抑制线粒体呼吸可阻止 BRAF 突变型黑色素瘤脑转移。

Inhibition of mitochondrial respiration prevents BRAF-mutant melanoma brain metastasis.

机构信息

Kristian Gerhard Jebsen Brain Tumour Research Centre, Department of Biomedicine, University of Bergen, Jonas Lies vei 91, 5009, Bergen, Norway.

Department of Clinical Medicine, University of Bergen, Haukelandsveien 22, 5021, Bergen, Norway.

出版信息

Acta Neuropathol Commun. 2019 Apr 10;7(1):55. doi: 10.1186/s40478-019-0712-8.

Abstract

Melanoma patients carry a high risk of developing brain metastases, and improvements in survival are still measured in weeks or months. Durable disease control within the brain is impeded by poor drug penetration across the blood-brain barrier, as well as intrinsic and acquired drug resistance. Augmented mitochondrial respiration is a key resistance mechanism in BRAF-mutant melanomas but, as we show in this study, this dependence on mitochondrial respiration may also be exploited therapeutically. We first used high-throughput pharmacogenomic profiling to identify potentially repurposable compounds against BRAF-mutant melanoma brain metastases. One of the compounds identified was β-sitosterol, a well-tolerated and brain-penetrable phytosterol. Here we show that β-sitosterol attenuates melanoma cell growth in vitro and also inhibits brain metastasis formation in vivo. Functional analyses indicated that the therapeutic potential of β-sitosterol was linked to mitochondrial interference. Mechanistically, β-sitosterol effectively reduced mitochondrial respiratory capacity, mediated by an inhibition of mitochondrial complex I. The net result of this action was increased oxidative stress that led to apoptosis. This effect was only seen in tumor cells, and not in normal cells. Large-scale analyses of human melanoma brain metastases indicated a significant role of mitochondrial complex I compared to brain metastases from other cancers. Finally, we observed completely abrogated BRAF inhibitor resistance when vemurafenib was combined with either β-sitosterol or a functional knockdown of mitochondrial complex I. In conclusion, based on its favorable tolerability, excellent brain bioavailability, and capacity to inhibit mitochondrial respiration, β-sitosterol represents a promising adjuvant to BRAF inhibitor therapy in patients with, or at risk for, melanoma brain metastases.

摘要

黑色素瘤患者发生脑转移的风险很高,生存时间的改善仍以周或月来衡量。血脑屏障的药物渗透性差,以及内在和获得性药物耐药性,阻碍了大脑内疾病的持久控制。增强的线粒体呼吸是 BRAF 突变型黑色素瘤的一个关键耐药机制,但正如我们在这项研究中所表明的,这种对线粒体呼吸的依赖也可能被用于治疗。我们首先使用高通量药物基因组学分析来鉴定针对 BRAF 突变型黑色素瘤脑转移的潜在再利用化合物。鉴定出的一种化合物是β-谷固醇,一种耐受性良好且可穿透血脑屏障的植物固醇。在这里,我们表明β-谷固醇在体外可抑制黑色素瘤细胞生长,并在体内抑制脑转移形成。功能分析表明,β-谷固醇的治疗潜力与线粒体干扰有关。从机制上讲,β-谷固醇通过抑制线粒体复合物 I 有效降低线粒体呼吸能力。这种作用的净结果是增加氧化应激,导致细胞凋亡。这种作用仅见于肿瘤细胞,而不存在于正常细胞中。对人类黑色素瘤脑转移的大规模分析表明,与来自其他癌症的脑转移相比,线粒体复合物 I 起重要作用。最后,当维莫非尼与β-谷固醇或线粒体复合物 I 的功能敲低联合使用时,我们观察到 BRAF 抑制剂耐药性完全被消除。总之,基于其良好的耐受性、优异的脑生物利用度以及抑制线粒体呼吸的能力,β-谷固醇代表了 BRAF 抑制剂治疗黑色素瘤脑转移患者或有脑转移风险患者的一种有前途的辅助治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6b8/6456988/c957e671f769/40478_2019_712_Fig1_HTML.jpg

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