Cancer Metabolism

Metabolic rewiring and redox alterations in malignant pleural mesothelioma


Malignant pleural mesothelioma (MPM) is a rare malignancy of mesothelial cells with increasing incidence, and in many cases, dismal prognosis due to its aggressiveness and lack of effective therapies. Environmental and occupational exposure to asbestos is considered the main aetiological factor for MPM. Inhaled asbestos fibres accumulate in the lungs and induce the generation of reactive oxygen species (ROS) due to the presence of iron associated with the fibrous silicates and to the activation of macrophages and inflammation. Chronic inflammation and a ROS-enriched microenvironment can foster the malignant transformation of mesothelial cells. In addition, MPM cells have a highly glycolytic metabolic profile and are positive in 18F-FDG PET analysis. Loss-of-function mutations of BRCA-associated protein 1 (BAP1) are a major contributor to the metabolic rewiring of MPM cells. A subset of MPM tumours show loss of the methyladenosine phosphorylase (MTAP) locus, resulting in profound alterations in polyamine metabolism, ATP and methionine salvage pathways, as well as changes in epigenetic control of gene expression. This review provides an overview of the perturbations in metabolism and ROS homoeostasis of MPM cells and the role of these alterations in malignant transformation and tumour progression.

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The authors thank D.M. D’Agostino for discussions.

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L.U., I.C., E.S., F.C., G.P. and V.C. wrote the paper, prepared the figures and revised the final version of the paper.

Correspondence to Vincenzo Ciminale.

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This work was supported by 5 × 1000 funds of the Veneto Institute of Oncology IOV-IRCCS and by a grant by the Italian Association for Cancer Research (AIRC IG17794).

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Urso, L., Cavallari, I., Sharova, E. et al. Metabolic rewiring and redox alterations in malignant pleural mesothelioma. Br J Cancer 122, 52–61 (2020).

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