# Lactylation in urological malignancies: emerging mechanisms and therapeutic direction

**Authors:** Jiafeng Lin, Chenye Yuan, Chunsheng Liu, Minjie Zhang, Jianbin Luo, Zhihuang Wu, Qinghong Ma, Shengbiao Xie, Yufeng Liang, Guoqiang Chen

PMC · DOI: 10.3389/fcell.2026.1764134 · Frontiers in Cell and Developmental Biology · 2026-02-12

## TL;DR

This review explores how lactylation, a new type of protein modification, affects urological cancers by linking metabolism and epigenetics, offering potential new treatment strategies.

## Contribution

The paper systematically reviews lactylation's role in urological malignancies and highlights its potential as a therapeutic target and biomarker.

## Key findings

- Lactylation regulates gene transcription and protein function in urological cancers.
- It influences cancer behaviors like proliferation, metastasis, and therapy resistance.
- The review identifies challenges and future directions for lactylation research in this context.

## Abstract

Urological malignancies represent a group of highly aggressive tumors with a strong tendency toward therapy resistance. Their pathogenesis is closely associated with metabolic reprogramming and epigenetic regulation. In recent years, lactylation, a novel form of post-translational modification, has garnered significant attention due to its crucial role in linking cellular metabolism with epigenetics. By covalently modifying lysine residues on both histone and non-histone proteins, lactylation dynamically regulates gene transcription and protein function, thereby influencing malignant behaviors in urological malignancies—including proliferation, metastasis, immune evasion, and therapeutic resistance. This review begins by systematically outlining the fundamental characteristics of lactylation and its regulatory networks. It then summarizes the general roles of lactylation in cancer, with a particular emphasis on its mechanisms and functional implications in urological malignancies. Finally, we discuss current research challenges and future directions, aiming to provide new insights into the metabolic–epigenetic interplay in urological malignancies and to establish a theoretical foundation for targeting lactylation as a potential therapeutic strategy and prognostic biomarker.

## Full-text entities

- **Genes:** SIRT3 (sirtuin 3) [NCBI Gene 23410] {aka SIR2L3}, Pom121 (nuclear pore membrane protein 121) [NCBI Gene 107939] {aka 2610027A18Rik, mKIAA0618}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, IDH1 (isocitrate dehydrogenase (NADP(+)) 1) [NCBI Gene 3417] {aka HEL-216, HEL-S-26, IDCD, IDH, IDP, IDPC}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, SMARCA4 (SWI/SNF related BAF chromatin remodeling complex subunit ATPase 4) [NCBI Gene 6597] {aka BAF190, BAF190A, BRG1, CSS4, MRD16, OTSC12}, RNF183 (ring finger protein 183) [NCBI Gene 138065], Neo1 (neogenin) [NCBI Gene 18007] {aka 2610028H22Rik, D930014N22Rik, Igdcc2}, SNAI1 (snail family transcriptional repressor 1) [NCBI Gene 6615] {aka SLUGH2, SNA, SNAH, SNAIL, SNAIL1, dJ710H13.1}, KAT5 (lysine acetyltransferase 5) [NCBI Gene 10524] {aka ESA1, HTATIP, HTATIP1, NEDFASB, PLIP, TIP}, NUMB (NUMB endocytic adaptor protein) [NCBI Gene 8650] {aka C14orf41, S171, c14_5527}, HIF1A (hypoxia inducible factor 1 subunit alpha) [NCBI Gene 3091] {aka HIF-1-alpha, HIF-1A, HIF-1alpha, HIF1, HIF1-ALPHA, MOP1}, Pdgfrb (platelet derived growth factor receptor, beta polypeptide) [NCBI Gene 18596] {aka CD140b, PDGFR-1, Pdgfr}, IGFBP3 (insulin like growth factor binding protein 3) [NCBI Gene 3486] {aka BP-53, IBP-3, IBP3, IGFBP-3}, CPT2 (carnitine palmitoyltransferase 2) [NCBI Gene 1376] {aka CPT1, CPTASE, IIAE4}, DNMT1 (DNA methyltransferase 1) [NCBI Gene 1786] {aka ADCADN, AIM, CXXC9, DNMT, HSN1E, MCMT}, SLC16A1 (solute carrier family 16 member 1) [NCBI Gene 6566] {aka HHF7, MCT, MCT1, MCT1D}, RPL9 (ribosomal protein L9) [NCBI Gene 6133] {aka L9, NPC-A-16, uL6}, Vhl (von Hippel-Lindau tumor suppressor) [NCBI Gene 22346] {aka Vhlh, pVHL}, Myc (Myc proto-oncogene, bHLH transcription factor) [NCBI Gene 17869] {aka Myc2, Niard, Nird, bHLHe39}, HK2 (hexokinase 2) [NCBI Gene 3099] {aka HKII, HXK2}, TNFSF9 (TNF superfamily member 9) [NCBI Gene 8744] {aka 4-1BB-L, CD137L, TNLG5A}, SLC4A4 (solute carrier family 4 member 4) [NCBI Gene 8671] {aka HNBC1, KNBC, NBC1, NBC2, NBCe1, NBCe1-A}, TOP2A (DNA topoisomerase II alpha) [NCBI Gene 7153] {aka TOP2, TOP2alpha, TOPIIA, TP2A}, Cd274 (CD274 antigen) [NCBI Gene 60533] {aka A530045L16Rik, B7h1, Pdcd1l1, Pdcd1lg1, Pdl1}, DHX15 (DEAH-box helicase 15) [NCBI Gene 1665] {aka DBP1, DDX15, PRP43, PRPF43, PrPp43p, hPrp43}, YTHDC1 (YTH N6-methyladenosine RNA binding protein C1) [NCBI Gene 91746] {aka YT521, YT521-B}, TIMP1 (TIMP metallopeptidase inhibitor 1) [NCBI Gene 7076] {aka CLGI, EPA, EPO, HCI, TIMP, TIMP-1}, SEMA3A (semaphorin 3A) [NCBI Gene 10371] {aka COLL1, HH16, Hsema-I, Hsema-III, SEMA1, SEMAD}, E2F2 (E2F transcription factor 2) [NCBI Gene 1870] {aka E2F-2}, ZMIZ1 (zinc finger MIZ-type containing 1) [NCBI Gene 57178] {aka MIZ, NEDDFSA, RAI17, TRAFIP10, ZIMP10}, HDAC2 (histone deacetylase 2) [NCBI Gene 3066] {aka HD2, KDAC2, RPD3, YAF1}, KAT2A (lysine acetyltransferase 2A) [NCBI Gene 2648] {aka GCN5, GCN5L2, PCAF-b, hGCN5}, YY1 (YY1 transcription factor) [NCBI Gene 7528] {aka DELTA, GADEVS, INO80S, NF-E1, UCRBP, YIN-YANG-1}, Nsun2 (NOL1/NOP2/Sun domain family member 2) [NCBI Gene 28114] {aka D13Wsu123e, Misu}, FASN (fatty acid synthase) [NCBI Gene 2194] {aka FAS, OA-519, SDR27X1}, METTL16 (methyltransferase 16, RNA N6-adenosine) [NCBI Gene 79066] {aka METT10D}, SIRT2 (sirtuin 2) [NCBI Gene 22933] {aka SIR2, SIR2L, SIR2L2}, RBM15 (RNA binding motif protein 15) [NCBI Gene 64783] {aka OTT, OTT1}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, CEACAM6 (CEA cell adhesion molecule 6) [NCBI Gene 4680] {aka CD66c, CEAL, NCA, NCA-50/90}, BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, VHL (von Hippel-Lindau tumor suppressor) [NCBI Gene 7428] {aka HRCA1, RCA1, VHL1, pVHL}, HDAC3 (histone deacetylase 3) [NCBI Gene 8841] {aka HD3, KDAC3, RPD3, RPD3-2}, HDAC9 (histone deacetylase 9) [NCBI Gene 9734] {aka HD7, HD7b, HD9, HDAC, HDAC7B, HDAC9B}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, GRAMD1A (GRAM domain containing 1A) [NCBI Gene 57655] {aka KIAA1533, LAMa}, VCAM1 (vascular cell adhesion molecule 1) [NCBI Gene 7412] {aka CD106, INCAM-100}, PDGFRB (platelet derived growth factor receptor beta) [NCBI Gene 5159] {aka CD140B, IBGC4, IMF1, JTK12, KOGS, OPDKD}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, NANOG (Nanog homeobox) [NCBI Gene 79923], CASP1 (caspase 1) [NCBI Gene 834] {aka ICE, IL1BC, P45}, CTNNB1 (catenin beta 1) [NCBI Gene 1499] {aka CTNNB, EVR7, MRD19, NEDSDV, armadillo}, ASH2L (ASH2 like, histone lysine methyltransferase complex subunit) [NCBI Gene 9070] {aka ASH2, ASH2L1, ASH2L2, Bre2}, Hif1a (hypoxia inducible factor 1, alpha subunit) [NCBI Gene 15251] {aka HIF-1-alpha, HIF1-alpha, HIF1alpha, MOP1, bHLHe78}, ZFP64 (ZFP64 zinc finger protein) [NCBI Gene 55734] {aka ZNF338}, DNA2 (DNA replication helicase/nuclease 2) [NCBI Gene 1763] {aka DNA2L, RTS4, hDNA2}, PRKDC (protein kinase, DNA-activated, catalytic subunit) [NCBI Gene 5591] {aka DNA-PKC, DNA-PKcs, DNAPK, DNAPKc, DNPK1, HYRC}, KAT8 (lysine acetyltransferase 8) [NCBI Gene 84148] {aka LIGOWS, MOF, MYST1, ZC2HC8, hMOF}, RPS6KC1 (ribosomal protein S6 kinase C1) [NCBI Gene 26750] {aka NEDSCW, RPK118, RSKL1, S6K-delta-1, S6PKh1, humS6PKh1}
- **Diseases:** breast cancer (MESH:D001943), cardiac dysfunction (MESH:D006331), ovarian cancer (MESH:D010051), HCC (MESH:D006528), urological (MESH:D014570), RCC (MESH:D002292), BC (MESH:D001749), glioblastoma (MESH:D005909), sepsis (MESH:D018805), Metastasis (MESH:D009362), Urological malignancies (MESH:D014571), tumorigenic (MESH:D002471), CL (MESH:D002971), CRC (MESH:D015179), hypoxic (MESH:D002534), gastric cancer (MESH:D013274), tumorigenesis (MESH:D063646), renal cancer (MESH:D007680), hypoxia (MESH:D000860), inflammatory (MESH:D007249), PCa (MESH:D011471), melanoma (MESH:D008545), glioma (MESH:D005910), pancreatic cancer (MESH:D010190), endometriosis (MESH:D004715), Parkinson's disease (MESH:D010300), prostate adenocarcinoma (MESH:D000230), Cancer (MESH:D009369)
- **Chemicals:** m6A (MESH:C005955), ATP (MESH:D000255), enzalutamide (MESH:C540278), glutathione (MESH:D005978), CY (MESH:D003545), NAD+ (MESH:D009243), lysine (MESH:D008239), glucose (MESH:D005947), docetaxel (MESH:D000077143), BDE-47 (MESH:C511295), D-lactate (-), cisplatin (MESH:D002945), doxorubicin (MESH:D004317), NADPH (MESH:D009249), lactyl-CoA. (MESH:C047009), 5-fluorouracil (MESH:D005472), Gambogic acid (MESH:C052659), bevacizumab (MESH:D000068258), cholesterol (MESH:D002784), Mannose (MESH:D008358), anthracycline (MESH:D018943), oxygen (MESH:D010100), Lactate (MESH:D019344), Irinotecan (MESH:D000077146)
- **Species:** Homo sapiens (human, species) [taxon 9606], Mus musculus (house mouse, species) [taxon 10090]
- **Cell lines:** H4K5la — Bubalus depressicornis (Lowland anoa), Telomerase immortalized cell line (CVCL_JH76)

## Full text

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## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12935874/full.md

## References

136 references — full list in the complete paper: https://tomesphere.com/paper/PMC12935874/full.md

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Source: https://tomesphere.com/paper/PMC12935874