ARTICLE: Warburg Ensemble

Monitoring Intracellular Oxygen Concentration: Implications for Hypoxia Studies and Real-time Oxygen Monitoring

• Cancer cells vary in how they produce their energy: we make progress understanding this variability, which may eventually help scientists design better therapies.

Cells can produce energy through several processes. We'll consider two – process "O" (for "oxidative phosphorylation"), and process "G" (for "glycolysis"). "O" uses oxygen, and harnesses the cell's mitochondria to produce energy. "G" does not use oxygen and produces energy without directly using mitochondria.

Healthy cells use both “O” and “G”, but cancer cells are often observed to rely on "G" much more. The shift away from "O+G" towards just "G" in cancer is often called the "Warburg effect", after Otto Warburg, who wrote about the shift in the 1950s. It remains unclear, however, whether the Warburg effect applies to all cancer cells under all conditions, or if different cells and different environments experience different shifts. This is important because understanding how cancer cells get their energy -- and, more generally, what changes occur in cancer cells compared to healthy cells -- may allow us to design therapies that challenge cancer cells while leaving healthy cells undamaged.

We used some fancy modern technology (focussed around the MitoXpress-Intra probe) to measure the difference between oxygen levels within a cell and oxygen levels in the cell's environment. We developed a mathematical way of producing "calibration curves", directly linking the observed MitoXpress behaviour to oxygen concentrations. If cells are using "G" alone, these levels are similar, as no oxygen is being consumed by the cells. If cells are also using "O", oxygen levels within cells should be rather lower than in their environment.

We found that two different cancer cell lines (with the rather jargon-y names "RD" and "U87MG") behaved surprisingly differently. When grown on glucose, U87MG looks quite "G", with oxygen levels within cells similar to those in the environment (e.g. 17.1% in cells, 18% outside). RD looks much more "O+G", with substantial differences between in-cell and outside-cell oxygen levels (e.g 13.2% in cells, 18% outside). Importantly, these findings were reproduced across a range of environmental oxygen levels (18% to 5%), modelling the range of conditions that cancer cells experience in tumours in the body. The two cancer cell lines thus seem to produce their energy in rather different ways, underlining that the Warburg effect is not an invariant across all cancers, and that treatments may be improved by taking this into account. We also showed that treating a different cancer cell line ("786-0") with phenformin, a drug inhibiting mitochondria, shifts cells away from "O+G" to "G", and that this shift can be monitored in real time with MitoXpress.

Different cancer cell lines (U87MG and RD) produce energy through different pathways, engaging more “G” (glycolysis) or “O” (oxidative phosphorylation). “O” uses oxygen (O2), lowering oxygen levels in cells compared to their environment. The different balance of “G” and “O” in different cases is important for understanding the heterogeneity of cancer.

Our paper appears in a book with the catchy title "Oxygen Transport to Tissue XXXVII", associated with the journal Advances in Experimental Medicine and Biology. You can get a sneak peek here and we'll update with a link when possible. Iain