2019/04/12 by Karin Eijkelenkamp, Thamara E. Osinga, Thera P. Links +1 · 1 citation
Biochemistry, Genetics and Molecular Biology · Medicine · #Adrenal and Paraganglionic Tumors #Cancer, Hypoxia, and Metabolism #Glioma Diagnosis and Treatment
paper · pdf · doi:10.1111/cge.13553
openalex publication_date 2019/04/12 · crossref created 2019/04/12 · openalex created_date 2019/04/25 · crossref issued 2019/05/06 · crossref published 2019/05/06 · crossref published-online 2019/05/06 · crossref published-print 2020/01/01 · crossref deposited 2023/09/07 · crossref indexed 2026/07/29 · openalex updated_date 2026/08/01
Succinate dehydrogenase (SDH) mutations lead to the accumulation of succinate, which acts as an oncometabolite. Germline SDHx mutations predispose to paraganglioma (PGL) and pheochromocytoma (PCC), as well as to renal cell carcinoma and gastro-intestinal stromal tumors. The SDHx genes were the first tumor suppressor genes discovered which encode for a mitochondrial enzyme, thereby supporting Otto Warburg's hypothesis in 1926 that a direct link existed between mitochondrial dysfunction and cancer. Accumulation of succinate is the hallmark of tumorigenesis in PGL and PCC. Succinate accumulation inhibits several α-ketoglutarate dioxygenases, thereby inducing the pseudohypoxia pathway and causing epigenetic changes. Moreover, SDH loss as a consequence of SDHx mutations can lead to reprogramming of cell metabolism. Metabolomics can be used as a diagnostic tool, as succinate and other metabolites can be measured in tumor tissue, plasma and urine with different techniques. Furthermore, these pathophysiological characteristics provide insight into therapeutic targets for metastatic disease. This review provides an overview of the pathophysiology and clinical implications of oncometabolite succinate in SDHx mutations.