title: Waves of gene regulation suppress and then restore oxidative phosphorylation in cancer cells.
abstract: We posit the following hypothesis: Independently of whether malignant tumors are initiated by a fundamental reprogramming of gene expression or seeded by stem cells, "waves" of gene expression that promote metabolic changes occur during carcinogenesis, beginning with oncogene-mediated changes, followed by hypoxia-induced factor (HIF)-mediated gene expression, both resulting in the highly glycolytic "Warburg" phenotype and suppression of mitochondrial biogenesis. Because high proliferation rates in malignancies cause aglycemia and nutrient shortage, the third (second oncogene) "wave" of adaptation stimulates glutaminolysis, which in certain cases partially re-establishes oxidative phosphorylation; this involves the LKB1-AMPK-p53, PI3K-Akt-mTOR axes and MYC dysregulation. Oxidative glutaminolysis serves as an alternative pathway compensating for cellular ATP. Together with anoxic glutaminolysis it provides pyruvate, lactate, and the NADPH pool (alternatively to pentose phosphate pathway). Retrograde signaling from revitalized mitochondria might constitute the fourth "wave" of gene reprogramming. In turn, upon reversal of the two Krebs cycle enzymes, glutaminolysis may partially (transiently) function even during anoxia, thereby further promoting malignancy. The history of the carcinogenic process within each malignant tumor determines the final metabolic phenotype of the selected surviving cells, resulting in distinct cancer bioenergetic phenotypes ranging from the highly glycolytic "classic Warburg" to partial or enhanced oxidative phosphorylation. We discuss the bioenergetically relevant functions of oncogenes, the involvement of mitochondrial biogenesis/degradation in carcinogenesis, the yet unexplained Crabtree effect of instant glucose blockade of respiration, and metabolic signaling stemming from the accumulation of succinate, fumarate, pyruvate, lactate, and oxoglutarate by interfering with prolyl hydroxylase domain enzyme-mediated hydroxylation of HIFα prolines.
authors.affiliation: Department of Membrane Transport Biophysics, Institute of Physiology, vvi, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
authors.forename: Katarína
authors.initials: K
authors.lastname: Smolková
authors.forename: Lydie
authors.initials: L
authors.lastname: Plecitá-Hlavatá
authors.forename: Nadége
authors.initials: N
authors.lastname: Bellance
authors.forename: Giovanni
authors.initials: G
authors.lastname: Benard
authors.forename: Rodrigue
authors.initials: R
authors.lastname: Rossignol
authors.forename: Petr
authors.initials: P
authors.lastname: Ježek
mesh_terms: D000220:Adaptation, Biological / Q000502:physiology; D015687:Cell Hypoxia; D049109:Cell Proliferation; D004734:Energy Metabolism / Q000502:physiology*; D005786:Gene Expression Regulation / Q000502:physiology*; D016259:Genes, myc / Q000502:physiology; D005947:Glucose / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D053858:Metabolic Networks and Pathways / Q000502:physiology; D008928:Mitochondria / Q000378:metabolism*; D009369:Neoplasms / Q000378:metabolism*; D010085:Oxidative Phosphorylation; D058539:Phosphatidylinositol 3-Kinase / Q000378:metabolism; D017346:Protein Serine-Threonine Kinases / Q000378:metabolism; D019289:Pyruvic Acid / Q000378:metabolism
chemical_list: D005973:Glutamine; D019344:Lactic Acid; D019289:Pyruvic Acid; D058539:Phosphatidylinositol 3-Kinase; D017346:Protein Serine-Threonine Kinases; D005947:Glucose