1. The Acidic Brain—Glycolytic Switch in the Microenvironment of Malignant Glioma
- Author
-
Dominik Groos, Anna Maria Reuss, Michael Buchfelder, and Nicolai E. Savaskan
- Subjects
Angiogenic Switch ,QH301-705.5 ,Angiogenesis ,MCT4 ,Review ,MCT1 ,Catalysis ,Inorganic Chemistry ,angiogenesis ,Downregulation and upregulation ,glioma ,Glioma ,medicine ,HIF ,Animals ,Humans ,tumor microenvironment ,Lactic Acid ,ddc:610 ,Biology (General) ,Physical and Theoretical Chemistry ,QD1-999 ,Molecular Biology ,Transcription factor ,Spectroscopy ,Carbonic Anhydrases ,Brain Chemistry ,acidic ,lactate ,Tumor microenvironment ,Neovascularization, Pathologic ,Brain Neoplasms ,Chemistry ,Organic Chemistry ,Brain ,General Medicine ,Hydrogen-Ion Concentration ,medicine.disease ,Computer Science Applications ,Anaerobic glycolysis ,Cancer cell ,Cancer research ,glycolytic ,Glycolysis ,carbonic anhydrase (CA)IX - Abstract
Malignant glioma represents a fatal disease with a poor prognosis and development of resistance mechanisms against conventional therapeutic approaches. The distinct tumor zones of this heterogeneous neoplasm develop their own microenvironment, in which subpopulations of cancer cells communicate. Adaptation to hypoxia in the center of the expanding tumor mass leads to the glycolytic and angiogenic switch, accompanied by upregulation of different glycolytic enzymes, transporters, and other metabolites. These processes render the tumor microenvironment more acidic, remodel the extracellular matrix, and create energy gradients for the metabolic communication between different cancer cells in distinct tumor zones. Escape mechanisms from hypoxia-induced cell death and energy deprivation are the result. The functional consequences are more aggressive and malignant behavior with enhanced proliferation and survival, migration and invasiveness, and the induction of angiogenesis. In this review, we go from the biochemical principles of aerobic and anaerobic glycolysis over the glycolytic switch, regulated by the key transcription factor hypoxia-inducible factor (HIF)-1α, to other important metabolic players like the monocarboxylate transporters (MCTs)1 and 4. We discuss the metabolic symbiosis model via lactate shuttling in the acidic tumor microenvironment and highlight the functional consequences of the glycolytic switch on glioma malignancy. Furthermore, we illustrate regulation by micro ribonucleic acids (miRNAs) and the connection between isocitrate dehydrogenase (IDH) mutation status and glycolytic metabolism. Finally, we give an outlook about the diagnostic and therapeutic implications of the glycolytic switch and the relation to tumor immunity in malignant glioma.
- Published
- 2021