Purpose: Elevation of L-2-hydroxylgutarate (L-2-HG) in renal cell carcinoma (RCC) is due in part to reduced expression of L-2-HG dehydrogenase (L2HGDH). However, the contribution of L-2-HG to renal carcinogenesis and insight into the biochemistry and targets of this small molecule remains to be elucidated. Experimental Design: Genetic and pharmacologic approaches to modulate L-2-HG levels were assessed for effects on in vitro and in vivo phenotypes. Metabolomics was used to dissect the biochemical mechanisms that promote L-2-HG accumulation in RCC cells. Transcriptomic analysis was utilized to identify relevant targets of L-2-HG. Finally, bioinformatic and metabolomic analyses were used to assess the L-2-HG/L2HGDH axis as a function of patient outcome and cancer progression. Results: L2HGDH suppresses both in vitro cell migration and in vivo tumor growth and these effects are mediated by L2HGDH9s catalytic activity. Biochemical studies indicate that glutamine is the predominant carbon source for L-2-HG via the activity of malate dehydrogenase 2 (MDH2). Inhibition of the glutamine-MDH2 axis suppresses in vitro phenotypes in an L-2-HG–dependent manner. Moreover, in vivo growth of RCC cells with basal elevation of L-2-HG is suppressed by glutaminase inhibition. Transcriptomic and functional analyses demonstrate that the histone demethylase KDM6A is a target of L-2-HG in RCC. Finally, increased L-2-HG levels, L2HGDH copy loss, and lower L2HGDH expression are associated with tumor progression and/or worsened prognosis in patients with RCC. Conclusions: Collectively, our studies provide biochemical and mechanistic insight into the biology of this small molecule and provide new opportunities for treating L-2-HG–driven kidney cancers.

The Cancer Genome Atlas (TCGA) and other large-scale genomic data pipelines have been integral to the current understanding of the molecular events underlying renal cell carcinoma (RCC). These data networks have focused mostly on primary RCC, which often demonstrates indolent behavior. However, metastatic disease is the major cause of mortality associated with RCC and data sets examining metastatic tumors are sparse. Therefore, a more comprehensive analysis of gene expression and DNA methylome profiling of metastatic RCC in addition to primary RCC and normal kidney was performed. Integrative analysis of the methylome and transcriptome identified over 30 RCC-specific genes whose mRNA expression inversely correlated with promoter methylation, including several known targets of hypoxia inducible factors. Notably, genes encoding several metabolism-related proteins were identified as differentially regulated via methylation including hexokinase 2, aldolase C, stearoyl-CoA desaturase, and estrogen-related receptor-γ (ESRRG), which has a known role in the regulation of nuclear-encoded mitochondrial metabolism genes. Several gene expression changes could portend prognosis in the TCGA cohort. Mechanistically, ESRRG loss occurs via DNA methylation and histone repressive silencing mediated by the polycomb repressor complex 2. Restoration of ESRRG in RCC lines suppresses migratory and invasive phenotypes independently of its canonical role in mitochondrial metabolism. Implications: Collectively, these data provide significant insight into the biology of aggressive RCC and demonstrate a novel role for DNA methylation in the promotion of HIF signaling and invasive phenotypes in renal cancer.

Upconversion nanoparticles (UCNPs) are well-reported for bioimaging. However, their applications are limited by low luminescence intensity. To enhance the intensity, often the UCNPs are coated with macromolecules or excited with high laser power, which is detrimental to their long-term biological applications. Herein, we report a novel approach to prepare co-doped CaF₂:Yb³⁺ (20%), Er³⁺ with varying concentrations of Er (2%, 2.5%, 3%, and 5%) at ambient temperature with minimal surfactant and high-pressure homogenization. Strong luminescence and effective red emission of the UCNPs were seen even at low power and without functionalization. X-ray diffraction (XRD) of UCNPs revealed the formation of highly crystalline, single-phase cubic fluorite-type nanostructures, and transmission electron microscopy (TEM) showed co-doped UCNPs are of $~$12 nm. The successful doping of Yb and Er was evident from TEM–energy dispersive X-ray analysis (TEM-EDAX) and X-ray photoelectron spectroscopy (XPS) studies. Photoluminescence studies of UCNPs revealed the effect of phonon coupling between host lattice (CaF₂), sensitizer (Yb³⁺), and activator (Er³⁺). They exhibited tunable upconversion luminescence (UCL) under irradiation of near-infrared (NIR) light (980 nm) at low laser powers (0.28–0.7 W). The UCL properties increased until 3% doping of Er³⁺ ions, after which quenching of UCL was observed with higher Er³⁺ ion concentration, probably due to non-radiative energy transfer and cross-relaxation between Yb³⁺-Er³⁺ and Er³⁺-Er³⁺ ions. The decay studies aligned with the above observation and showed the dependence of UCL on Er³⁺ concentration. Further, the UCNPs exhibited strong red emission under irradiation of 980 nm light and retained their red luminescence upon internalization into cancer cell lines, as evident from confocal microscopic imaging. The present study demonstrated an effective approach to designing UCNPs with tunable luminescence properties and their capability for cellular imaging under low laser power.

Extremely short half-life therapeutic molecule nitric oxide (NO) plays significant roles in the functioning of various physiological and pathological processes in the human body, whereas doxorubicin hydrochloride (DOX) is a clinically important anticancer drug widely used in cancer chemotherapy. Thus, the intracellular delivery of these therapeutic molecules is tremendously important to achieve their full potential. Herein, we report a novel approach for the development of highly water-dispersible magnetic nanocarriers for codelivery of NO and DOX. Primarily, bifunctional magnetic nanoparticles enriched with carboxyl and thiol groups were prepared by introducing cysteine onto the surface of citrate-functionalized Fe₃O₄ nanoparticles. DOX was electrostatically conjugated onto the surface of bifunctional nanoparticles via carboxyl moieties, whereas the thiol group was further nitrosated to provide NO-releasing molecules. The developed magnetic nanocarrier exhibited good aqueous colloidal stability, protein resistance behavior, and high encapsulation efficacy for NO (65.5%) and DOX (85%), as well as sustained release characteristics. Moreover, they showed superior cytotoxicity toward cancer (A549 and MCF-7) cells via apoptosis induction over normal (WI26VA4) cells. Specifically, we have developed magnetic nanocarriers having the capability of dual delivery of NO and DOX, which holds great potential for combinatorial cancer treatment.