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Estradiol promotes pentose phosphate pathway addiction and cell survival via reactivation of Akt in mTORC1 hyperactive cells.
[lymphangioleiomyomatosis]
Lymphangioleiomyomatosis
(
LAM
)
is
a
female
-predominant
interstitial
lung
disease
that
can
lead
to
respiratory
failure
.
LAM
cells
typically
have
inactivating
TSC
2
mutations
,
leading
to
mTORC
1
activation
.
The
gender
specificity
of
LAM
suggests
that
estradiol
contributes
to
disease
development
,
yet
the
underlying
pathogenic
mechanisms
are
not
completely
understood
.
Using
metabolomic
profiling
,
we
identified
an
estradiol-enhanced
pentose
phosphate
pathway
signature
in
Tsc
2
-
deficient
cells
.
Estradiol
increased
levels
of
cellular
NADPH
,
decreased
levels
of
reactive
oxygen
species
,
and
enhanced
cell
survival
under
oxidative
stress
.
Mechanistically
,
estradiol
reactivated
Akt
in
TSC
2
-
deficient
cells
in
vitro
and
in
vivo
,
induced
membrane
translocation
of
glucose
transporters
(
GLUT
1
or
GLUT
4
)
,
and
increased
glucose
uptake
in
an
Akt-dependent
manner
.
(
18
)
F-FDG-PET
imaging
demonstrated
enhanced
glucose
uptake
in
xenograft
tumors
of
Tsc
2
-
deficient
cells
from
estradiol-treated
mice
.
Expression
array
study
identified
estradiol-enhanced
transcript
levels
of
glucose-
6
-
phosphate
dehydrogenase
(
G
6
PD
)
,
the
rate-limiting
enzyme
of
the
pentose
phosphate
pathway
.
Consistent
with
this
,
G
6
PD
was
abundant
in
xenograft
tumors
and
lung
metastatic
lesions
of
Tsc
2
-
deficient
cells
from
estradiol-treated
mice
.
Molecular
depletion
of
G
6
PD
attenuated
estradiol-enhanced
survival
in
vitro
,
and
treatment
with
6
-
aminonicotinamide
,
a
competitive
inhibitor
of
G
6
PD
,
reduced
lung
colonization
of
Tsc
2
-
deficient
cells
.
Collectively
,
these
data
indicate
that
estradiol
promotes
glucose
metabolism
in
mTORC
1
hyperactive
cells
through
the
pentose
phosphate
pathway
via
Akt
reactivation
and
G
6
PD
upregulation
,
thereby
enhancing
cell
survival
under
oxidative
stress
.
Interestingly
,
a
strong
correlation
between
estrogen
exposure
and
G
6
PD
was
also
found
in
breast
cancer
cells
.
Targeting
the
pentose
phosphate
pathway
may
have
therapeutic
benefit
for
LAM
and
possibly
other
hormonally
dependent
neoplasms
.
Diseases
Validation
Diseases presenting
"deficient cells"
symptom
child syndrome
esophageal adenocarcinoma
gm1 gangliosidosis
junctional epidermolysis bullosa
kindler syndrome
lymphangioleiomyomatosis
neonatal adrenoleukodystrophy
werner syndrome
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