Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor. Malaysia.
InMed Pharmaceuticals, Vancouver, V6C 1T2. Canada.
Curr Cancer Drug Targets. 2017;17(8):707-721. doi: 10.2174/1568009617666170330150458.
Mutations in proto-oncogenes and tumor suppressor genes make cancer cells proliferate indefinitely. As they possess almost all mechanisms for cell proliferation and survival like healthy cells, it is difficult to specifically target cancer cells in the body. Current treatments in most of the cases are harmful to healthy cells as well. Thus, it would be of great prudence to target specific characters of cancer cells. Since cancer cells avidly use glucose and glutamine to survive and proliferate by upregulating the relevant enzymes and their specific isoforms having important regulatory roles, it has been of great interest recently to target the energy-related metabolic pathways as part of the therapeutic interventions.
This paper summarizes the isozymes overexpressed in breast cancer, their roles of energy metabolism and cross-talks with other important signaling pathways in regulating proliferation, invasion and metastasis in breast cancer.
Information has been collected from recently published literature available on Google Scholar and PubMed. Where available, in vivo results were given more importance over in vitro works.
Like many other cancers, breast cancer shows increased dependence on glycolysis rather than mitochondrial respiration, the main energy source in healthy cells. Cancer cells alter the cellular energy system in a way that helps minimize level of reactive oxygen species and simultaneously produce enough macromolecules- proteins, lipids and nucleotides for cellular proliferation. The altered system enables the cells to grow, proliferate, metastasize and to develop drug resistance. Certain isozymes of metabolic enzymes are overexpressed in breast cancer and the degree of expression of these enzymes vary among subtypes.
A clear understanding of the variations of energy metabolism in different molecular subtypes of breast cancer would help in treating each type with a very customized, safer and efficient treatment regimen. Anti-cancer drugs or RNAi or combination of both targeting cancer cell specific isozymes of metabolic enzymes mentioned in this article could offer a great treatment modality for breast cancer.
原癌基因和肿瘤抑制基因的突变使癌细胞无限增殖。由于它们拥有与健康细胞几乎相同的细胞增殖和存活机制,因此很难在体内特异性靶向癌细胞。目前大多数情况下的治疗方法对健康细胞也有一定的伤害。因此,针对癌细胞的特定特征进行靶向治疗将是非常谨慎的。由于癌细胞通过上调相关酶及其具有重要调节作用的特定同工型来贪婪地利用葡萄糖和谷氨酰胺来存活和增殖,因此最近靶向与能量相关的代谢途径作为治疗干预的一部分引起了极大的关注。
本文总结了乳腺癌中过度表达的同工酶,及其在调节乳腺癌增殖、侵袭和转移中的能量代谢作用和与其他重要信号通路的串扰。
从 Google Scholar 和 PubMed 上可获得的最近发表的文献中收集信息。在有条件的情况下,体内结果比体外研究更受重视。
与许多其他癌症一样,乳腺癌表现出对糖酵解的依赖性增加,而不是对线粒体呼吸的依赖性增加,线粒体呼吸是健康细胞的主要能量来源。癌细胞以一种有助于最大限度地降低活性氧水平的方式改变细胞能量系统,同时为细胞增殖产生足够的大分子——蛋白质、脂质和核苷酸。改变的系统使细胞能够生长、增殖、转移和产生耐药性。代谢酶的某些同工酶在乳腺癌中过度表达,并且这些酶的表达程度在不同的亚型之间有所不同。
对不同分子亚型乳腺癌能量代谢变化的清晰理解将有助于针对每种类型采用非常定制化、更安全和有效的治疗方案。本文提到的针对代谢酶癌细胞特异性同工酶的抗癌药物或 RNAi 或两者的组合,可以为乳腺癌提供一种很好的治疗方式。