The panoramic view of clear cell renal cell carcinoma metabolism: values of integrated global cancer metabolomics

Kidney is a highly metabolic organ that filters approximately 180 liters of plasma every day through glomeruli in adult human, reabsorbs most of filtered small molecule nutrients such as amino acid, glucose, fatty acid through renal tubules, consumes a large amount of energy through oxidizing free fatty acid, lactate and ketoacid, and produces glucose through gluconeogenesis during a fight-or-flight situation. Clear cell renal cell carcinoma (ccRCC) is the most common (~75%), lethal subtype of kidney cancer, and originates from the renal tubule epithelium (1). Morphologically, ccRCC cells are lipid- and glycogen- laden, implicating altered fatty acid and glucose metabolism in the development of ccRCC. However, the casual relationship between these unique metabolic derangements and the pathobiology of ccRCC is unknown. Furthermore, the global metabolic shifts during the pathogenesis and the progression of ccRCC remain to be determined.