Targeting Energy Metabolism for Cancer Therapeutic Discovery using Agilent Seahorse XF Technology

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Application Note
Cancer Research

                       Targeting Energy Metabolism for
                       Cancer Therapeutic Discovery using
                       Agilent Seahorse XF Technology

Authors                Abstract
George W. Rogers
                       Altered energy metabolism is now recognized as a driver in many diseases. In
Heather Throckmorton
                       cancer research, significant advances have been made in defining druggable
Sarah E. Burroughs
                       targets, with metabolic intermediates emerging as promising therapeutic targets.
                       Agilent Seahorse XF technology provides critical functional measurements in live
                       cells to identify potential druggable gene and protein targets, and to validate their
                       role in cancer cell proliferation, adaptation, and survival. By measuring bioenergetic
                       phenotype, cellular ATP production rate, and mitochondrial and glycolytic function,
                       metabolic vulnerabilities in cancer cells can be revealed to advance cancer
                       therapeutics.
Introduction                                                           Defining metabolic/bioenergetic
Background: Advancing opportunities in cancer drug                     phenotype
therapies
                                                                       An initial step in understanding any type of cancer is to char-
Cancer cell proliferation is a dynamic process that demands            acterize the metabolic and bioenergetic signature of the cell.
significant raw materials and energy. Conventional views               The Oxygen Consumption Rate (OCR)/Extracellular Acidifica-
have commonly inferred that cancer cells rely on upregulated           tion Rate (ECAR) ratio and Agilent Seahorse XF Cell Energy
glycolysis for their proliferation requirements, often character-      Phenotype Test (described in detail in Rogers et al, 2019 11)
ized as the Warburg effect 1, 2. However, with advancements            provide a high-level assessment of bioenergetic poise. Lan-
in metabolic analysis techniques, it is now clear that some            ning et al. used this assay to show that triple-negative breast
cancer cells preferentially utilize mitochondrial respiration          cancer (TNBC)-derived cell lines displayed significant hetero-
for unregulated proliferation and survival, often in concert           geneity with respect to basal metabolic phenotype (Figure 1)
with downregulated glycolysis 3, 4, 5. Therefore, there has been       12
                                                                          . In a similar study, Guha et al. profiled the basal metabolic
a recent paradigm shift towards understanding that cancer              signatures of several breast cancer cell lines (Figure 2). Here,
metabolic dependencies are not only variable across cancer             the authors showed that aggressive TNBC cells have a unique
subsets, but that they can also be measured to reveal cancer           metabolic phenotype associated with mitochondrial genetic
cell liabilities 6, 7. Once identified and validated, these metabol-   and functional defects 13. These oncogenic defects impaired
ic-pathway liabilities can be exploited for therapeutic targeting      mitochondrial respiration and induced a metabolic switch
8
  . Promising druggable targets for cancer metabolic therapies         to glycolysis, which is associated with tumorigenicity. These
include oncogenes that rewire energy metabolism, interme-              results suggest that metabolic phenotype could be used to
diates in oncogene pathways, and the genes, proteins, and              identify TNBC patients at risk of metastasis and that altered
pathways associated with substrate and nutrient transport              metabolism can be targeted to improve chemotherapeutic
and utilization/oxidation.                                             response.
A paradigm shift: Heterogeneity in metabolic phenotype                 Based on OCR and ECAR XF measurements, a more function-
driving oncogenesis                                                    al and quantitative measure of the bioenergetic phenotype is
Cancer cells undergo various metabolic changes as they                 to quantify the rate and source (mitochondrial versus glyco-
acquire altered traits to adapt, survive, and metastasize in           lytic) of ATP production. The Agilent Seahorse XF Real-Time
environments with varying substrate availability and oxygen            ATP rate assay measures the total ATP production rate in
concentration 9. As a result, they display profound genetic,           cells and distinguishes between ATP produced from mito-
bioenergetic, and functional differences from their nontrans-          chondrial oxidative phosphorylation (OXPHOS) and glycolysis
formed parental cells. In the last decade, bioenergetic studies        (Figure 3 and 14). When applied to a panel of cancer cell lines,
have highlighted the variability among cancer types, and even          this assay shows that cancer cell lines utilize mitochondrial
within cancer types, in the mechanisms and the substrates              OXPHOS and glycolytic activities differently to meet their
preferentially used for deriving this vital energy. While glycoly-     energy demands (Figure 4 and 15). These findings underscore
sis (or Warburg metabolism) has long been considered the               the fact that different cancer cells adopt unique metabolic
major metabolic process for energy production and anabolic             signatures that are critical to setting the strategy for targeting
growth in cancer cells, it is now clear that mitochondria play         a given disease subtype and determining whether a given cell
a key role in oncogenesis 10. In addition to central metabolic         line is a good model for the disease of interest.
and bioenergetic function, mitochondria also provide build-
ing blocks for tumor anabolism, as well as controlling redox
and calcium homeostasis 6. Although a main tenet of cancer
is dysregulation of normal cell metabolism that contributes
to abnormal cell growth, cancer is not one disease. Thus,
understanding how the metabolic pathways of a given type of
cancer are rewired is critical to identify and develop opportuni-
ties for therapeutic intervention.

   2
2.0                                                                                                        Oligomyin Rot/AA
          pmol/min/cell number)

                                              Increasing OXPHOS
                                  1.5                             MDA-MB-468
              OCR (relative

                                                                                                    HCC70
                                                                                                                                                                                  glycoATP
                                  1.0                                                                                                                                          Production Rate

                                                                                                                          OCR or ECAR
                                                                   MDA-MB-231
                                                                                   Hs578T
                                                                                                                                                                 Report                 +
                                  0.5                                                                                                                           Generator         mitoATP
                                                                                HME1
                                                                   Increasing Glycolysis                                                                                       Production Rate
                                      0                                                                                                                                                 II
                                          0                        0.5   1.0        1.5                       2.0
                                                                     ECAR (relative                                                                                               Total ATP
                                                                  mpH/min/cell number)                                                                                         Production Rate
                                                                                                                                                    Time (min)
Figure 1. Agilent Seahorse XF energy map of breast cancer cell lines
                                                                                                                        Figure 3. Representative scheme of the Agilent Seahorse XF Real-Time
reveals different metabolic phenotypes. Normalized ECAR and OCR data
                                                                                                                        ATP rate assay. This assay provides quantitative measurements of ATP
were plotted to reveal overall relative basal metabolic profiles for each cell
                                                                                                                        production rate from both mitochondrial and glycolytic pathways. Both
model 12.
                                                                                                                        OCR and ECAR of live cells are simultaneously measured using the Agilent
                                                                                                                        Seahorse XF Analyzer. Using standardized control compound injections and
                                                                                                                        data analysis, cellular ATP production rates are reported 14.
                           500
Basal OCR (nmol oxygen/

                           400
  min/0.1mg protein)

                                                                                                                                        mitoATP Production Rate        glycoATP Production Rate
                                                                                                                                   Panc1
                           300                                                                                                     BT474
                                                                                                                                      Hela
                                                                                                                                   H1975
                           200                                                                                                       ZR75
                                                                                                                                  HCT116
                                                                                                                                   HMEC
                                                                                                         **                         H460
                           100                                                      **         **                  **               MCF7
                                                                                                                                  SK-OV-3
                                                                                                                                     A431
                              0                                                                                                      A549
                                                                                                                                   BT549
                                                                               06

                                                                                           T

                                                                                                     31
                                      7

                                                          7D

                                                                                                              15
                                                                       PE

                                                                                                                                    HT-29
                                  CF

                                                                                         78

                                                                                                                                     T47D
                                                                               18

                                                                                                    B2

                                                                                                              13
                                                                    52
                                                 T4

                                                                                         S5
                                  M

                                                                                                                                   SKBR3
                                                                           CC

                                                                                                          M
                                                                                                M
                                                                   M

                                                                                     H

                                                                                                                                   Hs578
                                                                                                         SU
                                                                                               DA
                                                                  SU

                                                                           H

                                                                                                                                  MCF10a
                                                                                           M

                                                                                                                                     HL60
                                          Non-TNBC                                                                                 Jurkat
                                                                                               TNBC
                                                                                                                                         40    30     20   10      0      10    20     30    40

                           300
                                                                                                                                         ATP Production Rate (pmol/min/1x10 cells)      3

                           250                                                                                          Figure 4. Cancer cells have developed different strategies for cellular
                                               T47D                                                                     energy production, with significant implications for therapeutic strategy.
          OCR (pmol/min)

                                      Non-TNBC
                           200                    **                                                                    Measuring ATP production rates across a panel of 20 cancer cell lines
                                                                                                                        reveals a wide range of energy phenotypes, from predominantly oxidative
                           150                                    SUM52PE                 **
                                                                                                                        (top) to predominantly glycolytic (bottom) 15.
                                                                                     SUM1315
                           100                                       **
                                      TNBC                        MDA-MB231
                            50
                                                                    **
                                                                  HS578T
                             0
                                  0             10                 20    30   40               50        60
                                                                   ECAR (mpH/min)

Figure 2. TNBC and non-TNBC cell lines display distinct metabolic
phenotypes. Top: Basal cellular oxygen consumption rate (OCR) of TNBC-
and non-TBNC cell lines. Bottom: XF energy map of TNBC and non-TNBC cell
lines 13.

                                                                                                                                                                                                  3
Modulating cancer cell energy metabolism
Measuring changes in cancer cell metabolism in response                                                                                                                                                                  XF Cell Mito Stress Test, Wang et al. demonstrated dose-de-
to potential therapeutic compounds is paramount for under-                                                                                                                                                               pendent decreases in basal and maximal respiration for both
standing drug mechanism of action, efficacy, toxicity, and                                                                                                                                                               SGC-7901 and MGC-803 cells, both indicative of mitochon-
off-target effects. When investigating effects of γ-Tocotrienol                                                                                                                                                          drial dysfunction (Figure 6). Using the Agilent Seahorse XF
(γ-T3) on human gastric adenocarcinoma cells, Wang et al.                                                                                                                                                                Glycolytic Rate Assay to provide a quantifiable measurement
observed a significant shift away from mitochondrial and                                                                                                                                                                 of glycolysis (Figure 7 17), the authors also showed a dose-de-
towards glycolytic ATP production. Further, γ-T3 reduced the                                                                                                                                                             pendent increase in basal glycolysis in both cell types (Figure
total ATP production rate in these cells (Figure 5) 16.                                                                                                                                                                  8). This data supports the observation of cellular ATP produc-
Once a change in bioenergetic phenotype is detected, further                                                                                                                                                             tion switching predominantly to glycolysis, but at a lower total
investigation often involves uncovering the mechanism re-                                                                                                                                                                production rate. These results, with orthogonal data, suggest
sponsible for the shift in metabolic poise. Thus, to gain insight                                                                                                                                                        that mitochondrial function may be an effective target for
into observations presented in Figure 5, further assays were                                                                                                                                                             anticancer drug development efforts 16.
performed to directly assess mitochondrial and glycolytic
function in the presence of γ-T3. Using the Agilent Seahorse                                                                                                                                                                                                                                      400

                                                                                                                                                                                                                                                                  Proton Efflux Rate (pmol/min)
                                                                                                                                                                                                                                                                                                                         Rot/AA                                2-DG

                                                                                                                                                                                                                                                                                                                                                                            Total Proton Efflux
                                                                                                 *                                                        *                                                                                                                                       300
                                                                                                                                                                                                                                                                                                                                        Compensatory
                                                       800                                                                                                                                                                                                                                                                                glycolysis                        Glycolytic Proton Efflux

                                                       700
                            ATP Production Rate

                                                                                                                                                                                                                                                                                                  200
                                                       600
                              (pmol/min/mg)

                                                                                                                                                                                                                                                                                                                  Mito
                                                                                                                                                                                                                                                                                                              acidification

                                                       500
                                                                                                                                                                                                                                                                                                  100            Basal
                                                       400                                                                                                                                                                                                                                                     glycolysis

                                                       300                                                                                                                                                                                                                                           0
                                                       200                                                                                                                                                                                                                                               0        10          20 30 40 50                                         60                        70
                                                                                                                                                                                                                                                                                                                                Time (minutes)
                                                       100
                                                         0                                                                                                                                                               Figure 7. Representative scheme for the Agilent Seahorse XF Glycolytic
                                                                             7901-0                   7901-30                                803-0               803-30
                                                                                                                                                                                                                         Rate Assay. This assay provides a quantitative measure of glycolysis using
                                                        mitoATP Production Rate                                                         glycoATP Production Rate                                                         both OCR and ECAR (simultaneously measured by the Agilent Seahorse XF
                                                                                                                                                                                                                         Analyzer) to measure and subtract mitochondrial acidification. The resulting
Figure 5. Quantification of ATP production rate reveals a drug-induced                                                                                                                                                   glycolytic Proton Efflux Rate (glycoPER) under both basal and compensatory
glycolytic switch in two adenocarcinoma cell lines. Gastric cancer cells                                                                                                                                                 conditions are reported 17.
were treated with 0 or 30 μM γ-T3 for 4 h, and the ATP production rate was
measured using the Agilent Seahorse XF Real Time ATP rate assay. Adapted
                                                                                                                                                                                                                                                                   0                                    20        30                                         Basal Glycolysis                               Compensatory Glycolysis
from 16.                                                                                                                                                                                                                                                          Rot/AA                             2-DG
                                                                                                                                                                                                                      glycoPER (pmol/min/mg protein)

                                                                                                                                                                                                                                                       1400                                                                                           1500                                                 1500
                                                                                                                                                                                                                                                       1200
                                                                                                                                                                                                                                                                                                                              (pmol/min/mg protein)

                                                                                                                                                                                                                                                                                                                                                                                   (pmol/min/mg protein)
                                                                                                                                                                                                                                                                                                                                                                            ***
                                                                                                                                                                                                                                                       1000                                                                                                           ***
                                                       SGC-7901 cells                                                                                     MGC-803 cells                                                                                                                                                                               1000                                                 1000
                                                                                                                                                                                                                                                                                                                                    GlycolPER

                                                                                                                                                                                                                                                                                                                                                                                         GlycolPER

                                                                                                                                                                                                                                                       800
                                         Basal                                                 Maximal                                           Basal                                              Maximal                                            600
                      250                                                            250                                               200                                               200                                                                                                                                                           500                                                 500
                                                                                                                                                                                                                                                       400
Pmol/min/mg protein

                                                               Pmol/min/mg protein

                                                                                                                 Pmol/min/mg protein

                                                                                                                                                                   Pmol/min/mg protein

                      200                                                            200          *                                                                                                                                                    200
                                                                                                                                       150                                               150
                                                                                                                                                                                                                                                         0                                                                                              0                                                    0
                      150                         **                                 150                                                                                                                                                                      0             20                     40    60     80 100                                        0    20     30                                       0    20     30
                                                                                                                                       100                                               100
                                                                                                                                                                                                                                                                                                  Time (min)                                                 Concentrations                                       Concentrations
                      100                                                            100
                                                                                                                                                                                                       **                                                                                                                                                       (µmol/L)                                             (µmol/L)
                                                                                                                                        50          **                                    50
                       50                                ***                          50                 ***                                               ***                                                ***
                                                                                                                                                                                                                                                                   0                                    20        30                                         Basal Glycolysis                               Compensatory Glycolysis
                                                                                                                                                                                                                                                                  Rot/AA                             2-DG
                                                                                                                                                                                                                      glycoPER (pmol/min/mg protein)

                       0                                                              0                                                 0                                                 0                                                            1200                                                                                           1000                                                 1000
                                 0            20         30                                0      20     30                                  0      20     30                                   0      20     30
                        Concentrations (µmol/L)                                        Concentrations (µmol/L)                           Concentrations (µmol/L)                           Concentrations (µmol/L4)
                                                                                                                                                                                                                                                       1000
                                                                                                                                                                                                                                                                                                                              (pmol/min/mg protein)

                                                                                                                                                                                                                                                                                                                                                                                   (pmol/min/mg protein)

                                                                                                                                                                                                                                                                                                                                                       800                  ***                             800
                                 γ-T3                                                           γ-T3                                              γ-T3                                               γ-T3
                                                                                                                                                                                                                                                                                                                                                                      **
                                                                                                                                                                                                                                                       800
                                                                                                                                                                                                                                                                                                                                                      600                                                  600
                                                                                                                                                                                                                                                                                                                                    GlycolPER

                                                                                                                                                                                                                                                                                                                                                                                         GlycolPER

Figure 6. Dose-dependency of the effect of γ-T3 on mitochondrial function                                                                                                                                                                              600
is measured by the Agilent Seahorse XF Cell Mito Stress Test. SGC-7901                                                                                                                                                                                 400
                                                                                                                                                                                                                                                                                                                                                       400                                                  400
and MGC-803 cells were treated with indicated concentrations of γ-T3 for 4                                                                                                                                                                                                                                                                             200                                                  200
                                                                                                                                                                                                                                                       200
h, then basal and maximal OCR were measured using the XF Cell Mito Stress
                                                                                                                                                                                                                                                         0                                                                                              0                                                    0
Test 16.                                                                                                                                                                                                                                                      0             20                     40    60     80 100                                        0       20    30                                     0    20    30
                                                                                                                                                                                                                         Figure 8. Dose-dependency
                                                                                                                                                                                                                                       Time (min)      of the effect   of γ-T3 on the glycolytic
                                                                                                                                                                                                                                                                 Concentrations                  rate is
                                                                                                                                                                                                                                                                                            Concentrations
                                                                                                                                                                                                                                                                    (µmol/L)                  (µmol/L)
                                                                                                                                                                                                                         measured by the Agilent Seahorse XF Glycolytic         Rate Assay. SGC-7901
                                                                                                                                                                                                                         (top) and MGC-803 (bottom) cells were treated with indicated concentrations
                                                                                                                                                                                                                         of γ-T3 for 4 h and the extracellular acidification rates were measured using
                                                                                                                                                                                                                         the XF Glycolytic Rate Assay. Bar graphs show quantitative data of basal and
                                                                                                                                                                                                                         compensatory glycolysis rates 16.

                       4
Mitochondrial and glycolytic function as therapeutic targets: the genotype-metabolic
phenotype connection.
Beyond initial classification of cancer cell energetic phe-                                     the SMARCA4 deficient H1299 lung cell line was reconstituted
notypes, ATP production rates and the proportion of ATP                                         with SMARC4A (H1299 SMARCA4), both basal respiration
sourced from OXPHOS versus glycolysis can be further used                                       and spare respiratory capacity decreased (Figure 10 C, D), fur-
to investigate the functional effects of cancer-associated mu-                                  ther showing that these mutant lung cancer cells are sensitive
tations. For example, evaluation of KRAS-and EGFR-mutated                                       to inhibition of OXPHOS 19.
NSCLC cells showed distinct metabolic phenotypes concern-
ing the source of ATP production (Figure 9 18). The cell lines                                                               % Glycolysis            % OXPHOS
bearing EGFR mutations were, in general, more oxidative than
those bearing KRAS mutations, providing insight into meta-                                                 PC9
bolic vulnerabilities of cancer subsets, and EGFR as a poten-                                                                                                         EGFR
tial therapeutic target.                                                                          H1957

A study by Deribe et al. provides another example of how                                              H460
measurements with the XF Cell Mito Stress Test revealed                                                                                                               KRAS
mutations of well-known cancer-causing genes, which could                                              A549
serve as a target for metabolic modulation 19. In this study,
the authors showed that mutations in the SWI/SNF chroma-                                                               0      20          40       60     80    100
tin remodeling complex induce a targetable dependence on                                        Figure 9. KRAS-and EGFR-mutated NSCLC cells exhibit different ATP
OXPHOS in lung cancer cell lines. Cells deficient in the most                                   production patterns. Metabolic profiles of four cellular models of NSCLC
frequently inactivated complex subunit, SMARCA4 (KPS cells,                                     in standard assay medium (XF RPMI containing 10 mM glucose, 1 mM
                                                                                                pyruvate, 2 mM glutamine, pH 7.4) These two KRAS mutant cell lines are
Figure 10A, B), had increased mitochondrial respiration. When
                                                                                                slightly more glycolytic than the EGFR mutant cell lines 18.

       A                               Mitochondrial respiration                                  B
                         700                 FCCP Rotenone +                                                          350
                                                     Antimycin A
                         600                                                                                          300
     per 10,000 cells)

                                                                                                  per 10,000 cells)
     OCR (pmol/min

                                                                         KPS                                          250                                 KPS
                                                                                                  OCR (pmol/min

                         500       Oligomycin
                         400                                             KP                                           200                                 KP

                         300                                                                                          150          ***
                         200                                                                                          100
                         100                                                                                           50
                                                                                                                                                   ***
                          0                                                                                             0
                               0            50          100                                                                    Basal            Spare
                                             Time (min)                                                                     respiration        capacity

       C                                                                                          D
                                       Mitochondrial respiration
                                                            Rotenone +
                                                 FCCP
                         300                                Antimycin A                                               140

                         250                                                                                          120
                                    Oligomycin
    per 10,000 cells)
    OCR (pmol/min

                                                                                                                      100
                                                                                                  per 10,000 cells)

                                                                               H1299 Parental                                                              H1299 Parental
                                                                                                  OCR (pmol/min

                         200
                                                                               H1299 SMARCA4                          80                                   H1299 SMARCA4
                         150
                                                                                                                      60           ***              **
                         100
                                                                                                                      40
                          50                                                                                          20
                          0                                                                                            0
                               0                  50               100                                                         Basal            Spare
                                                Time (min)                                                                  respiration        capacity

Figure 10. Measuring the functional effect of mitochondrial gene mutations using basal respiration and spare respiratory capacity. A) trace of OCR
values from a mitochondrial stress test showing Kras-p53 (KP) -derived cell line (red) and Kras-p53-SMARCA4 -derived cell line (KPS , i.e. SMARCA4
deficient, blue). B) basal respiration and spare respiratory capacity. C) kinetic trace of the mitochondrial stress test showing H1299 parental (i.e.
SMARCA4 deficient, blue) and H1299 cell line reconstituted with SMARCA4 (red). D) basal respiration and spare respiratory capacity 19.

                                                                                                                                                                             5
The previous examples have discussed how XF measure-                                              and maximal (stressed) mitochondrial respiration of S47
ments and assays revealed metabolic vulnerabilities with                                          cells compared to wild type cells (Figure 11A), suggesting a
upregulated OXPHOS. Similarly, metabolic vulnerabilities                                          decreased ability to perform OXPHOS. In contrast, measure-
associated with upregulated glycolysis can be identified using                                    ment of basal and compensatory glycolysis (Figure 11 B–D)
In another example of oncogenes driving changes in meta-                                          showed that the S47 tumor cells were upregulating glycolysis
bolic phenotype, Barnoud et al. recently demonstrated that                                        under both basal and stressed conditions. This indicates that
tumor cells expressing a p53 allele with a serine at amino acid                                   metabolic rewiring resulted in a greater dependency on gly-
47 (S47 tumor cells) exhibited upregulated glycolysis with                                        colysis compared to the wild type. Taken together, the results
reduced dependency on OXPHOS compared to cell with wild                                           suggest that in these tumor cells, the glycolytic pathway is
type p53 20. This was accomplished by performing both XF                                          a potential metabolic target for S47 variant cancers. This is
Glycolytic Rate and XF Mito Stress Test assays to investigate                                     further supported by experiments showing increased sensitiv-
glycolytic and mitochondrial function, respectively. Measure-                                     ity of S47 cells to the glycolytic inhibitor, 2-deoxyglucose 20.
ment of mitochondrial function revealed decreased basal

 A                                                Oxygen Consumption Rate (OCR)
                                                                                                                C                              Basal Glycolysis
                                                  A                B               C
                               500                                                                                                    800
 OCR (pmol/min/40,000 cells)

                                                                                                                                                          ***

                                                                                                               glycoPER (pmol/min)
                               400                                                           WT E1A/RAS
                                                                                                                                      600
                                                                                             S47 E1A/RAS
                               300
                                                                                                                                      400
                               200
                                                                                                                                      200
                               100

                                0                                                                                                       0
                                     0   10            20     30      40      50       60        70     80                                        WT              S47
                                                                   Time (min)                                                                   E1A/RAS         E1A/RAS

 B                                                Glycolytic Rate Assay
                                                                                                                 D
                                              A              B
                                                                                                                                             Compensatory Glycolysis
                                                                                                                                      1500
 ECAR (mpH/min/60,000 cells)

                               120                                          WT E1A/RAS
                                                                            S47 E1A/RAS                                                                   ***
                                                                                                                glycoPER (pmol/min)

                               100
                               80                                                                                                     1000

                               60
                               40                                                                                                      500

                               20
                                0                                                                                                       0
                                     0            20           40           60              80                                                    WT              S47
                                                            Time (min)                                                                          E1A/RAS         E1A/RAS
Figure 11. Metabolic changes in tumor cells induced by a p53 allele with a serine at amino acid 47 (S47 tumor cells). A) The Agilent Seahorse XF Cell Mito
Stress Test reveals a decrease in basal mitochondrial respiration and spare respiratory capacity in S47 tumor cells compared to wild type cells. B, C, D) The
Agilent Seahorse XF Glycolytic Rate Assay reveals a statistically significant difference in basal and compensatory glycolysis for S47 tumor cells compared to
WT cells (Figure adapted from 20).

                     6
Summary
• To first understand changes in the bioenergetic poise be-     • Used in combination the quantitative and functional
  tween oxidative phosphorylation and glycolysis in cancer        parameters provided by the XF Real-Time ATP rate assay
  cells, it is recommended to measure the OCR/ECAR ratio.         (total, glyco-, and mitoATP production rates), the XF Cell
  This metric is an easy-to-use indicator of changes in cell      Mito Stress Test (basal and maximal OCR), and the XF
  phenotype or metabolic activity. Assays that can be used        Glycolytic Rate Assay (basal and compensatory glycolysis)
  to determine this ratio include the XF Cell Energy Pheno-       can reveal the effects of anticancer agents in terms of
  type Test, the XF Cell Mito Stress Test, and the XF Glyco-      metabolic liabilities, efficacy, toxicity, target identification,
  lytic Rate Assay.                                               mechanism of action, etc.
• A more functional and quantitative measure of cancer cell     • There is increasing evidence for a correlative pattern
  metabolic phenotype is to quantify the rate and source          among oncogenes (i.e. the expressed protein) and effects
  (mitochondrial versus glycolytic) of ATP production. The        on cancer cell metabolism regarding changes in mitochon-
  XF Real-Time ATP rate assay measures the total ATP pro-         drial and glycolytic function and the ATP production rate/
  duction rate in cells and distinguishes between ATP pro-        source. These metabolic changes or shifts can be poten-
  duced from mitochondrial OXPHOS versus glycolysis. This         tial targets for anticancer therapeutics.
  assay therefore provides a detailed, functional overview of
  cancer cell phenotype and metabolism.

                                                                                                                              7
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