Abstract

Oncogenic signaling in cancer cells alters glucose uptake and utilization to supply sufficient energy and biosynthetic intermediates for survival and sustained proliferation. Oncogenic signaling also prevents oxidative stress and cell death caused by increased production of reactive oxygen species. However, elevated glucose metabolism in cancer cells, especially in glioblastoma, results in the cells becoming sensitive to glucose deprivation (i.e. in high glucose dependence), which rapidly induces cell death. However, the precise mechanism of this type of cell death remains unknown. Here, we report that glucose deprivation alone does not trigger glioblastoma cell death. We found that, for cell death to occur in glucose-deprived glioblastoma cells, cystine and glutamine also need to be present in culture media. We observed that cystine uptake through the cystine/glutamate antiporter xCT under glucose deprivation rapidly induces NADPH depletion, reactive oxygen species accumulation, and cell death. We conclude that although cystine uptake is crucial for production of antioxidant glutathione in cancer cells its transport through xCT also induces oxidative stress and cell death in glucose-deprived glioblastoma cells. Combining inhibitors targeting cancer-specific glucose metabolism with cystine and glutamine treatment may offer a therapeutic approach for glioblastoma tumors exhibiting high xCT expression.

Highlights

  • Oncogenic signaling in cancer cells alters glucose uptake and utilization to supply sufficient energy and biosynthetic intermediates for survival and sustained proliferation

  • Addition of essential amino acid (EAA) solution, but not nonessential amino acid (NEAA) solution or glutamine, in the glucose- and amino acid-free medium restored cell death but not completely, and the combination of glutamine and EAA solution was sufficient to restore glucose deprivationinduced cell death (Fig. 1, A and B), suggesting that an amino acid(s) in EAAs and glutamine are required for glucose deprivation-induced cell death in U251 cells

  • To determine which amino acid(s) in EAA solution was responsible for the glucose deprivation-induced rapid cell death, glutamine and each amino acid in the EAA solution were added in the glucose- and amino acid-free medium, and cell death was analyzed by lactate dehydrogenase (LDH) release assay

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Summary

To whom correspondence should be addressed

Treatment with pharmacological inhibitors of xCT or depletion of glutathione in several types of cancer cells triggers iron-dependent nonapoptotic cell death termed ferroptosis [21,22,23]. Intracellular transport of cystine is important to reduce elevated ROS levels and to avoid oxidative stressinduced cell death in cancer cells. XCT has recently been reported to have an opposite effect on cell viability during glucose deprivation [24, 25]. We show that, in glioblastoma cells expressing high levels of xCT, intracellular transport of cystine through xCT rapidly induces NADPH depletion, ROS accumulation, and cell death

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