This review summarizes the cellular bases of the effects of NaCHOleate (2-hydroxyoleic
acid; 2OHOA;
Minerval) against
glioma and other types of
tumors. NaCHOleate, activates
sphingomyelin synthase (SGMS) increasing the levels of cell membrane
sphingomyelin (SM) and
diacylglycerol (DAG) together with reductions of
phosphatidylethanolamine (PE) and
phosphatidylcholine (PC). The increases in the membrane levels of NaCHOleate itself and of DAG induce a translocation and overexpression of
protein kinase C (PKC) and subsequent reductions of
Cyclin D,
cyclin-dependent kinases 4 and 6 (CDKs 4 and 6), hypophosphorylation of the
retinoblastoma protein, inhibition of E2F1 and knockdown of
dihydrofolate reductase (DHFR) impairing
DNA synthesis. In addition in some
cancer cells, the increases in SM are associated with
Fas receptor (FasR) capping and
ligand-free induction of apoptosis. In
glioma cell lines, the increases in SM are associated with the inhibition of the Ras/MAPK and PI3K/Akt pathways, in association with p27Kip1 overexpression. Finally, an analysis of the Repository of Molecular Brain
Neoplasia Data (REMBRANDT) database for
glioma patient survival shows that the weight of SM-related metabolism gene expression in
glioma patients' survival is similar to
glioma-related genes. Due to its low toxicity and anti-tumoral effect in cell and animal models its status as an orphan drug for
glioma treatment by the European Medicines Agency (EMA) was recently acknowledged and a phase 1/2A open label, non-randomized study was started in patients with advanced solid
tumors including
malignant glioma. This article is part of a Special Issue entitled: Membrane Structure and Function: Relevance in the Cell's Physiology, Pathology and
Therapy.