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Hypoxia, angiogenesis, and metabolism in the hereditary kidney cancers
John C. Chappell, … , Laura Beth Payne, W. Kimryn Rathmell
John C. Chappell, … , Laura Beth Payne, W. Kimryn Rathmell
Published January 7, 2019
Citation Information: J Clin Invest. 2019;129(2):442-451. https://doi.org/10.1172/JCI120855.
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Review Series

Hypoxia, angiogenesis, and metabolism in the hereditary kidney cancers

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Abstract

The field of hereditary kidney cancer has begun to mature following the identification of several germline syndromes that define genetic and molecular features of this cancer. Molecular defects within these hereditary syndromes demonstrate consistent deficits in angiogenesis and metabolic signaling, largely driven by altered hypoxia signaling. The classical mutation, loss of function of the von Hippel-Lindau (VHL) tumor suppressor, provides a human pathogenesis model for critical aspects of pseudohypoxia. These features are mimicked in a less common hereditary renal tumor syndrome, known as hereditary leiomyomatosis and renal cell carcinoma. Here, we review renal tumor angiogenesis and metabolism from a HIF-centric perspective, considering alterations in the hypoxic landscape, and molecular deviations resulting from high levels of HIF family members. Mutations underlying HIF deregulation drive multifactorial aberrations in angiogenic signals and metabolism. The mechanisms by which these defects drive tumor growth are still emerging. However, the distinctive patterns of angiogenesis and glycolysis-/glutamine-dependent bioenergetics provide insight into the cellular environment of these cancers. The result is a scenario permissive for aggressive tumorigenesis especially within the proximal renal tubule. These features of tumorigenesis have been highly actionable in kidney cancer treatments, and will likely continue as central tenets of kidney cancer therapeutics.

Authors

John C. Chappell, Laura Beth Payne, W. Kimryn Rathmell

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Figure 3

Vascular dysmorphogenesis during VHL mutations.

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Vascular dysmorphogenesis during VHL mutations.
Inducing VHL mutations e...
Inducing VHL mutations experimentally (compare WT conditions in A with VHL mutant condition in B) leads to vascular abnormalities characterized by an ectopic expression of smooth muscle α-actin (α-SMA; green) by vascular pericytes and vascular patterning defects, including elevated vessel density and the development of arteriovenous shunts spanning major arteries/arterioles (light red) and venules/veins (light blue).

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ISSN: 0021-9738 (print), 1558-8238 (online)

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