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Review
.2020 Jan;122(1):4-22.
doi: 10.1038/s41416-019-0650-z. Epub 2019 Dec 10.

Reprogramming of fatty acid metabolism in cancer

Affiliations
Review

Reprogramming of fatty acid metabolism in cancer

Nikos Koundouros et al. Br J Cancer.2020 Jan.

Abstract

A common feature of cancer cells is their ability to rewire their metabolism to sustain the production of ATP and macromolecules needed for cell growth, division and survival. In particular, the importance of altered fatty acid metabolism in cancer has received renewed interest as, aside their principal role as structural components of the membrane matrix, they are important secondary messengers, and can also serve as fuel sources for energy production. In this review, we will examine the mechanisms through which cancer cells rewire their fatty acid metabolism with a focus on four main areas of research. (1) The role of de novo synthesis and exogenous uptake in the cellular pool of fatty acids. (2) The mechanisms through which molecular heterogeneity and oncogenic signal transduction pathways, such as PI3K-AKT-mTOR signalling, regulate fatty acid metabolism. (3) The role of fatty acids as essential mediators of cancer progression and metastasis, through remodelling of the tumour microenvironment. (4) Therapeutic strategies and considerations for successfully targeting fatty acid metabolism in cancer. Further research focusing on the complex interplay between oncogenic signalling and dysregulated fatty acid metabolism holds great promise to uncover novel metabolic vulnerabilities and improve the efficacy of targeted therapies.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Major discoveries in lipid research. Seminal studies demonstrating the importance of dysregulated fatty acid metabolism in cancer. FASN, fatty acid synthase; SREBPs, sterol regulatory element-binding protein; ACLY, ATP–citrate lyase; mTORC1, mammalian target of rapamycin complex 1; mTORC2, mammalian target of rapamycin complex 2.
Fig. 2
Fig. 2
Cancer cells obtain fatty acids (FAs) from de novo lipogenesis and exogenous uptake. The exogenous uptake of FAs from the surrounding microenvironment is facilitated by specialised transporters, including CD36, FATPs and FABPpm. FAs and their synthetic products can be subsequently stored as LDs, and used for NADPH and acetyl-CoA production through β-oxidation. In terms of carbon sources for de novo lipogenesis, cancer cells rely on glucose, glutamine and acetate to synthesise citrate. Palmitate is ultimately generated from citrate through the enzymatic activities of ACLY, ACC and FASN, and can subsequently be desaturated and elongated to form a diverse group of lipid species. An alternative pathway for palmitate desaturation exists, which generates sapienate through FADS2, instead of palmitoleate. Abbreviations: GLUT1, glucose transporter 1; MCT, monocarboxylate transporter; CD36, cluster of differentiation 36; FATPs, fatty acid transport proteins; FABPpm, fatty acid-binding protein; GLS, glutaminase; IDH1/2, isocitrate dehydrogenase; ACLY, ATP–citrate lyase; ACSS2, acyl-CoA synthetase short-chain family member 2; ACC, acetyl-CoA carboxylase; FASN, fatty acid synthase; MUFAs, monounsaturated fatty acids; PUFAs, polyunsaturated fatty acids; SCD, stearoyl-CoA desaturase-1; FADS2, fatty acid desaturase 2; ELOVLs, elongation of very long-chain fatty acid protein; PA, phosphatidic acid; TAG, triacylglycerol; DAG, diacylglycerol; PE, phosphatidylethanolamine; PG, phosphatidylglycerol; PS; phosphatidylserine.
Fig. 3
Fig. 3
Regulation of lipid metabolism by PI3K–mTOR signalling. PI3K signalling is the most frequently dysregulated pathway in cancer, and stimulates growth, proliferation and survival. Activation of receptor tyrosine kinases recruits PI3Kα to the plasma membrane where it phosphorylates PIP2 to PIP3. AKT binds to PIP3, allowing activation by PDK1 and mTORC2. AKT directly promotes lipogenesis by stabilising SREBP1c through inhibition of GSK3β, activation of ACLY to generate acetyl-CoA and phosphorylation of NADK to produce NADP+ for NADPH synthesis. PI3K signalling is also closely linked to mTORC1 and mTORC2. mTORC1 regulates lipogenesis through inhibition of lipin-1, which is a negative regulator of nuclear SREBP1c, and activation of the splicing factor SRPK2, thereby promoting the expression of lipogenic enzymes, including ACLY, FASN and ACSS2. Finally, mTORC2 activation supports lipogenesis through AKT-dependent and -independent mechanisms, with the latter encompassing phosphorylation of SGK1 and PKCs, and subsequent activation of SREBP1c. Abbreviations: PIP3, phosphatidylinositol (3,4,5)-trisphosphate; PIP2, phosphatidylinositol (4,5)-bisphosphate; mTORC, mammalian target of rapamycin complex; SREBP, sterol regulatory element-binding protein; SGK, serum- and glucocorticoid-induced protein kinase 1; PKC, protein kinase C; GSK3, glycogen synthase kinase; FBXW7, F-Box and WD repeat domain containing 7; ACLY, ATP–citrate lyase, PDK1, phosphoinositide-dependent kinase 1; NADK, NAD+ kinase; NAD+, nicotinamide adenine dinucleotide; NADP+, nicotinamide adenine dinucleotide phosphate; SRPK2; SR-protein-specific kinase 2; S6K1, ribosomal protein S6 kinase β-1; FASN, fatty acid synthase; ACC, acyl-CoA synthetase short-chain family member 2.
Fig. 4
Fig. 4
Fatty acids (FAs) regulate membrane architecture and oncogenic signalling pathways.a Membrane fluidity is largely determined by cholesterol levels and degree of FA desaturation. Cancer cells displaying elevated de novo lipogenesis can synthesise saturated phospholipids, which not only increases membrane rigidity, but also protects against peroxidation induced by reactive oxygen species. Conversely, highly migratory cells display more fluid membranes as a result of increased desaturation and cholesterol abundance, thus contributing to the epithelial-to-mesenchymal transition and metastasis.b FAs and their synthetic products also function as secondary messengers in signalling pathways, with the best characterised being the phosphoinositides. PI(3,4,5)P3 activates oncogenic AKT, and contributes to hyperactivation of mTORC1 and mTORC2. In addition, PI(3)P stimulates SGK3 that promotes tumorigenesis independently of AKT. Finally, phosphatidic acid can also directly bind to and activate the mTOR complexes. Abbreviations: PI3Kα, phosphoinositide 3-kinase α; PI(4,5)P2, phosphatidylinositol (4,5)-bisphosphate; PI(3,4,5)P3, phosphatidylinositol (3,4,5)-trisphosphate; PI(3,4)P2, phosphatidylinositol (3,4)-bisphosphate; PI(3)P, phosphatidylinositol 3-phosphate; mTORC, mammalian target of rapamycin complex; PA, phosphatidic acid; PTEN, phosphatase and tensin homologue; SGK3, serum- and glucocorticoid-induced protein kinase-3; INPP4B, inositol polyphosphate-4-phosphatase type II B.
Fig. 5
Fig. 5
Remodelling of the tumour microenvironment by bioactive lipids. Eicosanoids and lysophosphatidic acid species can be secreted into the surrounding microenvironment and stimulate cell proliferation through both autocrine and paracrine mechanisms. Arachidonic acid (AA) serves as the main precursor for eicosanoid synthesis, and these include pro-inflammatory prostaglandins, leukotrienes and eicosatetraenoic acids. PGE2 can stimulate cell proliferation through autocrine and paracrine signalling, and this is largely mediated through the activation of EP1–EP4 receptors. Moreover, prostaglandins contribute to immunosuppression by attenuating the activation of natural killer, dendritic and cytotoxic T cells. Lysophosphatidic acids are also relevant signalling molecules, and can be produced intracellularly from glycerol-3-phosphate or phosphatidic acid, or extracellularly through the enzyme autotaxin, which uses existing phospholipids, such as phosphatidylglycerols and phosphatidylethanolamines as substrates. Similar to eicosanoids, lysophosphatidic acids exert their tumorigenic effects by binding to the LPAR family of G-protein-coupled receptors. Abbreviations: RTK, receptor tyrosine kinase; LOX, lipoxygenase; COX, cyclo-oxygenase; PGG2, prostaglandin G2; PGH2, prostaglandin H2; PGE2, prostaglandin E2; PGI2, prostaglandin I2; TXA2, thromboxane A2; HETE, hydroxytetraenoic acid; EP, prostaglandin E2 receptor; NK, natural killer cell; G3P, glyceraldehyde 3-phosphate; GPAT, glycerol-3-phosphate acyltransferase; PA, phosphatidic acid; PLA2, phospholipase A2; LPA, lysophosphatidic acid; LPAR, lysophosphatidic acid receptor; ATX, autotaxin.
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