Fructose 1-phosphate inhibits mannose phosphate isomerase to suppress hepatocellular carcinogenesis
Summary
Fructose consumption increases the risk of obesity-related metabolic diseases and some cancers, but its role in hepatocellular carcinogenesis (HCC) remains controversial. Animal studies suggest that high fructose promotes HCC, whereas human data fail to support the positive link between fructose intake and elevated risk of liver cancer. Moreover, fructose metabolism is progressively attenuated in HCC with the loss of key fructolytic enzymes, including fructose-1,6-bisphosphate aldolase B (
Content
# Fructose 1-phosphate inhibits mannose phosphate isomerase to suppress hepatocellular carcinogenesis
*Published: 2026 May 25*
Fructose consumption increases the risk of obesity-related metabolic diseases
and some cancers, but its role in hepatocellular carcinogenesis (HCC) remains
controversial. Animal studies suggest that high fructose promotes HCC, whereas
human data fail to support the positive link between fructose intake and
elevated risk of liver cancer. Moreover, fructose metabolism is progressively
attenuated in HCC with the loss of key fructolytic enzymes, including
fructose-1,6-bisphosphate aldolase B (ALDOB). Here, we report that fructose
suppresses HCC through fructose 1-phosphate (F1P)-mediated inhibition of mannose
phosphate isomerase (MPI) in the context of ALDOB deficiency. Transcriptomic and
metabolic flux analyses using human HCC cells and tissues revealed that liver
cancer cells retain a significant ability to metabolize fructose despite the
downregulation of fructolytic genes, with ALDOB showing the earliest and most
pronounced suppression compared with GLUT2 and KHK. Dietary supplementation with
10% fructose suppressed HCC in liver-specific Aldob knockout mice. Further
spatial and single-cell transcriptomic analyses of clinical HCC samples revealed
the spatiotemporal dynamics of fructolytic gene expression and identified
subsets of cancer cells that retain fructose uptake and phosphorylation capacity
(SLC2A2⁺/KHK⁺) but lack ALDOB expression. Upon fructose exposure, accumulated
F1P binds to and inhibits MPI, reducing protein N-glycosylation and triggering
apoptosis due to maladaptive ER stress. We further performed virtual
high-throughput screening of FDA-approved and clinical-trial drugs and
identified ebselen as a potent MPI inhibitor. Taken together, the results of our
study reveal a novel mechanism by which dietary fructose inhibits HCC through
the F1P-MPI axis, suggesting a therapeutic strategy targeting metabolic
vulnerabilities in cancer.
DOI: 10.1038/s41392-026-02695-4