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Ketogenic diets enhance oxidative stress and radio-chemo-therapy responses in lung cancer xenografts
Journal article   Open access   Peer reviewed

Ketogenic diets enhance oxidative stress and radio-chemo-therapy responses in lung cancer xenografts

Bryan G Allen, Sudershan K Bhatia, John M Buatti, Kristin E Brandt, Kaleigh E Lindholm, Anna M Button, Luke I Szweda, Brian J Smith, Douglas R Spitz and Melissa A Fath
Clinical cancer research, Vol.19(14), pp.3905-3913
07/15/2013
DOI: 10.1158/1078-0432.CCR-12-0287
PMCID: PMC3954599
PMID: 23743570
url
https://doi.org/10.1158/1078-0432.CCR-12-0287View
Published (Version of record) Open Access

Abstract

Ketogenic diets are high in fat and low in carbohydrates as well as protein which forces cells to rely on lipid oxidation and mitochondrial respiration rather than glycolysis for energy metabolism. Cancer cells (relative to normal cells) are believed to exist in a state of chronic oxidative stress mediated by mitochondrial metabolism. The current study tests the hypothesis that ketogenic diets enhance radio-chemo-therapy responses in lung cancer xenografts by enhancing oxidative stress. Mice bearing NCI-H292 and A549 lung cancer xenografts were fed a ketogenic diet (KetoCal 4:1 fats: proteins+carbohydrates) and treated with either conventionally fractionated (1.8-2 Gy) or hypofractionated (6 Gy) radiation as well as conventionally fractionated radiation combined with carboplatin. Mice weights and tumor size were monitored. Tumors were assessed for immunoreactive 4-hydroxy-2-nonenal-(4HNE)-modified proteins as a marker of oxidative stress as well as proliferating cell nuclear antigen (PCNA) and γH2AX as indices of proliferation and DNA damage, respectively. The ketogenic diets combined with radiation resulted in slower tumor growth in both NCI-H292 and A549 xenografts (P < 0.05), relative to radiation alone. The ketogenic diet also slowed tumor growth when combined with carboplatin and radiation, relative to control. Tumors from animals fed a ketogenic diet in combination with radiation showed increases in oxidative damage mediated by lipid peroxidation as determined by 4HNE-modified proteins as well as decreased proliferation as assessed by decreased immunoreactive PCNA. These results show that a ketogenic diet enhances radio-chemo-therapy responses in lung cancer xenografts by a mechanism that may involve increased oxidative stress.
 Oxidative Stress Diet, Ketogenic Humans Lung Neoplasms - metabolism Radiation Tolerance Carcinoma, Non-Small-Cell Lung - metabolism Combined Modality Therapy Lung Neoplasms - therapy Xenograft Model Antitumor Assays Carcinoma, Non-Small-Cell Lung - therapy Animals Mice, Nude Cell Line, Tumor Dose Fractionation Female Mice Lipid Peroxidation Proliferating Cell Nuclear Antigen - metabolism Ketones - metabolism

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