Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, Shenhe District, China.
Mol Carcinog. 2024 Nov;63(11):2133-2144. doi: 10.1002/mc.23799. Epub 2024 Jul 30.
Most EML4-ALK rearrangement non-small cell lung cancer (NSCLC) patients inevitably develop acquired drug resistance after treatment. The main mechanism of drug resistance is the acquired secondary mutation of ALK kinase domain. L1196M and G1202R are classical mutation sites. We urgently need to understand the underlying molecular mechanism of drug resistance to study the therapeutic targets of mutant drug-resistant NSCLC cells. The silent information regulator sirtuin1 (SIRT1) can regulate the normal energy metabolism of cells, but its role in cancer is still unclear. In our report, it was found that the SIRT1 in EML4-ALK G1202R and EML4-ALK L1196M mutant drug-resistant cells was downregulated compared with EML4-ALK NSCLC cells. The high expression of SIRT1 was related to the longer survival time of patients with lung cancer. Activation of SIRT1 induced autophagy and suppressed the invasion and migration of mutant cells. Further experiments indicated that the activation of SIRT1 inhibited the phosphorylation level of mTOR and S6K by upregulating the expression of AMPK, thus activating autophagy. SIRT1 can significantly enhanced the sensitivity of mutant cells to crizotinib, improved its ability to promote apoptosis of mutant cells, and inhibited cell proliferation. In conclusion, SIRT1 is a key regulator of drug resistant in EML4-ALK L1196M and G1202R mutant cells. SIRT1 may be a novel therapeutic target for EML4-ALK drug resistant NSCLC.
大多数 EML4-ALK 重排非小细胞肺癌(NSCLC)患者在治疗后不可避免地会产生获得性耐药。耐药的主要机制是 ALK 激酶结构域的获得性二次突变。L1196M 和 G1202R 是经典的突变位点。我们迫切需要了解耐药的潜在分子机制,以研究突变型耐药 NSCLC 细胞的治疗靶点。沉默信息调节因子 Sirtuin1(SIRT1)可以调节细胞的正常能量代谢,但它在癌症中的作用尚不清楚。在我们的报告中,发现 EML4-ALK G1202R 和 EML4-ALK L1196M 突变耐药细胞中的 SIRT1 与 EML4-ALK NSCLC 细胞相比下调。SIRT1 的高表达与肺癌患者的生存时间延长有关。SIRT1 的激活诱导自噬,抑制突变细胞的侵袭和迁移。进一步的实验表明,SIRT1 通过上调 AMPK 的表达抑制 mTOR 和 S6K 的磷酸化水平,从而激活自噬。SIRT1 可显著增强突变细胞对克唑替尼的敏感性,提高其促进突变细胞凋亡的能力,并抑制细胞增殖。总之,SIRT1 是 EML4-ALK L1196M 和 G1202R 突变细胞耐药的关键调节因子。SIRT1 可能是 EML4-ALK 耐药 NSCLC 的一个新的治疗靶点。