# α-ketoglutarate/succinate ratio imbalance impairs thymine DNA glycosylase function and base excision repair process increasing susceptibility to pancreatic cancer

**Authors:** Silvia Malatesta, Virginia Vigiano Benedetti, Emanuela Salviati, Barbara Illi, Isabella Manni, Emanuele Middonti, Gian Luca Rampioni Vinciguerra, Valerio Licursi, Francesca Troilo, Gianni Colotti, Lina Cipolla, Simone Sabbioneda, Livia Perfetto, Giulia Piaggio, Federico Bussolino, Federica Di Nicolantonio, Pietro Campiglia, Eduardo Maria Sommella, Mattia Mori, Chiara Cencioni, Francesco Spallotta

PMC · DOI: 10.1038/s41419-026-08475-w · 2026-02-21

## TL;DR

This study shows how a metabolic imbalance in pancreatic cancer leads to DNA repair failure, increasing cancer risk.

## Contribution

The study identifies a novel metabolic-epigenetic mechanism linking α-ketoglutarate/succinate imbalance to DNA repair impairment in pancreatic cancer.

## Key findings

- Succinate binds to thymine DNA glycosylase, increasing AP site formation.
- Metabolic imbalance impairs base excision repair by hypermethylating DNA ligases.
- This mechanism contributes to genomic instability and preneoplastic lesions in pancreatic cancer.

## Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer, with chronic metabolic disorders increasing risk and severity. Prolonged exposure to altered metabolism changes specific metabolite levels, impacting epigenetic landscape contributing neoplastic lesion acquisition. This study examines the interplay between metabolism and epigenetics in dysmetabolic-driven PDAC tumorigenesis, exploiting LSL-KrasG12D;PDX-1-Cre mice (KC mice) exposed to high-fat diet (HFD) and KRAS-mutated human pancreatic ductal epithelial (HPDE) cells. Untargeted metabolomics of HFD-fed KC pancreata reveals altered free fatty acid and elevated S-adenosyl methionine levels during tumorigenesis. Targeted metabolomics shows increased succinate alongside reduced α-ketoglutarate levels. This imbalance suggests an epigenetic derangement, targeting DNA methylation. In KRAS-mutated HPDE cells exposed to altered metabolism, the DNA demethylation complex of ten-to-eleven-translocation methylcytosine 1 and thymine DNA glycosylase (TDG) is disrupted, leading to iterative cytosine modification and apurinic/apyrimidinic (AP) site accumulation. Succinate directly binds TDG at arginine 275, hyperactivating it and increasing AP site formation. This alteration combined with the methylation-prone metabolic environment, impairs the base excision repair pathway by hypermethylating and downmodulating DNA ligases LIG1 and LIG3. This predisposes to genomic instability and pancreatic preneoplastic lesion development. These findings uncover a metabolic-epigenetic axis in dysmetabolic PDAC, highlighting how metabolite-driven epigenetic changes compromise DNA repair and drive tumorigenesis.

## Linked entities

- **Genes:** KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845], PDX1 (pancreatic and duodenal homeobox 1) [NCBI Gene 3651], TDG (thymine DNA glycosylase) [NCBI Gene 6996], LIG1 (DNA ligase 1) [NCBI Gene 3978], LIG3 (DNA ligase 3) [NCBI Gene 3980]
- **Chemicals:** succinate (PubChem CID 160419), S-adenosyl methionine (PubChem CID 34755)
- **Diseases:** pancreatic ductal adenocarcinoma (MONDO:0005184), pancreatic cancer (MONDO:0005192)
- **Species:** Mus musculus (taxon 10090)

## Full-text entities

- **Genes:** ACTA1 (actin alpha 1, skeletal muscle) [NCBI Gene 58] {aka ACTA, ASMA, CFTD, CFTD1, CFTDM, CMYO2A}, LIG1 (DNA ligase 1) [NCBI Gene 3978] {aka IMD96, LIGI, hLig1}, TET1 (tet methylcytosine dioxygenase 1) [NCBI Gene 80312] {aka CXXC6, LCX, bA119F7.1}, CDH1 (cadherin 1) [NCBI Gene 999] {aka Arc-1, BCDS1, CD324, CDHE, ECAD, LCAM}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, Tet1 (tet methylcytosine dioxygenase 1) [NCBI Gene 52463] {aka 2510010B09Rik, Cxxc6, D10Ertd17e, LCX, mKIAA1676}, VCL (vinculin) [NCBI Gene 7414] {aka CMD1W, CMH15, HEL114, MV, MVCL, VINC}, FEN1 (flap structure-specific endonuclease 1) [NCBI Gene 2237] {aka FEN-1, MF1, RAD2}, Pdx1 (pancreatic and duodenal homeobox 1) [NCBI Gene 18609] {aka IDX-1, IPF-1, Ipf1, Mody4, STF-1, pdx-1}, AKR1B10 (aldo-keto reductase family 1 member B10) [NCBI Gene 57016] {aka AKR1B11, AKR1B12, ALDRLn, ARL-1, ARL1, HIS}, ACSM3 (acyl-CoA synthetase medium chain family member 3) [NCBI Gene 6296] {aka SA, SAH}, EIF2AK3 (eukaryotic translation initiation factor 2 alpha kinase 3) [NCBI Gene 9451] {aka PEK, PERK, WRS}, MYC (MYC proto-oncogene, bHLH transcription factor) [NCBI Gene 4609] {aka MRTL, MYCC, bHLHe39, c-Myc}, PARP1 (poly(ADP-ribose) polymerase 1) [NCBI Gene 142] {aka ADPRT, ADPRT 1, ADPRT1, ARTD1, PARP, PARP-1}, XRCC1 (X-ray repair cross complementing 1) [NCBI Gene 7515] {aka RCC, SCAR26}, Tdg (thymine DNA glycosylase) [NCBI Gene 21665] {aka E130317C12Rik, JZA-3, Jza1}, TDG (thymine DNA glycosylase) [NCBI Gene 6996] {aka hTDG}, KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845] {aka 'C-K-RAS, C-K-RAS, CFC2, K-RAS2A, K-RAS2B, K-RAS4A}, Cdh1 (cadherin 1) [NCBI Gene 12550] {aka ARC-1, E-cad, Ecad, L-CAM, UVO, Um}, Acta2 (actin alpha 2, smooth muscle, aorta) [NCBI Gene 11475] {aka 0610041G09Rik, Actvs, SMAalpha, SMalphaA, a-SMA, alphaSMA}, Kras (Kras proto-oncogene, GTPase) [NCBI Gene 16653] {aka K-Ras, K-Ras 2, K-ras, Ki-ras, Kras-2, Kras2}, LIG3 (DNA ligase 3) [NCBI Gene 3980] {aka LIG2, LIG3alpha, MTDPS20}, APEX1 (apurinic/apyrimidinic endodeoxyribonuclease 1) [NCBI Gene 328] {aka APE, APE1, APEN, APEX, APX, HAP1}
- **Diseases:** neoplastic lesion (MESH:D009062), carcinogenesis (MESH:D063646), gastric and colon cancer (MESH:D013274), obesity (MESH:D009765), OA (MESH:D011015), type 2 diabetes (MESH:D003924), renal cell carcinoma (MESH:D002292), hepatocellular carcinoma (MESH:D006528), pancreatic preneoplastic lesion (MESH:D010182), metabolic diseases (MESH:D008659), pancreatic cancer (MESH:D010190), glioma (MESH:D005910), melanoma (MESH:D008545), invasive cancer (MESH:D009362), hyperglycemia (MESH:D006943), Dysmetabolic (MESH:D024821), HPDE (MESH:D021441), pancreatic tumorigenesis (MESH:D010195), PanIN (MESH:D002578), insulin resistance (MESH:D007333), Cancer (MESH:D009369)
- **Chemicals:** S-adenosyl methionine (MESH:D012436), FFA (MESH:D005230), palmitic acid (MESH:D019308), lipid (MESH:D008055), paraformaldehyde (MESH:C003043), citrate (MESH:D019343), CO2 (MESH:D002245), L-glutamine (MESH:D005973), cytosine (MESH:D003596), Water (MESH:D014867), Glycine (MESH:D005998), NaOH (MESH:D012972), aldehyde (MESH:D000447), folate (MESH:D005492), glucose (MESH:D005947), S-adenosyl-homocysteine (MESH:D012435), Asparagine (MESH:D001216), DMSO (MESH:D004121), DAPI (MESH:C007293), cholesterol (MESH:D002784), acetic acid (MESH:D019342), SDS (MESH:D012967), fumarate (MESH:D005650), 1,4-dithiothreitol (MESH:D004229), PBS (MESH:D007854), OA (MESH:D019301), Penicillin (MESH:D010406), glycerol (MESH:D005990), Alexafluor 647 (MESH:C569686), 5-hydroxymethylcytosine (MESH:C011865), alpha-ketoglutarate (MESH:D007656), P (MESH:D010758), linoleic acid (MESH:D019787), S (MESH:D013455), Crystal violet (MESH:D005840), NaCl (MESH:D012965), DOC (MESH:D003840), 5mC (-), D-2-hydroxyglutarate (MESH:C019417), fat (MESH:D005223), methionine (MESH:D008715), Succinate (MESH:D019802), carbon (MESH:D002244), tricarboxylic acid (MESH:D014233), Streptomycin (MESH:D013307), Alanine (MESH:D000409), Alexa Fluor 488 (MESH:C000711379), thymine (MESH:D013941), carbohydrates (MESH:D002241), arginine (MESH:D001120), Triton-X 100 (MESH:D017830), Cl- (MESH:D002713), Serine (MESH:D012694), methylhistidine (MESH:D008762), 5-carboxylcytosine (MESH:C560974), His (MESH:D006639), 5-formylcytosine (MESH:C560973)
- **Species:** Mycoplasma (genus) [taxon 2093], Homo sapiens (human, species) [taxon 9606], Rodentia (rodent, order) [taxon 9989], Mus musculus (house mouse, species) [taxon 10090]
- **Cell lines:** epithelial — Homo sapiens (Human), Induced pluripotent stem cell (CVCL_EE38), HPDE — Homo sapiens (Human), Finite cell line (CVCL_4376), K-RasG12V — Homo sapiens (Human), Transformed cell line (CVCL_C469), S2D — Mus musculus (Mouse), Hybridoma (CVCL_C5DS), LSL — Homo sapiens (Human), Hemophilia A, Induced pluripotent stem cell (CVCL_A4EK), HEK293T — Homo sapiens (Human), Transformed cell line (CVCL_0063), FVB — Mus musculus (Mouse), Embryonic stem cell (CVCL_F046)

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12960949/full.md

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Source: https://tomesphere.com/paper/PMC12960949