Abstract

Detachment of cells from the extracellular matrix into the peritoneal cavity initiates a cascade of metabolic alterations, leading usually to cell death by apoptosis, so-called anoikis. Glycolytic enzymes enable the switch from oxidative phosphorylation to aerobic glycolysis and allow resistance to anoikis of shed tumour cells. These enzymes also have moonlighting activities as protein kinases and transcription factors. Phosphoglycerate kinase (PGK) and pyruvate kinase are the only glycolytic enzymes generating ATP in the hexokinase pathway. Hypoxia, EGFR activation, expression of K-Ras G12V and B-Raf V600E induce mitochondrial translocation of phosphoglycerate kinase 1 (PGK1). Mitochondrial PGK1 acts as a protein kinase to phosphorylate pyruvate dehydrogenase kinase 1 (PDHK1), reducing mitochondrial pyruvate utilization, suppressing reactive oxygen species production, increasing lactate production and promoting tumourigenesis. PGK1 also plays a role as a transcription factor once transported into the nucleus. Resistance to anoikis is also facilitated by metabolic support provided by cancer-associated fibroblasts (CAFs). Our series of experiments in-vitro and in the animal model showed that PGK1 knock-out or inhibition is effective in controlling development and growth of peritoneal metastasis (PM) of gastric origin, establishing a causal role of PGK1 in this development. PGK1 also increases CXCR4 and CXCL12 expression, which is associated with a metastatic phenotype and plays a role in the metastatic homing of malignant cells. Thus, PGK1, its modulators and target genes may be exploited as therapeutic targets for preventing development of PM and for enhancing cytotoxic effects of conventional systemic chemotherapy.

Highlights

  • Peritoneal metastasis (PM) results from shedding of tumour cells from the primary malignancy, transport through the peritoneal cavity, adhesion to the peritoneum, invasion, proliferation, and angiogenesis [1]

  • These results suggest that phosphoglycerate kinase 1 (PGK1) is crucially involved in the glycolytic switch, cytosolic glycolysis, lactate production, extracellular acidification, autophagy and resistance to anoikis of tumour cells shed into the peritoneal cavity

  • Overexpression of PGK1 in peritoneal metastasis (PM) does not appear to be just an epiphenomenon associated with increased glucose metabolism in cancer

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Summary

Introduction

Peritoneal metastasis (PM) results from shedding of tumour cells from the primary malignancy, transport through the peritoneal cavity, adhesion to the peritoneum, invasion, proliferation, and angiogenesis [1]. Presence of malignant cells in the peritoneal cavity is a frequent observation and has been reported in 22% patients with colorectal cancer [2], 10% with pancreas cancer [3] and 6% patients with gastric cancer undergoing perceived curative resection [4]. The rate of intraperitoneal recurrence and peritoneal metastasis after curative surgery is high, for example 80% in ovarian cancer and 50% in gastric cancer [6].

Cancer cell contact with the ECM
Findings
Conclusion and outlook
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