Kozal K, Jóźwiak P, Krześlak A. Contemporary Perspectives on the Warburg Effect Inhibition in Cancer Therapy.
Cancer Control 2021;
28:10732748211041243. [PMID:
34554006 PMCID:
PMC8474311 DOI:
10.1177/10732748211041243]
[Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
In the 1920s, Otto Warburg observed the phenomenon of altered glucose metabolism
in cancer cells. Although the initial hypothesis suggested that the alteration
resulted from mitochondrial damage, multiple studies of the subject revealed a
precise, multistage process rather than a random pattern. The phenomenon of
aerobic glycolysis emerges not only from mitochondrial abnormalities common in
cancer cells, but also results from metabolic reprogramming beneficial for their
sustenance. The Warburg effect enables metabolic adaptation of cancer cells to
grow and proliferate, simultaneously enabling their survival in hypoxic
conditions. Altered glucose metabolism of cancer cells includes, inter alia,
qualitative and quantitative changes within glucose transporters, enzymes of the
glycolytic pathway, such as hexokinases and pyruvate kinase, hypoxia-inducible
factor, monocarboxylate transporters, and lactate dehydrogenase. This review
summarizes the current state of knowledge regarding inhibitors of cancer glucose
metabolism with a focus on their clinical potential. The altered metabolic
phenotype of cancer cells allows for targeting of specific mechanisms, which
might improve conventional methods in anti-cancer therapy. However, several
problems such as drug bioavailability, specificity, toxicity, the plasticity of
cancer cells, and heterogeneity of cells in tumors have to be overcome when
designing therapies based on compounds targeted in cancer cell energy
metabolism.
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