Tang Han-Hsuan, Hsu Chi-Pei, Su Pin-Yu, Tsai Shu-Ping, Doan Ly Hien, Chen Ching-Ying, Chen Hsin-Chih, Wang Pao-Yuan, Cheng Tai-Shan, Huang Chi-Ying F, Su Chun-Li
Graduate Program of Nutrition Science, School of Life Science, National Taiwan Normal University, Taipei, Taiwan.
Institute of Biopharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
J Cell Physiol. 2025 Aug;240(8):e70078. doi: 10.1002/jcp.70078.
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death. Sorafenib, a multikinase inhibitor, has been approved as a first-line systemic therapeutic for HCC patients based on the results of two large clinical trials, in which sorafenib significantly increased life expectancy of patients with Child Pugh A advanced stage of liver cancer, no matter which races they were or whether being infected with hepatitis B or C virus; however, its efficacy is compromised by the resistance of the tumor cells. By using integrative bioinformatics analysis, we identified ferroptosis as a candidate to modulate sorafenib-resistant HCC. Ferroptosis is a novel, iron-dependent, non-apoptotic regulated cell death with characteristics of impaired lipid peroxide repair, redox active iron, and the oxidation of polyunsaturated fatty acids. Here, glutathione peroxidase 4 (GPX4) was further identified as a favorable prognostic factor in cancer survival by analyzing data repositories. Compared to the parental human HCC Huh7 cells, lower expression of GPX4, dysregulated iron homeostasis, and higher expression of acyl-CoA synthetase long-chain family member 4 were observed in sorafenib-resistant Huh7R cells, and the Huh7R cells exhibited higher sensitivity to ferroptosis induction exerted by RSL3, a GPX4 inhibitor. The RSL3-induced ferroptosis was attenuated by lysosomal blocker bafilomycin A1, indicating that lysosomal degradation of ferritin may confer sensitivity to GPX4-inactivation-induced ferroptosis by providing accessible iron. Taken together, our findings demonstrate that GPX4-inactivation-induced ferroptosis is a promising and effective treatment option capable of overcoming sorafenib resistance in liver cancer, and our novel gene expression-screening platform via integrated analysis of differentially expressed genes and pathways allows efficient identification of therapeutic strategies.
肝细胞癌(HCC)是癌症死亡的主要原因之一。索拉非尼是一种多激酶抑制剂,基于两项大型临床试验的结果,已被批准作为HCC患者的一线全身治疗药物。在这两项试验中,无论患者种族如何,也无论是否感染乙肝或丙肝病毒,索拉非尼都显著提高了Child Pugh A期晚期肝癌患者的预期寿命;然而,肿瘤细胞的耐药性削弱了其疗效。通过综合生物信息学分析,我们确定铁死亡是调节索拉非尼耐药性HCC的一个候选因素。铁死亡是一种新的、铁依赖性的、非凋亡性的程序性细胞死亡,具有脂质过氧化修复受损、氧化还原活性铁和多不饱和脂肪酸氧化的特征。在此,通过分析数据存储库,谷胱甘肽过氧化物酶4(GPX4)被进一步确定为癌症生存的一个良好预后因素。与亲本人类HCC Huh7细胞相比,在索拉非尼耐药的Huh7R细胞中观察到GPX4表达降低、铁稳态失调以及酰基辅酶A合成酶长链家族成员4表达升高,并且Huh7R细胞对GPX4抑制剂RSL3诱导的铁死亡表现出更高的敏感性。溶酶体阻滞剂巴弗洛霉素A1减弱了RSL3诱导的铁死亡,这表明铁蛋白的溶酶体降解可能通过提供可利用的铁而赋予对GPX4失活诱导的铁死亡的敏感性。综上所述,我们的研究结果表明,GPX4失活诱导的铁死亡是一种有前景且有效的治疗选择,能够克服肝癌中的索拉非尼耐药性,并且我们通过对差异表达基因和通路进行综合分析的新型基因表达筛选平台能够高效识别治疗策略。
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