肿瘤自噬基质模型或“电池驱动的肿瘤生长”:自噬悖论的简单解决方案。
The autophagic tumor stroma model of cancer or "battery-operated tumor growth": A simple solution to the autophagy paradox.
机构信息
The Jefferson Stem Cell Biology and Regenerative Medicine Center, Thomas Jefferson University, Philadelphia, PA, USA.
出版信息
Cell Cycle. 2010 Nov 1;9(21):4297-306. doi: 10.4161/cc.9.21.13817. Epub 2010 Nov 30.
The role of autophagy in tumorigenesis is controversial. Both autophagy inhibitors (chloroquine) and autophagy promoters (rapamycin) block tumorigenesis by unknown mechanism(s). This is called the "Autophagy Paradox". We have recently reported a simple solution to this paradox. We demonstrated that epithelial cancer cells use oxidative stress to induce autophagy in the tumor microenvironment. As a consequence, the autophagic tumor stroma generates recycled nutrients that can then be used as chemical building blocks by anabolic epithelial cancer cells. This model results in a net energy transfer from the tumor stroma to epithelial cancer cells (an energy imbalance), thereby promoting tumor growth. This net energy transfer is both unilateral and vectorial, from the tumor stroma to the epithelial cancer cells, representing a true host-parasite relationship. We have termed this new paradigm "The Autophagic Tumor Stroma Model of Cancer Cell Metabolism" or "Battery-Operated Tumor Growth". In this sense, autophagy in the tumor stroma serves as a "battery" to fuel tumor growth, progression and metastasis, independently of angiogenesis. Using this model, the systemic induction of autophagy will prevent epithelial cancer cells from using recycled nutrients, while the systemic inhibiton of autophagy will prevent stromal cells from producing recycled nutrients-both effectively "starving" cancer cells. We discuss the idea that tumor cells could become resistant to the systemic induction of autophagy, by the upregulation of natural endogenous autophagy inhibitors in cancer cells. Alternatively, tumor cells could also become resistant to the systemic induction of autophagy, by the genetic silencing/deletion of pro-autophagic molecules, such as Beclin1. If autophagy resistance develops in cancer cells, then the systemic inhibition of autophagy would provide a therapeutic solution to this type of drug resistance, as it would still target autophagy in the tumor stroma. As such, an anti-cancer therapy that combines the alternating use of both autophagy promoters and autophagy inhibitors would be expected to prevent the onset of drug resistance. We also discuss why anti-angiogenic therapy has been found to promote tumor recurrence, progression and metastasis. More specifically, anti-angiogenic therapy would induce autophagy in the tumor stroma via the induction of stromal hypoxia, thereby converting a non-aggressive tumor type to a "lethal" aggressive tumor phenotype. Thus, uncoupling the metabolic parasitic relationship between cancer cells and an autophagic tumor stroma may hold great promise for anti-cancer therapy. Finally, we believe that autophagy in the tumor stroma is the local microscopic counterpart of systemic wasting (cancer-associated cachexia), which is associated with advanced and metastatic cancers. Cachexia in cancer patients is not due to decreased energy intake, but instead involves an increased basal metabolic rate and increased energy expenditures, resulting in a negative energy balance. Importantly, when tumors were surgically excised, this increased metabolic rate returned to normal levels. This view of cachexia, resulting in energy transfer to the tumor, is consistent with our hypothesis. So, cancer-associated cachexia may start locally as stromal autophagy, and then spread systemically. As such, stromal autophagy may be the requisite precursor of systemic cancer-associated cachexia.
自噬在肿瘤发生中的作用存在争议。自噬抑制剂(氯喹)和自噬促进剂(雷帕霉素)通过未知的机制阻断肿瘤发生。这被称为“自噬悖论”。我们最近提出了一个简单的解决方案。我们证明上皮癌细胞利用氧化应激在肿瘤微环境中诱导自噬。因此,自噬性肿瘤基质产生可被合成代谢上皮癌细胞用作化学构建块的再循环营养物质。这种模型导致来自肿瘤基质的净能量转移到上皮癌细胞(能量失衡),从而促进肿瘤生长。这种净能量转移是单向和向量的,从肿瘤基质到上皮癌细胞,代表着真正的宿主-寄生虫关系。我们将这种新的范式称为“上皮癌细胞代谢的自噬性肿瘤基质模型”或“电池驱动的肿瘤生长”。从这个意义上说,肿瘤基质中的自噬可以作为“电池”来为肿瘤生长、进展和转移提供燃料,而与血管生成无关。使用这种模型,系统诱导自噬将阻止上皮癌细胞使用再循环营养物质,而系统抑制自噬将阻止基质细胞产生再循环营养物质——这两种方法都能有效地“饿死”癌细胞。我们讨论了肿瘤细胞可能通过上调癌细胞中天然内源性自噬抑制剂对系统诱导自噬产生抗性的想法。或者,肿瘤细胞也可能通过基因沉默/缺失促自噬分子(如 Beclin1)对系统诱导自噬产生抗性。如果肿瘤细胞产生自噬抗性,那么系统抑制自噬将为这种类型的耐药性提供治疗解决方案,因为它仍然针对肿瘤基质中的自噬。因此,将自噬促进剂和自噬抑制剂交替使用的抗癌疗法有望防止耐药性的发生。我们还讨论了为什么抗血管生成疗法已被发现会促进肿瘤复发、进展和转移。更具体地说,抗血管生成疗法通过诱导基质缺氧诱导肿瘤基质中的自噬,从而将非侵袭性肿瘤类型转化为“致命”侵袭性肿瘤表型。因此,分离癌细胞与自噬性肿瘤基质之间的代谢寄生关系可能为癌症治疗带来巨大希望。最后,我们认为肿瘤基质中的自噬是全身消耗(癌症相关恶病质)的局部微观对应物,与晚期和转移性癌症有关。癌症患者的恶病质不是由于能量摄入减少,而是由于基础代谢率增加和能量消耗增加,导致能量负平衡。重要的是,当肿瘤被手术切除时,这种代谢率会恢复正常水平。这种导致能量转移到肿瘤的恶病质观点与我们的假设一致。因此,癌症相关恶病质可能首先从基质自噬开始,然后扩散到全身。因此,基质自噬可能是全身癌症相关恶病质的必要前体。