Metabolomic profiling reveals grade-specific niacinamide accumulation and its therapeutic Potential via SIRT1-CD38-EMT axis modulation in cervical cancer progression

Abstract

Despite the availability of new therapies for cervical cancer, innovative strategies are essential to address challenges related to drug resistance and high toxicity. The present study focuses on the metabolic profiling of cervical carcinoma using non-targeted metabolomics approach using liquid chromatography-mass spectrometry. Our study identified over 100 metabolites in cervical tissue samples (both cancerous and adjacent normal) using HILIC and reversed-phase chromatography in the positive and negative ionization modes. The major metabolic alterations included changes in glycolysis, the citric acid cycle, amino acid metabolism, nucleotide metabolism, and nicotinamide metabolism in a grade-dependent manner. Interestingly, metabolic differences between HPV-positive and HPV-negative tumors included elevated arginine and proline metabolism, nicotinamide metabolism, and phosphatidylcholine biosynthesis. We further validated our findings by analyzing transcriptomics datasets from the Gene Expression Omnibus database to understand the expression patterns of the underlying genes involved in the dysregulated pathways. We observed that nicotinamide metabolism exhibits significant effects in lower-grade cervical cancers and specific HPV genotypes. We treated cervical cancer cell lines with niacinamide (NAM), an amide form of niacin, to evaluate its potential therapeutic efficacy. NAM treatment modulated NAD+ metabolism with key players such as CD38, PARP, NAMPT, and SIRT1, promoting apoptosis and inhibiting cell proliferation in cervical cancer cells. Importantly, the metabolic responses differed between the HPV-positive SiHa cells and HPV-negative C33A cells, reflecting distinct NAD+ metabolic adaptations. The study highlights the metabolic adaptation or shifts in cancer progression and provides insights into NAMs molecular mechanisms and therapeutic potential for precision medicine in cervical cancer.