Otto Warburg noted decades ago that cancer cells maintain very high rates of glycolysis, converting glucose to lactate, despite sufficient oxygen to perform oxidative-phosphorylation, which is the more efficient means of generating energy (ATP) from glucose. This conundrum has generated considerable speculation as to whether altered metabolism, including altered glucose metabolism, is a cause or consequence of malignancy and, if the former, what benefits altered metabolism might confer upon cancer cells. Several lines of evidence, including the recent identification of mutations affecting Fumarate Hydratase, Succinate Dehydrogenase, and Isocitrate Dehydrogenase, have strengthened the notion that altered metabolism can cause cancer and a number of non-mutually exclusive models have been put forth to rationalize why cancer cells might benefit from a high rate of glycolysis and decreased oxidative phosphorylation. This chapter will focus on the role of HIF, 2-oxoglutarate, and 2-oxoglutarate-dependent enzymes in cancer and cancer metabolism.
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