The truncated TCA cycle in cancer cells, due to aconitase knockdown, results in citrate accumulation and efflux into cytosol, where it is converted into acetyl-CoA and oxalacetate by ATP citrate lyase (ACLY), allowing lipid synthesis from acetyl-CoA, and gluconeogenesis [53,54,183] (Figure 2E). The gene discussed is ACLY; the disease is cancer.