Metabolic Reprogramming in Urothelial Carcinoma- A Theragnostic Target for Betulinic Acid

A pivotal role of metabolic reprogramming in urothelial carcinoma is hallmarked by the dependence of two-fold faster proliferation of urothelial carcinoma cell line T24 than benign cell line, TRT-HU1 on five-fold higher glucose (basal) 16mM vs 3mM in McCoy’s 5A media and Keratinocyte Serum Free media, respectively. Here, we report that an additional 10% increase to 17.6mM and 3.3mM glucose significantly shortens the doubling time by 3h and 1h for T24 and TRT-HUI, respectively. T24 grown at 17.6mM glucose lowers the confocal localization fatty acid mimetic, Betulinic Acid (BA conjugated to FITC (BA-FITC) with Mito-tracker red (mitochondrial marker), which doubles the IC50 of BA and BA-FITC by lowering cell cycle arrest in G0/G1 phase from 54.2% to 43.8% and caspase-3/7 mediated apoptosis and by reversing caspase 3, p53, PTEN, GAPDH and XIAP gene expression induced by BA in T24 grown at basal glucose (16mM). Besides slowing the glycogen and pH decline of T24 at basal glucose, BA exhibited eight-fold higher IC50 than Mitomycin C (MC) on TRT-HU1 by not mimicking the glucose-insensitive cycle arrest and apoptosis of MC. Overall, glucose-sensitivity of lower IC50 of BA-FITC and BA on T24 vs TRT-HU1 supports the safety of BA conjugates for theragnostic purposes.