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Mannose metabolism inhibition sensitizes acute myeloid leukaemia cells to therapy by driving ferroptotic cell death.

Published version
Peer-reviewed

Repository DOI


Type

Article

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Authors

Woodley, Keith 
Dillingh, Laura S 
Giotopoulos, George  ORCID logo  https://orcid.org/0000-0003-1390-6592
Rattigan, Kevin M 

Abstract

Resistance to standard and novel therapies remains the main obstacle to cure in acute myeloid leukaemia (AML) and is often driven by metabolic adaptations which are therapeutically actionable. Here we identify inhibition of mannose-6-phosphate isomerase (MPI), the first enzyme in the mannose metabolism pathway, as a sensitizer to both cytarabine and FLT3 inhibitors across multiple AML models. Mechanistically, we identify a connection between mannose metabolism and fatty acid metabolism, that is mediated via preferential activation of the ATF6 arm of the unfolded protein response (UPR). This in turn leads to cellular accumulation of polyunsaturated fatty acids, lipid peroxidation and ferroptotic cell death in AML cells. Our findings provide further support to the role of rewired metabolism in AML therapy resistance, unveil a connection between two apparently independent metabolic pathways and support further efforts to achieve eradication of therapy-resistant AML cells by sensitizing them to ferroptotic cell death.

Description

Funder: American Society of Hematology

Keywords

Humans, Mannose, Cell Death, Cytarabine, Cell Line, Tumor, Leukemia, Myeloid, Acute, Apoptosis, fms-Like Tyrosine Kinase 3

Journal Title

Nat Commun

Conference Name

Journal ISSN

2041-1723
2041-1723

Volume Title

14

Publisher

Springer Science and Business Media LLC
Sponsorship
Wellcome Trust (109967/Z/15/Z)
Medical Research Council (MC_PC_17230)
Wellcome Trust (210926/Z/18/Z)
Cancer Research UK (23015)
Cancer Research UK (25508)
Cancer Research UK (C57799/A27964)
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