Abstract B76: Pyruvate dehydrogenase: A key to epigenetic regulation in CAFs
Authors: Kay Emily , Neilson Lisa , Boldrini Claudia , Hernandez-Fernaud Juan , Gjerga Enio , Sumpton David , Dhayade Sandeep , McGregor Grace , Koulouras Grigorios , Kamphorst Jurre , Blyth Karen , Saez-Rodriguez Julio , Mackay Gillian , Zanivan Sara 
Published: September 2020

Abstract
Cancer-associated fibroblasts (CAFs) play fundamental roles in cancer and are emerging as therapeutic target in tumors with extensive stromal regions and in those for which there are limited targeted therapies against the cancer cells, such as ovarian cancer. A unique feature of the CAFs is their ability to secrete abundant collagen-rich extracellular matrix (ECM) that promotes the desmoplastic reaction that accompanies tumor progression and drives tumor growth and metastasis. Altered tumor metabolism is a hallmark of cancer, and understanding whether and how metabolic pathways support protumorigenic and proinvasive CAF functions may identify ways to target these cells to effectively target tumors. Using global phosphoproteomics, we have found that the activity of the pyruvate dehydrogenase complex (PDC), which is the rate-limiting enzyme for the entry of glycolysis-derived metabolites into the TCA cycle by converting pyruvate into acetyl-CoA, is strongly increased in patient-derived CAFs compared to their normal fibroblast counterpart. Consistently, the expression of pyruvate dehydrogenase kinase (PDK), which phosphorylates and inhibits PDC activity, is downregulated in CAFs and in the stroma of tumor patient samples. We found that PDC activity in CAFs leads to increased acetyl-CoA production. Surprisingly, 13C-glucose tracing experiments showed that CAFs do not channel acetyl-CoA into the TCA cycle. Instead, CAFs use acetyl-CoA to activate an epigenetic switch triggered by acetylation of H3K27. H3K27 acetylation is a known marker of gene expression activation. In CAFs, it triggered the expression of several collagen genes. Interestingly, also the expression of enzymes of the proline synthesis pathway was induced following H3K27 acetylation. Collagens have an unusually high content of proline residues, and we show that enhanced proline synthesis is necessary to support the production of collagen-rich ECM in CAFs. Targeting the PDK/PDC pathway or H3K27 acetylation or the proline synthesis pathway was sufficient to inhibit collagen synthesis in CAFs in in vitro experiments. Targeting proline synthesis in the stroma was sufficient to reduce tumor growth in vivo. Our work provides a first evidence that metabolism and epigenetics are tightly intertwined in regulating CAF functions and that targeting the PDK/PDC pathway or the proline synthesis pathway in the stroma could halt the development of a desmoplastic reaction and tumor progression.
Citation Format: Emily Kay, Lisa Neilson, Claudia Boldrini, Juan Hernandez-Fernaud, Enio Gjerga, David Sumpton, Sandeep Dhayade, Grace McGregor, Grigorios Koulouras, Jurre Kamphorst, Karen Blyth, Julio Saez-Rodriguez, Gillian Mackay, Sara Zanivan. Pyruvate dehydrogenase: A key to epigenetic regulation in CAFs [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research; 2019 Sep 13-16, 2019; Atlanta, GA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(13_Suppl):Abstract nr B76.