Seyfried · iScience 2020 · narrative review · n=?

On the Origin of ATP Synthesis in Cancer.

Level 5 - mechanism / opinion, no new human data

Narrative review and theoretical biochemical framework with no primary human data.

PubMed 33251492 · doi:10.1016/j.isci.2020.101761 · record verified 2026-08-26

What was done

This paper is a narrative theoretical review examining bioenergetic mechanisms of ATP synthesis in cancer cells, focusing on oxidative phosphorylation impairment, glycolytic dynamics, and mitochondrial substrate-level phosphorylation.

What was found

The abstract reports no empirical clinical or experimental data. It outlines a mechanistic model where mitochondrial anomalies impair oxidative phosphorylation and dimeric pyruvate kinase M2 limits glycolytic ATP production. Under this framework, mitochondrial substrate-level phosphorylation via the glutamine-driven succinate-CoA ligase reaction compensates for ATP deficits to sustain the standard ATP hydrolysis free energy of -56 kJ/mole, driving proliferation and apoptotic resistance.

Why it matters

It highlights mitochondrial substrate-level phosphorylation as a potential critical driver of cancer cell energetics and rationalizes dual dietary or metabolic targeting of glucose and glutamine.

Limits

This is a conceptual review presenting mechanism-based reasoning without primary experimental measurements, sample sizes, or clinical trial data reported in the abstract.

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