Palma Flavio R, Ratti Bianca A, Paviani Veronica, Coelho Diego R, Miguel Rodrigo, Danes Jeanne M, Zaichik Sofia V, de Abreu Andre L, Silva Sueli O, Chen Yiliang, Silverstein Roy L, Karan Uppal, Jones Dean P, Bonini Marcelo G
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
Department of Medicine and Biophysics, Medical College of Wisconsin, Milwaukee, WI, 5322, USA.
Oncogene. 2021 Sep;40(36):5455-5467. doi: 10.1038/s41388-021-01943-x. Epub 2021 Jul 21.
Epidemiologic studies in diabetic patients as well as research in model organisms have indicated the potential of metformin as a drug candidate for the treatment of various types of cancer, including breast cancer. To date most of the anti-cancer properties of metformin have, in large part, been attributed either to the inhibition of mitochondrial NADH oxidase complex (Complex I in the electron transport chain) or the activation of AMP-activated kinase (AMPK). However, it is becoming increasingly clear that AMPK activation may be critical to alleviate metabolic and energetic stresses associated with tumor progression suggesting that it may, in fact, attenuate the toxicity of metformin instead of promoting it. Here, we demonstrate that AMPK opposes the detrimental effects of mitochondrial complex I inhibition by enhancing glycolysis at the expense of, and in a manner dependent on, pyruvate availability. We also found that metformin forces cells to rewire their metabolic grid in a manner that depends on AMPK, with AMPK-competent cells upregulating glycolysis and AMPK-deficient cell resorting to ketogenesis. In fact, while the killing effects of metformin were largely rescued by pyruvate in AMPKcompetent cells, AMPK-deficient cells required instead acetoacetate, a product of fatty acid catabolism indicating a switch from sugar to fatty acid metabolism as a central resource for ATP production in these cells. In summary, our results indicate that AMPK activation is not responsible for metformin anticancer activity and may instead alleviate energetic stress by activating glycolysis.
对糖尿病患者的流行病学研究以及对模式生物的研究表明,二甲双胍有潜力成为治疗包括乳腺癌在内的各种癌症的候选药物。迄今为止,二甲双胍的大多数抗癌特性在很大程度上要么归因于对线粒体NADH氧化酶复合物(电子传递链中的复合物I)的抑制,要么归因于AMP激活的蛋白激酶(AMPK)的激活。然而,越来越清楚的是,AMPK激活对于减轻与肿瘤进展相关的代谢和能量应激可能至关重要,这表明它实际上可能减轻二甲双胍的毒性而非促进其毒性。在此,我们证明AMPK通过以丙酮酸可用性为代价并以其为依赖的方式增强糖酵解来对抗线粒体复合物I抑制的有害影响。我们还发现,二甲双胍迫使细胞以依赖AMPK的方式重新调整其代谢网络,具有功能性AMPK的细胞上调糖酵解,而缺乏AMPK的细胞则诉诸生酮作用。事实上,虽然在具有功能性AMPK的细胞中丙酮酸在很大程度上挽救了二甲双胍的杀伤作用,但缺乏AMPK的细胞反而需要乙酰乙酸,这是脂肪酸分解代谢的产物,表明从糖代谢转变为脂肪酸代谢作为这些细胞中ATP产生的主要资源。总之,我们的结果表明,AMPK激活并非二甲双胍抗癌活性的原因,反而可能通过激活糖酵解来减轻能量应激。