Cancer cells take advantage of glutamine metabolism and autophagy/mitophagy activation to survive the harsh tumor microenvironment [
27,
32,
43] Moreover, cancer cells concentrate inorganic phosphate in the tumor microenvironment to sustain their rapid growth [
20] as well as to increase the activity of mitochondrial glutaminase, the first enzyme in glutamine metabolic pathway [
17]. Recently, we have shown that mitochondrial glutaminase activity can be influenced by Sirtuin 5 [
27]. In this direction, our present results indicate that the use of a selective activator of Sirtuin 5, called MC3138, alone or in association with a phosphate binder such as lanthanum acetate, can reduce cell viability, colonies formation and mitophagy of breast and thyroid cancer cells. The use of cell lines from two different tumors evidenced a different response to the treatments. In fact, MDA-MB-231 cells show a higher increase in cell death and decrease in colony formation than CAL-62 cells (
Figure 1,
Figure 2,
Figure 3 and
Figure 4). The anti-tumoral effects of MC3138 and lanthanum acetate were observed after 24h in breast cancer cells and after 48h in thyroid cancer cells (
Figure 1). Glutaminase 1 silencing significantly reduced colony formation in both MDA-MB-231 and CAL-62 cells (
Figure 3). It is important to point out that, to date, inorganic phosphate is considered as a critical metabolic molecule that increases cell viability and the formation of metastases and literature suggests that it may be a possible predictive marker in the case of breast cancer. In fact, inorganic phosphate is six times more concentrated in the tumor microenvironment and for this reason, its presence could be used as a tumor marker as well as a predictive microscopic molecular biomarker for the assessment of the relative risk of malignant transformation of pretumor lesions [
20]. Our results confirm the important role of inorganic phosphate for tumor survival and growth and suggest that lanthanum or other chelators could be used to reduce the presence of inorganic phosphate in the tumor. Phosphate chelation, however, raises the problem related to a systemic reduction of inorganic phosphate. Recently, Qiu-Chen et al., proposed a new technique for the administration of a phosphate binder, called "transarterial sevelamer embolization (TASE)". This technique not only occludes the tumor-feeding vessel, but simultaneously deplete intratumoral inorganic phosphate (Pi), thereby inducing severe necrosis as well reducing metastasis formation and recurrence in liver cancer [
44]. We also evaluated the expression of the membrane Pi transporters PiT-1/SLC20A1 and PiT-2/SLC20A2, and the mitochondrial transporter SLC25A3 important for the cellular and mitochondrial uptake of Pi. Our results show that MC3138 decreases the expression of both membrane and mitochondrial Pi transporters in MDA-MB-231 and in CAL-62 cells (
Figure 5). Moreover, when treated with MC3138, wt MDA-MB-231 showed a greater reduction in the expression of PiT-1/SLC20A1, PiT-2/SLC20A2 and SLC25A3 than GLS1-silenced MDA-MB-231 after 24h and 48h of treatment. On the contrary in CAL-62, wt or GLS1-silenced, such a reduction is observed only after 24 hours of treatment. Our results suggest, for the first time, a correlation between the activity of Sirtuin 5 and the expression of phosphate transporters. Interestingly, these results connect and expand a recent observation reporting that, in cardiomyocytes, SLC25A3 silencing increases acylation of mitochondrial proteins by decreasing SIRT5 activity and bringing to an activation of IDH2 [
36]. Our results suggests that such an effect could work in both ways with activation of SIRT5 causing a decrease of SLC25A3 expression. It should be taken into consideration that MDA-MB-231 have higher levels of GAC than CAL-62 (
Figure S1A). The differences in term of Pi transporters and glutaminase levels between these two cancer cell lines may also reflect a different sensitivity to treatments. Overall, wt and GLS1-silenced MDA-MB-231 cells appear to be more sensitive to lanthanum acetate, in terms of cell death, whereas CAL-62, present a greater percentage of dead cells with the MC3138 treatment. Hypoxia represents another important feature of the tumor microenvironment. Hypoxia increases the demand for inorganic phosphate to sustain tumor cells growth [
17]. Our results demonstrated a reduction in the number of colonies in both MDA-MB-231 and CAL-62 cell lines when the treatments are administered in hypoxic conditions (
Figure 4), an effect particularly evident in GLS1-silenced cells. We have previously shown that by acting on glutaminase, SIRT5 also regulates ammonia-induced autophagy [
27,
45]. Our results confirm the involvement of autophagy following modulation of glutamine metabolism either through MC3138 or lanthanum acetate treatment in both MDA-MB-231 and CAL-62 cell lines (
Figure 6 and
Figure 7). LC3 II levels increased with MC3138 plus lanthanum acetate treatment in wt and GLS1-silenced MDA-MB-231 and in GLS1-silenced CAL-62 cells. Importantly, our results indicate that the mitophagy marker BNIP3 is more affected by the treatments carried out in this study. In fact, after 48h, both in breast and thyroid tumor cells, there is an evident reduction in the expression of BNIP3, after treatment with MC3138. This suggests that SIRT5 activation reduces mitophagy. If MC3138 treatment is coupled to lanthanum acetate, BNIP3 expression is almost undetectable suggesting the accumulation of dysfunctional mitochondria. Indeed, sirtuins induce post translation modifications of autophagic and mitophagic proteins thereby modulating such homeostatic mechanisms [
37]. In particular, SIRT5 is associated with autophagy and mitophagy through the regulation of glutamine metabolism. Polletta et al., stated that SIRT5 inhibition leads to an increase in ammonia production which, in turn, stimulates autophagy and mitophagy conferring increasing benefit to cancer cells [
27]. Our results confirm this finding since by activating SIRT5 with MC3138, a relevant decrease in mitophagy is observed which also reduces cancer cells vitality and proliferative capacity. Mitophagy activation is used by cancer cells as a protective mechanism from insults such as hypoxia. In fact, the hypoxic tumor microenvironment increases mitophagy [
41]. Furthermore, hypoxia activates the metastatic process supported by mitophagy [
46]. Interestingly, we observed a decrease in the mitophagy marker BNIP3 when the cells are treated with MC3138 alone or in combination with lanthanum acetate, an effect that was more evident under hypoxia (
Figure 6,
Figure 7,
Figure 8 and
Figure 9). Cancer cells use glutamine metabolism and mitophagy to contain ROS levels by producing glutathione and removing dysfunctional mitochondria, respectively [
47]. Therefore, inhibition of one or both mechanisms would result in a toxic ROS increase for cancer cells [
41]. This is confirmed by our results, indeed, even if with differences in term of time (24 or 48h) or of response to hypoxia treatment, GLS1-silenced MDA-MB-231 and CAL-62 cells, show higher levels of ROS (
Figure 10). In normoxia, MC3138 and lanthanum acetate either alone or in combination, increased ROS levels in both MDA-MB-231 and CAL-62. Hypoxia decreased the extent of ROS production. However, treatments with MC3138 and lanthanum acetate could still increase ROS content (
Figure 10). Mitochondria represent the most important source of ROS and mitochondrial sirtuins are engaged for ROS control [
48,
49]. Our results show that: i) mitochondrial ROS increased after GLS1 silencing, ii) lanthanum acetate, MC3138 or lanthanum acetate plus MC3138 further increased mitochondrial ROS in normoxia and hypoxia.