Every year, 150 to 300 children in the United States are diagnosed with diffuse intrinsic pontine gliomas (DIPGs), aggressive and lethal tumours that grow deep inside the brain, for which there are no cures.
In a study funded by the National Institutes of Health, researchers showed that experimental drugs designed to lower the body's natural production of alpha-ketoglutarate extended the lives of mice harbouring DIPG tumours by slowing the growth of the cancer cells.
Interestingly, they also found that artificially raising alpha-ketoglutarate levels with DIPG-causing genes may slow the growth of other brain tumours.
The results, published in Cancer Cell, were part of a nationwide study that explored the cyclical role that cancer cell metabolism may play in regulating brain tumour genes.
Led by senior author Sriram Venneti, M.D., Ph.D., and a team of researchers at the University of Michigan Medical School in Ann Arbor, the researchers primarily studied H3K27M tumours, DIPGs linked to mutations in a gene, called histone 3.
Histones are proteins cells spool chromosomes around.
This helps cells cram lengthy chromosomes into tiny nuclei and control gene activity.
Any genes that are buried in the spools cannot be read and are thus turned off. Cells can "epigenetically" fine tune spooling by using a process known as methylation to chemically tag histones.
For years scientists knew that cancer genes often alter the metabolism of tumours.
In this study, the researchers not only found that this may be true for patients with H3K27M tumours but also that these alterations in metabolism may be part of a feedback loop involving alpha-ketoglutarate (α-KG), that epigenetically keeps these and other brain tumours in a cancerous state.
Brain scans of H3K27M patients showed that they had higher levels of certain precursor metabolites - namely glucose and glutamine - than patients with deep brain tumours who do not carry the H3K27M mutations.
Then through a series of detailed experiments on mice and cells in petri dishes, the researchers found that H3K27M mutations induced the cancer cells to produce high levels of α-KG and this, in turn, spurred more growth.
Further results suggested that this happened because α-KG prevented methylation of histones and thus epigenetically kept genes that are vital for cancer cells exposed and active.
For instance, lowering α-KG levels with experimental drugs increased histone methylation, slowed cancer cell growth, and helped mice harbouring the DIPG tumours live longer.
In contrast, they saw surprisingly opposite results in lower grade tumours associated with mutations in isocitrate dehydrogenase genes (IDH1), which naturally produce lower levels of α-KG.
Introducing H3K237M genes into IDH1 tumours slowed growth by raising alpha-ketoglutarate levels which, in turn, increased methylation and turned off cancer-sustaining genes.
The researchers concluded that understanding the intricate details behind these feedback loops may help researchers devise effective ways to treat DIPG and other brain tumours.
The World Cancer Declaration recognises that to make major reductions in premature deaths, innovative education and training opportunities for healthcare workers in all disciplines of cancer control need to improve significantly.
ecancer plays a critical part in improving access to education for medical professionals.
Every day we help doctors, nurses, patients and their advocates to further their knowledge and improve the quality of care. Please make a donation to support our ongoing work.
Thank you for your support.