Key Points• Homologs to cancer-derived IDH1 and IDH2 mutants produce D-2HG and drive expansion of Drosophila blood cells.
• In flies, mutant Idh interactswith genes that regulate reduced nicotinamide adenine dinucleotide phosphate, reactive oxygen species, and apoptosis.Gain-of-function mutations in nicotinamide adenine dinucleotide phosphate-dependent isocitrate dehydrogenase (IDH)1 and IDH2 frequently arise in human leukemias and other cancers and produce high levels of D-2-hydroxyglutarate (D-2HG). We expressed the R195H mutant of Drosophila Idh (CG7176), which is equivalent to the human cancerassociated IDH1-R132H mutant, in fly tissues using the UAS-Gal4 binary expression system. Idh-R195H caused a >25-fold elevation of D-2HG when expressed ubiquitously in flies. Expression of mutant Idh in larval blood cells (hemocytes) resulted in higher numbers of circulating blood cells. Mutant Idh expression in fly neurons resulted in neurologic and wing-expansion defects, and these phenotypes were rescued by genetic modulation of superoxide dismutase 2, p53, and apoptotic caspase cascade mediators. Idh-R163Q, which is homologous to the common leukemia-associated IDH2-R140Q mutant, resulted in moderately elevated D-2HG and milder phenotypes. We identified the fly homolog of D-2-hydroxyglutaric acid dehydrogenase (CG3835), which metabolizes D-2HG, and showed that coexpression of this enzyme with mutant Idh abolishes mutant Idh-associated phenotypes. These results provide a flexible model system to interrogate a cancer-related genetic and metabolic pathway and offer insights into the impact of IDH mutation and D-2HG on metazoan tissues. (Blood. 2015;125(2):336-345) Introduction Somatic, gain-of-function mutations in nicotinamide adenine dinucleotide phosphate (NADP 1 )-dependent isocitrate dehydrogenase (IDH)1 and IDH2 occur frequently in acute myeloid leukemias, myelodysplastic syndromes, angioimmunoblastic T-cell lymphomas, brain tumors, and other cancers. [1][2][3][4][5][6][7][8][9] The mutations occur at the conserved active-site residues of Arg132 in IDH1, or Arg140 and Arg172 in IDH2. When mutated, IDH1 and IDH2 lose their normal function to convert isocitrate to a-ketoglutarate and acquire a gain of function to convert a-ketoglutarate to D-2-hydroxyglutarate (D-2HG).10 D-2HG accumulates to ;100-fold higher levels in IDHmutated cancer tissues.10,11 D-2HG inhibits Fe(II)-a-ketoglutaratedependent dioxygenases, including histone demethylases, DNA hydroxymethyltransferases, and collagen proline hydroxylases. 12,13 Inhibition of these dioxygenase enzymes leads to histone lysine hypermethylation, DNA hypermethylation, and collagen dysfunction in mammalian tissues expressing mutated IDH1 or IDH2. 5,[14][15][16] IDH mutations can also sensitize cells to reactive oxygen species (ROS) induction, possibly because mutant IDH consumes reduced NADP (NADPH), a cofactor important for scavenging intracellular ROS. 17 Targeting mutated IDH1 or IDH2 to mouse hematopoietic progenitors results in an increased number of these progeni...