PI3K/AKT/mTOR signaling

The PI3K/AKT, mTOR and PTEN pathways are interconnected cellular signaling components that regulate many cellular processes like growth, proliferation, survival, metabolism and more. The dysregulation of one pathway often impacts the others with profound implications, such as in cancer biology.

The Harmony of Cellular Regulation: Exploring the PI3K/AKT/mTOR and PTEN Dynamics

Cells use a complex intracellular signaling system to interpret and respond to various signals or stimuli. This intricate communication system involves pathways of molecular events inside of cells that enable them to react to cues from other cells, their environment or even from within the cells themselves. Among the myriad of pathways involved in intracellular signaling, the PI3K/AKT, mTOR and PTEN pathways are particularly pivotal. These pathways not only play central roles in regulating cell growth, survival and metabolism but are also frequently implicated in various diseases, including cancer.

PI3K/AKT Signaling

The PI3K/AKT pathway is a vital communication route within cells, directing their responses based on signals from their surroundings. These responses can range from determining when to grow and divide to adjusting to changes in nutrient availability. Such signals guide cells in maintaining balance and ensuring proper function.

Activation and Role of PI3K

The PI3K/AKT pathway can become activated in response to various stimuli, particularly when growth factors bind to their specific receptors on a cell's surface such as when insulin binds the insulin receptor to affect glucose metabolism. A key step in this cascade is the activation of PI3K, which then produces PIP3 (phosphatidylinositol (3,4,5)-trisphosphate), a phospholipid messenger. The presence of PIP3 in the cell membrane acts as a beacon, signaling for the activation of AKT and further propelling the cascade.

AKT – The Central Coordinator

At the heart of the PI3K/AKT pathway lies AKT (also referred to as protein kinase B or PKB). This serine/threonine kinase serves as a central coordinator, receiving signals and ensuring that the cell responds appropriately to maintain health and balance. Once activated, AKT goes on to influence a multitude of processes within the cell.

For instance, AKT plays a pivotal role in promoting cell survival by inhibiting pro-apoptotic proteins such as Bad, Bax and caspase 9. The inhibition of these proteins by AKT is essential because cells often face stresses, like DNA damage or oxidative stress, which might push them towards apoptosis. AKT acts as a safeguard, determining if a cell should recover or undergo apoptosis, ensuring cells don't hastily self-destruct when they can still recover.

Furthermore, AKT is instrumental in regulating the cell cycle. It interacts with key cell cycle regulators like cyclin D1 and p27Kip1 (cyclin-dependent kinase inhibitor 1B), ensuring a balance between cell proliferation and growth arrest. On the metabolic front, AKT not only aids in the uptake and utilization of glucose but also modulates lipid metabolism. This influence on both glucose and lipid processes makes AKT especially relevant in conditions like diabetes, where metabolic balance is disrupted.

PTEN – The Guardian of the PI3K/AKT Pathway

PTEN (phosphatase and tensin homolog) acts as a critical regulator, ensuring that the PI3K/AKT pathway's activities are kept in check. Its primary function is to counteract PI3K's actions. While PI3K promotes the production of PIP3, which activates AKT, PTEN dephosphorylates PIP3, converting it back to PIP2, thereby dampening AKT activation.

PTEN's inhibition of the PI3K/AKT pathway is pivotal for controlling cell growth and survival. Often referred to as a tumor suppressor, PTEN prevents cells from growing and dividing too rapidly or in an uncontrolled way. Dysfunctional PTEN, due to its reduced activity or absence, can lead to unchecked AKT activation, fostering excessive cell survival and proliferation. Such scenarios are often linked to tumor growth. For instance, PTEN mutations have been identified in many advanced prostate cancers, emphasizing its protective role against cancer progression.

Regulation of PTEN

The activity and stability of PTEN are intricately regulated within the cell, ensuring that it functions optimally in response to changing cellular conditions. Post-translational modifications play a role in modulating its function. For instance, phosphorylation of PTEN can decrease its activity, acting as a regulatory switch that fine-tunes its tumor-suppressive functions. On the other hand, ubiquitination can target PTEN for degradation, affecting its levels within the cell. Additionally, PTEN's localization within the cell, shifting between the cytoplasm and the nucleus, can influence its diverse roles, from controlling cell growth to maintaining DNA integrity.

PTEN and Other Pathways

Beyond its central role in the PI3K/AKT pathway, PTEN interacts with and influences other pathways, including the MAPK/ERK pathway and the Wnt/β-catenin signaling pathway. It aids in maintaining chromosomal stability, participates in DNA repair processes and has been implicated in cell migration and adhesion through its interactions with the FAK-Paxillin pathway. These diverse interactions underscore PTEN's multifaceted role in ensuring cellular health and function.

mTOR – The Master Growth Regulator

mTOR (mechanistic target of rapamycin) is a pivotal protein kinase that orchestrates cell growth, proliferation and survival. As a master regulator, it determines whether cells grow and divide or conserve their resources, in response to a myriad of cues, including nutrient availability, energy status and growth factors. Activation signals from the PI3K/AKT pathway, such as those triggered by insulin or other growth factors, play a significant role in modulating mTOR's activity.

mTOR and its Regulatory Complexes

mTOR operates through two distinct complexes: mTORC1 and mTORC2. mTORC1 is particularly sensitive to nutrient availability, especially amino acids. When nutrients are abundant, mTORC1 is activated, promoting protein synthesis, ribosome biogenesis and nutrient uptake, thereby driving cell growth and proliferation. This activation is kept in check by the TSC1/2 complex (tuberous sclerosis complex 1 and 2), a critical negative regulator of mTORC1. When growth factors are low or cellular energy is compromised, the TSC1/2 complex inhibits mTORC1, ensuring cellular resources are conserved. However, signals from the PI3K/AKT pathway can inhibit the TSC1/2 complex, leading to mTORC1 activation. In contrast, when nutrients are scarce, mTORC1 activity diminishes, pushing cells into a conservation mode.

Though not as well-understood, mTORC2 plays roles in controlling the actin cytoskeleton and is crucial for the full activation of AKT, linking it to the broader PI3K/AKT signaling pathway.

Interplay Between PI3K/AKT and mTOR

The PI3K/AKT pathway directly influences mTOR, especially mTORC1. AKT can promote mTORC1 activity, leading to increased protein synthesis and cell growth. Conversely, PTEN, by inhibiting the PI3K/AKT pathway, can indirectly suppress mTOR activity, emphasizing the interconnectedness of these pathways.

Impact on Human Health and Therapeutic Potential

The PI3K/AKT, mTOR, and PTEN pathways are integral to human health, influencing a range of diseases, especially cancer. Dysregulation, such as overactivation of the PI3K/AKT pathway due to PTEN dysfunction, can drive tumor growth and resistance to therapies. Similarly, aberrant mTOR signaling has been linked to metabolic disorders and neurodevelopmental diseases like autism and epilepsy.

A deep understanding of these pathways paves the way for therapeutic interventions. Drugs like rapamycin, which targets mTOR, and inhibitors for PI3K and AKT are in clinical use or trials, offering hope for enhanced disease management. Given mTOR's pivotal role in cellular processes, its dysfunction is a prime target for therapeutic interventions. The sensitivity of mTORC1 to rapamycin is utilized in treatments, including organ transplant rejection prevention and cancer therapies. Moreover, mTOR inhibitors are being researched for treating conditions like tuberous sclerosis, a rare genetic disorder that causes non-malignant tumors to grow in various parts of the body, and aggressive cancers, further highlighting its promise as a therapeutic target.

Further Reading

Altomare DA, Khaled AR. Homeostasis and the importance for a balance between AKT/mTOR activity and intracellular signaling. Curr Med Chem. 2012;19(22):3748-62. doi: 10.2174/092986712801661130.

Miricescu D, Totan A, Stanescu-Spinu II, Badoiu SC, Stefani C, Greabu M. PI3K/AKT/mTOR Signaling Pathway in Breast Cancer: From Molecular Landscape to Clinical Aspects. Int J Mol Sci. 2020 Dec 26;22(1):173. doi: 10.3390/ijms22010173.

Ortega MA, Fraile-Martínez O, Asúnsolo Á, Buján J, García-Honduvilla N, Coca S. Signal Transduction Pathways in Breast Cancer: The Important Role of PI3K/Akt/mTOR. J Oncol. 2020 Mar 9;2020:9258396. doi: 10.1155/2020/9258396. PMID: 32211045; PMCID: PMC7085392.

Papa A, Pandolfi PP. The PTEN-PI3K Axis in Cancer. Biomolecules. 2019 Apr 17;9(4):153. doi: 10.3390/biom9040153. PMID: 30999672.

Porta C, Paglino C, Mosca A. Targeting PI3K/Akt/mTOR Signaling in Cancer. Front Oncol. 2014 Apr 14;4:64. doi: 10.3389/fonc.2014.00064.