Metabolic Stress in Autophagy and Cell Death Pathways
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Downloaded from http://cshperspectives.cshlp.org/ on October 6, 2021 - Published by Cold Spring Harbor Laboratory Press Metabolic Stress in Autophagy and Cell Death Pathways Brian J. Altman and Jeffrey C. Rathmell Department of Pharmacology and Cancer Biology, Department of Immunology, Sarah Stedman Nutrition and Metabolism Center, Duke University, Durham, North Carolina 27710 Correspondence: [email protected] Growth factors and oncogenic kinases play important roles in stimulating cell growth during development and transformation. These processes have significant energetic and synthetic requirements and it is apparent that a central function of growth signals is to promote glucose metabolism to support these demands. Because metabolic pathways represent a fundamen- tal aspect of cell proliferation and survival, there is considerable interest in targeting metab- olism as a means to eliminate cancer. A challenge, however, is that molecular links between metabolic stress and cell death are poorly understood. Here we review current literature on how cells cope with metabolic stress and how autophagy, apoptosis, and necrosis are tightly linked to cell metabolism. Ultimately, understanding of the interplay between nutrients, autophagy, and cell death will be a key component in development of new treatment strat- egies to exploit the altered metabolism of cancer cells. lthough single-celled organisms grow and intrinsic growth signals that mimic growth fac- Aproliferate based on nutrient availability, tor input, which can be the source of oncogene metazoan cells rely on growth factor input to addiction. Growth factor input or oncogenic promote nutrient uptake, regulate growth and signals often drive highly elevated glucose up- proliferation, and survive (Raff 1992; Rathmell take and metabolism (Rathmell et al. 2000; De- et al. 2000). Access and competition for these Berardinis et al. 2008; Michalek and Rathmell signals are critical in developmental patterning 2010). First described in cancer by Warburg in and to maintain homeostasis of mature tissues. the 1920s, this highly glycolytic metabolic pro- Cells that do not receive proper growth factor gram is termed aerobic glycolysis and is a general signals typically atrophy, lose the ability to up- feature of many nontransformed proliferative take and use extracellular nutrients, and instead cells (Warburg 1956; DeBerardinis et al. 2008). induce the self-digestive process of autophagy as Nutrient uptake and aerobic glycolysis in- an intracellular energy source before ultimately duced by growth signals play key roles in cell undergoing programmed cell death. Cancer survival (Vander Heiden et al. 2001). Manipu- cells, in contrast, often become independent of lating cell metabolism as a meansto promote the extracellular growth signals by gaining muta- death of inappropriately dividing cells, there- tions or expressing oncogenic kinases to drive fore, is a promising new avenue to treat disease. Editors: Eric H. Baehrecke, Douglas R. Green, Sally Kornbluth, and Guy S. Salvesen Additional Perspectives on Cell Survival and Cell Death available at www.cshperspectives.org Copyright # 2012 Cold Spring Harbor Laboratory Press; all rights reserved; doi: 10.1101/cshperspect.a008763 Cite this article as Cold Spring Harb Perspect Biol 2012;4:a008763 1 Downloaded from http://cshperspectives.cshlp.org/ on October 6, 2021 - Published by Cold Spring Harbor Laboratory Press B.J. Altman and J.C. Rathmell Targeting the altered metabolism of cancer cells Unique double-membraned vesicles known as in particular is of great interest. It is still unclear autophagosomes engulf cellular material and at the molecular level, however, how inhibit- fuse with lysosomes to promote degradation of ing or modulating cell metabolism leads to ap- the contents (Kelekar 2005). Described in great- optosis, and how these pathways may best be er detail below, autophagy can reduce sources of exploited (Dang et al. 2009; Wise and Thomp- stress, such as protein aggregates and damaged son 2010). or dysfunctional intracellular organelles, and Growth factor or oncogenic kinases pro- provide nutrients during times of transient and mote multiple metabolic pathways that are es- acute nutrient withdrawal. sential to prevent metabolic stress and may be Despite the protective effects of autophagy, targets in efforts to link metabolism and cell cells deprived of growth signals, nutrients, or death (Vander Heiden et al. 2001). Decreased oxygen for prolonged times will eventually suc- glucose metabolism on loss of growth signals cumb to cell death. Apoptosis is the initial death leads to decreased ATP generation as well as response on metabolic stress and is regulated by loss in generation of many biosynthetic precur- Bcl-2 family proteins. In healthy cells, antiapop- sor molecules, including nucleic acids, fatty ac- totic Bcl-2 family proteins, such as Bcl-2, Bcl-xl, ids, and acetyl-CoA for acetylation (Zhao et al. and Mcl-1, bind and inhibit the multidomain 2007; Wellen et al. 2009; Coloff et al. 2011). proapoptotic proteins Bax and Bak (van Delft Glucose is also important as a precursor for and Huang 2006; Walensky 2006; Chipuk et al. the hexosamine pathway, to allow proper glyco- 2010). In metabolic stress, proapoptotic “BH3- sylation and protein folding in the endoplasmic only” proteins of the Bcl-2 family are induced or reticulum (Dennis et al. 2009; Kaufman et al. activated and bind to and inhibit the antiapop- 2010). If glucose metabolism remains insuffi- totic Bcl-2 family proteins to allow activation of cient or disrupted, the cells can switch to rely the proapoptotic Bax and Bak (Galonek and on mitochondrial oxidation of fatty acids and Hardwick 2006). The BH3-only proteins Bim, amino acids, which are energy rich but do not Bid, and Puma can also directly bind and acti- readily support cell growth and can lead to po- vate Bax and Bak (Letai et al. 2002; Ren et al. tentially dangerous levels of reactive oxygen spe- 2010). Active Bax and Bak disrupt the outer cies (Wellen and Thompson 2010). Amino acid mitochondrial membrane (termed mitochon- deficiency can directly inhibit components of drial outer-membrane permeabilization, or the signaling pathways downstream from MOMP) and release several proapoptotic fac- growth factors and activate autophagy (Lynch tors including cytochrome-C that activate the 2001; Beugnet et al. 2003; Byfield et al. 2005; apoptosome that in turn activates effector cas- Nobukuni et al. 2005). Finally, hypoxia induces pases to cleave a variety of cellular proteins and a specific pathway to increase nutrient uptake drive apoptosis (Schafer and Kornbluth 2006). and metabolism via the hypoxia-inducible fac- In cases in which these apoptotic pathways are tor (HIF1/2a) that promotes adaptation to an- suppressed, metabolic stress can instead lead to aerobic conditions, but may lead to apoptosis if necrotic cell death (Jin et al. 2007). hypoxia is severe (Saikumar et al. 1998; Suzuki et al. 2001; Fulda and Debatin 2007). ROLE OF GROWTH FACTORS IN Typically a combination of metabolic stress- METABOLISM AND CELL DEATH es rather than loss of a single nutrient input oc- cur at a given time (Degenhardt et al. 2006) and The phosphatidylinositol-3-kinase (PI3K)/AKT/ autophagy is activated to mitigate damage and mTOR pathway, outlined in Figure 1, is central provide nutrients for short-term survival (Ber- in growth factor-stimulated control of glucose nales et al. 2006; Tracy et al. 2007; Altman et al. uptake and metabolism and is often altered in 2011; Guo et al. 2011). Autophagy is a cellular cancer. PI3K catalyzes the phosphorylation of process of bulk cytoplasmic and organelle deg- phosphatidylinositol (PI) 4,5 bisphosphate radation common to nearly all eukaryotes. (PIP2) to PI 3,4,5 triphosphate (PIP3). After 2 Cite this article as Cold Spring Harb Perspect Biol 2012;4:a008763 Downloaded from http://cshperspectives.cshlp.org/ on October 6, 2021 - Published by Cold Spring Harbor Laboratory Press Bioenergetics, Autophagy, and Cell Death Growth factor + receptor Nutrients PI3K (glucose, amino acids) Akt AMPK mTORC1 ULK1/2 Protein translation Autophagy Figure 1. The PI3K-Akt-mTORC1 pathway and control of autophagy. PI3K is induced downstream from growth factor input and activates Akt and mTORC1. Akt supports the localization of nutrient transporters to the cell surface and maintains nutrient uptake. mTORC1 both supports protein translation and inhibits autophagy through phosphorylation of ULK1 and ULK2. AMPK, activated under energetic stress, inhibits mTORC1 and directly associates with ULK1/2 to activate autophagy. growth factor signals are received, PIP3 accu- presses the catabolism of intracellular compo- mulates, leading to recruitment and phosphor- nents such as fatty acids that would otherwise be ylation of Akt (Frech et al. 1997; Zoncu et al. used to support cell growth (Deberardinis et al. 2011). Activated Akt supports metabolism in a 2006). Thus, Akt activation promotes glucose number of ways, notably by maintaining pro- metabolism and inhibits other metabolic path- tein translation, glucose metabolism, and in- ways, leading to a glycolytic phenotype in hibiting autophagy and apoptosis. Akt is essen- growth factor-stimulated cells and the aerobic tial for growth factor-stimulated glucose uptake glycolysis characteristic of cancer cells (Elstrom and glycolysis by localizing Glut1 to the cell et al. 2004). Importantly, Akt is highly anti- surface (Plas et al. 2001; Vander Heiden et al. apoptotic, but requires glucose