Summary
Diagnosis of endometrial cancer is primarily based on symptoms and imaging, with early-stage disease being difficult to diagnose. Therefore, development of potential diagnostic biomarkers is required. Metabolomics, a quantitative measurement of the dynamic metabolism in living systems, can be applied to determine metabolite profiles in different disease states. Here, serum metabolomics was performed in forty-six early stage endometrial cancer patients and forty-six healthy volunteers. In addition, the effect of identified metabolites on tumour cell behavior (invasion, migration, proliferation, apoptosis, autophagy), was examined in endometrial cancer cell lines. Compared with controls, phenylalanine, indoleacrylic acid (IAA), phosphocholine and lyso-platelet activating factor-16 (lyso-PAF), were differentially detected in patients. Functional analyses demonstrated that IAA, PAF and phenylalanine all dose-dependently inhibited tumour cell invasion and migration, and suppressed cell proliferation. PAF also induced tumour cell apoptosis and autophagy, while phenylalanine had no effect on apoptosis or autophagy. IAA triggered apoptosis and had a biphasic effect on autophagy: inhibiting autophagy with doses less than 1mM but inducing at 1mM. Interestingly, the alterations in proliferation, apoptosis and autophagy caused by 1mM IAA, were all reversed by the concomitant treatment of tryptophan (100μM). Phosphocholine inhibited tumour cell invasion and migration, and promoted cell proliferation and autophagy all in a dose-dependent manner. Phosphocholine also protected cells from TNF-α-induced apoptosis. In conclusion, four serum metabolites were identified by serum metabolomics in endometrial cancer patients and functional analyses suggested that they may play roles in modulation of tumour cell behavior, although their exact mode of action still needs to be determined.
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