Front Immunol. 2026 ;17
1838182
Background: Tumor heterogeneity is the key driver of disease progression and therapeutic resistance in clear cell renal cell carcinoma (ccRCC). Within this landscape, mitochondrial (MT) heterogeneity has emerged as a critical but poorly understood feature. This study identified a specific manifestation of MT heterogeneity termed "nucleo-mitochondrial expression asymmetry (NMA)". It is characterized by a dysregulated burst of mitochondrial DNA (mtDNA)-encoded genes compared to the nuclear genome, marking a pivotal tipping point in tumor proliferation and spatial reconstruction.
Methods: We employed an integrative multi-omics approach combining single-cell RNA sequencing (scRNA-seq), spatial transcriptomics (stRNA-seq), and mass spectrometry imaging (MSI)-based spatial metabolomics from the Tongji Renal Cell Carcinoma (TJ-RCC) cohort. To identify and characterize the profound NMA malignant subpopulations, we utilized Gaussian Mixture Model (GMM) clustering, CytoTRACE 2 for differentiation potential, and scFEA for metabolic flux inference. We implemented neighborhood and pseudo-spatiotemporal map (pSM) analyses to quantify spatial reconstruction. We validated these findings through mitochondrially encoded cytochrome c oxidase I (MT-CO1) immunohistochemistry (IHC) in an independent cohort of 53 patients.
Results: We identified a unique malignant subpopulation (C0) defined by NMA, where nucleo-mitochondrial coordination significantly decreased to R = 0.30 compared to R = 0.50 in other clusters. C0 functioned as a proliferative engine, exhibiting the highest ribosomal activity, peak differentiation potential, and concentrated G2M/S-phase activity. Metabolic modeling and MSI revealed that C0-dominant regions act as metabolic hubs, correlating with total metabolic flux (R = 0.631) and the physical accumulation of tricarboxylic acid (TCA) cycle intermediates. Spatially, C0 abundance was highly predictive of global MT gene scores (R = 0.852). As ccRCC progressed, NMA-driven niches underwent a dramatic reconstruction: transitioning from an "immune-active core" in the early stages to stroma-shielded "metabolic islands" in the advanced stages. Furthermore, we observed a resurgence of NMA and the C0 subpopulation in metastatic lesions. Clinical validation confirmed that MT-CO1 protein levels-a histological proxy for NMA-positively correlated with the proliferation marker Ki67 (r = 0.702) and served as an independent prognostic factor for overall survival.
Conclusion: This study characterized NMA as a hallmark of ccRCC progression and spatial niche reconstruction, offering a novel, clinically actionable framework for metabolic risk stratification via MT-CO1.
Keywords: MT-CO1; clear cell renal cell carcinoma; nucleo- mitochondrial asymmetry; scRNA-seq; stRNA-seq