乳酸和质子在癌细胞抵抗葡萄糖剥夺中的核心作用及其临床转化。
Central role of lactate and proton in cancer cell resistance to glucose deprivation and its clinical translation.
机构信息
Cancer Institute (a Key Laboratory For Cancer Prevention & Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
出版信息
Signal Transduct Target Ther. 2017 Mar 10;2:16047. doi: 10.1038/sigtrans.2016.47. eCollection 2017.
Targeting common weaknesses of cancer is an important strategy for cancer therapy. Glucose is a nutrient that maintains essential cellular metabolism, supporting cancer cell survival, growth and proliferation. Depriving glucose rapidly kills cancer cells. Most cancer cells possess a feature called Warburg effect, which refers to that cancer cells even with ample oxygen exhibit an exceptionally high glycolysis rate and convert most incoming glucose to lactate. Although it is recognized that Warburg effect confers growth advantage to cancer cells when glucose supply is sufficient, this feature could be considered as a fatal weakness of cancer cells when glucose supply is a problem. As glucose supply in many solid tumors is poor, and as most cancer cells have exceptionally high glycolytic capacity, maximizing cancer cell glycolysis rate would possibly exhaust intratumoral glucose, leading cancer cell to death. Lactate and proton are two common factors in solid tumors, they jointly protect cancer cells against glucose deprivation, and they are also powerful regulators dictating glucose metabolic phenotypes of cancer cells. Disrupting the joint action of lactate and proton, for example, by means of bicarbonate infusion into tumor, could maximize cancer cell glycolytic rate to rapidly use up glucose, expose their vulnerability to glucose deprivation and ultimately kill cancer cells. A pilot clinical study demonstrated that this approach achieved a remarkable improvement in local control of large and huge hepatocellular carcinoma.
针对癌症的共同弱点是癌症治疗的重要策略。葡萄糖是维持细胞基本代谢所必需的营养物质,支持癌细胞的存活、生长和增殖。剥夺葡萄糖会迅速杀死癌细胞。大多数癌细胞具有一种称为瓦博格效应的特征,即即使有充足的氧气,癌细胞仍表现出异常高的糖酵解率,并将大部分进入的葡萄糖转化为乳酸。尽管人们认识到,当葡萄糖供应充足时,瓦博格效应赋予癌细胞生长优势,但当葡萄糖供应成为问题时,这一特征可以被认为是癌细胞的致命弱点。由于许多实体肿瘤中的葡萄糖供应较差,并且大多数癌细胞具有异常高的糖酵解能力,最大限度地提高癌细胞的糖酵解率可能会耗尽肿瘤内的葡萄糖,导致癌细胞死亡。乳酸和质子是实体肿瘤中的两个常见因素,它们共同保护癌细胞免受葡萄糖剥夺的影响,也是决定癌细胞葡萄糖代谢表型的强大调节因子。例如,通过向肿瘤中输注碳酸氢盐来破坏乳酸和质子的联合作用,可以最大限度地提高癌细胞的糖酵解率,迅速消耗葡萄糖,暴露出它们对葡萄糖剥夺的脆弱性,并最终杀死癌细胞。一项初步的临床研究表明,这种方法显著改善了大肝癌和巨大肝癌的局部控制。