Ascorbate kills breast cancer cells by rewiring metabolism via redox imbalance and energy crisis
Ali Ghanem Free Radical Biology and Medicine Volume 163, 1 February 2021, Pages 196-209
Highlights
• Megadoses of ascorbate are rapidly lethal to cultured breast cancer cells.
• Ascorbate disrupts redox homeostasis, and consequently rewires metabolism and jeopardises energy production.
• Disruption of glycolysis at the triose phosphate level DHAP/G3P is linked to increased glycerol and trigylceride synthesis.
• Ascorbate induces extracellular H2O2 and intracellular ROS.
• Both extra and intra-cellular ROS scavenging mitigated ascorbate’s cytotoxicity.
The idea to use megadoses of ascorbate (vitamin C) for cancer treatment has recently been revived. Despite clear efficacy in animal experimentation, our understanding of the cellular and molecular mechanisms of this treatment is still limited and suggests a combined oxidative and metabolic mechanism behind the selective cytotoxicity of ascorbate towards cancerous cells. To gain more insight into the cellular effects of high doses of ascorbate, we performed a detailed analysis of metabolic changes and cell survival of both luminal and basal-like breast cancer cells treated with ascorbate and revealed a distinctive metabolic shift virtually reversing the Warburg effect and triggering a severe disruption of redox homeostasis.
High doses of ascorbate were cytotoxic against MCF7 and MDA-MB231 cells representing luminal and basal-like breast cancer phenotypes. Cell death was dependent on ascorbate-induced oxidative stress and accumulation of ROS, DNA damage, and depletion of essential intracellular co-factors including NAD+/NADH, associated with a multifaceted metabolic rewiring. This included a sharp disruption of glycolysis at the triose phosphate level, a rapid drop in ATP levels, and redirection of metabolites toward lipid droplet accumulation and increased metabolites and enzymatic activity in the pentose phosphate pathway (PPP). High doses of ascorbate also inhibited the TCA cycle and increased oxygen consumption. Together the severe disruptions of the intracellular metabolic homeostasis on multiple levels “redox crisis and energetic catastrophe” consequently trigger a rapid irreversible cell death.