Diabetes is a complex metabolic syndrome that is characterized by prolonged high blood glucose levels and frequently associated with life-threatening complications1,2. Epidemiological studies have suggested that diabetes is also linked to an increased risk of cancer3-5. High glucose levels may be a prevailing factor that contributes to the link between diabetes and cancer, but little is known about the molecular basis of this link and how the high glucose state may drive genetic and/or epigenetic alterations that result in a cancer phenotype. Here we show that hyperglycaemic conditions have an adverse effect on the DNA 5-hydroxymethylome. We identify the tumour suppressor TET2 as a substrate of the AMP-activated kinase (AMPK), which phosphorylates TET2 at serine 99, thereby stabilizing the tumour suppressor. Increased glucose levels impede AMPK-mediated phosphorylation at serine 99, which results in the destabilization of TET2 followed by dysregulation of both 5-hydroxymethylcytosine (5hmC) and the tumour suppressive function of TET2 in vitro and in vivo. Treatment with the anti-diabetic drug metformin protects AMPK-mediated phosphorylation of serine 99, thereby increasing TET2 stability and 5hmC levels. These findings define a novel 'phospho-switch' that regulates TET2 stability and a regulatory pathway that links glucose and AMPK to TET2 and 5hmC, which connects diabetes to cancer. Our data also unravel an epigenetic pathway by which metformin mediates tumour suppression. Thus, this study presents a new model for how a pernicious environment can directly reprogram the epigenome towards an oncogenic state, offering a potential strategy for cancer prevention and treatment.

译文

糖尿病是一种复杂的代谢综合征,其特征是长期的高血糖水平,并经常与危及生命的并发症相关联1,2。流行病学研究表明,糖尿病也与cancer3-5风险增加有关。高糖水平可能是导致糖尿病与癌症之间联系的主要因素,但对这种联系的分子基础以及高糖状态如何驱动导致癌症表型的遗传和/或表观遗传改变知之甚少。在这里,我们显示高血糖状态对DNA 5-羟甲基组有不利影响。我们将肿瘤抑制因子TET2鉴定为AMP激活激酶 (AMPK) 的底物,该激酶在丝氨酸99处磷酸化TET2,从而稳定了肿瘤抑制因子。葡萄糖水平的升高会阻碍AMPK介导的丝氨酸99磷酸化,这导致TET2的不稳定,然后导致5-羟甲基胞嘧啶 (5hmC) 的失调以及TET2在体外和体内的肿瘤抑制功能。用抗糖尿病药物二甲双胍治疗可保护AMPK介导的丝氨酸99磷酸化,从而提高TET2稳定性和5hmC水平。这些发现定义了一种新的调节TET2稳定性的 “磷酸开关”,以及将葡萄糖和AMPK与TET2和5hmC联系起来的调节途径,后者将糖尿病与癌症联系起来。我们的数据还揭示了二甲双胍介导肿瘤抑制的表观遗传途径。因此,这项研究提出了一种新的模型,说明有害环境如何直接将表观基因组重新编程为致癌状态,从而为癌症的预防和治疗提供了潜在的策略。

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