Increased demand for NAD(+) relative to ATP drives aerobic glycolysis
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Abstract
Abstract Aerobic glycolysis, or preferential fermentation of glucose-derived pyruvate to lactate despite available oxygen, is a hallmark of proliferative metabolism that is observed across many organisms and conditions. To better understand why aerobic glycolysis is associated with cell proliferation, we examined the metabolic consequence of activating the pyruvate dehydrogenase complex (PDH) to increase mitochondrial pyruvate oxidation at the expense of fermentation. We find that increasing PDH activity impairs cell proliferation by reducing the nicotinamide adenine dinucleotide cofactor ratio (NAD+/NADH). This change in NAD+/NADH ratio is caused by an increase in mitochondrial membrane potential that impairs mitochondrial electron transport and NAD+ regeneration. Uncoupling mitochondrial respiration from ATP synthesis or increasing ATP hydrolysis restores NAD+/NADH homeostasis and proliferation even when glucose oxidation is increased. These data suggest that when the demand for NAD+ to support oxidation reactions exceeds the demand for ATP consumption in cells, NAD+ regeneration by mitochondrial respiration becomes constrained, promoting fermentation despite available oxygen. This argues that cells engage in aerobic glycolysis when the cellular demand for NAD+ is in excess of the cellular demand for ATP.
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Cell proliferation can be impaired when demand for mitochondrial NAD+ exceeds that of ATP, which may explain why highly proliferative cells often engage in aerobic glycolysis over pyruvate oxidation and OXPHOS even with sufficient oxygen.
“These results indicate that cell proliferation can be impaired when the demand for mitochondrial NAD+ exceeds that of ATP and may explain why highly proliferative cells often engage in aerobic glycolysis over pyruvate oxidation and OXPHOS, even in the presence of sufficient oxygen (138).”
From Regulation and function of the mammalian tricarboxylic acid cycle (2023) · cites this paper as [138]
Increasing flux through OXPHOS by increasing ATP consumption reverses the growth inhibitory effects of PDHC activation.
“Increasing flux through OXPHOS by increasing ATP consumption reverses the growth inhibitory effects of PDHC activation (138).”
From Regulation and function of the mammalian tricarboxylic acid cycle (2023) · cites this paper as [138]
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- Authors
- Luengo, A., Li, Z., Gui, D. Y., Sullivan, L. B., Zagorulya, M., Do, B. T., Ferreira, R., Naamati, A., Ali, A., Lewis, C. A., Thomas, C. J., Spranger, S., Matheson, N. J., & Vander Heiden, M. G.
- Affiliations
- Koch Institute for Integrative Cancer Research At MIT (US)
- Fred Hutch Cancer Center (US)
- Harvard University (US)
- University of Cambridge (GB)
- Whitehead Institute for Biomedical Research (US)
- National Institutes of Health (US)
- ORCID
- Venue
- Molecular Cell
- Publisher
- Elsevier BV
- Published
- 2021-02
- Volume
- 81
- Issue
- 4
- Pages
- 691-707.e6
- ISSN
- 1097-2765 (ISSN-L)
- PMC
- PMC8315838
- OpenAlex
- W3113834486
- Cited by
- 547
- References
- 100
- Citations by year
- 2026: 90 · 2025: 139 · 2024: 113 · 2023: 92 · 2022: 69 · 2021: 44
- FWCI
- 17.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Molecular Cell (publishedVersion, cc-by-nc-nd)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Chalmers Research (Chalmers University of Technology) (submittedVersion)
- DSpace@MIT (Massachusetts Institute of Technology) (submittedVersion, cc-by-nc-nd)
- Funders
- National Science Foundation
- Howard Hughes Medical Institute
- Medical Research Council
- National Cancer Institute
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Health Sciences › Medicine › Geriatrics and Gerontology › Sirtuins and Resveratrol in Medicine
- Keywords
- aerobic glycolysis, NAD+/NADH ratio, pyruvate dehydrogenase complex, pyruvate oxidation, cell proliferation, mitochondrial membrane potential, mitochondrial electron transport chain, NAD+ regeneration, uncoupled respiration, ATP turnover, glucose metabolism
- MeSH terms
- A549 Cells, Adenosine Triphosphate, Aerobiosis, Glucose, Glycolysis, HeLa Cells, Humans, NAD, Oxidation-Reduction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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