# The Role of Mortalin in Thyroid Cancer

> **NIH NIH R01** · MEDICAL COLLEGE OF WISCONSIN · 2024 · $409,836

## Abstract

The goal of this project is to elucidate the mechanism by which mortalin is upregulated in thyroid cancer,
determine the role of mortalin for tumor cell metabolism, and evaluate the potential of the metabolic
processes that mortalin regulates as a therapeutic target. Metabolic reprogramming in the processes of
energy and building block production is critical for tumor development and maintenance, but is associated
with the risk of a lethal metabolic stress. It is therefore conceivable that malignant tumor cells might have
successfully developed a protective mechanism in this context. If identified, such a mechanism may be
targeted to unleash a death signal in tumor cells. We previously demonstrated that depletion of mortalin
(GRP75/HSPA9), a molecular chaperone in the HSP70 family, causes lethal bioenergetic and oxidative
stress in tumor cells, proposing that mortalin upregulation is a mechanism to protect tumor cells from a
metabolic stress. Current understanding of the role of mortalin and its regulation is very limited in thyroid
cancer, which is a metabolically active tumor. Our analysis of the TCGA RNAseq dataset revealed that a
thyroid cancer-specific correlation exists between mortalin and ESRRA, an orphan transcription factor that
regulates metabolic reprogramming. In our preliminary study, ESRRA depletion downregulated mortalin
expression and induced cell death in different thyroid tumor cell lines, while this lethality was substantially
abrogated by mortalin overexpression. These data led us to hypothesize that ESRRA is a tumor type-
specific transcription factor that mediates mortalin overexpression in thyroid cancer and that mortalin is
necessary for ESRRA to regulate thyroid tumor cell metabolism. Our metabolome analysis suggests that
mortalin knockdown markedly depletes acetyl-CoA and its precursors in the context of the reductive TCA
cycle, while increasing lactate and glucose. Moreover, depletion of ATP-citrate lyase (ACL), the enzyme
that synthesizes cytosolic acetyl-CoA from citrate produced through the reductive TCA cycle, induced
similar lethal effects as mortalin depletion whereas overexpression of pyruvate kinase M2 (PKM2), the
enzyme that produces pyruvate to often facilitate the Warburg effect, conferred tolerance to mortalin
depletion. Based upon these data, we further hypothesize that mortalin regulates the interplay between the
Warburg effect and the reductive TCA cycle to facilitate cytosolic acetyl-CoA production. By extension, we
predict that ACL inhibition is a promising strategy to suppress mortalin-dependent thyroid tumor cells and
can be effectively combined with glycolysis inhibition. To test these hypotheses, Aim 1 will determine how
ESRRA regulates mortalin transcription and examine their correlated expression and functional relationship
in different thyroid tumor subtypes. Aim 2 will determine how mortalin regulates the interplay between
glycolysis and the reductive TCA cycle to facilitate cytosolic acetyl-Co...

## Key facts

- **NIH application ID:** 10884160
- **Project number:** 5R01CA269452-02
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Jong-In Park
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $409,836
- **Award type:** 5
- **Project period:** 2023-07-10 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10884160

## Citation

> US National Institutes of Health, RePORTER application 10884160, The Role of Mortalin in Thyroid Cancer (5R01CA269452-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10884160. Licensed CC0.

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