Debanti Sengupta
- Stanford University School of Medicine, A226 Building A, 1050 Arastradero Road, Palo Alto, CA, 94304, USA
| | - Guillem Pratx
- Stanford University School of Medicine, A226 Building A, 1050 Arastradero Road, Palo Alto, CA, 94304, USA.
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25
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Curry JM, Tassone P, Cotzia P, Sprandio J, Luginbuhl A, Cognetti DM, Mollaee M, Domingo M, Pribitkin EA, Keane WM, Zhan TT, Birbe R, Tuluc M, Martinez-Outschoorn U. Multicompartment metabolism in papillary thyroid cancer. Laryngoscope 2015; 126:2410-2418. [PMID: 26666958 DOI: 10.1002/lary.25799] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 01/26/2023]
Abstract
OBJECTIVES/HYPOTHESIS In many cancers, varying regions within the tumor are often phenotypically heterogeneous, including their metabolic phenotype. Further, tumor regions can be metabolically compartmentalized, with metabolites transferred between compartments. When present, this metabolic coupling can promote aggressive behavior. Tumor metabolism in papillary thyroid cancer (PTC) is poorly characterized. STUDY DESIGN Immunohistochemical staining of tissue samples. METHODS Papillary thyroid cancer specimens from 46 patients with (n = 19) and without advanced disease (n = 27) were compared to noncancerous thyroid tissue (NCT) and benign thyroid specimens (n = 6 follicular adenoma [FA] and n = 5 nodular goiter [NG]). Advanced disease was defined as the presence of lateral neck lymphadenopathy. Immunohistochemistry was performed for translocase of outer mitochondrial membrane 20 (TOMM20), a marker of oxidative phosphorylation, and monocarboxylate transporter 4 (MCT4), a marker of glycolysis. RESULTS Papillary thyroid cancer and FA thyrocytes had high staining for TOMM20 compared to NCT and nodular goiter (NG) (P < 0.01). High MCT4 staining in fibroblasts was more common in PTC with advanced disease than in any other tissue type studied (P < 0.01). High MCT4 staining was found in all 19 cases of PTC with advanced disease, in 11 of 19 samples with low-stage disease, in one of five samples of FA, in one of 34 NCT, and in 0 of six NG samples. Low fibroblast MCT4 staining in PTC correlated with the absence of clinical adenopathy (P = 0.028); the absence of extrathyroidal extension (P = 0.004); low American Thyroid Association risk (P = 0.001); low AGES (age, grade, extent, size) score (P = 0.004); and low age, metastasis, extent of disease, size risk (P = 0.002). CONCLUSION This study suggests that multiple metabolic compartments exist in PTC, and low fibroblast MCT4 may be a biomarker of indolent disease. LEVEL OF EVIDENCE N/A. Laryngoscope, 126:2410-2418, 2016.
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Affiliation(s)
- Joseph M Curry
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Patrick Tassone
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Paolo Cotzia
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA
| | - John Sprandio
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Adam Luginbuhl
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - David M Cognetti
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Mehri Mollaee
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA
| | - Marina Domingo
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Edmund A Pribitkin
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - William M Keane
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Ting Ting Zhan
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Ruth Birbe
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA
| | - Madalina Tuluc
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA
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26
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Afonso J, Santos LL, Morais A, Amaro T, Longatto-Filho A, Baltazar F. Metabolic coupling in urothelial bladder cancer compartments and its correlation to tumor aggressiveness. Cell Cycle 2015; 15:368-80. [PMID: 26636903 DOI: 10.1080/15384101.2015.1121329] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Monocarboxylate transporters (MCTs) are vital for intracellular pH homeostasis by extruding lactate from highly glycolytic cells. These molecules are key players of the metabolic reprogramming of cancer cells, and evidence indicates a potential contribution in urothelial bladder cancer (UBC) aggressiveness and chemoresistance. However, the specific role of MCTs in the metabolic compartmentalization within bladder tumors, namely their preponderance on the tumor stroma, remains to be elucidated. Thus, we evaluated the immunoexpression of MCTs in the different compartments of UBC tissue samples (n = 111), assessing the correlations among them and with the clinical and prognostic parameters. A significant decrease in positivity for MCT1 and MCT4 occurred from normoxic toward hypoxic regions. Significant associations were found between the expression of MCT4 in hypoxic tumor cells and in the tumor stroma. MCT1 staining in normoxic tumor areas, and MCT4 staining in hypoxic regions, in the tumor stroma and in the blood vessels were significantly associated with UBC aggressiveness. MCT4 concomitant positivity in hypoxic tumor cells and in the tumor stroma, as well as positivity in each of these regions concomitant with MCT1 positivity in normoxic tumor cells, was significantly associated with an unfavourable clinicopathological profile, and predicted lower overall survival rates among patients receiving platinum-based chemotherapy. Our results point to the existence of a multi-compartment metabolic model in UBC, providing evidence of a metabolic coupling between catabolic stromal and cancer cells' compartments, and the anabolic cancer cells. It is urgent to further explore the involvement of this metabolic coupling in UBC progression and chemoresistance.
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Affiliation(s)
- Julieta Afonso
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga , Portugal.,b ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães , Portugal
| | - Lúcio L Santos
- c Department of Surgical Oncology , Portuguese Institute of Oncology (IPO) , Porto , Portugal.,d Faculty of Health Sciences, University Fernando Pessoa (UFP) , Porto , Portugal
| | - António Morais
- e Department of Urology , Portuguese Institute of Oncology (IPO) , Porto , Portugal
| | - Teresina Amaro
- f Experimental Pathology and Therapeutics Research Center, Portuguese Institute of Oncology (IPO) , Porto , Portugal
| | - Adhemar Longatto-Filho
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga , Portugal.,b ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães , Portugal.,g Laboratory of Medical Investigation (LIM 14), Faculty of Medicine, São Paulo State University , São Paulo , Brazil.,h Molecular Oncology Research Center, Barretos Cancer Hospital , São Paulo , Brazil
| | - Fátima Baltazar
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga , Portugal.,b ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães , Portugal
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27
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Mills TA, Orloff M, Domingo-Vidal M, Cotzia P, Birbe RC, Draganova-Tacheva R, Martinez Cantarin MP, Tuluc M, Martinez-Outschoorn U. Parathyroid Hormone-Related Peptide-Linked Hypercalcemia in a Melanoma Patient Treated With Ipilimumab: Hormone Source and Clinical and Metabolic Correlates. Semin Oncol 2015; 42:909-14. [PMID: 26615135 DOI: 10.1053/j.seminoncol.2015.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
A patient diagnosed with metastatic melanoma developed the paraneoplastic syndrome of humoral hypercalcemia of malignancy and cachexia after receiving ipilumumab. The cause of the hypercalcemia was thought to be secondary to parathyroid hormone-related peptide (PTHrP) as plasma levels were found to be elevated. The patient underwent two tumor biopsies: at diagnosis (when calcium levels were normal) and upon development of hypercalcemia and cachexia. PTHrP expression was higher in melanoma cells when hypercalcemia had occurred than prior to its onset. Metabolic characterization of melanoma cells revealed that, with development of hypercalcemia, there was high expression of monocarboxylate transporter 1 (MCT1), which is the main importer of lactate and ketone bodies into cells. MCT1 is associated with high mitochondrial metabolism. Beta-galactosidase (β-GAL), a marker of senescence, had reduced expression in melanoma cells upon development of hypercalcemia compared to pre-hypercalcemia. In conclusion, PTHrP expression in melanoma is associated with cachexia, increased cancer cell lactate and ketone body import, high mitochondrial metabolism, and reduced senescence. Further studies are required to determine if PTHrP regulates cachexia, lactate and ketone body import, mitochondrial metabolism, and senescence in cancer cells.
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Affiliation(s)
- Teresa Anne Mills
- Sidney Kimmel College of Medicine Thomas Jefferson University, Philadelphia, PA
| | - Marlana Orloff
- Department of Medical Oncology Thomas Jefferson University, Philadelphia, PA
| | | | - Paolo Cotzia
- Department of Pathology Thomas Jefferson University, Philadelphia, PA
| | - Ruth C Birbe
- Department of Pathology Thomas Jefferson University, Philadelphia, PA
| | | | | | - Madalina Tuluc
- Department of Pathology Thomas Jefferson University, Philadelphia, PA
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28
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Cuyàs E, Corominas-Faja B, Menendez JA. The nutritional phenome of EMT-induced cancer stem-like cells. Oncotarget 2015; 5:3970-82. [PMID: 24994116 PMCID: PMC4147299 DOI: 10.18632/oncotarget.2147] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The metabolic features of cancer stem (CS) cells and the effects of specific nutrients or metabolites on CS cells remain mostly unexplored. A preliminary study to delineate the nutritional phenome of CS cells exploited the landmark observation that upon experimental induction into an epithelial-to-mesenchymal (EMT) transition, the proportion of CS-like cells drastically increases within a breast cancer cell population. EMT-induced CS-like cells (HMLERshEcad) and isogenic parental cells (HMLERshCntrol) were simultaneously screened for their ability to generate energy-rich NADH when cultured in a standardized high-throughput metabolic phenotyping platform comprising >350 wells that were pre-loaded with different carbohydrates/starches, alcohols, fatty acids, ketones, carboxylic acids, amino acids, and bi-amino acids. The generation of “phenetic maps” of the carbon and nitrogen utilization patterns revealed that the acquisition of a CS-like cellular state provided an enhanced ability to utilize additional catabolic fuels, especially under starvation conditions. Crucially, the acquisition of cancer stemness activated a metabolic infrastructure that enabled the vectorial transfer of high-energy nutrients such as glycolysis end products (pyruvate, lactate) and bona fide ketone bodies (β-hydroxybutyrate) from the extracellular microenvironment to support mitochondrial energy production in CS-like cells. Metabolic reprogramming may thus constitute an efficient adaptive strategy through which CS-like cells would rapidly obtain an advantage in hostile conditions such as nutrient starvation following the inhibition of tumor angiogenesis. By understanding how specific nutrients could bioenergetically boost EMT-CS-like phenotypes, “smart foods” or systemic “metabolic nichotherapies” may be tailored to specific nutritional CSC phenomes, whereas high-resolution heavy isotope-labeled nutrient tracking may be developed to monitor the spatiotemporal distribution and functionality of CS-like cells in real time.
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Affiliation(s)
- Elisabet Cuyàs
- Metabolism & Cancer Group, Translational Research Laboratory, Catalan Institute of Oncology, Girona, Catalonia, SPAIN; Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, SPAIN
| | - Bruna Corominas-Faja
- Metabolism & Cancer Group, Translational Research Laboratory, Catalan Institute of Oncology, Girona, Catalonia, SPAIN; Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, SPAIN
| | - Javier A Menendez
- Metabolism & Cancer Group, Translational Research Laboratory, Catalan Institute of Oncology, Girona, Catalonia, SPAIN; Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, SPAIN
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29
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Fujiwara S, Wada N, Kawano Y, Okuno Y, Kikukawa Y, Endo S, Nishimura N, Ueno N, Mitsuya H, Hata H. Lactate, a putative survival factor for myeloma cells, is incorporated by myeloma cells through monocarboxylate transporters 1. Exp Hematol Oncol 2015; 4:12. [PMID: 25909034 PMCID: PMC4407384 DOI: 10.1186/s40164-015-0008-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/02/2015] [Indexed: 01/30/2023] Open
Abstract
Background Lactate levels within tumors are correlated with metastases, tumor recurrence, and radioresistance, thus apparently contributing to poor outcomes in patients with various cancers. We previously reported that high-level production of lactate by multiple myeloma (MM) cell lines is associated with high-level LDH activity within such MM cells. However, the kinetics of lactate remains to be studied. In the present study, we attempted to elucidate the mechanism of lactate incorporation into MM cells. Methods Six MM cell lines and stromal cells obtained through long-term culture of bone marrow samples from MM patients were employed. Incorporation of lactate was quantified using C14-labeled lactate. The role of MCT1, a member of the monocarboxylate transporters (MCTs), expressed on MM cells, was examined in the presence of its inhibitor (α-cyano-4-hydroxycinnamic acid: CHC) and by using gene-silencing technique. Results MM cell lines as well as stromal cells were found to produce lactate. Incorporation of C14-labeled lactate into MM cells occurred in all 6 MM cell lines analyzed. Inhibition of MCT1 by using CHC or MCT1-targeting siRNA reduced lactate incorporation and caused apoptosis in MM cells. This apoptosis was enhanced when the activity of pyruvate dehydrogenase kinase was blocked by dichroloacetate. Survival of normal peripheral blood mononuclear cells was not influenced by MCT1 inhibition. Conclusions The present data suggest that lactate is produced by MM cell lines and stromal cells, and contributes to the survival of such MM cells in autocrine or paracrine manners. Suppression of lactate incorporation by targeting MCT1 may provide a novel therapeutic strategy for MM which may be applicable for other B-cell neoplasms.
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Affiliation(s)
- Shiho Fujiwara
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Naoko Wada
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Yawara Kawano
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Yutaka Okuno
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Yoshitaka Kikukawa
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Shinya Endo
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Nao Nishimura
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Nina Ueno
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Hiroaki Mitsuya
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan
| | - Hiroyuki Hata
- Department of Hematology, Kumamoto University School of Medicine, 1-1-1, Honjo, Chu-ouku, Kumamoto city, Kumamoto 860-8556 Japan ; Graduate School of Health Sciences, Faculty of Medical Sciences, Division of Informative Clinical Sciences, Kumamoto University School of Medicine, 4-24-1 Kuhonji, Kumamoto, 862-0976 Japan
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30
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Complete heart block and persistent lactic acidosis as an initial presentation of non-hodgkin lymphoma in a critically ill newly diagnosed AIDS patient. Case Rep Crit Care 2014; 2014:214970. [PMID: 25431684 PMCID: PMC4241285 DOI: 10.1155/2014/214970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 10/13/2014] [Accepted: 10/19/2014] [Indexed: 11/18/2022] Open
Abstract
A 66-year-old male with newly diagnosed untreated acquired immunodeficiency syndrome (AIDS) presented with chronic nonspecific complaints of weakness, fatigue, myalgia, and weight loss. His initial EKG showed complete heart block necessitating temporary pacemaker placement. He had no previous history of cardiac disease. He was also found to have a persistent lactic acidosis and imaging studies showed abdominal lymphadenopathy. The patient underwent biopsy of these lymph nodes and was found to have diffuse large B-cell lymphoma. The hospital course was complicated by respiratory failure requiring mechanical ventilator support and cardiac arrest. Patient remained critically ill; he was not a candidate for chemotherapy and, after a month of hospitalization, he died. Lactic acidosis and heart block as an initial presentation of non-Hodgkin lymphoma in an AIDS patient are an unusual and unique presentation.
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31
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Lactate transporters in the context of prostate cancer metabolism: what do we know? Int J Mol Sci 2014; 15:18333-48. [PMID: 25314297 PMCID: PMC4227218 DOI: 10.3390/ijms151018333] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/05/2014] [Accepted: 09/22/2014] [Indexed: 02/06/2023] Open
Abstract
Metabolic changes during malignant transformation have been noted for many years in tumours. Otto Warburg first reported that cancer cells preferentially rely on glycolysis for energy production, even in the presence of oxygen, leading to the production of high levels of lactate. The crucial role of lactate efflux and exchange within the tumour microenvironment drew attention to monocarboxylate transporters (MCTs). MCTs have been recognized as promising targets in cancer therapy, and their expression was described in a large variety of tumours; however, studies showing how these isoforms contribute to the acquisition of the malignant phenotype are scarce and still unclear regarding prostate cancer. In this review, we focus on the role for MCTs in cell metabolism, supporting the development and progression of prostate cancer, and discuss the exploitation of the metabolic nature of prostate cancer for therapeutic and diagnostic purposes.
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32
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Martinez-Outschoorn U, Sotgia F, Lisanti MP. Tumor microenvironment and metabolic synergy in breast cancers: critical importance of mitochondrial fuels and function. Semin Oncol 2014; 41:195-216. [PMID: 24787293 DOI: 10.1053/j.seminoncol.2014.03.002] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Metabolic synergy or metabolic coupling between glycolytic stromal cells (Warburg effect) and oxidative cancer cells occurs in human breast cancers and promotes tumor growth. The Warburg effect or aerobic glycolysis is the catabolism of glucose to lactate to obtain adenosine triphosphate (ATP). This review summarizes the main findings on this stromal metabolic phenotype, and the associated signaling pathways, as well as the critical role of oxidative stress and autophagy, all of which promote carcinoma cell mitochondrial metabolism and tumor growth. Loss of Caveolin 1 (Cav-1) and the upregulation of monocarboxylate transporter 4 (MCT4) in stromal cells are novel markers of the Warburg effect and metabolic synergy between stromal and carcinoma cells. MCT4 and Cav-1 are also breast cancer prognostic biomarkers. Reactive oxygen species (ROS) are key mediators of the stromal Warburg effect. High ROS also favors cancer cell mitochondrial metabolism and tumorigenesis, and anti-oxidants can reverse this altered stromal and carcinoma metabolism. A pseudo-hypoxic state with glycolysis and low mitochondrial metabolism in the absence of hypoxia is a common feature in breast cancer. High ROS induces loss of Cav-1 in stromal cells and is sufficient to generate a pseudo-hypoxic state. Loss of Cav-1 in the stroma drives glycolysis and lactate extrusion via HIF-1α stabilization and the upregulation of MCT4. Stromal cells with loss of Cav-1 and/or high expression of MCT4 also show a catabolic phenotype, with enhanced macroautophagy. This catabolic state in stromal cells is driven by hypoxia-inducible factor (HIF)-1α, nuclear factor κB (NFκB), and JNK activation and high ROS generation. A feed-forward loop in stromal cells regulates pseudo-hypoxia and metabolic synergy, with Cav-1, MCT4, HIF-1α, NFκB, and ROS as its key elements. Metabolic synergy also may occur between cancer cells and cells in distant organs from the tumor. Cancer cachexia, which is due to severe organismal metabolic dysregulation in myocytes and adipocytes, shares similarities with stromal-carcinoma metabolic synergy, as well. In summary, metabolic synergy occurs when breast carcinoma cells induce a nutrient-rich microenvironment to promote tumor growth. The process of tumor metabolic synergy is a multistep process, due to the generation of ROS, and the induction of catabolism with autophagy, mitophagy and glycolysis. Studying epithelial-stromal interactions and metabolic synergy is important to better understand the ecology of cancer and the metabolic role of different cell types in tumor progression.
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Affiliation(s)
| | - Federica Sotgia
- University of Manchester, Manchester Breast Centre & Breakthrough Breast Cancer Research Unit, Manchester, United Kingdom
| | - Michael P Lisanti
- University of Manchester, Manchester Breast Centre & Breakthrough Breast Cancer Research Unit, Manchester, United Kingdom
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Martinez-Outschoorn UE, Lisanti MP, Sotgia F. Catabolic cancer-associated fibroblasts transfer energy and biomass to anabolic cancer cells, fueling tumor growth. Semin Cancer Biol 2014; 25:47-60. [PMID: 24486645 DOI: 10.1016/j.semcancer.2014.01.005] [Citation(s) in RCA: 306] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 01/17/2014] [Accepted: 01/17/2014] [Indexed: 12/22/2022]
Abstract
Fibroblasts are the most abundant "non-cancerous" cells in tumors. However, it remains largely unknown how these cancer-associated fibroblasts (CAFs) promote tumor growth and metastasis, driving chemotherapy resistance and poor clinical outcome. This review summarizes new findings on CAF signaling pathways and their emerging metabolic phenotypes that promote tumor growth. Although it is well established that altered cancer metabolism enhances tumor growth, little is known about the role of fibroblast metabolism in tumor growth. New studies reveal that metabolic coupling occurs between catabolic fibroblasts and anabolic cancer cells, in many types of human tumors, including breast, prostate, and head & neck cancers, as well as lymphomas. These catabolic phenotypes observed in CAFs are secondary to a ROS-induced metabolic stress response. Mechanistically, this occurs via HIF1-alpha and NFκB signaling, driving oxidative stress, autophagy, glycolysis and senescence in stromal fibroblasts. These catabolic CAFs then create a nutrient-rich microenvironment, to metabolically support tumor growth, via the local stromal generation of mitochondrial fuels (lactate, ketone bodies, fatty acids, glutamine, and other amino acids). New biomarkers of this catabolic CAF phenotype (such as caveolin-1 (Cav-1) and MCT4), which are reversible upon treatment with anti-oxidants, are strong predictors of poor clinical outcome in various types of human cancers. How cancer cells metabolically reprogram fibroblasts can also help us to understand the effects of cancer cells at an organismal level, explaining para-neoplastic phenomena, such as cancer cachexia. In conclusion, cancer should be viewed more as a systemic disease, that engages the host-organism in various forms of energy-transfer and metabolic co-operation, across a whole-body "ecosystem".
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Affiliation(s)
| | - Michael P Lisanti
- Manchester Breast Centre & Breakthrough Breast Cancer Research Unit, Institute of Cancer Sciences, University of Manchester, UK; Manchester Centre for Cellular Metabolism (MCCM), University of Manchester, UK.
| | - Federica Sotgia
- Manchester Breast Centre & Breakthrough Breast Cancer Research Unit, Institute of Cancer Sciences, University of Manchester, UK; Manchester Centre for Cellular Metabolism (MCCM), University of Manchester, UK.
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