Research Papers:

HIF-1-alpha links mitochondrial perturbation to the dynamic acquisition of breast cancer tumorigenicity

Ching-Ying Kuo, Chun-Ting Cheng, Peifeng Hou, Yi-Pei Lin, Huimin Ma, Yiyin Chung, Kevin Chi, Yuan Chen, Wei Li, Hsing-Jien Kung and David K. Ann _

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Oncotarget. 2016; 7:34052-34069. https://doi.org/10.18632/oncotarget.8570

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Ching-Ying Kuo1, Chun-Ting Cheng1,2, Peifeng Hou1,3,4, Yi-Pei Lin5, Huimin Ma1, Yiyin Chung1, Kevin Chi1, Yuan Chen6, Wei Li7, Hsing-Jien Kung5,8, David K. Ann1,2

1Diabetes and Metabolism Research Institute, City of Hope, Duarte, CA, USA

2Irell & Manella Graduate School of Biological Sciences, City of Hope, Duarte, CA, USA

3Department of Oncology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China

4Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China

5Integrated Laboratory, Center of Translational Medicine, Taipei Medical University, Taipei, Taiwan, ROC

6Department of Molecular Medicine, Beckman Research Institute, City of Hope, Duarte, CA, USA

7Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

8Institute of Molecular and Genomic Medicine, National Health Research Institutes, Taiwan, ROC

Correspondence to:

David K. Ann, e-mail: [email protected]

Keywords: α-ketoglutarate, mitochondria, metabolic reprogramming, hypoxia-inducible factor-1α (HIF-1α), breast cancer tumorigenicity

Received: November 19, 2015     Accepted: March 10, 2016     Published: April 4, 2016


Up-regulation of hypoxia-inducible factor-1α (HIF-1α), even in normoxia, is a common feature of solid malignancies. However, the mechanisms of increased HIF-1α abundance, and its role in regulating breast cancer plasticity are not fully understood. We have previously demonstrated that dimethyl-2-ketoglutarate (DKG), a widely used cell membrane-permeable α-ketoglutarate (α-KG) analogue, transiently stabilizes HIF-1α by inhibiting prolyl hydroxylase 2. Here, we report that breast cancer tumorigenicity can be acquired through prolonged treatment with DKG. Our results indicate that, in response to prolonged DKG treatment, mitochondrial respiration becomes uncoupled, leading to the accumulation of succinate and fumarate in breast cancer cells. Further, we found that an early increase in the oxygen flux rate was accompanied by a delayed enhancement of glycolysis. Together, our results indicate that these events trigger a dynamic enrichment for cells with pluripotent/stem-like cell markers and tumorsphere-forming capacity. Moreover, DKG-mediated metabolic reprogramming results in HIF-1α induction and reductive carboxylation pathway activation. Both HIF-1α accumulation and the tumor-promoting metabolic state are required for DKG-promoted tumor repopulation capacity in vivo. Our data suggest that mitochondrial adaptation to DKG elevates the ratio of succinate or fumarate to α-KG, which in turn stabilizes HIF-1α and reprograms breast cancer cells into a stem-like state. Therefore, our results demonstrate that metabolic regulation, with succinate and/or fumarate accumulation, governs the dynamic transition of breast cancer tumorigenic states and we suggest that HIF-1α is indispensable for breast cancer tumorigenicity.

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