# The Yin-Yang balance of SIRT1 and SIRT2 in cancer metabolic remodeling

**Authors:** Fei Yi, Li Shen, Xindi Yang, Zhuo Wang, Xue Li, Zishi Shen, Wenting Liu, Qi Miao, Shuang Jiang, Eryan Kong, Xiaoyu Song, Tingting Zhou, Ning Bai, Liu Cao

PMC · DOI: 10.7150/ijbs.127696 · 2026-02-11

## TL;DR

SIRT1 and SIRT2 regulate cancer metabolism in opposing ways, influencing tumor growth and immune responses, and targeting their balance could lead to new cancer therapies.

## Contribution

The paper introduces the Yin-Yang regulatory balance of SIRT1 and SIRT2 in cancer metabolism and their therapeutic targeting potential.

## Key findings

- SIRT1 and SIRT2 modulate glucose, lipid, and mitochondrial metabolism in cancer cells.
- SIRT2 acts as a metabolic checkpoint for CD8⁺ T cells, suggesting a role in immune checkpoint therapy.
- Autophagy is a key node regulated by both SIRT1 and SIRT2 in tumor metabolic adaptation.

## Abstract

Sirtuin 1 (SIRT1) and Sirtuin 2 (SIRT2) are NAD⁺-dependent deacetylases that regulate cancer metabolic stress, exerting their effects primarily through post-translational modification of metabolic enzymes and transcription factors. They modulate glucose, lipid, and mitochondrial metabolism, as well as immune metabolism responses within the tumor microenvironment. Depending on cellular context, they can promote or suppress tumor growth by directing energy production, redox balance, and metabolic adaptation. These context-dependent and often opposing activities constitute a Yin-Yang mode of regulation in cancer metabolism, reflecting a dynamic balance between metabolic activation and constraint. Autophagy has emerged as a critical metabolic integration node regulated by both SIRT1 and SIRT2, linking nutrient sensing, mitochondrial quality control, and stress adaptation. This review summarizes recent advances in understanding how SIRT1 and SIRT2 coordinate tumor metabolism and discusses therapeutic strategies that target their regulatory balance to reprogram cancer metabolism. SIRT2 also functions as a metabolic checkpoint that restrains CD8⁺ T cell effector metabolism, providing a rationale for combining SIRT2 inhibition with immune checkpoint blockade in metabolically stressed tumor microenvironments.

## Linked entities

- **Genes:** SIRT1 (sirtuin 1) [NCBI Gene 23411], SIRT2 (sirtuin 2) [NCBI Gene 22933]
- **Chemicals:** NAD⁺ (PubChem CID 5892)

## Full-text entities

- **Genes:** Tfam (transcription factor A, mitochondrial) [NCBI Gene 21780] {aka Hmgts, mtTFA, tsHMG}, Pnpla2 (patatin-like phospholipase domain containing 2) [NCBI Gene 66853] {aka 0610039C21Rik, 1110001C14Rik, Atgl, TTS-2.2}, Cx3cl1 (C-X3-C motif chemokine ligand 1) [NCBI Gene 20312] {aka ABCD-3, CX3C, Cxc3, D8Bwg0439e, FK, Scyd1}, Eno1 (enolase 1, alpha non-neuron) [NCBI Gene 13806] {aka Eno-1, MBP-1, NNE}, Mlh1 (mutL homolog 1) [NCBI Gene 17350] {aka 1110035C23Rik}, Pik3r1 (phosphoinositide-3-kinase regulatory subunit 1) [NCBI Gene 18708] {aka PI3K, p50alpha, p55alpha, p85alpha}, Pdcd1 (programmed cell death 1) [NCBI Gene 18566] {aka Ly101, PD-1, Pdc1}, Cx3cr1 (C-X3-C motif chemokine receptor 1) [NCBI Gene 13051] {aka mCX3CR1}, Sirt1 (sirtuin 1) [NCBI Gene 93759] {aka SIR2L1, Sir2, Sir2a, Sir2alpha}, Map1lc3a (microtubule-associated protein 1 light chain 3 alpha) [NCBI Gene 66734] {aka 1010001H21Rik, 4922501H04Rik, LC3, LC3a}, Foxo3 (forkhead box O3) [NCBI Gene 56484] {aka 1110048B16Rik, 2010203A17Rik, FKHRL1, Fkhr2, Foxo3a}, HIF1A (hypoxia inducible factor 1 subunit alpha) [NCBI Gene 3091] {aka HIF-1-alpha, HIF-1A, HIF-1alpha, HIF1, HIF1-ALPHA, MOP1}, SIRT1 (sirtuin 1) [NCBI Gene 23411] {aka SIR2, SIR2L1, SIR2alpha}, Pgam1 (phosphoglycerate mutase 1) [NCBI Gene 18648] {aka 2310050F24Rik, Pgam-1}, AK1 (adenylate kinase 1) [NCBI Gene 203] {aka ADK, Adk1, CNSHA3, HTL-S-58j}, Cxcl9 (C-X-C motif chemokine ligand 9) [NCBI Gene 17329] {aka CMK, Mig, MuMIG, Scyb9, crg-10}, EGLN1 (egl-9 family hypoxia inducible factor 1) [NCBI Gene 54583] {aka C1orf12, ECYT3, HALAH, HIF-PH2, HIFPH2, HPH-2}, Cd4 (CD4 antigen) [NCBI Gene 12504] {aka L3T4, Ly-4}, Gcg (glucagon) [NCBI Gene 14526] {aka GLP-1, Glu, PPG}, Ppargc1a (peroxisome proliferative activated receptor, gamma, coactivator 1 alpha) [NCBI Gene 19017] {aka A830037N07Rik, Gm11133, PGC-1, PPARGC-1-alpha, Pgc-1alpha, Pgc1}, Pgam2 (phosphoglycerate mutase 2) [NCBI Gene 56012], Ucp2 (uncoupling protein 2 (mitochondrial, proton carrier)) [NCBI Gene 22228] {aka Slc25a8, UCP 2, UCPH}, Sirt2 (sirtuin 2) [NCBI Gene 64383] {aka 5730427M03Rik, SIR2L2, Sir2l}, Fasn (fatty acid synthase) [NCBI Gene 14104] {aka A630082H08Rik, FAS}, Ifng (interferon gamma) [NCBI Gene 15978] {aka IFN-g, If2f, Ifg}, Ccar2 (cell cycle activator and apoptosis regulator 2) [NCBI Gene 219158] {aka 2610301G19Rik, Dbc1, mKIAA1967}, Srebf1 (sterol regulatory element binding transcription factor 1) [NCBI Gene 20787] {aka ADD1, SREBP1, bHLHd1}, Pkm (pyruvate kinase, muscle) [NCBI Gene 18746] {aka Pk-2, Pk-3, Pk3, Pkm2}, Ptprj (protein tyrosine phosphatase receptor type J) [NCBI Gene 19271] {aka BET, Byp, CD148, DEP-1, PTPbeta2, Ptpb2}, Foxo1 (forkhead box O1) [NCBI Gene 56458] {aka Afxh, FKHR, Fkhr1, Foxo1a}, Atg4b (autophagy related 4B, cysteine peptidase) [NCBI Gene 66615] {aka 2510009N07Rik, Apg4b, Atg4bl, Autl1, MmAPG4B}, Map1lc3b (microtubule-associated protein 1 light chain 3 beta) [NCBI Gene 67443] {aka 1010001C15Rik, Atg8, LC3b, MAP1A/MAP1B, Map1lc3}, Sp1 (trans-acting transcription factor 1) [NCBI Gene 20683] {aka 1110003E12Rik, Sp1-1}, Itgax (integrin alpha X) [NCBI Gene 16411] {aka Cd11c, Cr4, N418}, Hk2 (hexokinase 2) [NCBI Gene 15277] {aka HKII}, Arnt (aryl hydrocarbon receptor nuclear translocator) [NCBI Gene 11863] {aka D3Ertd557e, Drnt, ESTM42, Hif1b, bHLHe2, mKIAA4051}, Ldha (lactate dehydrogenase A) [NCBI Gene 16828] {aka Ldh1, Ldhm, l7R2}, Tnfrsf9 (tumor necrosis factor receptor superfamily, member 9) [NCBI Gene 21942] {aka 4-1BB, A930040I11Rik, CDw137, Cd137, ILA, Ly63}, Nedd4 (neural precursor cell expressed, developmentally down-regulated 4) [NCBI Gene 17999] {aka E430025J12Rik, EG639396, Gm7265, KIAA0093, Nedd4-1, Nedd4a}, Mtor (mechanistic target of rapamycin kinase) [NCBI Gene 56717] {aka 2610315D21Rik, FRAP, FRAP2, Frap1, RAFT1, RAPT1}, Hif1a (hypoxia inducible factor 1, alpha subunit) [NCBI Gene 15251] {aka HIF-1-alpha, HIF1-alpha, HIF1alpha, MOP1, bHLHe78}, Sumo1 (small ubiquitin-like modifier 1) [NCBI Gene 22218] {aka GMP1, PIC1, SENTRIN, SMT3, SMT3H3, SMTP3}, Btg2 (BTG anti-proliferation factor 2) [NCBI Gene 12227] {aka APRO1, Pc3, TIS21}, Slc2a1 (solute carrier family 2 (facilitated glucose transporter), member 1) [NCBI Gene 20525] {aka GT1, Glut-1, Glut1, M100200, Rgsc200}, Atg7 (autophagy related 7) [NCBI Gene 74244] {aka 1810013K23Rik, Agp7, Apg7l, Atg7l, Gm21553}, Satb1 (special AT-rich sequence binding protein 1) [NCBI Gene 20230] {aka 2610306G12Rik}, COX1 (cytochrome c oxidase subunit I) [NCBI Gene 17708] {aka CoxI}, Becn1 (beclin 1, autophagy related) [NCBI Gene 56208] {aka Atg6}, Ep300 (E1A binding protein p300) [NCBI Gene 328572] {aka A430090G16, A730011L11, KAT3B, p300, p300 HAT}, Cd274 (CD274 antigen) [NCBI Gene 60533] {aka A530045L16Rik, B7h1, Pdcd1l1, Pdcd1lg1, Pdl1}, Atg5 (autophagy related 5) [NCBI Gene 11793] {aka 2010107M05Rik, 3110067M24Rik, Apg5l, Atg5l, Paddy}, Pdk1 (pyruvate dehydrogenase kinase, isoenzyme 1) [NCBI Gene 228026] {aka B830012B01, D530020C15Rik}, MYC (MYC proto-oncogene, bHLH transcription factor) [NCBI Gene 4609] {aka MRTL, MYCC, bHLHe39, c-Myc}, Tgfb1 (transforming growth factor, beta 1) [NCBI Gene 21803] {aka TGF-beta1, TGFbeta1, Tgfb, Tgfb-1}, Pdha1 (pyruvate dehydrogenase E1 alpha 1) [NCBI Gene 18597] {aka Pdha-1}, Cxcl10 (C-X-C motif chemokine ligand 10) [NCBI Gene 15945] {aka C7, CRG-2, INP10, IP-10, IP10, Ifi10}, Nfkb1 (nuclear factor of kappa light polypeptide gene enhancer in B cells 1, p105) [NCBI Gene 18033] {aka NF-KB1, NF-kappaB, NF-kappaB1, p105, p50, p50/p105}, G6pd2 (glucose-6-phosphate dehydrogenase 2) [NCBI Gene 14380] {aka G6pdx-ps1, Gpd-2, Gpd2}, LDHA (lactate dehydrogenase A) [NCBI Gene 3939] {aka GSD11, HEL-S-133P, LDHM, PIG19}, ND6 (NADH dehydrogenase subunit 6) [NCBI Gene 17722]
- **Diseases:** HCC (MESH:D006528), metabolic diseases (MESH:D008659), DLBCL (MESH:D016403), renal ischemia reperfusion injury (MESH:D007511), acute myeloid leukemia (MESH:D015470), neuroblastoma (MESH:D009447), NSCLC (MESH:D002289), hypoxia (MESH:D000860), hypoxic (MESH:D002534), metabolic toxicity (MESH:D065606), cholangiocarcinoma (MESH:D018281), tumorigenesis (MESH:D063646), ovarian cancer (MESH:D010051), liver failure (MESH:D017093), fibrosarcoma (MESH:D005354), Tumor (MESH:D009369), von hippel-lindau (MESH:D006623), cytotoxicity (MESH:D064420), metastasis (MESH:D009362), PGAMs (MESH:C536176), melanoma (MESH:D008545), fibrosis (MESH:D005355), cervical cancer (MESH:D002583), endometrial cancer (MESH:D016889), tumorigenic (MESH:D002471), pancreatic cancer (MESH:D010190), colorectal cancer (MESH:D015179)
- **Chemicals:** resveratrol (MESH:D000077185), NAD+ (MESH:D009243), cycloheximide (MESH:D003513), cholesterol (MESH:D002784), glucose (MESH:D005947), AC-93253 (MESH:C542662), 2-PG (MESH:C008885), ROS (MESH:D017382), sirtinol (MESH:C439060), ATP (MESH:D000255), Salermide (MESH:C539427), SirReal2 (MESH:C000609012), citrate (MESH:D019343), phosphoenolpyruvate (MESH:D010728), 3-PG (MESH:C005156), lipid (MESH:D008055), acetyl-CoA (MESH:D000105), 6-phosphogluconate (MESH:C008884), lactate (MESH:D019344), amino acid (MESH:D000596), histidine (MESH:D006639), NADPH (MESH:D009249), G6P (MESH:D019298), DATS (MESH:C042577), fatty acid (MESH:D005227), pentose phosphate (MESH:D010428), TCA (MESH:D014233), rapamycin (MESH:D020123), TM (MESH:D013932), pyruvate (MESH:D019289), cisplatin (MESH:D002945), BioRender (-), dichloroacetic acid (MESH:D003999), Bou (MESH:C000607206), Adriamycin (MESH:D004317), EX-527 (MESH:C550547), oxygen (MESH:D010100)
- **Species:** Gallus gallus (bantam, species) [taxon 9031], Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]
- **Mutations:** K403Q, K323R, serine/threonine, Lys323, Lys403
- **Cell lines:** Th9 — Homo sapiens (Human), Transformed cell line (CVCL_8306), HeLa — Homo sapiens (Human), Human papillomavirus-related endocervical adenocarcinoma, Cancer cell line (CVCL_0030), Hep3B — Homo sapiens (Human), Childhood hepatocellular carcinoma, Cancer cell line (CVCL_0326), Nalm-6 — Homo sapiens (Human), Adult B acute lymphoblastic leukemia, Cancer cell line (CVCL_0092), DT40 — Gallus gallus (Chicken), Chicken bursal lymphoma, Cancer cell line (CVCL_0249), SK-Hep-1 — Homo sapiens (Human), Liver and intrahepatic bile duct epithelial neoplasm, Cancer cell line (CVCL_0525), HEK293T — Homo sapiens (Human), Transformed cell line (CVCL_0063), SiHa — Homo sapiens (Human), Human papillomavirus-related cervical squamous cell carcinoma, Cancer cell line (CVCL_0032), MEFs — Mus musculus (Mouse), Finite cell line (CVCL_9115), HepG2 — Homo sapiens (Human), Hepatoblastoma, Cancer cell line (CVCL_0027), HT1080 — Homo sapiens (Human), Fibrosarcoma, Cancer cell line (CVCL_0317)

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12965217/full.md

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Source: https://tomesphere.com/paper/PMC12965217