Neuro-Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland.
Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland.
Clin Cancer Res. 2020 Jul 15;26(14):3868-3880. doi: 10.1158/1078-0432.CCR-19-2335. Epub 2020 Mar 9.
PURPOSE: Pheochromocytomas and paragangliomas (PCPG) are usually benign neuroendocrine tumors. However, PCPGs with mutations in the succinate dehydrogenase B subunit () have a poor prognosis and frequently develop metastatic lesions. -mutated PCPGs exhibit dysregulation in oxygen metabolic pathways, including pseudohypoxia and formation of reactive oxygen species, suggesting that targeting the redox balance pathway could be a potential therapeutic approach. EXPERIMENTAL DESIGN: We studied the genetic alterations of cluster I PCPGs compared with cluster II PCPGs, which usually present as benign tumors. By targeting the signature molecular pathway, we investigated the therapeutic effect of ascorbic acid on PCPGs using and models. RESULTS: By investigating PCPG cells with low SDHB levels, we show that pseudohypoxia resulted in elevated expression of iron transport proteins, including transferrin (TF), transferrin receptor 2 (TFR2), and the divalent metal transporter 1 ( DMT1), leading to iron accumulation. This iron overload contributed to elevated oxidative stress. Ascorbic acid at pharmacologic concentrations disrupted redox homeostasis, inducing DNA oxidative damage and cell apoptosis in PCPG cells with low levels. Moreover, through a preclinical animal model with PCPG allografts, we demonstrated that pharmacologic ascorbic acid suppressed -low metastatic lesions and prolonged overall survival. CONCLUSIONS: The data here demonstrate that targeting redox homeostasis as a cancer vulnerability with pharmacologic ascorbic acid is a promising therapeutic strategy for -mutated PCPGs.
目的:嗜铬细胞瘤和副神经节瘤(PCPG)通常为良性神经内分泌肿瘤。然而,携带有琥珀酸脱氢酶 B 亚基()突变的 PCPG 预后较差,且常发生转移性病变。-突变的 PCPG 表现出氧代谢途径的失调,包括假性缺氧和活性氧的形成,这表明靶向氧化还原平衡途径可能是一种潜在的治疗方法。
实验设计:我们研究了簇 I PCPG 的遗传改变与簇 II PCPG 相比,簇 II PCPG 通常表现为良性肿瘤。通过靶向特征分子通路,我们使用和模型研究了抗坏血酸对 PCPG 的治疗效果。
结果:通过研究 SDHB 水平较低的 PCPG 细胞,我们表明假性缺氧导致铁转运蛋白(包括转铁蛋白(TF)、转铁蛋白受体 2(TFR2)和二价金属转运蛋白 1(DMT1))的表达升高,从而导致铁积累。这种铁过载导致氧化应激增加。在低水平的 PCPG 细胞中,药物浓度的抗坏血酸破坏了氧化还原平衡,诱导 DNA 氧化损伤和细胞凋亡。此外,通过 PCPG 同种异体移植物的临床前动物模型,我们证明了药物浓度的抗坏血酸抑制了-低转移性病变并延长了整体生存时间。
结论:这些数据表明,靶向氧化还原平衡作为一种具有药理活性的抗坏血酸的癌症脆弱性是治疗-突变 PCPG 的一种很有前途的治疗策略。
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