MR-visible lipids or mobile lipids are defined as lipids that are observable using proton magnetic resonance spectroscopy in cells and in tissues. These MR-visible lipids are composed of triglycerides and cholesterol esters that accumulate in intracellular neutral lipid droplets, where their MR visibility is conferred as a result of the increased molecular motion available in this unique physical environment. This review will discuss factors that lead to the biogenesis of MR-visible lipids in cancer cells and in other cell types such as immune cells and fibroblasts. We focus on the accumulations of mobile lipids that are inducible in cultured cells by a number of stresses, including culture conditions and in response to activating stimuli or apoptotic cell death induced by anticancer drugs. This is compared with animal tumor models, where increases in mobile lipids are observed in response to chemo and radiotherapy, and to human tumors where mobile lipids are observed predominantly in high-grade brain tumors and in regions of necrosis. Conducive conditions for mobile lipid formation in the tumor microenvironment will be discussed including low pH, oxygen availability and the presence of inflammatory cells. It is concluded that MR-visible lipids appear in cancer cells and human tumors as a stress response. Mobile lipids stored as neutral lipid droplets may play a role in detoxification of the cell or act as an alternate energy source, especially in cancer cells, which often grow in ischemic/hypoxic environments. The role of MR-visible lipids in cancer diagnosis and assessment of treatment response both in animal models of cancer as well as human brain tumors will also be discussed. Although technical limitations exist in the accurate detection of intratumoral mobile lipids, early increases in mobile lipids after therapeutic interventions may be used as a potential biomarker for assessing treatment response in cancer.
It is well established that lipid metabolism is drastically altered during tumor
development and response to therapy. Choline kinase alpha (ChoKα) is a key
mediator of these changes, as it represents the first committed step in the Kennedy
pathway of phosphatidylcholine biosynthesis and ChoKα expression is upregulated in
many human cancers. ChoKα activity is associated with drug resistant, metastatic,
and malignant phenotypes, and represents a robust biomarker and therapeutic target in
cancer. Effective ChoKα inhibitors have been developed and have recently entered
clinical trials. ChoKα's clinical relevance was, until recently,
attributed solely to its production of second messenger intermediates of phospholipid
synthesis. The recent discovery of a non-catalytic scaffolding function of ChoKα
may link growth receptor signaling to lipid biogenesis and requires a reinterpretation of
the design and validation of ChoKα inhibitors. Advances in positron emission
tomography, magnetic resonance spectroscopy, and optical imaging methods now allow for a
comprehensive understanding of ChoKα expression and activity in
vivo. We will review the current understanding of ChoKα metabolism, its
role in tumor biology and the development and validation of targeted therapies and
companion diagnostics for this important regulatory enzyme. This comes at a critical time
as ChoKα-targeting programs receive more clinical interest.
Systemic ICG identifies subcentimeter tumor metastases to the lung in murine models, and this work provides proof of principle in humans. Future research is focused on improving depth of penetration into the lung parenchyma.
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