Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Clin Transl Med. 2023 Feb;13(2):e1198. doi: 10.1002/ctm2.1198.
Radiation-induced hepatic stellate cell (HSC) activation promotes radiation-induced liver fibrosis (RILF), a complication for hepatocellular carcinoma (HCC) radiotherapy. The demethylase alpha-ketoglutarate-dependent dioxygenase alkB homolog 5 (ALKBH5) decreases N6-methyladenylate methylation (m A) modification of RNA, while its role in regulating RILF pathogenesis and HCC radiosensitivity remains unknown.
Methylated RNA immunoprecipitation sequencing (MeRIP-seq) and RNA-sequencing (RNA-seq) were used to screen target genes regulated by ALKBH5. HSC with altered ALKBH5 expression was used to assess irradiation-induced HSC activation and the effect of HSC on recruitment and polarisation of monocytes. Key cytokines in medium from irradiated HSC-educated monocytes were identified by cytokine array detection. The effects of blocking ALKBH5 and key cytokines on RILF and HCC radiosensitivity were also evaluated.
Radiation-induced ALKBH5 expression in HSC mediated m A demethylation of toll-interleukin 1 receptor domain containing adaptor protein (TIRAP) mRNA and activated its downstream NF-κB and JNK/Smad2 pathways to promote HSC activation. Additionally, ALKBH5 regulated CCL5 secretion by irradiated HSC to promote monocyte recruitment and M2 macrophage polarisation. Notably, polarised monocytes secreted CCL20 to up-regulate ALKBH5 expression in HSC, and reduce HCC radiosensitivity by activating ALKBH5/TIRAP axis in HCC cells. ALKBH5 knockdown-combined CCR6 (CCL20 receptor) inhibitor significantly alleviated RILF and improved HCC radiosensitivity in mice. HCC patients with high ALKBH5 and TIRAP expression were prone to radiation-induced liver injury and poor tumour response to radiotherapy.
Collectively, irradiation up-regulates ALKBH5 in HSC to mediate monocyte recruitment and M2 polarisation and form positive feedback to promote RILF and reduce HCC radiosensitivity. The dual roles of ALKBH5 as a microenvironmental regulator and radiosensitisation target provide new ideas for RILF prevention and radiosensitisation of HCC.
辐射诱导的肝星状细胞(HSC)激活促进了辐射诱导的肝纤维化(RILF),这是肝细胞癌(HCC)放疗的一种并发症。依赖α-酮戊二酸的去甲基酶 alkB 同源物 5(ALKBH5)降低 RNA 的 N6-甲基腺苷酸甲基化(m A)修饰,但其在调节 RILF 发病机制和 HCC 放射敏感性中的作用尚不清楚。
使用甲基化 RNA 免疫沉淀测序(MeRIP-seq)和 RNA 测序(RNA-seq)筛选受 ALKBH5 调节的靶基因。使用改变的 ALKBH5 表达的 HSC 来评估辐照诱导的 HSC 激活以及 HSC 对单核细胞募集和极化的影响。通过细胞因子阵列检测鉴定来自辐照 HSC 教育单核细胞的关键细胞因子。还评估了阻断 ALKBH5 和关键细胞因子对 RILF 和 HCC 放射敏感性的影响。
HSC 中辐射诱导的 ALKBH5 表达介导了 TIRAP 信使 RNA 的 m A 去甲基化,并激活了其下游的 NF-κB 和 JNK/Smad2 途径,从而促进了 HSC 的激活。此外,ALKBH5 调节辐照 HSC 分泌的 CCL5 以促进单核细胞募集和 M2 巨噬细胞极化。值得注意的是,极化的单核细胞分泌 CCL20 以上调 HSC 中的 ALKBH5 表达,并通过激活 HCC 细胞中的 ALKBH5/TIRAP 轴降低 HCC 的放射敏感性。与 ALKBH5 敲低联合 CCR6(CCL20 受体)抑制剂显著缓解了 RILF,并改善了小鼠的 HCC 放射敏感性。ALKBH5 和 TIRAP 高表达的 HCC 患者易发生辐射诱导的肝损伤和对放疗的肿瘤反应不良。
总之,辐照上调 HSC 中的 ALKBH5 以介导单核细胞募集和 M2 极化,并形成正反馈以促进 RILF 并降低 HCC 的放射敏感性。ALKBH5 作为微环境调节剂和 HCC 放射增敏剂的双重作用为预防 RILF 和增强 HCC 放射敏感性提供了新的思路。