Abstract
Oxidative stress modulates carcinogenesis in the liver; however, direct evidence for metabolic control of oxidative stress during pathogenesis, particularly, of progression from cirrhosis to hepatocellular carcinoma (HCC), has been lacking. Deficiency of transaldolase (TAL), a rate-limiting enzyme of the non-oxidative branch of the pentose phosphate pathway (PPP), restricts growth and predisposes to cirrhosis and HCC in mice and humans. Here, we show that mitochondrial oxidative stress and progression from cirrhosis to HCC and acetaminophen-induced liver necrosis are critically dependent on NADPH depletion and polyol buildup by aldose reductase (AR), while this enzyme protects from carbon trapping in the PPP and growth restriction in TAL deficiency. Both TAL and AR are confined to the cytosol; however, their inactivation distorts mitochondrial redox homeostasis in opposite directions. The results suggest that AR acts as a rheostat of carbon recycling and NADPH output of the PPP with broad implications for disease progression from cirrhosis to HCC.
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Data availability
All original data will be available through sharing and databases with accession codes provided by the time of publication. RNA-seq data have been deposited in the NCBI Gene Expression Omnibus database (accession code GSE217133). Source data are provided with this paper.
Change history
08 February 2023
A Correction to this paper has been published: https://doi.org/10.1038/s42255-023-00752-8
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Acknowledgements
This work was supported in part by grants RO1 DK078922 (A. Perl), R01 AI072648 (A. Perl), P30CA006516 (J.M.A.) and P01CA120964 (J.M.A.) from the National Institutes of Health and the Central New York Community Foundation (A. Perl).
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A. Perl conceived and designed the study. A. Perl, Z.O., A. Patel, N.H., J.A., T.F. and D.K. developed methodology, executed experiments and analyzed data. M.B., S.B., J.L., M.D. and R.K. acquired the data (bred, genotyped and provided animals matched for age and sex). D.R.F., T.W. and G.C. designed, executed and analyzed experiments. S.L. and K.B. designed experiments and analyzed data.
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Nature Metabolism thanks Gregory Ducker, Huiyong Yin and Christian Frezza for their contribution to the peer review of this work. Editor recognition statement Primary Handling Editor: Alfredo Giménez-Cassina, in collaboration with the Nature Metabolism team.
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Extended data
Extended Data Fig. 1 Impact of AR on carbon recycling and NADPH output by PPP.
a, Bar chart shows opposite effects of AR inactivation on concentrations of substrates sequestered in the non-oxidative branch of the PPP with respect to those depleted in the oxidative PPP and connected pathways. Data represent individual and mean values from five mice per genotype. Changes in metabolite concentration affected by TAL deficiency at two-tailed t-test p < 0.05 are shown. b, Global impact of TAL deficiency on the metabolome is indicated by analysis of pathways arranged according to the scores from enrichment analysis (y axis: −log p) and from topology analysis using betweenness centrality to estimate node importance (x axis: impact: number of detected metabolites with significant p value, using two-tailed t-test via Metaboanalyst). TAL deficiency most prominently impacted the PPP, glycerophospholipid and glycine/serine/threonine (G/S/T), valine/leucine/isoleucine (V/L/I) and alanine, aspartate, glutamate (A/D/E) amino acid metabolism. c, Global impact of AR deficiency on metabolic pathways, using two-tailed t-test via Metaboanalyst Pathway analysis module. d, Global impact of combined TAL and AR deficiency on metabolic pathways by comparison of DKO and WT mice, using two-tailed t-test via Metaboanalyst Pathway analysis module. e, Western blot detection recombinant AR (rAR, left panel) and assays of its enzyme activity (right panel). Data represent independent measurements for the following substrates: glyceraldehyde (GAD, n = 28), ascorbate (n = 2), E4P (n = 3), S7P (n = 4), OAA (n = 7), PGA (n = 8), erythrose (n = 8), sedoheptulose (n = 18). f, Schematic diagram of metabolic pathways affected by inactivation of the TAL-AR axis.
Extended Data Fig. 2 Segregation of metabolites by impact of AR inactivation in TAL deficiency.
a, Metabolites affected synergistically by inactivation of the TAL-AR axis. b, Metabolite changes corrected by inactivation of AR. Displayed metabolites exhibited significant fold changes in TAL deficiency at two-tailed t-test p < 0.05.
Extended Data Fig. 3 Western blot analysis of expression in genes implicated by RNA-seq changes in livers of TAL-deficient mice at FDR p < 0.05.
a, Western blot analysis of protein levels corrected by inactivation of AR. *, two-tailed t-test p < 0.05. b, Western blot analysis of protein levels uncorrected by inactivation of AR. Representative blots and bar charts of cumulative analysis of five mice per genotype are shown for each gene. *, two-tailed t-test p < 0.05.
Extended Data Fig. 4 Effect of the TAL-AR axis on de novo GSH biosynthesis.
a, Measurement of GSH synthesis intermediates in liver of WT (n = 4), TALKO (n = 4), ARKO (n = 5), and DKO mice (n = 5). *, p < 0.05 relative to WT using two-tailed t-test. Brackets indicate differences between mouse strains at p < 0.05. b, Enrichment of [M1-13C]-PGA, [M2-13C]-PGA, and [M5-13C]-GSH in hepatocytes of WT (n = 4), TALKO (n = 4), ARKO (n = 4), and DKO mice (n = 4) labeled with [U-13C]-glutamine (DLM-1150-0.5, Cambridge Isotope Laboratories; Cambridge, MA) for 24 hours. *, p < 0.05 relative to WT using one-tailed t-test. c, Schematic diagram of GSH biosynthesis involving substrates regulated by the TAL-AR axis.
Extended Data Fig. 5 Effect of aldose reductase inhibitors, zopolrestat and sorbinil, on serum replenishment-induced proliferation of HepG2 hepatoma and MCF7 breast carcinoma cells.
MCF7 or HepG2 cells seeded 96-well plates at 5,000 cells/well in complete Dulbecco’s minimal essential medium with 10% fetal bovine serum (Hyclone, Logan, UT), 2 mM L-glutamine, 100 units/ml penicillin, 100 μg/ml streptomycin, 25 µg/ml amphotericin B (GIBCO/Thermo Fisher catalog number 15240096) at 37 °C with 5% CO2. After 24 hours, sub-confluent cells were growth arrested in 0.1% FBS with or without sorbinil (Millipore/Sigma catalog number S7701) or zopolrestat (Millipore/Sigma catalog number Z4527). After 24 h, 10% serum was added to the medium and the cells were incubated for another 24 h. Cells were counted after trypan blue staining (upper and lower left panels and upper right panel) and viability was evaluated by the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay (lower right panel)1. MTT powder was dissolved in PBS to a final concentration of 5 mg/ml, and 500 µl of MTT solution was added to cells and incubated for 1 h at 37oC. Subsequently, 500 µl of isopropyl alcohol with 0.04 N HCl was added to dissolve the precipitate. Absorbance was read at the 570-nm wavelength subtracting background reading at the 650-nm wavelength. Data represent four experiments. Brackets reflect p values <0.05 as compared by 1-way ANOVA.
Extended Data Fig. 6 Effect of siRNA-mediated knockdown of IDH2 on metabolic flux through the TCA cycle in primary hepatocytes from age-matched female WT, TALKO, ARKO, and DKO mice.
a, Effect of IDH2 knockdown on enrichment of [M4-13C]-citrate in hepatocytes labelled with [U-13C]-glutamine (DLM-1150-0.5, Cambridge Isotope Laboratories; Cambridge, MA) for 24 hours. b, Effect of IDH2 knockdown on enrichment of [M1-13C]-citrate, and [M2-13C]-citrate in hepatocytes labelled with [1, 2-13C]-glucose (CLM-504-0.5, Cambridge Isotope Laboratories; Cambridge, MA) for 24 hours. Data represent mean ± SE of experiments using 4 WT, 4 TALKO, 4 ARKO, and 4 DKO mice. *, Brackets reflect p values 0.05 using unpaired two-tailed t-tests for comparison of mice with different genotypes. Effect of IDH2 knockdown was evaluated with two-tailed paired t-tests; p values <0.05 are displayed.
Extended Data Fig. 7 IDH2 moderates carbon sequestration in the non-oxidative PPP in primary DKO hepatocytes.
a, Effect of IDH2 knockdown on enrichment of [M1-13C]-S7P and [M2-13C]-S7P in WT, TALKO, ARKO, and DKO hepatocytes labelled with [1, 2-13C]-glucose (CLM-504-0.5, Cambridge Isotope Laboratories; Cambridge, MA) for 24 hours. b, Effect of IDH2 knockdown on enrichment of [M5-13C]-O8P and [M6-13C]-O8P in WT, TALKO, ARKO, and DKO hepatocytes labelled with [1, 2-13C]-glucose (CLM-504-0.5, Cambridge Isotope Laboratories; Cambridge, MA) for 24 hours. c, Effect of IDH2 knockdown on enrichment of [M1-13C]-R5P and [M2-13C]-R5P and [M1-13C]-G6P and [M2-13C]-G6P in WT, TALKO, ARKO, and DKO hepatocytes labelled with [1, 2-13C]-glucose (CLM-504-0.5, Cambridge Isotope Laboratories; Cambridge, MA) for 24 hours. d, Effect of IDH2 knockdown on enrichment of [M2-13C]-erythronic acid in WT, TALKO, ARKO, and DKO hepatocytes labelled with [1, 2-13C]-glucose (CLM-504-0.5, Cambridge Isotope Laboratories; Cambridge, MA) for 24 hours. Data represent mean ± SE of experiments using 4 WT, 3 TALKO, 4 ARKO, and 4 DKO mice. *, p < 0.05 relative to WT using unpaired two-tailed t-tests. Brackets reflect p values 0.05 using 2-way ANOVA.
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List of abbreviations (pages 2–4); legends for Supplementary Figs. 1–8 (pages 4–5); Supplementary References (page 5); Supplementary Figs. 1–8 (pages 6–13); Supplementary Table 1 (pages 14–20) and Supplementary Table 2 (pages 21–32).
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Oaks, Z., Patel, A., Huang, N. et al. Cytosolic aldose metabolism contributes to progression from cirrhosis to hepatocarcinogenesis. Nat Metab 5, 41–60 (2023). https://doi.org/10.1038/s42255-022-00711-9
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DOI: https://doi.org/10.1038/s42255-022-00711-9