International Journal of Molecular Sciences Review The Pentose Phosphate Pathway and Its Involvement in Cisplatin Resistance Isabella Giacomini 1, Eugenio Ragazzi 1 , Gianfranco Pasut 2 and Monica Montopoli 1,3,* 1 Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Largo Egidio Meneghetti 2, 35131 Padova, Italy;
[email protected] (I.G.);
[email protected] (E.R.) 2 Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Via Marzolo 5, 35131 Padova, Italy;
[email protected] 3 Veneto Institute of Molecular Medicine, Via Giuseppe Orus 2, 35129 Padova, Italy * Correspondence:
[email protected]; Tel.: +39-049-827-5090 Received: 30 December 2019; Accepted: 29 January 2020; Published: 31 January 2020 Abstract: Cisplatin is the first-line treatment for different types of solid tumors, such as ovarian, testicular, bladder, cervical, head and neck, lung, and esophageal cancers. The main problem related to its clinical use is the onset of drug resistance. In the last decades, among the studied molecular mechanisms of cisplatin resistance, metabolic reprogramming has emerged as a possible one. This review focuses on the pentose phosphate pathway (PPP) playing a pivotal role in maintaining the high cell proliferation rate and representing an advantage for cancer cells. In particular, the oxidative branch of PPP plays a role in oxidative stress and seems to be involved in cisplatin resistance. In light of these considerations, it has been demonstrated that overexpression and higher enzymatic activity of different enzymes of both oxidative and non-oxidative branches (such as glucose-6-phosphate dehydrogenase, 6-phosphogluconate dehydrogenase, and transketolase) increase cisplatin resistance, and their silencing or combined treatment with cisplatin could restore cisplatin sensitivity.