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2015 ; 21
(22
): 5037-46
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Autophagy, Metabolism, and Cancer
#MMPMID26567363
White E
; Mehnert JM
; Chan CS
Clin Cancer Res
2015[Nov]; 21
(22
): 5037-46
PMID26567363
show ga
Macroautophagy (autophagy hereafter) captures intracellular proteins and
organelles and degrades them in lysosomes. The degradation breakdown products are
released from lysosomes and recycled into metabolic and biosynthetic pathways.
Basal autophagy provides protein and organelle quality control by eliminating
damaged cellular components. Starvation-induced autophagy recycles intracellular
components into metabolic pathways to sustain mitochondrial metabolic function
and energy homeostasis. Recycling by autophagy is essential for yeast and mammals
to survive starvation through intracellular nutrient scavenging. Autophagy
suppresses degenerative diseases and has a context-dependent role in cancer. In
some models, cancer initiation is suppressed by autophagy. By preventing the
toxic accumulation of damaged protein and organelles, particularly mitochondria,
autophagy limits oxidative stress, chronic tissue damage, and oncogenic
signaling, which suppresses cancer initiation. This suggests a role for autophagy
stimulation in cancer prevention, although the role of autophagy in the
suppression of human cancer is unclear. In contrast, some cancers induce
autophagy and are dependent on autophagy for survival. Much in the way that
autophagy promotes survival in starvation, cancers can use autophagy-mediated
recycling to maintain mitochondrial function and energy homeostasis to meet the
elevated metabolic demand of growth and proliferation. Thus, autophagy inhibition
may be beneficial for cancer therapy. Moreover, tumors are more
autophagy-dependent than normal tissues, suggesting that there is a therapeutic
window. Despite these insights, many important unanswered questions remain about
the exact mechanisms of autophagy-mediated cancer suppression and promotion, how
relevant these observations are to humans, and whether the autophagy pathway can
be modulated therapeutically in cancer. See all articles in this CCR Focus
section, "Cell Death and Cancer Therapy."