Ovarian cancer is the fifth leading cause of all cancer deaths in women and the most lethal gynecologic cancer in the United States. During metastasis, cancer cells exfoliate from the primary tumor and aggregate to form spheroids, enhancing their survival within the peritoneal cavity during dissemination to a secondary outgrowth site. The inability of removal of these aggregates by traditional surgical interventions may contribute to the high recurrence and mortality rate of ovarian cancer diagnosed at late stages. Obesity, particularly abdominal obesity, has been shown to increase ovarian cancer risk and decrease survival. The recruitment of stromal vascular fraction (SVF) present in adipose tissue represents a growth and proliferation advantage to ovarian tumors, and endogenous sphingolipids like sphingosine-1-phosphate are increased in ovarian cancer patients. These conditions, combined with the physiological conditions within malignant ascites (hypoxia and low glucose), represent a physiological environment that can impact the metabolic responses of ovarian cancer spheroids. Here, we investigated the metabolic adaptations of serous ovarian cancer cells across the metastatic cycle and in conditions that mimic those of the peritoneal cavity and malignant ascites. We first investigated the different in metabolic responses between adherent monolayers and 3D spheroids. We confirmed that spheroids have a reduced metabolic rate and drug response that is affected by the incorporation of obese SVF into aggregates. To investigate these changes in the next stages of the metastatic cycle, we used time trials to observe how adherence of spheroids to a secondary site changes metabolic response and substrate utilization in physiological conditions. Adhesion of spheroids showed changes in energy metabolism and substrate utilization, switching from mainly glutamine oxidation to glucose oxidation that could support successful outgrowth. Spheroids also were resilient to culture conditions, even non-permissive conditions such as those found in the peritoneal cavity. Finally, we utilized human malignant ascites from ovarian cancer patients as a further investigation into conditions that imitate in vivo characteristics that could affect spheroid metabolism. Exposure to malignant ascites reduced spheroid viability as well as basal respiration and ATP synthesis. However, spare respiratory capacity was increased, and human spheroids changed their substrate utilization in response to ascites. Taken together, these studies provide an identification of metabolic switches across different stages of ovarian cancer metastasis that contribute to their survival, which represents an emerging target for prevention and treatment for individuals with ovarian cancer. / Doctor of Philosophy / Ovarian cancer is the deadliest reproductive cancer in women, and most women who are diagnosed will die from the disease because of its high recurrence rate and because it is typically detected at late stages. When ovarian cancer metastasizes, cells or cell clusters from the original tumor aggregate together to form balls of cells called spheroids, which move through the abdominal cavity to other sites to grow additional tumors. These spheroids are thought to contribute to recurrence of this cancer, since they cannot be removed by surgery. As these spheroids move through the abdominal cavity, they are exposed to an environment that has a low amount of oxygen and glucose. These spheroids may also be exposed to bioactive lipids and cells from the adipose tissue called stromal vascular fraction, both of which are related to obesity and may help cancer spheroids survive. The survival of these spheroids is in part related to how their metabolism functions, which may help them make energy and the building blocks needed to continue growing and form successful secondary tumors. Identifying how these spheroids change their metabolism at different points during the disease may help identify points that can be targeted to prevent changes in metabolism that could support their growth. This dissertation identified metabolic changes that occur in spheroids, in conditions that are similar to those spheroids would be exposed to in an abdominal cavity. First, we compared single layers of cells to spheroids and found that spheroids had a lower metabolic rate and lower drug response, which may help them survive in the abdominal cavity. Next, we allowed the spheroids to lay down and grow out, like they would when they found a new location during metastasis, to see how their metabolism changed and what substances they used to make energy in conditions that mimicked the abdominal cavity. As spheroids adhered, they changed their energy metabolism and switched the substances they used to make energy, all while continuing to survive and grow out even in conditions that were not supportive. These switches could help them grow out and successfully metastasize. Lastly, we used ascites fluid from human ovarian cancer patients and treated spheroids with this to see how their metabolism changed in response. While some aspects of metabolism and survival was reduced, their ability to increase their metabolism when stressed increased and human spheroids used nutrients to make energy differently. Overall, we show that across the stages of metastasis, ovarian cancer spheroids can change their metabolism in response to their environment. Identifying these metabolic switches helps us understand how successful metastasis happens, and can inform future targets to slow or prevent metastasis, prolonging the life of women who have been diagnosed with ovarian cancer.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/109640 |
| Date | 11 April 2022 |
| Creators | Compton, Stephanie Lynn Edwards |
| Contributors | Human Nutrition, Foods and Exercise, Schmelz, Eva Maria, Craige, Siobhan, Drake, Joshua Chadwick, Gilbert, Elizabeth R. |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Language | English |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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