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Research ArticleBasic Science Investigations

Metformin—an Adjunct Antineoplastic Therapy—Divergently Modulates Tumor Metabolism and Proliferation, Interfering with Early Response Prediction by 18F-FDG PET Imaging

Peiman Habibollahi, Nynke S. van den Berg, Darshini Kuruppu, Massimo Loda and Umar Mahmood
Journal of Nuclear Medicine February 2013, 54 (2) 252-258; DOI: https://doi.org/10.2967/jnumed.112.107011
Peiman Habibollahi
1Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and
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Nynke S. van den Berg
1Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and
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Darshini Kuruppu
1Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and
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Massimo Loda
2Department of Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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Umar Mahmood
1Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and
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  • FIGURE 1.
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    FIGURE 1.

    MET mechanism of action. MET activates AMPK (main energy sensor in cells), mimicking starvation conditions inside cells. In response to AMPK activation, all energy-consuming pathways are downregulated and adenosine triphosphate–producing mechanisms (such as glycolysis) are increased. CoA = coenzyme A; mTOR = mammalian target of rapamycin; TSC = tuberous sclerosis complex.

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    FIGURE 2.

    MET-mediated activation of AMPK. (A) Results of Western blotting for expression of AMPK, phosphorylated AMPK (pAMPK), and β-actin internal control in HT29 and MC26 cells after 24 h of MET treatment. (B) Semiquantitative analysis after gating of AMPK expression–to–actin expression ratio to 100% shows severalfold increases in phosphorylation and dose-dependent activation of AMPK in both cell lines.

  • FIGURE 3.
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    FIGURE 3.

    Alteration of 18F-FDG uptake after MET treatment. MET treatment caused increased 18F-FDG retention in both HT29 and MC26 cell lines. Results were corrected for decay and cell count and are presented as mean ± SEM (n = 10) percentage of initial activity absorbed/106 cells.

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    FIGURE 4.

    Effect of MET on 18F-FLT retention. MET treatment decreased 18F-FLT retention in both HT29 and MC26 cell lines. Results were corrected for decay and cell count and are presented as mean ± SEM (n = 10) percentage of initial activity absorbed/106 cells.

  • FIGURE 5.
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    FIGURE 5.

    Effect of MET on proliferation. (A) Decreased relative percentages of cells in S phase of cell cycle (normalized to control at 100%) were observed in both cell lines (HT29 and MC26) after treatment with MET. Data are presented as mean ± SEM (n = 3). (B) Representative flow cytometry results from control and treatment groups of MC26 cells (10 mM MET for 24 h), with S-phase cells gated in P2 window.

  • FIGURE 6.
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    FIGURE 6.

    Increases in tumor 18F-FDG uptake and decreases in 18F-FLT uptake after MET therapy. PET images were acquired before (0 h) and after (24 h) MET therapy (500 mg/kg) in HT29 tumor–bearing animals. (A and B) Representative 18F-FDG (A) and18F-FLT (B) PET scans before and after treatment. (C) SUVs before and after treatment (mean ± SEM; n = 3; imaged with both tracers). *Statistically significant difference (P < 0.05). White arrows indicate HT29 tumors.

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    TABLE 1

    MET-Induced Apoptosis in HT29 and MC26 Cells After Incubation for 72 Hours

    Mean ± SE no. of cells at MET concentration (mM) of:
    CellsCondition00.1110
    HT29Apoptosis5.6 ± 0.365.47 ± 0.079.97 ± 0.52*59.03 ± 0.85*
    Necrosis1.63 ± 0.071.97 ± 0.574.23 ± 0.30*8.27 ± 0.15*
    MC26Apoptosis1.87 ± 0.091.83 ± 0.192.02 ± 0.1510.93 ± 3.60†
    Necrosis0.87 ± 0.120.73 ± 0.030.43 ± 0.03†0.67 ± 0.07
    • ↵* P ≤ 0.005.

    • ↵† P ≤ 0.05.

    • For significance, MET incubation condition was compared with control condition (no MET added [0 mM]) (n = 3).

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Journal of Nuclear Medicine: 54 (2)
Journal of Nuclear Medicine
Vol. 54, Issue 2
February 1, 2013
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Metformin—an Adjunct Antineoplastic Therapy—Divergently Modulates Tumor Metabolism and Proliferation, Interfering with Early Response Prediction by 18F-FDG PET Imaging
Peiman Habibollahi, Nynke S. van den Berg, Darshini Kuruppu, Massimo Loda, Umar Mahmood
Journal of Nuclear Medicine Feb 2013, 54 (2) 252-258; DOI: 10.2967/jnumed.112.107011

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Metformin—an Adjunct Antineoplastic Therapy—Divergently Modulates Tumor Metabolism and Proliferation, Interfering with Early Response Prediction by 18F-FDG PET Imaging
Peiman Habibollahi, Nynke S. van den Berg, Darshini Kuruppu, Massimo Loda, Umar Mahmood
Journal of Nuclear Medicine Feb 2013, 54 (2) 252-258; DOI: 10.2967/jnumed.112.107011
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Keywords

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