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Pentose phosphate pathway (PPP) intermediates are a group of sugar phosphates, including glucose-6-phosphate, 6-phosphogluconate, and ribose-5-phosphate, that facilitate essential metabolic processes in the cellular cytoplasm (StatPearls, Pentose Phosphate Pathway, 2023). These metabolites are generated through the oxidative and non-oxidative branches of the PPP to provide the cell with NADPH for reductive biosynthesis and ribose-5-phosphate for nucleotide synthesis (National Center for Biotechnology Information, 2023). Intermediates like xylulose-5-phosphate also play roles in signaling to regulate glycolysis and lipogenesis. While the intermediates themselves are substrates and products rather than therapeutic targets, the enzymes that catalyze their transformations, such as glucose-6-phosphate dehydrogenase (G6PD) and transketolase, are significant targets in oncology and infectious disease research (Nature Reviews Cancer, 2013). Dysregulation of these intermediate levels is a hallmark of many cancers, which exploit the pathway to support rapid proliferation and protect against oxidative stress (PubMed, 2022). Therapeutic strategies involving drugs like 6-aminonicotinamide or oxythiamine focus on disrupting the flux of these intermediates to starve tumor cells of biosynthetic precursors (Journal of Biological Chemistry, 2020).
Drugs do not typically bind to these intermediates directly; instead, they act through the inhibition or activation of enzymes that produce or consume these molecules, such as glucose-6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6PGD), or transketolase (TKT).
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