Autophagy and Cancer Therapy

Autophagy is a dynamic process of protein degradation which is typically observed during nutrient deprivation. Recently, interest in autophagy has been renewed among oncologists, because different types of cancer cells undergo autophagy after various anticancer therapies. This type of non-apoptotic cell death has been documented mainly by observing morphological changes, e.g., numerous autophagic vacuoles in the cytoplasm of dying cells. Thus, autophagic cell death is considered programmed cell death type II, whereas apoptosis is programmed cell death type I. These two types of cell death are predominantly distinctive, but many studies demonstrate cross-talk between them. Whether autophagy in cancer cells causes death or protects cells is controversial. In multiple studies, autophagy has been inhibited pharmacologically or genetically, resulting in contrasting outcomes—survival or death—depending on the specific context. Interestingly, the regulatory pathways of autophagy share several molecules with the oncogenic pathways activated by tyrosine kinase receptors. Tumor suppressors such as Beclin 1, PTEN, and p53 also play an important role in autophagy induction. Taken together, these accumulating data may lead to development of new cancer therapies that manipulate autophagy.     

细胞衰老与癌症治疗

细胞衰老是生物界普遍存在的现象。肿瘤细胞是一类摆脱细胞周期束缚,突破Hayflick界限,能够无限增殖而不衰老的细胞。癌症是一种与细胞衰老密切相关的疾病。从进化的角度来看,衰老对于生物体是有益的,可以导致细胞不可逆的周期阻滞,被认为是一种自主的肿瘤抑制机制。在恶性增殖的癌细胞中,在胞外及胞内多种刺激下,如端粒缩短、DNA损伤、氧化应激以及化疗药物的处理等,都会出现细胞周期阻滞,生长迟缓等细胞衰老现象。诱导肿瘤细胞衰老也被认为是一种治疗癌症的有效手段。衰老细胞可以向胞外分泌数十种因子,维持细胞自身衰老表型,并影响周围细胞的生长,这种特性被称为衰老相关的分泌表型(SASP)。本文详细综述细胞衰老的形态学特征与分子标记物及检测方法,细胞衰老的信号调控通路（p53-p21,p16-pRB和PTEN-p27）,以及细胞衰老与恶性肿瘤发生发展的关系等。尤其是应激压力诱导下的细胞衰老在癌症治疗中的潜在作用,并进一步讨论当下流行的促衰老癌症治疗的靶点与药物以及存在的问题,以期为今后的研究提供新思路和新方向。     

细胞衰老与癌症治疗

细胞衰老是生物界普遍存在的现象。肿瘤细胞是一类摆脱细胞周期束缚,突破Hayflick界限,能够无限增殖而不衰老的细胞。癌症是一种与细胞衰老密切相关的疾病。从进化的角度来看,衰老对于生物体是有益的,可以导致细胞不可逆的周期阻滞,被认为是一种自主的肿瘤抑制机制。在恶性增殖的癌细胞中,在胞外及胞内多种刺激下,如端粒缩短、DNA损伤、氧化应激以及化疗药物的处理等,都会出现细胞周期阻滞,生长迟缓等细胞衰老现象。诱导肿瘤细胞衰老也被认为是一种治疗癌症的有效手段。衰老细胞可以向胞外分泌数十种因子,维持细胞自身衰老表型,并影响周围细胞的生长,这种特性被称为衰老相关的分泌表型(SASP)。本文详细综述细胞衰老的形态学特征与分子标记物及检测方法,细胞衰老的信号调控通路（p53-p21,p16-pRB和PTEN-p27）,以及细胞衰老与恶性肿瘤发生发展的关系等。尤其是应激压力诱导下的细胞衰老在癌症治疗中的潜在作用,并进一步讨论当下流行的促衰老癌症治疗的靶点与药物以及存在的问题,以期为今后的研究提供新思路和新方向。     

细胞衰老与肿瘤发生及药物治疗

肿瘤细胞往往具有衰老障碍而表现出无限增殖的能力。细胞衰老障碍与肿瘤化疗和多药耐药关系密切,恢复肿瘤细胞衰老通路是肿瘤治疗和逆转多药耐药的一个很有前途的研究方向。     

Heterochromatin and its Relationship to Cell Senescence and Cancer Therapy

Our goal is to understand the impact of chromatin structure on cell proliferation, cell and tissue aging, cancer and cancer therapies. To this end, we have investigated the formation of specialized domains of facultative heterochromatin, called Senescence Associated Heterochromatin Foci (SAHF), in senescent human cells. A complex of histone chaperones, HIRA and ASF1a, drives formation of SAHF. Remarkably, although SAHF are highly compacted domains of heterochromatin, these domains of facultative heterochromatin largely exclude other domains of chromatin at telomeres and pericentromeres, which are themselves thought to be constitutively heterochromatic. The relationship between SAHF formation and these other domains of heterochromatin is discussed. Also, in the course of our studies, we have obtained evidence that points to a novel function for the widely-studied but poorly-understood family of heterochromatin proteins, HP1 proteins. We propose that HP1 proteins are essential components of a dynamic nuclear response that senses and rectifies defects in epigenetic information, encoded in chromatin through histone modifications and DNA methylation. We further propose that defects in this essential "chromatin repair" response in transformed human cells contributes to the preferential killing of cancer cells by the epigenetic cancer therapies that are currently in clinical development.     

自噬与癌症

自噬是溶酶体降解途径之一,在众多真核生物细胞生理过程中发挥着重要作用。近年来,人们发现自噬对肿瘤的发生、发展过程同样具有显著的影响。自噬对肿瘤的影响具有两面性:一方面,自噬能够避免细胞遭受氧化胁迫、持续性炎症及DNA损伤的积累等,从而抑制癌症的发生;另一方面,自噬又为肿瘤细胞提供生长所需的代谢中间产物,维持肿瘤细胞内环境的稳定,进而促进肿瘤的发展。因此,自噬在肿瘤的治疗过程中同样具有正、反两方面的影响,诱导自噬:一方面能够减少放射治疗及化学治疗引起的细胞DNA损伤和染色体突变的积累,从而防止肿瘤的加剧;另一方面,肿瘤细胞又能够依赖自噬来缓解药物和射线产生的压力,从而有利于自身的存活。     

细胞衰老与肿瘤治疗

人口老龄化是全世界都面临的重大挑战,随着老年人口的增加,肿瘤等衰老相关疾病发病率随之升高.流行病学调查结果显示,大约2/3的新增肿瘤患者为65岁以上的老年人,并且这一比例在不断攀升.细胞衰老是指在DNA损伤或癌基因失调等一系列条件下引起的稳定的细胞周期阻滞,并伴有形态、生化及表观遗传的改变.大量研究证明细胞衰老对抑制潜在癌细胞增殖具有重要作用.然而,目前研究认为除了抑制肿瘤发生,细胞衰老也可能促进肿瘤的演进,细胞衰老对肿瘤发挥了双刃剑作用.因此,深入了解细胞衰老与肿瘤之间的联系,充分利用细胞衰老对肿瘤抑制功能,规避其对肿瘤的促进作用可为肿瘤的治疗提供更多可能的选择.     

细胞自噬在肿瘤化疗耐药中的作用

肿瘤有多种机制产生化疗药物耐药性．自噬是一种在正常细胞和病理细胞中普遍存在的生理机制,调控自噬的分子和信号传导通路错综复杂．自噬与凋亡有着独特的交叉联系,使得自噬在肿瘤化疗耐药性中发挥着促进或抑制耐药的双重作用．自噬在肿瘤耐药中的这种截然相反的作用与化疗给药浓度、细胞类型、自噬强度等因素有关,但具体机制尚未完全明确．然而,将自噬途径作为治疗肿瘤、降低化疗药物耐药性的靶点有着广阔的应用前景．     

BID-Deficient Breast Cancer MCF-7 Cells as a Model for the Study of Autophagy in Cancer Therapy

The BH3-only death factors share just the short BH3 domain with the other Bcl-2 family subclasses. With the exception of BID, which might also bind to BAX, they are thought to act by binding to and neutralizing Bcl-2 like survival factors.Camptothecin (CPT)-induced apoptosis in breast cancer MCF-7 cells is associated with activation of cathepsin B and aggregation of BAX and BID on mitochondria. BID knock down protects cancer cells against apoptosis and induces autophagy, manifested with increased expression of Beclin1 and MAP1LC3. The compensatory increase in the concentration of Hrk (another member of the BH3-only protein family) and its co-localization with BCL-2 on organelles in BID(-) breast cancer cells has also been observed. Nonetheless, Hrk is not able to substitute for BID in triggering apoptosis. Its role in autophagy induction is also doubtful, since MAP1LC3 expression was equally high in BID(-)Hrk(-) and BID(-)Hrk(+) breast cancer cells exposed to CPT. We conclude that BID can serve as a molecular switch between apoptosis and autophagy. BID(+) and BID(-) breast cancer MCF-7 cells could be considered to be a useful model for the study of the molecular interdependences between apoptosis and autophagy and the role of both processes in cancer therapy.

Addenda to:

Cathepsins and BID are Involved in the Molecular Switch between Apoptosis and Autophagy in Breast Cancer MCF-7 Cells Exposed to Camptothecin

M. Lamparska-Przybysz, B. Gajkowska and T. Motyl

J Physiol Pharmacol 2005; 56:159-79     

细胞自噬与肿瘤耐药

细胞自噬是一种细胞自我降解的过程,在适应代谢应激、保持基因组完整性及维持内环境稳定方面发挥重要作用. 在肿瘤治疗中,凋亡耐受是产生肿瘤耐药的重要机制. 细胞自噬可防止抗肿瘤药诱导的凋亡,促进肿瘤耐药. 然而,自噬性细胞死亡可能是凋亡耐受肿瘤细胞的一种死亡方式. 因此,细胞自噬对肿瘤细胞的耐药性有双重影响. 本文综述了细胞自噬的分子机制、细胞自噬与凋亡的关系、细胞自噬与肿瘤耐药以及治疗的主要研究进展.     

Autophagy Inhibition Mediates Apoptosis Sensitization in Cancer Therapy by Relieving FOXO3a Turnover

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Autophagy Controls BCG-Induced Trained Immunity and the Response to Intravesical BCG Therapy for Bladder Cancer

The anti-tuberculosis-vaccine Bacillus Calmette-Guérin (BCG) is the most widely used vaccine in the world. In addition to its effects against tuberculosis, BCG vaccination also induces non-specific beneficial effects against certain forms of malignancy and against infections with unrelated pathogens. It has been recently proposed that the non-specific effects of BCG are mediated through epigenetic reprogramming of monocytes, a process called trained immunity. In the present study we demonstrate that autophagy contributes to trained immunity induced by BCG. Pharmacologic inhibition of autophagy blocked trained immunity induced in vitro by stimuli such as β–glucans or BCG. Single nucleotide polymorphisms (SNPs) in the autophagy genes ATG2B (rs3759601) and ATG5 (rs2245214) influenced both the in vitro and in vivo training effect of BCG upon restimulation with unrelated bacterial or fungal stimuli. Furthermore, pharmacologic or genetic inhibition of autophagy blocked epigenetic reprogramming of monocytes at the level of H3K4 trimethylation. Finally, we demonstrate that rs3759601 in ATG2B correlates with progression and recurrence of bladder cancer after BCG intravesical instillation therapy. These findings identify a key role of autophagy for the nonspecific protective effects of BCG.     

Role of Autophagy in Breast Cancer

Autophagy is an evolutionarily conserved process of cytoplasm and cellular organelle degradation in lysosomes. Autophagy is a survival pathway required for cellular viability during starvation; however, if it proceeds to completion, autophagy can lead to cell death. In neurons, constitutive autophagy limits accumulation of polyubiquitinated proteins and prevents neuronal degeneration. Therefore, autophagy has emerged as a homeostatic mechanism regulating the turnover of long-lived or damaged proteins and organelles, and buffering metabolic stress under conditions of nutrient deprivation by recycling intracellular constituents. Autophagy also plays a role in tumorigenesis, as the essential autophagy regulator beclin1 is monoallelically deleted in many human ovarian, breast, and prostate cancers, and beclin1^+/- mice are tumor-prone. We found that allelic loss of beclin1 renders immortalized mouse mammary epithelial cells susceptible to metabolic stress and accelerates lumen formation in mammary acini. Autophagy defects also activate the DNA damage response in vitro and in mammary tumors in vivo, promote gene amplification, and synergize with defective apoptosis to accelerate mammary tumorigenesis. Thus, loss of the prosurvival role of autophagy likely contributes to breast cancer progression by promoting genome damage and instability. Exploring the yet unknown relationship between defective autophagy and other breast cancer-promoting functions may provide valuable insight into the pathogenesis of breast cancer and may have significant prognostic and therapeutic implications for breast cancer patients.

Addendum to:

Autophagy Mitigates Metabolic Stress and Genome Damage in Mammary Tumorigenesis

V. Karantza-Wadsworth, S. Patel, O. Kravchuk, G. Chen, R. Mathew, S. Jin and E. White

Genes Dev 2007; 21:1621-35     

自噬与间充质干细胞衰老的关系研究进展

间充质干细胞(mesenchymal stem cells,MSCs)具备多向分化、免疫调控和靶向迁移的能力,在再生医学领域一直备受关注。但是,随着供体年龄的增长和体外培养时间的延长,MSCs通常表现出衰老特征。MSCs衰老以及功能衰退被认为是机体衰老和相关退行性疾病发展的重要诱发因素,同时也制约着MSCs在再生医学领域中的应用。自噬是溶酶体依赖途径介导细胞内物质的降解和再循环过程,是真核细胞的非核(细胞质)部分得以更新的有效途径,对维持细胞稳态至关重要,是调节MSCs衰老的潜在调控靶标。对MSCs衰老的表型特征、功能变化和分子机制,以及自噬与衰老之间的关系进行综述,为促进MSCs临床应用提供理论基础。     

肿瘤治疗过程中凋亡与自噬的关系

凋亡和自噬是参与维持机体正常的生理平衡和内环境稳定重要机制,与正常生长发育以及肿瘤等多种疾病发展过程都有着密切的联系。对于肿瘤的治疗,传统的方法是诱导肿瘤细胞凋亡,然而,肿瘤细胞中凋亡抗性的出现成为肿瘤治疗的主要障碍。近来,通过诱导其它细胞死亡方式致肿瘤细胞死亡已经成为有潜力的新的抗肿瘤机制。自噬作为另外一种细胞程序性死亡方式与凋亡一样有着复杂的分子机制和调控机制,它们之间存在密切的联系,并且存在许多相同的调节蛋白。本文就凋亡和自噬在形态特征、分子机制、检测方法以及在肿瘤治疗过程两者之间的关系做一综述。     

Autophagy Plays a Role in Chloroplast Degradation during Senescence in Individually Darkened Leaves

Chloroplasts contain approximately 80% of total leaf nitrogen and represent a major source of recycled nitrogen during leaf senescence. While bulk degradation of the cytosol and organelles in plants is mediated by autophagy, its role in chloroplast catabolism is largely unknown. We investigated the effects of autophagy disruption on the number and size of chloroplasts during senescence. When leaves were individually darkened, senescence was promoted similarly in both wild-type Arabidopsis (Arabidopsis thaliana) and in an autophagy-defective mutant, atg4a4b-1. The number and size of chloroplasts decreased in darkened leaves of wild type, while the number remained constant and the size decrease was suppressed in atg4a4b-1. When leaves of transgenic plants expressing stroma-targeted DsRed were individually darkened, a large accumulation of fluorescence in the vacuolar lumen was observed. Chloroplasts exhibiting chlorophyll fluorescence, as well as Rubisco-containing bodies, were also observed in the vacuole. No accumulation of stroma-targeted DsRed, chloroplasts, or Rubisco-containing bodies was observed in the vacuoles of the autophagy-defective mutant. We have succeeded in demonstrating chloroplast autophagy in living cells and provide direct evidence of chloroplast transportation into the vacuole.Chloroplasts contain 75% to 80% of total leaf nitrogen mainly as proteins (Makino and Osmond, 1991). During leaf senescence, chloroplast proteins are gradually degraded as a major source of nitrogen for new growth (Wittenbach, 1978; Friedrich and Huffaker, 1980; Mae et al., 1984), correlating with a decline in photosynthetic activity, while chloroplasts gradually shrink and transform into gerontoplasts, characterized by the disintegration of the thylakoid membranes and accumulation of plastoglobuli (for a recent review, see Krupinska, 2006). Concomitantly, a decline in the cellular population of chloroplasts is also evident in many cases, for example, during natural (Kura-Hotta et al., 1990; Inada et al., 1998), dark-induced (Wittenbach et al., 1982), and nutrient-limited senescence (Mae et al., 1984; Ono et al., 1995), suggesting the existence of a whole chloroplast degradation system. Some electron microscopic studies have shown whole chloroplasts in the central vacuole, which is rich in lytic hydrolases (Wittenbach et al., 1982; Minamikawa et al., 2001). However, there is no direct evidence of chloroplasts moving into the vacuole in living cells and the mechanism of transport is not yet understood (Hörtensteiner and Feller, 2002; Krupinska, 2006).The most abundant chloroplast protein is Rubisco (EC 4.1.1.39), comprising approximately 50% of the soluble protein (Wittenbach, 1978). The amount of Rubisco decreases rapidly in the early phase of leaf senescence, although more slowly in the later phase (Friedrich and Huffaker, 1980; Mae et al., 1984). In contrast, the chloroplast number remains relatively constant, making it impossible to explain Rubisco loss solely by whole chloroplast degradation. However, the mechanism of intrachloroplastic Rubisco degradation is still unknown (for review, see Feller et al., 2008). Using immunoelectron microscopy, we previously demonstrated in naturally senescing wheat (Triticum aestivum) leaves that Rubisco is released from chloroplasts into the cytoplasm and transported to the vacuole for subsequent degradation in small spherical bodies, named Rubisco-containing bodies (RCBs; Chiba et al., 2003). Similar chloroplast-derived structures were also subsequently confirmed in senescent leaves of soybean (Glycine max) and/or Arabidopsis (Arabidopsis thaliana) by electron microscopy (Otegui et al., 2005), and recently in tobacco (Nicotiana tabacum) leaves by immunoelectron microscopy, although the authors gave them a different name, Rubisco vesicular bodies (Prins et al., 2008). RCBs have double membranes, which seem to be derived from the chloroplast envelope; thus, the RCB-mediated degradation of stromal proteins represents a potential mechanism for chloroplast shrinkage during senescence. We recently demonstrated that Rubisco and stroma-targeted fluorescent proteins can be mobilized to the vacuole by ATG-dependent autophagy via RCBs, using leaves treated with concanamycin A, a vacuolar H⁺-ATPase inhibitor (Ishida et al., 2008). To investigate further, we wished to observe chloroplast autophagy and degradation directly in living cells to determine whether autophagy is responsible for chloroplast shrinkage and whether it is involved in the vacuolar degradation of whole chloroplasts during leaf senescence.Autophagy is known to be a major system for the bulk degradation of intracellular proteins and organelles in the vacuole in yeast and plants, or the lysosome in animals (for detailed mechanisms, see reviews by Ohsumi, 2001; Levine and Klionsky, 2004; Thompson and Vierstra, 2005; Bassham et al., 2006). In those systems, a portion of the cytoplasm, including entire organelles, is engulfed in membrane-bound vesicles and delivered to the vacuole/lysosome. A recent genome-wide search confirmed that Arabidopsis has many genes homologous to the yeast autophagy genes (ATGs; Doelling et al., 2002; Hanaoka et al., 2002; for detailed functions of ATGs, see the reviews noted above). Using knockout mutants of ATGs and a monitoring system with an autophagy marker, GFP-ATG8, numerous studies have demonstrated the presence of the autophagy system in plants and its importance in several biological processes (Yoshimoto et al., 2004; Liu et al., 2005; Suzuki et al., 2005; Thompson et al., 2005; Xiong et al., 2005, 2007; Fujiki et al., 2007; Phillips et al., 2008). These articles suggest that autophagy plays an important role in nutrient recycling during senescence, especially in nutrient-starved plants. The atg mutants exhibited an accelerated loss of some chloroplast proteins, but not all, under nutrient-starved conditions and during senescence, suggesting that autophagy is not the sole mechanism for the degradation of chloroplast proteins; other, as yet unidentified systems must be responsible for the degradation of chloroplast contents when the ATG system is compromised (Levine and Klionsky, 2004; Bassham et al., 2006). However, it still remains likely that autophagy is responsible for the vacuolar degradation of chloroplasts in wild-type plants.Prolonged observation is generally required to follow leaf senescence events in naturally aging leaves and senescence-associated processes tend to become chaotic over time. To observe chloroplast degradation over a short period, and to draw clear conclusions, a suitable experimental model of leaf senescence is required. Weaver and Amasino (2001) reported that senescence is rapidly induced in individually darkened leaves (IDLs) of Arabidopsis, but retarded in plants subjected to full darkness. In addition, Keech et al. (2007) observed a significant decrease of both the number and size of chloroplasts in IDLs within 6 d.In this study, using IDLs as a senescence model, we aimed to investigate the involvement of autophagy in chloroplast degradation. We show direct evidence for the transport of whole chloroplasts and RCBs to the vacuole by autophagy.     

Initiation of Apoptosis and Autophagy by Photodynamic Therapy

This study was designed to examine modes of cell death after photodynamic therapy (PDT). Murine leukemia L1210 cells and human prostate Bax-deficient DU-145 cells were examined after PDT-induced photodamage to the endoplasmic reticulum (ER). Previous studies indicated that this resulted in a substantial loss of Bcl-2 function. Both apoptosis and autophagy occurred in L1210 after ER photodamage with the latter predominating after 24 hr. These processes were characterized by altered cellular morphology, chromatin condensation, loss of mitochondrial membrane potential, and formation vacuoles containing cytosolic components. Western blots demonstrated processing of LC3-I to LC3-II, a marker for autophagy. Inhibitors of apoptosis and/or autophagy were then used to delineate the contributions of the two pathways to the effects of PDT. In DU145 cells, PDT initiated only autophagy. PI3-kinase inhibitors suppressed autophagy in both cell lines as indicated by inhibition of vacuolization and LC3 processing. Autophagy may play a role in the ability of photodynamic therapy to stimulate immunologic recognition of target cells.

Addendum to

Initiation of Apoptosis and Autophagy by Photodynamic Therapy

D. Kessel, M.G.H. Vicente and J.J. Reiners Jr.

Lasers Surg Med 2006; In press