154 Recent Patents on Anti-Cancer Drug Discovery, 2012, 7, 154-167 ATP Citrate Lyase Inhibitors as Novel Cancer Therapeutic Agents Xu-Yu Zu1,#, Qing-Hai Zhang1,#, Jiang-Hua Liu1, Ren-Xian Cao1, Jing Zhong1, Guang-Hui Yi2, Zhi-Hua Quan1 and Giuseppe Pizzorno3,* 1 Clinical Research Institution, the First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, P.R. China; 2Institute of Cardiovascular Disease, School of Medicine, University of South China, Hengyang, Hunan 421001, P.R. China; 3Director, Human Health and Environment Program, Desert Research Institute Summerlin, 10530 Discovery Drive, Las Vegas, NV 89135, USA Received: November 1, 2011; Accepted: January 12, 2012; Revised: February 6, 2012 Abstract: ATP citrate lyase (ACL or ACLY) is an extra-mitochondrial enzyme widely distributed in various human and animal tissues. ACL links glucose and lipid metabolism by catalyzing the formation of acetyl-CoA and oxaloacetate from citrate produced by glycolysis in the presence of ATP and CoA. ACL is aberrantly expressed in many immortalized cells and tumors, such as breast, liver, colon, lung and prostate cancers, and is correlated reversely with tumor stage and differentiation, serving as a negative prognostic marker. ACL is an upstream enzyme of the long chain fatty acid synthesis, providing acetyl-CoA as an essential component of the fatty acid synthesis. Therefore, ACL is a key enzyme of cellular lipogenesis and potent target for cancer therapy. As a hypolipidemic strategy of metabolic syndrome and cancer treatment, many small chemicals targeting ACL have been designed and developed. This review article provides an update for the research and development of ACL inhibitors with a focus on their patent status, offering a new insight into their potential application. Keywords: ACL inhibitors, ATP citrate lyase, cancer therapy, citrate, lipogenesis, small chemicals. 1. INTRODUCTION Cancer treatment has been improved considerably during the past 50 years. This malignant disease, however, still holds its frightening impact and only about 50% of patients could be cured [1]. Increasing evidence has highlighted the importance of cellular metabolism in carcinogenesis [2-4]. Metabolic changes, such as increased lipogenesis, frequently occurs in malignant cells and the impact of metabolic dysregulation on tumor development and progression has long been recognized [3, 5]. ATP citrate lyase is a key enzyme linking glucose and lipid metabolism, which converts citrate produced by glycolysis to acetyl-CoA and oxaloacetate in the presence of ATP and coenzyme A. The acetyl-CoA is in turn used for cholesterol and long-chain fatty acid biosynthesis [2, 6-10]. Hereby, ACL acts as a mediator between increased lipogenesis and so-called Warburg effect in cancer cells. Up to date, numerous reports have shown marked elevation of ACL expression and enzyme activity in immortalized cells and tumors, including urinary bladder, breast, liver, stomach, colon, lung, brain and prostate cancers [1117]. Reduction of ACL activity with genetic or pharmacologic strategies significantly inhibits cancer cell proliferation in a dose-dependent manner and suppresses tumor growth in animals. As increased understanding of ACL *Address correspondence to this author at the Director, Human Health and Environment Program, Desert Research Institute Summerlin, 10530 Discovery Drive, Las Vegas, NV 89135, USA; Tel: 702-822-5380; Fax: 702-944-2355; E-mail: [email protected] # These authors contributed equally to this work. 2212-3970/12 $100.00+.00 enzymology, mechanism-based and active site-directed inhibitors have been developed. This review article updates the current research and development of ACL small molecule inhibitors, with a focus on their patent status. 2. ATP CITRATE LYASE 2.1. Structure of ATP Citrate Lyase ATP citrate lyase [ATP citrate (pro-3S)-lyase, ACL or ACLY; EC 4.1.3.8] is an extra-mitochondrial enzyme [18]. In prokaryotic and lower-rank eukaryotic (e.g. fungi) cells, ACL is composed of two subunits, but in mammalian cells, ACL is a 110kDa polypeptide forming a functional homomeric tetramer [19]. In humans, there are two ACL isoforms. The ACL isoform-I consists of 1101 amino acids, and isoform-II is 10 residues shorter [20]. ACL protein contains five functional domains, named from N-terminus domains 3, 4, 5, 1 and 2 Fig. (1). Domains 1 and 2 make up the -subunit (residues 487-820) and domains 3-5 compose the -subunit (residues 2-425). Domain 1 binds CoA and domain 2 contains a phosphorylation site His765, regulating enzyme activity [20]. Domains 3 and 4 adopt an ATP-grasp fold and bind nucleotide [6, 21, 22]. Domain 5 interacts with domain 2, producing one of the two "power helices" to whose aminoterminus the phosphohistidine residue bind to in the phosphorylated ACL [23-25]. Between domains 5 and 1 lies a stretch of residues that can be phosphorylated on three serine or threonine residues [26-28]. When citrate binds to ACL, a loop formed by residues 343-348 interacts through hydrogen bonds with hydroxyl and carboxyl groups on the prochiral © 2012 Bentham Science Publishers ACL as Novel Cancer Therapeutic Target Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 A 155 820 425 487 750 2 767 B 3 4 5 1 2 CS a -subunit b -subunit Fig. (1). Human ATP-citrate lyase structure. A. Complex with citrate. The protein is shown as a ribbon diagram, while citrate is shown as a stick model in magenta. Residues 2-31 and 108-243 form domain 4, which is colored green. Domain 3 includes residues 32-107 and is red. Domain 5 includes residues 244-425 and is yellow. Domain 1 includes residues 487-624 and is cyan. Domain 2 includes residues 625-820 and is blue. The terminal residues seen in the electron density are labeled with their residue numbers. The ATP-grasp fold, formed by domains 3 and 4, is at the bottom of the diagram and ATP/ADP would be expected to bind to the back, as oriented here [32]. B. Arrangement of five domains. center of citrate, and Arg379 forms a salt bridge with the pro-R carboxylate of citrate. 2.2. Function of ATP Citrate Lyase ACL links glycolysis to fatty acid/lipid synthesis. Much of the bioenergetic supply is produced by the glycolysis of glucose, in cancer cells in particular, and glycolytically derived pyruvate enters the truncated tricarboxylic acid cycle (TCA cycle, also known as citric acid cycle), where citrate is preferentially exported to cytosol via the tricarboxylate transporter [29-31]. In the cytosol, citrate is cleaved by ACL to produce cytosolic acetyl-CoA and oxaloacetate. The enzyme reaction catalyzed by ACL includes four steps [32, 33]: ATP +E E-P + ADP (1) E-P + citrate E•citryl-P (2) E•citryl-P + CoA E•citryl-CoA + Pi (3) E•citryl-CoA E + acetyl-CoA + oxaloacetate (4) Where E represents enzyme (i.e., ACL). ACL is phosphorylated by ATP on histidine residue at the active site to form E-P in step 1. The phosphoryl group is transferred to citrate in step 2. Citryl-phosphate binds with the enzyme, symbolized by E•citryl-P. Phosphate is released in the attack by CoA to form a citryl-CoA thioester bond in step 3. In the last step, citryl-CoA is cleaved into acetyl-CoA and oxaloacetate. Cytosolic acetyl-CoA serves three important biosynthesis: 1) lipogenesis in the liver, adipose tissue, and mammary gland [7, 9]; 2) acetylcholine biosynthesis in the nervous tissue [34]; and histone acetylation in nuclei to control DNA accessibility and gene transcription. More recently, ACL is found to play a critical role in beta-cell survival [10, 35], platelet activation [36], and tumorigenesis [37]. Therefore, ACL has been attractive and its protein chemistry, enzyme kinetics and substrate specificity, and transcriptional and post-translational regulations have been extensively studied [18, 38-44]. 2.3. Regulation of ATP Citrate Lyase 2.3.1. Transcriptional Regulation At transcriptional level, ACL is regulated by sterol regulatory element-binding protein-1 (SREBP-1) [44], and insulin and glucose metabolites are important stimulatory factors [45-47]. In vitro, insulin/glucose stimulates ACL expression in primary hepatocytes through the SREBP-1 pathway, but transcription factor Sp1 acts as a repressor [48]. Decreased binding affinity of Sp1 to the G/C-rich region at -64 to -41bp in ACL promoter is observed in response to insulin and glucose [48-50]. The PI3K/Akt signaling pathway is involved in insulin-stimulated ACL expression, and tissue-specific growth factors that activate the PI3K/Akt pathway appear to play a similar role [51]. But nateglinide as an insulin secretagogue has recently been shown to suppress the expression of ATP citrate lyase [52]. Glucose plays a synergistic 156 Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 role in ACL expression through the PI3K/Akt signaling, indicating its importance in regulating ACL activity [13, 53, 54]. 2.3.2. Posttranslational Regulation ACL activity is also regulated by phosphorylation and dephosphorylation. ACL has a catalytic autophosphorylation site, His760 that is phosphorylated by ATP as the first step in citrate cleavage [55]. This His760 can also be phosphorylated by nucleoside diphosphate kinase (NDPK) from rat liver and PC12 cells [56]. ACL is also phosphorylated at other sites, including Ser3, Ser450 and Thr446. Evidence shows that the phosphorylation of these sites in ACL is increased during cell differentiation [55] and in response to biologically active agents, such as glucagon, insulin, adrenergic agonists, vasopressin, and transforming growth factor 1 [57]. In response to insulin, ACL is phosphorylated on Ser450 by cAMP-dependent protein kinase and insulinstimulated kinase [58, 59]. Ser450 can also be phosphorylated by Akt in primary adipocytes [28], indicating that the PI3K/Akt pathway is involved not only in ACL transcription, but also in ACL activity regulation through phosphorylation. In addition, Ser450 and Thr446 as well are also phosphorylated by glycogen synthase kinase-3 [10, 55]; and Ser3 of ACL is phosphorylated by cAMP-dependent protein kinase. The later abolishes homotropic allosteric regulation of ACL by citrate and increases enzyme activity [41, 56]. 3. ATP CITRATE LYASE AND CANCER It is well known that bioenergetics of cancer cells is altered, including increased glucose uptake and glycolysis, lactic acid production and lipogenesis [54]. The increased lipogenesis is a hallmark of cancer and an early event in tumorigenesis, providing lipids essential for cell growth and division [60]. It is understood that cancer cells are highly dependent on the de novo fatty acid synthesis for cellular lipids [61]. On the other hand, cancer cells typically depend more on glycolysis, the anaerobic breakdown of glucose for ATP, even in the presence of available oxygen. This phenomenon is known as Warburg effect [62]. The elevated glucose catabolism produces excessive glycolytic endproduct, pyruvate that is then converted either to lactate or acetyl-CoA for de novo fatty acid synthesis [61]. Glycolysis may suppress tumor cell differentiation by increasing cytosolic acetyl-CoA and resultant lipid synthesis [13]. Cytosolic acetyl-CoA is an essential component of de novo fatty acid synthesis. ACL integrates glucose glycolysis with lipid synthesis by converting citrate to acetyl-CoA Fig. (2). Citrate is a metabolite inhibitor of glycolysis and a precursor of acetyl-CoA for de novo fatty acid synthesis. Therefore, ACL activity may affect not only lipid synthesis but also glucose glycolysis for ATP production, and ACL expression is pervasively up-regulated in immortalized cells and various tumors, including in urinary bladder, breast, liver, stomach, colon, lung, brain and prostate tumors [11-13, 16]. The phosphorylated ACL (active form) is correlated with tumor stage, differentiation grade, and prognosis. In cultured cancer cells, increased ACL expression promotes cancer cell proliferation and survival [13, 59] and enhances aggressive biological behaviors, such as clonogenic growth, Zu et al. migration and invasion [16, 60, 61]. Genetic and pharmacologic abrogation of ACL activity in cancer cells results in dose-dependent inhibition of cell proliferation and tumor growth, and the effectiveness of this treatment rely on the glycolytic phenotype of tumor cells. Cancer cells with a high rate of glucose aerobic glycolysis are much more sensitive to ACL inhibition than those with a low glycolytic rate [63]. In glucose-dependent cancer cells, selective ACL inhibition or knockdown promotes cell differentiation, elevates mitochondrial membrane potential, decreases cell viability, and stimulates apoptosis [54, 64]. Hence, therapeutic strategies targeting ACL need taking the glycolytic status of cells into consideration. ACL inhibition may also down-regulate lactate dehydrogenase, allowing pyruvate to be imported into mitochondria and enter Krebs cycle [63]. Furthermore, it is noteworthy that ACL inhibition may affect certain oncogenic gene expression by suppressing histone acetylation due to reduction of cytosolic acetyl-CoA [65]. In summary, although it is controversial whether increased ACL expression and activity in cancer cells is a cause of tumorigenic process, it is clear that ACL as an enzyme linking glucose and lipid metabolism is a promising target for cancer therapy. The research and development of ACL inhibitors represent a novel strategy of cancer treatment. 4. ATP CITRATE LYASE INHIBITORS In view of the importance of ACL in glucose and lipid metabolism, investigators have done much work for designing and developing ACL inhibitors for hypolipidemic treatment of metabolic and malignant diseases [66]. In particular, mechanism-based, active-site directed, or tight-binding small chemicals have been developed, having an irreversible, specific inhibition on ACL. Followed is a summary of some representative ACL inhibitors. 4.1. Hydroxycitrate Hydroxycitric acid (HCA) [67] is derived from fruit rinds of Garcinia species, including G. cambogia, G. indica, and G. atroviridis that grow prolifically on the Indian subcontinent and in Western Sri Lanka [68]. Hydroxycitric acid is also produced in calyxes of Hibiscus subdariffa and H. rosasinensis that are cultivated in several tropical and semitropical countries. Nowadays, the extracts of Garcinia fruits or flowers are popularly used as an ingredient in diet supplements or drinks. Studies with Garcinia extracts have showed that ingested HCA is absorbed in the gastrointestinal tract and enters the systemic circulation [69]. However, bioavailability of HCA is low and its competitive competence with endogenous citric acid is weak. Administration of HCA at 250mg/kg twice a day for three weeks is innocuous with no effects on weight, behavior, and survival of animals [63]. The safety dose to humans is up to 13.5g of hydroxycitrate per day [16]. HCA has two diastereomers due to the existence of two chiral centers in the molecule. Therefore, there are four stereoisomers of HCA [70], comprising two pairs of enantiomers which are (2S,3S)-2-hydroxy citrate and (2R,3R)-2hydroxycitrate, (2S,3R)-2-hydroxycitrate and (2R,3S)-2- hy- ACL as Novel Cancer Therapeutic Target Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 157 Glucose Glucose transporter Lactate Cellular membrane Glucose HK Lactate LDH NAD+ Pentose phosphate pathway 2NADP + NAD+ 2NADPH Glucose-6P NADH CO 2 Glycolytic pathway Pyruvate Pyruvate NADP+ ATP NADPH 3 CO 2 Acetyl-CoA CO 2 FA S Malonyl-CoA Acetyl-CoA ACC Oxaloacetate Oxaloacetate Citric acid cycle 2 CO 2 NAD+ 1 ACL Citrate Citrate NADH Fatty acids Pentose sugars NADH Malate Malate 4 NADP + Mitochondria CO 2 Pyruvate Malic enzyme Cholesterol NADPH Oncogene transcriotion histone acetylation Nucleus Fig. (2). De novo synthesis of fatty acids from carbohydrate precursors and possible anticancer mechanisms of ACL inhibition. Upon cellular uptake by glucose transporters, glucose is phosphorylated by hexokinases (HKs) to glucose-6-phosphate, most of which enters the glycolytic pathway generating pyruvate and ATP. In the mitochondria, pyruvate is converted to acetyl-CoA, entering the citric acid cycle. Depending on the oxygen tension, citrate can be oxidized to carbon dioxide and oxaloacetate, generating ATP via oxidative phosphorylation, or can be transported into cytosol, converted by ATP citrate lyase (ACL) to acetyl-CoA and oxaloacetate. Acetyl-CoA is the requisite building block for fatty acid and cholesterol synthesis. NADPH required for fatty acid synthesis is produced by malic enzyme or via the pentose phosphate pathway. Under anaerobic conditions, pyruvate may also be used as electron acceptor, producing lactate by lactate dehydrogenase (LDH), which is excreted from the cell [54]. When genetic and pharmacologic downregulation of ACL is applied, there are four possible approaches against cancer, labeled with blue-colored numbers. They are inhibition of fatty acid (1) and cholesterol (2) synthesis, glycolytic pathway (3) by cytosolic citrate, and histone acetylation, affecting oncogenic gene expression (4). droxycitrate, respectively Fig. (3). Each of the stereoisomers can form a -lactone ring and, in general, HCA is a mixture of nonlactone and lactone forms. Nonlactone can be converted to lactone in 1N HCl with a high yield [71]. It was found forty years ago that Garcinia’s constituent (2S,3S)-2-hydroxycitrate, also named 4S-hydroxycitrate or ()-hydroxycitrate, is a strong competitive ACL inhibitor [72]. Later studies showed that among the four hydroxycitrate stereoisomers, only (2S,3S)-2-hydroxycitrate possesses inhibitory effect on rat and human ACLs [72-74], and its lactone form is less effective [73]. The other three HCA stereoisomers are not potent inhibitors of ACL with low affinity (30 - 132M) [75]. Therefore, inhibitory potency of (-)-hydroxycitrate depends on its stereochemistry. It is noteworthy that ACL inhibitory (2S,3S)-2-hydroxycitrate does not have substrate activity for this enzyme, but the other three do, in spite of lack of inhibitory activity. Inhibitory activity of (-)-hydroxycitrate on ACL has been extensively investigated. It was reported that ACL activity in colonocyte was decreased by 86.6% at 7mM of HCA [76]. Under glycolytic condition, hydroxycitrate suppressed migration of human glioblastoma cells U87 and Glioblastoma cells LN229 with IC50 at 16.7 and 12.1mM, respectively [16]. Hydroxycitrate at 10-500M could inhibit growth of human bladder cancer cells T-24 or colon tumor cells HT-29 by 5-60%. HCA also inhibits cell invasion and increases 3hydroxy-3-methylglutaryl-CoA reductase and low-density lipoprotein (LDL) receptor activity in HepG2 cells [77].Used together with lipoic acid, HCA induces significant tumor growth retardation and enhances survival in MBT-2 bladder transitional cell carcinoma, B16-F10 melanoma and LL/2 Lewis lung carcinoma mouse syngenic cancer models [63]. A combination of lipoic acid,hydroxycitrate and cisplatin/ methotrexate shows more tumor suppression efficacy than 158 Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 COOH COOH HO HO S S H H COOH HOOC H H O O S H R COOH OH HO OH HOOC H HOOC OH O H (2S,3S)-HCA O H R H R COOH H H HO OH H O COOH OH H H (2R,3R)-HCA O COOH COOH R H COOH S H COOH S OH R COOH H R COOH S H COOH COOH S R H COOH H Zu et al. HOOC O OH H (2S,3R)-HCA O H R OH COOH S H H (2R,3S)-HCA Fig. (3). Structures of HCA stereoisomers. Upper panels show the nonlactone forms, and lower panels demonstrate the lactone forms [71]. cisplatin or methotrexate alone [78, 79]. In rat, (-)-hydroxycitrate reduces the synthesis of both cholesterol and fatty acids and thus decrease plasma triglyceride level by inhibiting ACL [69, 80, 81]. Nevertheless, HCA inhibits lipogenesis in brown adipose tissue in response to glucose feeding, but not in starved rat [82]. Therefore, (-)-hydroxycitrate is a potential agent used for hypolipidaemic treatment of metabolic or malignant diseases [81]. 4.2. Non-hydroxycitrate Citric Acid Analogues Methionine sulfoximine [83] is a well-known irreversible inhibitor of glutamine synthetase [6, 83, 84]. Since ACL shares the similar reaction mechanism with glutamine synthetase, Dolle et al. [84] designed and synthesized a few citric acid analogs derived from this glutamine synthetase inhibitor. Diastereomers (+)-12a, b are citric acid analogs by replacing the primary carboxylate groups with a sulfoximinoyl Fig. (4A), leading to occurrence of enzyme-mediated phosphorylation at 14a, b rather than 12a, b. These compounds mimic the enzyme-bound intermediate (citrate phosphate anhydride) and thus are potential tight-binding inhibitors of ACL. Unfortunately, testing results showed that only the (+)12a had a weak, reversible inhibition on rat ACL activity with a Ki at 250M, 10-fold greater than the Km for citrate, but the relative Vmax was only 25% of the normal substrate. This data suggest that the sulfoximinoyl functional group can mimic, to some extent, the carboxylate group in the active site of the enzyme, probably due to its hydrogen-bonding ability [84]. Via covalently modifying the active-site nucleophiles, a novel class of citrate analogues has been developed [85]. The (-)-5 and (+)-6 are the representative compounds in which the epoxides are potentially active-site-directed. Other compounds include chlorocitrates (+)-10, (+)-11 and thiocitrates 12-16 Fig. (4B) [86]. Among these agents, epoxyaconitic acid (-)-5 [87] showed modest reversible inhibition on rat ACL with Ki at 18M, 22 fold higher than (+) -6 (Ki = 400M). Earlier studies reported enantiomers of 2-monofluorocitrate Fig. (4C) as substrates and competitive inhibitors of ACL, but their inhibitory activity was relatively weak [73μM for the (2S,3S) and 192μM for the (2R,3R) forms] [88]. A similar enzymatic kinetics emerges from 2-vinylcitrates which, despites having very high Ki values, are cleaved by ACL [89]. Therefore, enantiomers (+) and (-)-2,2-difluorocitrate Fig. (4C) were designed [90], and these difluorocitrate isomers have significant stronger competitive inhibition to ACL than any compounds published thus far. These compounds have competitive inhibition against citrate at Ki of 0.7μM for (+)-2,2-difluorocitrate and 3.2μM for (-)-2,2difluorocitrate. Their inhibitory patterns with either ATP or CoA as a substrate are uncompetitive or mixed and the inhibition constants are much weaker. Neither isomer undergoes carbon-carbon bond cleavage as a substrate, nor is there evidence of irreversible time-dependent inactivation. When ACL is incubated with CoA and difluorocitrate, the maximal intrinsic ATPase rate is 10% of the citrate-induced for (+)enantiomers and 2% for (-)-enantiomers. 4.3. Radicicol Radicicol [91] Fig. (5), a 14-membered macrolide, is a potent tranquilizer, inducing morphological changes of various transformed cells and cell cycle arrest in G1 and G2 phases, as well as angiogenesis inhibition [92]. Radicicol targets Hsp90, showing strong binding in a manner competitive with ATP [93, 94]. Recent studies have shown that radicicol is also a noncompetitive inhibitor of ACL. Kinetic analysis demonstrated that radicicol and its derivative BR-1 Fig. (5) inhibited the activity of rat liver ACL with no apparent effect on Km but decreased Vmax. As an inhibitor of ACL, radicicol has a Ki at 13M for citrate and 7M for ATP. Guay et al. [95] reproted that 50M radicicol inhibited ACL activity along with decrease in insulin secretion by about 50% in the presence of 5 and 10mM glucose or 0.3mM palmitate in vitro. ACL as Novel Cancer Therapeutic Target Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 159 A O O NR NR S HOOC HOOC ( ( S HOOC OH HOOC )-12a:R=H )-14a:R=P(O)(O - ) 2 ( ( OH )-12b:R=H )-14b:R=P(O)(O - ) 2 B O O HOOC HOOC COOH COOH HOOC HOOC (+)-6 (-)-5 Cl Cl COOH HOOC HO ( O )-10 ( SR COOH )-11 SH HOOC COOH HO COOH O COOH R HOOC COOH COOH HO (-)-12:R=H (-)-13:R=SMe COOH HOOC COOH COOH 15: R=SH 16: R=SSMe (-)-14 C F F COOH COOH HO COOH COOH COOH HO (2R,3R)-2-fluorocitrate (2S,3S)-2-fluorocitrate F F COOH COOH F F COOH HO COOH (3S )2, 2 -d i f luorocitrate COOH COOH HO COOH (3R)2, 2 -d i f luorocitrate Fig. (4). Representatives of non-hydroxycitrate citric acid analogues. A. Sulfoximine-containing citric acids. B. Epoxide-containing citric acids, chloro-containing citric acids and thiol-containing citric acid. C. Fluoro-containing citric acid. 4.4. Antimycins Antimycins [96] Fig. (6) were antibiotics isolated from Streptomyces sp [97]. More recently, novel derivatives were identified and named antimycins A2 to A6 and each of them is a mixture of two closely related isomers [97]. Antimycins are characterized with a carboxy phenol amido unit, a ninememberedcyclic bis-lactone, and two alkyl side chains with variations of carbon length. Although, well identified as antibiotics and fungicides, more antimycins have been extensively investigated in energy metabolism in eukaryotic or- ganisms due to their inhibition on electron flow in the mitochondrial respiratory chain between cytochromes b and c1 [97]. Lately, Barrow et al. reported that antimycins are inhibitors of ACL against the substrate citrate with promising Ki values: 29.5M for antimycin Al, 4.2M for antimycin A2, 60.1M for antimycin A3, 64.8M for antimycin A4, 55.0M for antimycin A7, and 4.0M for antimycin A8 [97]. 4.5. Butanedioic Acid Derivatives A series of 2-substituted butanedioic acids have been developed as inhibitors of ACL based on the concept of link- 160 Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 CH3 O O Zu et al. H O H HO Radicicol O Cl OH CH3 O O H O O H O NH NH O 2 S O O Cl OH NH BR-1 Fig. (5). Radicicol and representative of radicicol derivatives. O NH H OH O O O O NH R1 O R2 O Antimycin A1a R1 = CH(CH3)CH2CH3, R2 = (CH2)5CH3 Antimycin A1b R1 = CH2CH(CH3)2, R2 = (CH2)5CH3 Antimycin A2a R1 = CH(CH3)2, R2 = (CH2)5CH3 Antimycin A2b R1 = CH2CH2CH3, R2 = (CH2)5CH3 Antimycin A3a R1 = CH(CH3)CH2CH3, R3 =(CH2)3CH3 Antimycin A3b R1 = CH2CH(CH3)2, R2 =(CH2)3CH3 Antimycin A4a R1 = CH(CH3)2, R2 =(CH2)3CH3 Antimycin A4b R1 = CH2CH2CH3, R2 =(CH2)3CH3 Antimycin A7a R1 = CH(CH3)2, R2 =(CH2)2CH(CH3)2 Antimycin A7b R1 = CH2CH2CH3, R2 =(CH2)2CH(CH3)2 Antimycin A8a R1 = CH(CH3)CH2CH3, R2 =(CH2)2CH(CH3)2 Antimycin A8b R1 = CH2CH(CH3)2, R2 =(CH2)2CH(CH3)2 Fig. (6). Basic structure of antimycins. ing a lipophilic group to a “citrate-like” head. The most promising compounds are butanedioic acid derivatives with a substitute in the second position with an appropriate length (8 atom) spacer for a 2, 4-dichlorophenyl group. The compounds 1a-c Fig. (7) have reversible Ki’s at 1-3M against rat ACL and show a competitive inhibitory mechanism against citrate and noncompetitive with respect to CoA. Further studies suggest that these compounds interact with ACL by binding to butanedioic acid moiety to the citrate site, supporting the competitive inhibition mechanism against citrate. Unfortunately, butanedioic acid derivatives could not suppress cholesterol or fatty acid synthesis in cultured cells (HepG2) due to the poor cell-permeability of these polar chemicals [6]. Novel 2-substituted butanedioic acid derivatives have demonstrated better promise as ACL inhibitors [2, 98]. SB- ACL as Novel Cancer Therapeutic Target Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 Cl (CH2)6 X HO Cl COOH COOH 161 1a: X=S 1b: X=CO 1c: X=CH2 1 Cl Cl (CH2)6 Cl COOH HO HO COOH OH (CH2)6 COOH O Cl O SB-204990 SB-201076 Fig. (7). Representatives of butanedioic acid derivatives. 201076 [66] Fig. (7) was found to be equally potent in inhibiting rat (Ki = 1±0.05M) or human (Ki = 1±0.1M) ACL. SB-204990 [66] Fig. (7), the cell-penetrant -lactone prodrug of SB-201076, was found to be inactive to ACL in the assay without cellular context, because SB-201076 is formed inside the cells by hydrolysis of lactone. Pre-incubation of SB204990 with either diabetic or control platelet suspension for 30 minutes at 37°C did not affect ACL activity, but a longer incubation led to 61% inhibition for diabetic and 37% for control platelets [36]. Oral administration of SB-201076 dose-dependently reduces plasma cholesterol (up to 46%) and triglyceride levels (up to 80%) in rats and plasma cholesterol (up to 23%) and triglyceride levels (up to 38%) in dogs [2]. competitive to citrate at Ki of 16M [101] and to CoA at Ki of 3 M [8]. Other biological effects of SB-204990 are observed. In vitro studies showed SB-204490 at 0.1mmol/L decreases acetyl-CoA content in platelet cytoplasm along with suppression of MDA synthesis and platelet aggregation [36]. Interestingly, SB-204990 can reduce D-[6-14C] glucose-dependent lipid synthesis in a dose-dependent manner, resulting in proliferation inhibition and death of tumor cells with active aerobic glycolysis [13]. Recently, SB-204990 has been shown to be effective to induce apoptosis in greater than 50% of cancer cells in an in vitro apoptosis assay at a concentration of less than 50M [66]. 4.7. 2-Hydroxy-N-arylbenzenesulfonamide 4.6. Dicarboxylic Acid Derivatives MEDICA compounds are a class of ,'-methylsubstituted , -dicarboxylic acids, defined as MEDICA 616 upon the number of carbon atoms. MEDICA 16 [99] Fig. (8) is a ,'-dimethyl hexadecanedioic acid with hypolipidemic effect, leading to 60 and 45% reduction of cholesterol and high density lipoprotein in rats, respectively [100]. Recently, MEDICA 16 was reported to be an ACL inhibitor HOOC (CH2)10 COOH MEDICA 16 Fig. (8). Representatives of dicarboxylic acid derivatives. Sulfur-substituted fatty acid analogue 3-thiadicarboxylic acid Fig. (8) is a novel dicarboxylic acid derivative that can inhibit ACL and fatty acid synthase activity [102]. Treatment with 3-thiadicarboxylic acid reduced plasma levels of triglycerides from 5.8 to 2.7mmol/L and cholesterol from 11.0 to 7.7mmol/L in rats and suppressed the activity of the ratelimiting enzyme in cholesterol biosynthesis, 3-hydroxy-3methylglutaryl-CoA reductase by 58%. It is believed that hyperlipidem in experimental nephrosis could be ameliorated by 3-thiadicarboxylic acid via decreasing the overproduction of very-low-density lipoprotein [102]. With attempts to identify a cell-permeable ACL inhibitors, Li et al. [103] identified 2-hydroxy-N-arylbenzenesulfonamide [104] as a modest inhibitor of ACL with 50% inhibition of ACL activity (IC50) at 1.1M) [103]. Among approximately 50 analogs synthesized by Li et al. [103], 11 showed greater than 50% inhibition at 10M Fig. (9) and the compound 9 showed an IC50 of 0.13μM and had no cytotoxicity up to 50M. Long-term oral dosing of compound 9 in high-fat-fed mice lowered down plasma cholesterol, triglyceride, and glucose and blocked weight gain. Those data suggest that 2-hydroxy-N-arylbenzenesulfo-namide 9 is the most potent ACL inhibitor with appreciable cell permeability. 4.8. Purpurone Purpurone is a purple, non-crystalline glassy solid. HRFAB mass spectrum ([M + H]+, m/z = 698.1673) established its molecular formula of C40H27NO11 Fig. (10). HOOC S (CH2)10 S COOH 3-thiadicarboxylic acid 162 Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 Zu et al. OH OH Cl Cl OH HO OH O S NHR O Compound IC50a (mM) R N O 4 t-Bu 1.1 t-Bu CH2 HO 2.3 5 Cl O CH2 OH OH OH Cl 6 7.6 F F OH t-Bu 7 5.6 Purpurone t-Bu Ph Ph 0.19 8 Ph OMe 9 0.13 Ph Fig. (10). Structure of purpurone. viability and cellular ATP level of HepG2 cells at 100μg/ml. Recently, a new rapid synthesis of purpurone has been developed, which will promote investigation and development of new purpurone derivatives as inhibitors of ACL [106]. 4.9. Other Agents 10 6.9 n-Hex 10.9 11 Me N COMe 8.1 12 OPh Me O 13 0.37 O i-Pr O 14 0.34 O Ph 36 Fig. (9). In vitro SAR summary. In vitro data are at least two separate measurements using recombinant hACL [103]. Purpurone was isolated from the sponge Iotrochota sp. and has antioxidant activity. Purpurone exhibits its inhibitory activity on ACL in a dose-dependent manner, and has an IC50 of 7μ [105]. Purpurone reduced fatty acid synthesis, but not cholesterol [105]. Purpurone had no effect on the Apart from ACL inhibitors discussed above, a few other chemicals have partial or indirect inhibitory activity to ACL and are discussed below. 4.9.1. 2, 3-Butanedione and Phenylglyoxal As arginine-targeted agents, both 2, 3-butanedione and phenylglyoxal could inactivate ACL in a concentrationdependent manner. Phenylglyoxal induces rapid inactivation of ACL by 85%, but butanedione does to a lesser degree (35%). Inhibition to ACL by these two compounds is at least in part due to their modifications of arginine residues at the CoA binding site. Phenylglyoxal-modified ACL shows a decrease in Vmax, but its Km for substrates does not alter significantly. However, ACL substrates, CoA or CoA plus citrate, could protect the enzyme against inactivation by 2, 3butanedione and phenylglyoxal in rats [38]. 4.9.2. L-Glutamate Glutamate, as the most abundant excitatory neurotransmitter in the vertebrate nervous system, is found to be a specific inhibitor of ACL from adult rat brain and liver [34, 107]. Glutamate, especially L-glutamate, has a time-dependent inhibitory effect on ACL activity in the presence of both ATP and MgCI2 and a high concentration of ATP could reverse this process [107]. Szutowicz et al. found that Lglutamate is a competitive inhibitor of ACL (Ki = 0.3mM) with no effect on Km and Vmax at a low concentration of MgCL2, suggesting excessive Mg2+ ions is indispensable for glutamate inhibition [107]. The inhibitory activity of glutamate may arise from the production by glutamine synthetase of ADP, a known product inhibitor of ACL [34]. ACL as Novel Cancer Therapeutic Target Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 phosphorylation at histidine by 67%, inactivating ACL [111]. Vanadate has also inhibitory activity to succinyl-COA synthease (SCS) [111]. 4.9.3. Deoxycholate Deoxycholic acid is one of the secondary bile acids that are metabolic byproducts of intestinal bacteria. Eriyamremu et al. reported that sodium deoxycholatecould can significantly reduce ACL activity in the experimental rat liver [108]. 5. CURRENT & FUTURE DEVELOPMENTS Cancer is a potentially fatal disease with poor responses to current therapies. Recent new insights on tumor metabolism alterations contribute to the concept of targeting tumor bioenergetics as an anticancer strategy. Based on the marked elevation of expression and activity of ACL in many immortalized cells and tumors and the effect on cancer cell proliferation or tumor growth induced by ACL downregulation, various ACL inhibitors with different structures and targeting sites have been designed, synthesized and evaluated on anticancer activity. Of these discussed compounds Table 1, most inhibitors, such as hydroxycitrate, vinylcitrates, thiocitrates, fluorocitrates, play a competitive inhibition against citrate, which are characterized by a common citrate-featured head. Others are competitive inhibitors to CoA, such as MEDICA 16. Some of them exert a multiple inhibition simultaneously, like SB-201076 which inhibits ACL activity through competitive mechanism with respect to citrate and noncompetitive manner to CoA. This class of inhibitors may hold stronger promises due to their dual targets. 4.9.4. Polychlorinated Biphenyls Polychlorinated biphenyls (PCBs), a molecule composed of two benzene rings, are a class of organic compounds with 1 to 10 chlorine atoms attached to biphenyl. It is well known that PCBs have great toxicity due to its structural similarities to dioxin and certain hormones, such as thyroxine and estradiol. Recently, Kling et al. [109] found that PCBs administered in diet (0.01%, w/v) inhibits citrate cleavage independent of citrate concentrations. Hereby, PCBs are probably noncompetitive inhibitors of ACL. 4.9.5. Vanadate Vanadium is a trace element essential for the growth and normal existence of living cells. Vanadium affects many biochemical processes, such as protein phosphorylation by its biologically active forms, pcntavalenr vanadate (VO3-, H2VO4-) or tetravalent vanadyl cation (VO2+) [110]. However, investigators reported that vanadate at 1 mM inhibits Table 1. Common Inhibitors of ATP Citrate Lyase. Name Inhibotor Type and Study Feature In Vitro Ki /IC50 Value Hydroxycitrate Competitive inhibitor with Ki of 0.15 and 50μM for rat enzyme and Ki of 300μM for human enzyme. In Vivo Clinical Trial 1) Decreased plasma cholesterol and triglyceride levels 2) Suppressed platelet aggregation Tumor Type Reference [67, 72-75, 78, 81] Yes Yes Yes Glioblastoma; bladder carcinoma; colon carcinoma; melanoma; lung carcinoma; adenocarcinoma 3) Suppressed cancer growth, migration and invasion Sulfoximinecontaining citric acid Reversible inhibitior with Ki of 250μM for rat enzyme No evidence Yes No No No evidence [6, 83-84] Epoxidecontaining citric acid Reversible inhibitior with Ki of 18μM to 400μM for rat enzyme No evidence Yes No No No evidence [85, 87] Chlorocontaining citric acid Reversible inhibitior with Ki of 29μM to 340μM for rat enzyme No evidence Yes No No No evidence [85-86] Thiol-containing citric acid Reversible inhibitior with Ki of 58μM to 480μM for rat enzyme No evidence Yes No No No evidence [85] Fluorocontaining citric acid Competitive inhibitor with Ki of 0.7μM to 192μM for rat enzyme No evidence Yes No No No evidence [88-90] 163 164 Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 Zu et al. (Table 1) Contd…. Name Inhibotor Type and Study Feature Ki /IC50 Value In Vitro In Vivo Clinical Trial Tumor Type Reference Noncompetitive inhibitor with Ki of 13μM for citrate and 7 μM for ATP 1) Decreased insulin secretion Radicicol 2) Suppressed cancer cells migration and invasion Yes No No Glioblastoma [91-94] Antimycin With Ki of 4.0 to 64.8μM No evidence Yes No No No evidence [96-97] Butanedioic acid derivatives Competitive inhibitor with respect to citrate and noncompetitive inhibitor with respect to CoA; Ki= 1-3μM Yes Yes No Lung carcinoma; prostate carcinoma; ovarian cancer [2, 6, 98] 1) Decreased plasma cholesterol and triglyceride 2) Suppressed platelet aggregation 3) Reduced tumor growth and induced tumor differentiation Dicarboxylic acid derivatives A citrate competitive inhibitor of ACL with a Ki of 16 μM and a competitive inhibitor with respect to CoA (Ki = 3μM) Reduced cholesterol level Yes Yes No No evidence [99-102] 2-Hydroxy-Narylbenzenesulfonamide derivatives With IC50 of 0.13 to 10.9μM Lowered plasma cholesterol, triglyceride and glucose levels Yes Yes No No evidence [103-104] Purpurone With IC50 of 0.7μM Reduced fatty acid synthesis Yes No No No evidence [105] 2, 3-Butanedione Noncompetitive inhibitor No evidence Yes No No No evidence [38] Phenylglyoxal Noncompetitive inhibitor No evidence Yes No No No evidence [38] L-Glutamate Indirect competitive inhibitor with Ki of 0.3 mM No evidence Yes No No No evidence [34, 108] Deoxycholate No evidence No evidence No Yes No No evidence [108] Polychlorinated biphenyls* Noncompetitive inbibitor No evidence No Yes No No evidence [109] Vanadium No evidence No evidence Yes No No No evidence [110, 111] * Such compounds are toxic substances for body. A couple of concerns need to be taken into consideration in developing ACL inhibitors as antitumor agents. It is noted that some chemicals possess promising inhibitory activity to ACL, but the cell-permeability limit their uses in organisms, such as SB-201076. Therefore, relevant chemical modifications may be required, such as SB-204490, a cell-penetrant derivative of SB-201076. Second, some inhibitors show efficient ACL inhibition, reducing plasma cholesterol and triglyceride levels, but cytotoxicity is limited. These inhibitors may hold the promise as treatment agents for metabolic syndromes, but their potential as antitumor agents need to be carefully evaluated, or combinational therapies are required. Third, clinical trials are required to document the safety and efficacy of ACL inhibitors as antitumor agents. Currently, although some ACL inhibitors present efficacy of inhibiting ACL and suppressing cell proliferation and tumor growth in laboratory studies, clinical data are limited and relevant studies need to be strengthened. In summary, in spite of the limit in ACL investigation and application, it is convincing that targeting ACL as a therapeutic strategy of human cancer holds the promisea and is under active investigation. ACKNOWLEDGEMENTS This work is supported by projects from Hunan Provincial Natural Science Foundation of China (11JJ4068) and ACL as Novel Cancer Therapeutic Target from Medical Scientific Research Foundation of Hunan Province, China (B2010-045). Recent Patents on Anti-Cancer Drug Discovery, 2012, Vol. 7, No. 2 [20] [21] CONFLICT OF INTEREST The authors declare no potential conflict of interest. REFERENCES [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] Arends J. Metabolism in cancer patients. Anticancer Res 2010; 30: 1863-8. 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