Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Blood Adv. 2024 Jan 9;8(1):56-69. doi: 10.1182/bloodadvances.2023010786.
Cysteine is a nonessential amino acid required for protein synthesis, the generation of the antioxidant glutathione, and for synthesizing the nonproteinogenic amino acid taurine. Here, we highlight the broad sensitivity of leukemic stem and progenitor cells to cysteine depletion. By CRISPR/CRISPR-associated protein 9-mediated knockout of cystathionine-γ-lyase, the cystathionine-to-cysteine converting enzyme, and by metabolite supplementation studies upstream of cysteine, we functionally prove that cysteine is not synthesized from methionine in acute myeloid leukemia (AML) cells. Therefore, although perhaps nutritionally nonessential, cysteine must be imported for survival of these specific cell types. Depletion of cyst(e)ine increased reactive oxygen species (ROS) levels, and cell death was induced predominantly as a consequence of glutathione deprivation. nicotinamide adenine dinucleotide phosphate hydrogen oxidase inhibition strongly rescued viability after cysteine depletion, highlighting this as an important source of ROS in AML. ROS-induced cell death was mediated via ferroptosis, and inhibition of glutathione peroxidase 4 (GPX4), which functions in reducing lipid peroxides, was also highly toxic. We therefore propose that GPX4 is likely key in mediating the antioxidant activity of glutathione. In line, inhibition of the ROS scavenger thioredoxin reductase with auranofin also impaired cell viability, whereby we find that oxidative phosphorylation-driven AML subtypes, in particular, are highly dependent on thioredoxin-mediated protection against ferroptosis. Although inhibition of the cystine-glutamine antiporter by sulfasalazine was ineffective as a monotherapy, its combination with L-buthionine-sulfoximine (BSO) further improved AML ferroptosis induction. We propose the combination of either sulfasalazine or antioxidant machinery inhibitors along with ROS inducers such as BSO or chemotherapy for further preclinical testing.
半胱氨酸是一种非必需氨基酸,是蛋白质合成、抗氧化剂谷胱甘肽生成以及非蛋白氨基酸牛磺酸合成所必需的。在这里,我们强调了白血病干细胞和祖细胞对半胱氨酸耗竭的广泛敏感性。通过 CRISPR/CRISPR 相关蛋白 9 介导的胱硫醚γ-裂解酶(半胱氨酸到胱氨酸的转化酶)基因敲除,以及对半胱氨酸上游代谢物的补充研究,我们从功能上证明了急性髓系白血病(AML)细胞中的半胱氨酸不是由蛋氨酸合成的。因此,尽管半胱氨酸在营养上可能是非必需的,但这些特定细胞类型的生存仍需要从细胞外摄取。半胱氨酸耗竭会增加活性氧(ROS)水平,并主要导致谷胱甘肽耗竭引起细胞死亡。烟酰胺腺嘌呤二核苷酸磷酸氧化酶抑制强烈挽救了半胱氨酸耗竭后的细胞活力,这突出了其在 AML 中作为 ROS 的重要来源。ROS 诱导的细胞死亡是通过铁死亡介导的,而抑制谷胱甘肽过氧化物酶 4(GPX4),其功能是减少脂质过氧化物,也是高度有毒的。因此,我们提出 GPX4 可能是介导谷胱甘肽抗氧化活性的关键。与此一致,用 auronofin 抑制 ROS 清除剂硫氧还蛋白还原酶也会损害细胞活力,我们发现,特别是由氧化磷酸化驱动的 AML 亚型,非常依赖于硫氧还蛋白介导的对铁死亡的保护。虽然磺胺嘧啶对半胱氨酸-谷氨酰胺反向转运体的抑制作用作为单一疗法无效,但它与 L-丁硫氨酸亚砜(BSO)联合使用可进一步增强 AML 铁死亡诱导。我们建议将磺胺嘧啶或抗氧化剂机制抑制剂与 ROS 诱导剂(如 BSO 或化疗)联合使用,以进行进一步的临床前测试。
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