Lin Zhihao, Xu Yuting, Li Mifang, Liu Yibiao, Yu Jianbo, Zhang Lingyan
Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen 518116, China.
Longgang Central Hospital of Shenzhen, Shenzhen 518116, China.
Biomedicines. 2025 Apr 12;13(4):948. doi: 10.3390/biomedicines13040948.
: Chloroquine (CQ) has been extensively validated for its safety as an antimalarial drug. The treatment regimen combining CQ with 5-fluorouracil (5-FU) has demonstrated promising antitumor effects in both in vitro and animal models. However, the clinical application of this combination therapy still faces numerous challenges, primarily due to the unelucidated mechanistic underpinnings. : We validated the synergistic effect of CQ in antitumor therapy using 5-fluorouracil and N-acetylcysteine. Subsequently, we employed lysosomal pH probes and inhibitors (5-BDBD and bafilomycin A1) to verify the mechanism of CQ in synergistic antitumor therapy. Finally, the therapeutic efficacy and underlying mechanisms of CQ were further confirmed through in vivo experiments. : Here, we found that CQ can inhibit the ATP-induced activation of mammalian target of rapamycin (mTOR), enhancing the inhibition of 5-FU on the proliferation and survival of tumors. Mechanistically, CQ affects the lysosomal pH value, leading to the inhibition of P2X4 receptor activity. The ATP-P2X4-mTOR axis is consequently disrupted, resulting in the weakened activation of mTOR. : Our findings suggest that CQ may inhibit ATP-induced mTOR activation by suppressing P2X4 receptor signaling, thereby altering the apoptosis resistance of tumors. The combination of CQ and 5-FU represents a promising therapeutic strategy, particularly for mTOR-hyperactivated malignancies refractory to conventional chemotherapy. These findings not only advance our understanding of the mechanisms underlying CQ-based combination therapy but also highlight the therapeutic potential of pharmacologically targeting mTOR and its alternative pathways in combination chemotherapy regimens.
氯喹(CQ)作为一种抗疟药物,其安全性已得到广泛验证。CQ与5-氟尿嘧啶(5-FU)联合治疗方案在体外和动物模型中均显示出有前景的抗肿瘤效果。然而,这种联合疗法的临床应用仍面临诸多挑战,主要是由于其作用机制尚不明确。
我们使用5-氟尿嘧啶和N-乙酰半胱氨酸验证了CQ在抗肿瘤治疗中的协同作用。随后,我们采用溶酶体pH探针和抑制剂(5-BDBD和巴弗洛霉素A1)来验证CQ在协同抗肿瘤治疗中的作用机制。最后,通过体内实验进一步证实了CQ的治疗效果及其潜在机制。
在此,我们发现CQ可以抑制ATP诱导的雷帕霉素靶蛋白(mTOR)激活,增强5-FU对肿瘤增殖和存活的抑制作用。机制上,CQ影响溶酶体pH值,导致P2X4受体活性受到抑制。ATP-P2X4-mTOR轴因此被破坏,导致mTOR的激活减弱。
我们的研究结果表明,CQ可能通过抑制P2X4受体信号传导来抑制ATP诱导的mTOR激活,从而改变肿瘤的凋亡抗性。CQ与5-FU的联合代表了一种有前景的治疗策略,特别是对于对传统化疗难治的mTOR过度激活的恶性肿瘤。这些发现不仅加深了我们对基于CQ的联合治疗机制的理解,也突出了在联合化疗方案中对mTOR及其替代途径进行药理学靶向治疗的潜力。
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