Metabolic determinants of stemness in medulloblastoma

Table 1 Main features of medulloblastoma groups

MB group	Pathway	Prognosis	Cell of origin	CSC markers	Metabolism
WNT[2]	↑ WNT signalling (Activated β-catenin)[4,5]	Good[4,5]	Progenitors in the dorsal brainstem[23]	CD133[20], Nestin[20], CD15[30], Sox2[30,31], ki67/nestin, Ki67/DCX, and Ki67/TUC-4[32]	↑ Glycolysis[47]
SHH[2]	↑ SHH signalling pathway[5]	Intermediate[4]	Immature cerebellar granule neuron precursors[19,20] or neural stem cells[21-23]	CD133[20], Nestin[20], CD15[30], Sox2[30,31], CD271 [28], ki67/nestin, ki67/DCX, and ki67/TUC-4[32]	↑ Glycolysis[46]; ↑ Fatty acid synthesis[40]; ↓ Fatty acid oxidation[40]
Group 3[2]	↑ MYCN gene[4,5]	Poor prognosis and high metastatic rate[4,5]	Cerebellar stem cells[25,26]	CD133[20], Nestin[20], CD15[30], Sox2[30,31], ki67/nestin, ki67/DCX, and ki67/TUC-4[32]	↑ Glycolysis[47]; ↑ Fatty acid synthesis[51]; ↑ Gluconeogenesis[51]; ↑Glutamine anabolism[51]
Group 4[2]	Chromosome 17 abnormalities[4,5]	Intermediate[2]	Further investigation needed	CD133[20], Nestin[20], CD15[30], Sox2[30,31], ki67/nestin, ki67/DCX, and ki67/TUC-4[32]	↑ Fatty acid synthesis[41]; ↑ One carbon pool by folate[41]

CD15: Cluster of differentiation 15; CD133: Cluster of differentiation 133; CD271: Cluster of differentiation 271; DCX: Doublecortin; MB: Medulloblastoma; SHH: Sonic hedgehog; Sox2: SRY-box transcription factor 2; TUC-4: TOAD/Ulip/CRMP family protein 4; WNT: Wingless/integrated.