Cancer cells require #energy to buttress their out-of-control #growth. This energy is acquired by the consumption of large amounts of glucose, so much so that some methods of #cancer_detection simply look for regions of extreme #glucose_consumption. But, the question remains, how do cancer cells get access to this much glucose?

A recent study demonstrates that #leukemia cells create a diabetic like condition that undercuts the availability of glucose to normal cells, thereby leaving more #glucose available for their own needs. This energy theft by the cancer cells may be responsible for the #weight_loss and #fatigue frequently observed in #cancer_patients.

Similar to #diabetes, the strategies of #cancer propagation are dependent on insulin. Healthy cells require insulin to utilize glucose. In diabetes, there are strategies whereby glucose consumption is affected- (1) the #pancreas under-produces insulin, or (2) tissues are unable to respond to insulin (lack of #insulin_sensitivity), and so, even though there is sufficient glucose in the blood, the cells are energy-starved.

It seems that leukemia also creates similar scenarios of glucose build-up in the blood. Firstly, the tumor cells trick the #fat_cells into over-expressing a protein called #IGFBP1, which makes the cells less sensitive to insulin; meaning, in conditions where IGFBP1 levels are high, more insulin is required for consumption of glucose i.e., glucose consumption by healthy cells goes down. This may also be the link connecting cancer and #obesity i.e., more fat cells equals more IGFBP1, and more available glucose for the cancer cells.

The second strategy employed by cancer cells ensures that the insulin levels do not match up to the demands created by the increased IGFBP1 levels. In fact, most cancer cells reduce #insulin_production; in large part, this is done in the #gut, through the gut #microbiome.

The composition of the microbiota in leukemic animals is different from that of control mice. More precisely bacteria called the #bacteroids are lacking in leukemic animals, whose absence specifically aids cancer.

One way through which the #gut_microbiota impacts #oncogenesis is by influencing the secretion of gut hormones known as #incretins, which are involved in maintaining normal #blood_glucose levels. Leukemia inactivates incretins, allowing for elevated levels of glucose in the blood. Additionally, leukemia also tamps down the activity of #serotonin, a "feel good" chemical that is also essential for insulin production from the pancreas. Using these two strategies (lowered activity of incretins and serotonin), leukemia reduces insulin production, and by extension, glucose consumption by healthy cells.

In a classic #parasite_trick, cancer cells hijack of one of the host processes to subvert it for their own purposes. Through a two pronged attack- reduced insulin secretion and reduced insulin sensitivity, the cancer undercuts the healthy cells' use of insulin. Less insulin use by healthy cells amounts to less glucose consumption, leaving more glucose for the cancer.

When the glucose system was recalibrated using serotonin and #tributyrin (a fatty acid produced by bacteroids) supplementation, it was found that glucose regulation could be restored and the growth of leukemia cells could be slowed down, leading to an #extended_lifespan.

This dependence of cancer on its ability to out-compete healthy cells for access to limited energy resources may be leveraged as a #therapeutic_target for the design of novel #anticancer_drugs.

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