Scientists have discovered a unique mechanism by which glioblastoma, a brain tumor, interacts with serine, an amino acid. (Image credit: DR P. MARAZZI/SCIENCE PHOTO LIBRARY via Getty Images)
A new study suggests that changing your diet could make the deadly brain cancer glioblastoma more vulnerable to cancer treatment.
The researchers behind the work believe that this dietary change exploits a key metabolic vulnerability in cancer, and their work shows that the approach increases survival in mice when used in combination with chemoradiation therapy.
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Healthy brain cells need fuel to support a wide range of functions, such as transmitting electrical signals and releasing chemical messengers. Cancer cells abandon these normal processes, rewiring themselves to become “professional dividing cells,” says study co-author Costas Lissiotis, a professor of oncology at the University of Michigan.
These changes are of great interest to cancer researchers because they could allow therapy to distinguish between healthy cells and tumors, making it more targeted.
“The real art of therapy is to kill cancer cells much more than normal [cells],” Lissiotis told Live Science.
The work, coordinated by University of Michigan oncologist Dr. Dan Wahl, examined how glioblastoma affects metabolism in the human and animal brains. The study ambitiously combined laboratory research and clinical practice, using some data from brain tissue from patients undergoing cancer surgery. The research required collaboration between experts in human and rodent neurosurgery, metabolic pathways, and molecular analysis.
The protocol began several hours before surgery. Patients were injected with glucose, labeled for molecular detection. The glucose traveled through the bloodstream and penetrated both healthy and tumor cells.
The usual approach to surgically treating glioblastoma involves removing the tumor and some of the surrounding brain tissue to minimize the risk of the tumor growing back quickly. During the surgery, the team took blood samples every 30 minutes and then quickly froze the removed tumor and healthy tissue for analysis.
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The extracted cells metabolized glucose, and the researchers tracked the molecules' pathways inside the cells. Combined with experiments in mice, the researchers got a clear picture of what was happening differently in the tumor cells as they ingested sugar.
Healthy cells metabolized glucose for cellular processes such as respiration, which converts sugar and oxygen into fuel for the cell. These cells also converted glucose into the amino acid serine, a key component of important neurotransmitter molecules.
Tumor cells, on the other hand, ignore these processes. Instead, they channel glucose into producing nucleotides, the building blocks of DNA. These molecules are a vital source of energy for the endless replication of tumor cells.
Chemoradiation attacks cancer by damaging its DNA, but this redirection provides cancer cells with a constant supply of nucleotides to repair the damage. The study found that tumor cells also take up serine from surrounding tissue to further fuel their growth.
Wahl and his team saw an opportunity. They put mice transplanted with human cancer cells on a diet that dramatically reduced the serine in their diet. Lissiotis hypothesized that the effect could potentially be replicated in cancer patients fed a low-protein diet supplemented with serine-free protein shakes.
Because this reduced the amount of serine available to tumor cells, the cancer was forced to redirect glucose metabolism back to serine production. This, in turn, reduced nucleotide synthesis and made the cells more vulnerable to chemoradiation. Mice given this combination of drugs lived longer than mice given chemoradiation alone.
Lissiotis explained that this vulnerability is likely to be temporary, since glioblastoma cells are adept at adapting their metabolism. Additionally, some tumor cells seem to be less dependent on internalized serine than others. “If you can hit that serine sweet spot, deprive them of serine, and then give them a therapy, you can get to them before they find a way around it,” he suggested.
Wahl is already starting work on a follow-up clinical study to back up these mouse results with data from human cancer patients.
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“We hope to be able to offer this to our patients later this year or early next year,” he said. The work will also require complex tasks and coordination. “Cancer treatment is a tough process. We ask people to come in every day for radiation and chemotherapy. I think asking someone else to follow a prescribed diet can be challenging,” he added.
But the current study provided valuable information that will be useful for future clinical trials. “We are excited that this isotope tracing protocol [tracking labeled glucose] can identify which tumors are synthesizing serine from glucose and which are taking up serine from the environment,” Wahl said.
Lissiotis noted that the paper’s innovative metabolic analysis identified additional dietary changes that could be explored in future studies. For now, the easiest modification to implement is serine. “We think this is just the tip of the iceberg,” he said.
Disclaimer
This article is for informational purposes only and does not provide medical or dietary advice.
RJ MackenzieLive Science Contributor
RJ Mackenzie is an award-winning science and health journalist. He holds degrees in neuroscience from the Universities of Edinburgh and Cambridge. He became a writer after deciding that the best way to contribute to science was at a keyboard rather than a lab bench. He has covered topics ranging from neural interface technology to shape-shifting materials science, from the rise of predator conferences to the importance of newborn screening programmes. He is a former staff writer for Technology Networks.
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