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. 2023 Dec 30;130(4):568–584. doi: 10.1038/s41416-023-02553-y

Fig. 1. Homocysteine and glutathione (GSH) levels decrease in response to RT in NSCLC patient’s plasma samples.

Fig. 1

a Lung adenocarcinoma (TCGA PanCancer Atlas) dataset collected in cBioportal was used to identify the % of lung adenocarcinoma cancer patients with high and low expression of ser/gly synthesis enzymes, i.e. PHGDH, PSAT1, PSPH, SHMT1/2 using the standard setting in cBioportal (genetic alterations e.g. amplifications + RNA sequencing z-score threshold = 2.0 relative to diploid samples). The Kaplan Meier curve compared the overall survival of patients with with high versus low ser/gly synthesis enzyme expression. b Study design of plasma metabolite analysis. Patient blood samples of stage I/III NSCLC patients were collected before (t1), during (t2), and after chemo-radiation therapy (t3). Stage I NSCLC patients received stereotactic radiotherapy and stage III NSCLC patients received concurrent chemo-radiation therapy. Blood plasma was extracted and processed for mass spectrometry analysis using a LC-Q-Exactive Focus orbitrap. Ser/gly synthesis pathway metabolites were analyzed. c Box plots showing homocysteine and gluthatione (GSH) plasma levels during (t2) and after RT (t3) relative to the values before RT (t1). Kruskal–Wallis test with a Dunn’s multiple comparisons test was performed, where *p-value  <  0.05, ***p-value < 0.001, ****p-value < 0.0001. d Serine and glycine bidirectional inter-conversion donates carbon units to one carbon metabolism, comprised by folate and methionine cycle, and therefore being upstream metabolites of homocysteine and GSH synthesis. Homocysteine and GSH are important during and after RT in patients with NSCLC.