Grp78 is required for intestinal Kras-dependent glycolysis proliferation and adenomagenesis

In development of colorectal cancer, mutations in APC are often followed by mutations in oncogene KRAS. The latter changes cellular metabolism and is associated with the Warburg phenomenon. Glucose-regulated protein 78 (Grp78) is an important regulator of the protein-folding machinery, involved in processing and localization of transmembrane proteins. We hypothesize that targeting Grp78 in Apc and Kras (AK)-mutant intestines interferes with the metabolic phenotype imposed by Kras mutations. In mice with intestinal epithelial mutations in Apc, Kras(G12D) and heterozygosity for Grp78 (AK-Grp78(HET)) adenoma number and size is decreased compared with AK-Grp78(WT) mice. Organoids from AK-Grp78(WT) mice exhibited a glycolysis metabolism which was completely rescued by Grp78 heterozygosity. Expression and correct localization of glucose transporter GLUT1 was diminished in AK-Grp78(HET) cells. GLUT1 inhibition restrained the increased growth observed in AK-mutant organoids, whereas AK-Grp78(HET) organoids were unaffected. We identify Grp78 as a critical factor in Kras-mutated adenomagenesis. This can be attributed to a critical role for Grp78 in GLUT1 expression and localization, targeting glycolysis and the Warburg effect.