ccRCC is fundamentally a metabolic disorder

摘要

Clear cell renal-cell carcinoma (ccRCC) represents the most common RCC subtype, being exceptionally resistant to therapy and responding poorly to radiotherapy, hormonal therapy and chemotherapy ; thus urging the development of early diagnostic markers for this particular RCC subtype. Hypoxic, rapidly proliferating tumor cells predominantly exhibit a metabolic switch toward aerobic glycolysis (the Warburg effect), which is characterized by an increase in glucose catabolism to lactate at the expense of mitochondrial oxidation. In fact, glutamine is able of contributing to citrate and lipid metabolism by reversing the tricarboxylic acid (TCA) cycle or through the reductive carboxylation of a-ketoglutarate or even through forward cycling of glutamine carbons (Fig. 1).