低糖質がん治療のリスクを発見(SYSU team uncovers hidden risk of low-carb cancer diets: fostering lung metastasis)

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2025-07-17 中山大学(SYSU)

中山大学の匡東明教授と袁偉准教授の研究チームは、低炭水化物(低糖)食が癌治療において予期せぬリスクを持つことを明らかにした。研究によると、糖質制限により癌細胞の代謝が阻害されると、TRAILというタンパク質がエクソソームを通じて肺に運ばれ、肝臓癌の肺転移リスクが著しく高まることが判明。さらに、血漿中エクソソームTRAILは肺転移の予測に有効なバイオマーカーとなる可能性が示された。これは癌の早期スクリーニングや標的治療に新たな道を開く知見であり、臨床的意義も大きい。本研究成果は『Cell』誌に掲載された。

<関連情報>

グルコース制限により、エクソソームTRAILを介した肺の転移前自然免疫ランドスケープが形成される Glucose restriction shapes pre-metastatic innate immune landscapes in the lung through exosomal TRAIL

Cai-Yuan Wu ∙ Chun-Xiang Huang ∙ Xiang-Ming Lao ∙ … ∙ Limin Zheng ∙ Yuan Wei ∙ Dong-Ming Kuang
Cell  Published:July 15, 2025
DOI:https://doi.org/10.1016/j.cell.2025.06.027

Graphical abstract

低糖質がん治療のリスクを発見(SYSU team uncovers hidden risk of low-carb cancer diets: fostering lung metastasis)

Highlights

  • Low-carbohydrate diets or impaired glucose metabolism foster lung metastasis
  • Glucose deprivation establishes a lung macrophage-dominated pre-metastatic niche
  • Exosomal TRAIL polarizes PVR+ macrophages to trigger NK cell exhaustion in lungs
  • Plasma exosomal TRAIL accurately predicts early postoperative lung metastasis

Summary

Targeting glucose metabolism has emerged as a promising strategy for inhibiting tumor growth. However, we herein uncover an unexpected paradox: while glucose deprivation through a low-carbohydrate diet or impaired in situ metabolism suppresses primary tumor growth, it simultaneously promotes lung metastasis by depleting natural killer (NK) cells via lung macrophages. Mechanistically, glucose deprivation induces endoplasmic reticulum (ER) stress, activating HMG-CoA reductase degradation protein 1 (HRD1) to catalyze K63-linked ubiquitination of TRAIL, which is then packaged into exosomes via the endosomal sorting complex required for transport (ESCRT) complex. These exosomal TRAIL molecules polarize PVR+ macrophages, triggering NK cell exhaustion and establishing a pre-metastatic niche. Notably, TIGIT blockade not only prevents metastasis induced by glucose deprivation but also enhances its anti-tumor effects. Clinically, low glucose metabolism correlates with higher 2-year postoperative recurrence across 15 cancer types. Furthermore, plasma exosomal TRAIL outperforms traditional markers, such as α-fetoprotein (AFP) and tumor size, in predicting early postoperative lung metastasis, revealing both the risks and therapeutic potential of targeting glucose metabolism.

医療・健康
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