Bi J, Witt E, McGovern MK, Cafi AB, Rosenstock LL, Pearson AB, Brown TJ, Karasic TB, Absler LC, Machkanti S, Boyce H, Gallo D, Becker SL, Ishida K, Jenkins J, Hayward A, Scheiflinger A, Bodeker KL, Kumar R, Shaw SK, Jabbour SK, Lira VA, Henry MD, Tift MS, Otterbein LE, Traverso G, Byrne JD. Oral Carbon Monoxide Enhances Autophagy Modulation in Prostate, Pancreatic, and Lung Cancers.
Adv Sci (Weinh) 2024;
11:e2308346. [PMID:
38084435 PMCID:
PMC10916612 DOI:
10.1002/advs.202308346]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/30/2023] [Indexed: 01/22/2024]
Abstract
Modulation of autophagy, specifically its inhibition, stands to transform the capacity to effectively treat a broad range of cancers. However, the clinical efficacy of autophagy inhibitors has been inconsistent. To delineate clinical and epidemiological features associated with autophagy inhibition and a positive oncological clinical response, a retrospective analysis of patients is conducted treated with hydroxychloroquine, a known autophagy inhibitor. A direct correlation between smoking status and inhibition of autophagy with hydroxychloroquine is identified. Recognizing that smoking is associated with elevated circulating levels of carbon monoxide (CO), it is hypothesized that supplemental CO can amplify autophagy inhibition. A novel, gas-entrapping material containing CO in a pre-clinical model is applied and demonstrated that CO can dramatically increase the cytotoxicity of autophagy inhibitors and significantly inhibit the growth of tumors when used in combination. These data support the notion that safe, therapeutic levels of CO can markedly enhance the efficacy of autophagy inhibitors, opening a promising new frontier in the quest to improve cancer therapies.
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