# NHE1-Mediated Metabolic Reprogramming in Cancer

**Authors:** Majd A. Al-Hamaly, Beau R. Forester, Jessica S. Blackburn

PMC · DOI: 10.3390/metabo16030195 · 2026-03-15

## TL;DR

This paper reviews how NHE1, a transporter protein, influences cancer cell metabolism and could be a target for new cancer therapies.

## Contribution

The paper synthesizes emerging evidence on NHE1's role in metabolic reprogramming and evaluates its therapeutic potential.

## Key findings

- NHE1 influences cancer metabolism by regulating intracellular pH and the tumor microenvironment.
- NHE1 impacts mitochondrial function, glycolytic flux, and stress pathways in cancer cells.
- Pharmacological targeting of NHE1 shows promise but faces clinical translation challenges.

## Abstract

The sodium–hydrogen exchanger-1 (NHE1) is a ubiquitously expressed transmembrane transporter that plays a central role in maintaining intracellular pH homeostasis and supporting normal cellular function. In cancer, NHE1 is overexpressed in many tumor types and has been associated with increased cancer cell metastasis and proliferation. Beyond these established roles, emerging evidence implicates NHE1 as a regulator of cancer cell metabolism. By driving intracellular alkalinization and shaping the tumor microenvironment, NHE1 influences metabolic pathway activity, mitochondrial function, redox balance, and cellular stress responses. In this review, we synthesize current evidence linking NHE1 dysregulation to metabolic reprogramming in cancer, with a focus on mitochondrial metabolism, glycolytic flux, lysosomal biology, and reactive oxygen species-associated stress pathways. We further evaluate pharmacological strategies targeting NHE1, emphasizing their metabolic consequences, translational potential, and the challenges that have limited clinical application to date. Collectively, this review highlights NHE1 as a potential integrator of ion transport and metabolic control in cancer and discusses how targeting NHE1-driven metabolic programs may support the development of novel therapeutic strategies.

## Linked entities

- **Genes:** SLC9A1 (solute carrier family 9 member A1) [NCBI Gene 6548]
- **Diseases:** cancer (MONDO:0004992)

## Full-text entities

- **Genes:** CDH1 (cadherin 1) [NCBI Gene 999] {aka Arc-1, BCDS1, CD324, CDHE, ECAD, LCAM}, TKT (transketolase) [NCBI Gene 7086] {aka HEL-S-48, HEL107, SDDHD, TK, TKT1}, Slc9a1 (solute carrier family 9 (sodium/hydrogen exchanger), member 1) [NCBI Gene 20544] {aka Apnh, Mir5122, Nhe1, mir-5122, swe}, CCL25 (C-C motif chemokine ligand 25) [NCBI Gene 6370] {aka Ck beta-15, Ckb15, SCYA25, TECK, TECKvar}, EGF (epidermal growth factor) [NCBI Gene 1950] {aka HOMG4, URG}, SLC16A3 (solute carrier family 16 member 3) [NCBI Gene 9123] {aka MCT 3, MCT 4, MCT-3, MCT-4, MCT3, MCT4}, CCND1 (cyclin D1) [NCBI Gene 595] {aka BCL1, D11S287E, PRAD1, U21B31}, Hk2 (hexokinase 2) [NCBI Gene 15277] {aka HKII}, SLC9A9 (solute carrier family 9 member A9) [NCBI Gene 285195] {aka AUTS16, NHE9}, EZR (ezrin) [NCBI Gene 7430] {aka CVIL, CVL, HEL-S-105, VIL2}, LAMP1 (lysosome associated membrane protein 1) [NCBI Gene 3916] {aka CD107a, LAMPA, LGP120}, MAPK8 (mitogen-activated protein kinase 8) [NCBI Gene 5599] {aka JNK, JNK-46, JNK1, JNK1A2, JNK21B1/2, PRKM8}, SLC9A1 (solute carrier family 9 member A1) [NCBI Gene 6548] {aka APNH, LIKNS, NHE-1, NHE1, PPP1R143}, EGF (epidermal growth factor) [NCBI Gene 397083], Akt1 (Akt serine/threonine kinase 1) [NCBI Gene 11651] {aka Akt, LTR-akt, PKB, PKB/Akt, PKBalpha, Rac}, CCNB1 (cyclin B1) [NCBI Gene 891] {aka CCNB}, SLC8A1 (solute carrier family 8 member A1) [NCBI Gene 6546] {aka NCX1}, Slc2a1 (solute carrier family 2 (facilitated glucose transporter), member 1) [NCBI Gene 20525] {aka GT1, Glut-1, Glut1, M100200, Rgsc200}, GAPDH (glyceraldehyde-3-phosphate dehydrogenase) [NCBI Gene 2597] {aka G3PD, GAPD, HEL-S-162eP}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, EGFR (epidermal growth factor receptor) [NCBI Gene 397070], MMP14 (matrix metallopeptidase 14) [NCBI Gene 397471] {aka MT1-MMP}, LAMC2 (laminin subunit gamma 2) [NCBI Gene 3918] {aka B2T, BM600, CSF, EBR2, EBR2A, JEB3A}, SLC9A2 (solute carrier family 9 member A2) [NCBI Gene 6549] {aka NHE2}, ENO1 (enolase 1) [NCBI Gene 2023] {aka ENO1-IT1, ENO1L1, HEL-S-17, MPB1, NNE, PPH}, CX3CR1 (C-X3-C motif chemokine receptor 1) [NCBI Gene 1524] {aka CCRL1, CMKBRL1, CMKDR1, GPR13, GPRV28, V28}, SLC24A3 (solute carrier family 24 member 3) [NCBI Gene 57419] {aka NCKX3}, Slc9a1 (solute carrier family 9 member A1) [NCBI Gene 24782] {aka Nhe1}, MAPK1 (mitogen-activated protein kinase 1) [NCBI Gene 5594] {aka ERK, ERK-2, ERK2, ERT1, MAPK2, NS13}, TFE3 (transcription factor binding to IGHM enhancer 3) [NCBI Gene 7030] {aka MRXSPF, RCCP2, RCCX1, TFEA, bHLHe33}, PLAU (plasminogen activator, urokinase) [NCBI Gene 5328] {aka ATF, BDPLT5, QPD, UPA, URK, u-PA}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, SLC9C1 (solute carrier family 9 member C1) [NCBI Gene 285335] {aka NHE, NHE-10, SLC9A10, sperm-NHE}, SLC9A1 (solute carrier family 9 member A1) [NCBI Gene 397458] {aka NHE1}, PCNA (proliferating cell nuclear antigen) [NCBI Gene 5111] {aka ATLD2}, Il9 (interleukin 9) [NCBI Gene 16198] {aka Il-9, P40}, VIM (vimentin) [NCBI Gene 7431], PDCD1 (programmed cell death 1) [NCBI Gene 100533201], NHERF1 (NHERF family PDZ scaffold protein 1) [NCBI Gene 9368] {aka EBP50, NHE-RF, NHERF, NHERF-1, NPHLOP2, SLC9A3R1}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}
- **Diseases:** hypertension (MESH:D006973), benign lesions (MESH:D001932), congestive heart failure (MESH:D006333), breast cancer (MESH:D001943), Ovarian cancer (MESH:D010051), hematologic malignancies (MESH:D019337), Non-obese diabetic/severe combined immunodeficiency (MESH:D009767), inflammatory (MESH:D007249), CML (MESH:D015464), cardiac arrhythmias (MESH:D001145), T-ALL (MESH:D054218), mesothelioma (MESH:D008654), Glioma (MESH:D005910), SCID (MESH:D053632), NOD (MESH:D020191), Cancer (MESH:D009369), cytotoxic (MESH:D064420), Gastric cancer (MESH:D013274), ESCC (MESH:D000077277), colon cancer (MESH:D015179), mitochondrial damage (MESH:D028361), Epithelial ovarian cancer (MESH:D000077216), pancreatic cancer (MESH:D010190), acidosis (MESH:D000138), MM (MESH:D009101), injury to (MESH:D014947), AML (MESH:D015470), metastasis (MESH:D009362), leukemic (MESH:D007938), tumorigenesis (MESH:D063646)
- **Chemicals:** pyruvate (MESH:D019289), 5-(N,N-hexamethylene)amiloride (MESH:C057360), tetracycline (MESH:D013752), GAMs (MESH:C042626), ATP (MESH:D000255), erlotinib (MESH:D000069347), pyrazine (MESH:D011719), glucose (MESH:D005947), venetoclax (MESH:C579720), cytarabine (MESH:D003561), Na+ (MESH:D012964), HOE642 (MESH:C093373), eniporide (MESH:C118397), N-acetylcysteine (MESH:D000111), proton (MESH:D011522), ROS (MESH:D017382), ribose (MESH:D012266), TMZ (MESH:D000077204), 5-(N-ethyl-N-isopropyl)amiloride (MESH:C039614), carfilzomib (MESH:C524865), K+ (MESH:D011188), TCA (MESH:D014238), phosphocreatine (MESH:D010725), 2-NBDG (MESH:C098340), guanidine (MESH:D019791), DMA (MESH:C405765), 5-(N,N-dimethyl)amiloride (MESH:C039465), Cr (MESH:D002857), H+ (MESH:D006859), Phenoxazine (MESH:C039203), 5'-benzylglycinyl-amiloride (MESH:C584412), creatine (MESH:D003401), HMA (-), oxygen (MESH:D010100), fatty acid (MESH:D005227), Carbon (MESH:D002244), lactate (MESH:D019344), paclitaxel (MESH:D017239), Amiloride (MESH:D000584)
- **Species:** Sus scrofa (pig, species) [taxon 9823], Oryctolagus cuniculus (domestic rabbit, species) [taxon 9986], Rattus norvegicus (brown rat, species) [taxon 10116], Homo sapiens (human, species) [taxon 9606], Mus musculus (house mouse, species) [taxon 10090]
- **Cell lines:** SGC-7901 — Homo sapiens (Human), Human papillomavirus-related endocervical adenocarcinoma, Cancer cell line (CVCL_0520), MDA-MB-231 — Homo sapiens (Human), Breast adenocarcinoma, Cancer cell line (CVCL_0062), TE2 — Homo sapiens (Human), Esophageal squamous cell carcinoma, Cancer cell line (CVCL_4455), MOLT-4 — Homo sapiens (Human), Adult T acute lymphoblastic leukemia, Cancer cell line (CVCL_0013), RPMI-8226 — Homo sapiens (Human), Plasma cell myeloma, Cancer cell line (CVCL_0014), SKOV3 — Homo sapiens (Human), Ovarian serous cystadenocarcinoma, Cancer cell line (CVCL_0532), TE5 — Homo sapiens (Human), Esophageal squamous cell carcinoma, Cancer cell line (CVCL_1764), OVCAR-3 — Homo sapiens (Human), High grade ovarian serous adenocarcinoma, Cancer cell line (CVCL_0465), NIH3T3 — Mus musculus (Mouse), Spontaneously immortalized cell line (CVCL_0594), THP-1 — Homo sapiens (Human), Childhood acute monocytic leukemia, Cancer cell line (CVCL_0006), Kasumi-1 — Homo sapiens (Human), Childhood acute myeloid leukemia with maturation, Cancer cell line (CVCL_0589), KG-1alpha — Homo sapiens (Human), Acute myeloid leukemia without maturation, Cancer cell line (CVCL_1824), GL26 — Rattus norvegicus (Rat), Transformed cell line (CVCL_8806), MKN-45 — Homo sapiens (Human), Gastric adenocarcinoma, Cancer cell line (CVCL_0434), 3AO — Homo sapiens (Human), Ovarian mucinous cystadenocarcinoma, Cancer cell line (CVCL_C6VI), Th9 — Homo sapiens (Human), Transformed cell line (CVCL_8306), LS174 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_1384), A2780 — Homo sapiens (Human), Ovarian endometrioid adenocarcinoma, Cancer cell line (CVCL_0134), MV4-11 — Homo sapiens (Human), Childhood acute monocytic leukemia, Cancer cell line (CVCL_0064), MOLM13 — Homo sapiens (Human), Adult acute monocytic leukemia, Cancer cell line (CVCL_2119)

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC13027589/full.md

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Source: https://tomesphere.com/paper/PMC13027589