Mavroeidi Dimitra, Georganta Anastasia, Panagiotou Emmanouil, Syrigos Konstantinos, Souliotis Vassilis L
Institute of Chemical Biology, National Hellenic Research Foundation, 116 35 Athens, Greece.
Third Department of Medicine, Sotiria General Hospital for Chest Diseases, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
Int J Mol Sci. 2024 Feb 27;25(5):2767. doi: 10.3390/ijms25052767.
The DNA damage response (DDR) system is a complicated network of signaling pathways that detects and repairs DNA damage or induces apoptosis. Critical regulators of the DDR network include the DNA damage kinases ataxia telangiectasia mutated Rad3-related kinase (ATR) and ataxia-telangiectasia mutated (ATM). The ATR pathway coordinates processes such as replication stress response, stabilization of replication forks, cell cycle arrest, and DNA repair. ATR inhibition disrupts these functions, causing a reduction of DNA repair, accumulation of DNA damage, replication fork collapse, inappropriate mitotic entry, and mitotic catastrophe. Recent data have shown that the inhibition of ATR can lead to synthetic lethality in ATM-deficient malignancies. In addition, ATR inhibition plays a significant role in the activation of the immune system by increasing the tumor mutational burden and neoantigen load as well as by triggering the accumulation of cytosolic DNA and subsequently inducing the cGAS-STING pathway and the type I IFN response. Taken together, we review stimulating data showing that ATR kinase inhibition can alter the DDR network, the immune system, and their interplay and, therefore, potentially provide a novel strategy to improve the efficacy of antitumor therapy, using ATR inhibitors as monotherapy or in combination with genotoxic drugs and/or immunomodulators.
DNA损伤反应(DDR)系统是一个复杂的信号通路网络,可检测和修复DNA损伤或诱导细胞凋亡。DDR网络的关键调节因子包括DNA损伤激酶共济失调毛细血管扩张突变Rad3相关激酶(ATR)和共济失调毛细血管扩张突变(ATM)。ATR通路协调复制应激反应、复制叉稳定、细胞周期停滞和DNA修复等过程。ATR抑制会破坏这些功能,导致DNA修复减少、DNA损伤积累、复制叉崩溃、不适当的有丝分裂进入和有丝分裂灾难。最近的数据表明,ATR抑制可导致ATM缺陷型恶性肿瘤出现合成致死性。此外,ATR抑制通过增加肿瘤突变负担和新抗原负荷,以及触发胞质DNA积累,随后诱导cGAS-STING通路和I型干扰素反应,在免疫系统激活中发挥重要作用。综上所述,我们回顾了一些令人振奋的数据,这些数据表明,ATR激酶抑制可改变DDR网络、免疫系统及其相互作用,因此,有可能提供一种新的策略来提高抗肿瘤治疗的疗效,将ATR抑制剂作为单一疗法或与基因毒性药物和/或免疫调节剂联合使用。
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