Effects of Extracellular pH Modulation on HIF-1α, c-Myc, and FOXO1 Expression in Colorectal Cancer Cells

  • Sugeng Ibrahim Faculty of Medicine, Soegijapranata Catholic University, Semarang, Indonesia
  • Fauziah Novita Putri Rifai Lecturer, Biotechnology Undergraduate Program, Institut Karya Mulia Bangsa (IKMB), Semarang, 50223, Indonesia
  • Adzani Gaisani Arda Research and Development, Stem Cell and Cancer Research (SCCR), Semarang, Indonesia
Keywords: Colorectal cancer (CRC), HCT116, pH Modulation, Gene Expression

Abstract

Background: The tumor microenvironment (TME) of colorectal cancer (CRC) is characterized by an inverted pH gradient, with acidic extracellular and alkaline intracellular conditions that promote tumor progression and metabolic reprogramming. This altered pH landscape regulates key transcriptional drivers of glycolysis and proliferation, including hypoxia-inducible factor-1 alpha (HIF-1α), c-Myc, and the tumor suppressor Forkhead Box Protein O1 (FOXO1). Understanding how extracellular pH influences these regulators may provide new insights for pH-targeted cancer therapy. Methods: Human colorectal carcinoma HCT116 cells were cultured for 24 hours under six extracellular pH conditions (5.5–9.2). The expression of HIF-1α, c-Myc, and FOXO1 was quantified using quantitative real-time polymerase chain reaction (qPCR), and relative fold changes were analyzed by the 2^-ΔΔCt method. Results: Acidic conditions (pH 5.5–6.7) markedly upregulated HIF-1α and c-Myc while strongly suppressing FOXO1 expression. Conversely, mild alkalinity (pH 8.4) reversed this pattern, reducing HIF-1α and c-Myc while restoring FOXO1 expression, suggesting a transcriptional shift from glycolytic to oxidative metabolism. At higher alkalinity (pH 9.2), the expression of all three genes declined, indicating a threshold beyond which excessive pH elevation becomes detrimental to cellular regulation. Conclusion: Extracellular pH critically modulates metabolic gene expression in CRC cells. Acidic conditions activate glycolytic and oncogenic pathways via HIF-1α and c-Myc, while mild alkalinity suppresses these signals and reinstates tumor-suppressive FOXO1 activity. Controlled alkalinization of the TME may therefore represent a promising adjunctive approach to disrupt tumor metabolism and limit cancer progression.

References

Bray F, Laversanne M, Sung H, Ferlay J, Soerjomataram I, Siegel RL. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer Journal for Clinicians. 2024;74:229–263. doi:10.3322/caac.21834

D’Alterio C, Scala S, Sozzi G, Roz L, Bertolini G. Paradoxical effects of chemotherapy on tumor relapse and metastasis promotion. Seminars in Cancer Biology. 2020. doi:10.1016/j.semcancer.2019.08.019

Boedtkjer E, Pedersen SF. The acidic tumor microenvironment as a driver of cancer. Annual Review of Physiology. 2019;81:103–126. doi:10.1146/annurev-physiol-021119-034627

Wang J, Choi S, Niu X, Cho Y, Zhang W, Li X, Huang H, Liu Y. Lactic acid and an acidic tumor microenvironment suppress anticancer immunity. International Journal of Molecular Sciences. 2020;21:8363. doi:10.3390/ijms21218363

Wang L, Zhang L, Zhang Z, Li Y, Li W, Zhou Q, Chen Y. Advances in targeting tumor microenvironment for immunotherapy. Frontiers in Immunology. 2024;15:1472772. doi:10.3389/fimmu.2024.1472772

Schiliro C, Firestein BL. Mechanisms of metabolic reprogramming in cancer cells supporting enhanced growth and proliferation. Cells. 2021;10(5):1056. doi:10.3390/cells10051056

Granja S, Tavares-Valente D, Queirós O, Baltazar F. Value of pH regulators in the diagnosis, prognosis and treatment of cancer. Seminars in Cancer Biology. 2017;43:17–34. doi:10.1016/j.semcancer.2016.12.003

Ward C, Meehan J, Gray M, Murray A, Argyle DJ, Kunkler IH, Langdon SP. The impact of tumour pH on cancer progression: strategies for clinical intervention. Exploration of Targeted Anti-Tumor Therapy. 2020;1:71–100. doi:10.37349/etat.2020.00005

Bogdanov A, Verlov N, Bogdanov A, Koroleva L, Fedorenko V, Sokolov A, Volkova O, Khokhlova A. Tumor alkalization therapy: misconception or good therapeutics perspective? Frontiers in Oncology. 2024;14:1342802. doi:10.3389/fonc.2024.1342802

Gillies RJ, Ibrahim-Hashim A, Ordway B, Gatenby RA. Back to basic: trials and tribulations of alkalizing agents in cancer. Frontiers in Oncology. 2022;12:981718. doi:10.3389/fonc.2022.981718

Ishii D, Shindo Y, Arai W, Ueno S, Hattori S, Watanabe T, Kimura K. The roles and regulatory mechanisms of tight junction protein Cingulin and transcription factor FOXO1 in human lung adenocarcinoma. International Journal of Molecular Sciences. 2024;25:31411. doi:10.3390/ijms25031411

Zhang B, Li S, Gao L, Zhao X, Li L, Liu Q, Wang Q. FOXO1 is a tumor suppressor in cervical cancer. Genetics and Molecular Research. 2015;14(2):6605–6616. doi:10.4238/2015.June.18.3

Fiore D, Conti A, Amadio G, Zuppi P, Forte M, Fini M, Macchiarelli G. [Study on alkaline therapy and transcription factors; details unavailable in text.]

Markov N, Sabirova S, Sharapova G, Taran E, Fedorenko T, Smirnova Y, Ivanov D. Mitochondrial, metabolic, and bioenergetic adaptations drive plasticity of colorectal cancer cells. Cell Death and Disease. 2025;16:7596. doi:10.1038/s41419-025-07596-y

Nenkov M, Yunxia G, Gassler N, Chen YH. Metabolic reprogramming of colorectal cancer cells and the microenvironment: implication for therapy. International Journal of Molecular Sciences. 2021;22:126262. doi:10.3390/ijms22126262

Sedlak J, Yilmaz Ö, Roper J. Metabolism and colorectal cancer. Annual Review of Pathology. 2022;17:421–447. doi:10.1146/annurev-pathmechdis-031521-041113

Asgharzadeh M, Barar J, Pourseif M, Eskandani M, Jafari S, Omidi Y. Molecular machineries of pH dysregulation in tumor microenvironment: potential targets for cancer therapy. BioImpacts. 2017;7:115–133. doi:10.15171/bi.2017.15

Bogdanov A, Bogdanov A, Chubenko V, Fedorov V, Verlov N, Karpov N. Tumor acidity: from hallmark of cancer to target of treatment. Frontiers in Oncology. 2022;12:979154. doi:10.3389/fonc.2022.979154

Gastelum G, Kraut J, Veena M, Wang D, Ortiz L, Espinoza J, Mendoza A. Acidification of intracellular pH in tumor cells overcomes resistance to hypoxia-mediated apoptosis. Frontiers in Oncology. 2023;13:1268421. doi:10.3389/fonc.2023.1268421

Koltai T, Reshkin SJ, Harguindey S. An Innovative Approach to Understanding and Treating Cancer: Targeting pH. Academic Press; 2020.

Rabinowitz MH. Inhibition of hypoxia-inducible factor prolyl hydroxylase domain oxygen sensors: tricking the body into orchestrated repair responses. Journal of Medicinal Chemistry. 2013;56(23):9369–9402. doi:10.1021/jm400566p

Camagni G, Minervini G, Tosatto SCE. Structural characterization of hypoxia inducible factor α–prolyl hydroxylase domain 2 interaction through MD simulations. International Journal of Molecular Sciences. 2023;24:4710. doi:10.3390/ijms24054710

Chan MC, Ilott N, Schödel J, Hagen T, Gleadle JM, Mole DR, Ratcliffe PJ. Tuning the transcriptional response to hypoxia by inhibiting hypoxia-inducible factor (HIF) prolyl and asparaginyl hydroxylases. Journal of Biological Chemistry. 2016;291:20661–20673. doi:10.1074/jbc.M116.749291

Lawson H, Holt-Martyn J, Dembitz V, Houghton T, Evans A, Cockman ME, Pugh CW, Ratcliffe PJ. The selective prolyl hydroxylase inhibitor IOX5 stabilizes HIF-1α and compromises development and progression of AML. Nature Cancer. 2024;5:916–937. doi:10.1038/s43018-024-00761-w

Guo Z, Yang Y, Li L, Chen C, Huang Y, Xu Y. The novel prolyl hydroxylase-2 inhibitor caffeic acid upregulates hypoxia inducible factor and protects against hypoxia. European Journal of Pharmacology. 2022;175307. doi:10.1016/j.ejphar.2022.175307

Li L, Yan Maerkeya K, Reyanguly D, Han L. LncRNA OIP5-AS1 regulates the Warburg effect through miR-124-5p/IDH2/HIF-1α pathway in cervical cancer. Frontiers in Cell and Developmental Biology. 2021;9:655018. doi:10.3389/fcell.2021.655018

Kim JW, Gao P, Liu Y, Semenza GL, Dang CV. Hypoxia-inducible factor 1 and dysregulated c-Myc cooperatively induce VEGF and metabolic switches HK2 and PDK1. Molecular and Cellular Biology. 2007;27:7381–7393. doi:10.1128/MCB.00440-07

Huang Y, Chen Z, Lu T, Zhang L, Wang H, Zheng S, Li M, Xu Y. HIF-1α switches TGF-β signaling partners to drive glucose metabolic reprogramming in NSCLC. Journal of Experimental and Clinical Cancer Research. 2021;40:188. doi:10.1186/s13046-021-02188-y

Jiramongkol Y, Lam EW. FOXO transcription factor family in cancer and metastasis. Cancer Metastasis Reviews. 2020;39:681–709. doi:10.1007/s10555-020-09883-w

Liu Y, Ao X, Ding W, Ponnusamy M, Wu W, Zhao Y, Wang S, Yu W, Wang J. Critical role of FOXO3a in carcinogenesis. Molecular Cancer. 2018;17:139. doi:10.1186/s12943-018-0856-3

Rani M, Kumari R, Singh S, Raj S, Verma G, Kaur P, Singh A. MicroRNAs as master regulators of FOXO transcription factors in cancer management. Life Sciences. 2023;121535. doi:10.1016/j.lfs.2023.121535

Yadav R, Chauhan A, Li Z, Gan B. FoxO transcription factors in cancer metabolism. Seminars in Cancer Biology. 2018;50:65–76. doi:10.1016/j.semcancer.2018.01.004

Lee S, Shanti A. Effect of exogenous pH on cell growth of breast cancer cells. International Journal of Molecular Sciences. 2021;22(18):9910. doi:10.3390/ijms22189910

Rahman MA, Yadab M, Ali M. Emerging role of extracellular pH in tumor microenvironment as a therapeutic target. Cells. 2024;13:1924. doi:10.3390/cells13221924

Wolff M, Rauschner M, Reime S, Riemann A, Thews O. Role of the mTOR signalling pathway during extracellular acidosis in tumour cells. Advances in Experimental Medicine and Biology. 2022;1395:281–285. doi:10.1007/978-3-031-14190-4_46

Zhang Y, Liang J, Cao N, Li M, Zhao J, Chen J, Tang H. ASIC1α up-regulates MMP-2/9 via PI3K/AKT/mTOR pathway in liver cancer. BMC Cancer. 2022;22:9874. doi:10.1186/s12885-022-09874-w

Tavares-Valente D, Sousa B, Schmitt F, Baltazar F. Disruption of pH dynamics suppresses proliferation and potentiates doxorubicin cytotoxicity. Pharmaceutics. 2021;13:20242. doi:10.3390/pharmaceutics13020242

Published
2025-10-13
How to Cite
Ibrahim, S., Putri Rifai, F. N., & Arda, A. G. (2025). Effects of Extracellular pH Modulation on HIF-1α, c-Myc, and FOXO1 Expression in Colorectal Cancer Cells. International Journal of Cell and Biomedical Science, 4(10), 324-331. https://doi.org/10.59278/cbs.v4i10.67
Section
Articles

Most read articles by the same author(s)