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Ji J, Cheng Z, Zhang J, Wu J, Xu X, Guo C, Feng J. Dihydroartemisinin induces ferroptosis of hepatocellular carcinoma via inhibiting ATF4-xCT pathway. J Cell Mol Med 2024; 28:e18335. [PMID: 38652216 PMCID: PMC11037408 DOI: 10.1111/jcmm.18335] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/21/2023] [Accepted: 04/04/2024] [Indexed: 04/25/2024] Open
Abstract
Management of hepatocellular carcinoma (HCC) remains challenging due to population growth, frequent recurrence and drug resistance. Targeting of genes involved with the ferroptosis is a promising alternative treatment strategy for HCC. The present study aimed to investigate the effect of dihydroartemisinin (DHA) against HCC and explore the underlying mechanisms. The effects of DHA on induction of ferroptosis were investigated with the measurement of malondialdehyde concentrations, oxidised C11 BODIPY 581/591 staining, as well as subcutaneous xenograft experiments. Activated transcription factor 4 (ATF4) and solute carrier family 7 member 11 (SLC7A11 or xCT) were overexpressed with lentiviruses to verify the target of DHA. Here, we confirmed the anticancer effect of DHA in inducing ferroptosis is related to ATF4. High expression of ATF4 is related to worse clinicopathological prognosis of HCC. Mechanistically, DHA inhibited the expression of ATF4, thereby promoting lipid peroxidation and ferroptosis of HCC cells. Overexpression of ATF4 rescued DHA-induced ferroptosis. Moreover, ATF4 could directly bound to the SLC7A11 promoter and increase its transcription. In addition, DHA enhances the chemosensitivity of sorafenib on HCC in vivo and in vitro. These findings confirm that DHA induces ferroptosis of HCC via inhibiting ATF4-xCT pathway, thereby providing new drug options for the treatment of HCC.
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Affiliation(s)
- Jie Ji
- Department of GastroenterologyShanghai Tenth People's Hospital, Tongji University School of MedicineShanghaiChina
| | - Ziqi Cheng
- Department of GastroenterologyShanghai Tenth People's Hospital, Tongji University School of MedicineShanghaiChina
| | - Jie Zhang
- Department of GastroenterologyShanghai Tenth People's Hospital, Tongji University School of MedicineShanghaiChina
| | - Jianye Wu
- Department of GastroenterologyPutuo People's Hospital, Tongji UniversityShanghaiChina
| | - Xuanfu Xu
- Department of GastroenterologyShidong Hospital, University of Shanghai for Science and TechnologyShanghaiChina
| | - Chuanyong Guo
- Department of GastroenterologyShanghai Tenth People's Hospital, Tongji University School of MedicineShanghaiChina
| | - Jiao Feng
- Department of GastroenterologyShanghai Tenth People's Hospital, Tongji University School of MedicineShanghaiChina
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Dong X, Xu L, Wang S, Jiao X, Yan S, Huang Y, Yuan M, Wang G. Endometrial stromal cell autophagy-dependent ferroptosis caused by iron overload in ovarian endometriosis is inhibited by the ATF4-xCT pathway. Mol Hum Reprod 2023; 30:gaad046. [PMID: 38113413 DOI: 10.1093/molehr/gaad046] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/01/2023] [Indexed: 12/21/2023] Open
Abstract
Ferroptosis is an iron-dependent programmed cell death process characterized by the accumulation of lethal oxidative damage. Localized iron overload is a unique clinical phenomenon in ovarian endometriosis (EM). However, the role and mechanism of ferroptosis in the course of ovarian EM remain unclear. Traditionally, autophagy promotes cell survival. However, a growing body of research suggests that autophagy promotes ferroptosis under certain conditions. This study aimed to clarify the status of ferroptosis in ovarian EM and explore the mechanism(s) by which iron overload causes ferroptosis and ectopic endometrial resistance to ferroptosis in human. The results showed increased levels of iron and reactive oxygen species in ectopic endometrial stromal cells (ESCs). Some ferroptosis and autophagy proteins in the ectopic tissues differed from those in the eutopic endometrium. In vitro, iron overload caused decreased cellular activity, increased lipid peroxidation levels, and mitochondrial morphological changes, whereas ferroptosis inhibitors alleviated these phenomena, illustrating activated ferroptosis. Iron overload increased autophagy, and ferroptosis caused by iron overload was inhibited by autophagy inhibitors, indicating that ferroptosis caused by iron overload was autophagy-dependent. We also confirmed the effect of iron overload and autophagy on lesion growth in vivo by constructing a mouse EM model; the results were consistent with those of the in vitro experiments of human tissue and endometrial stomal cells. However, ectopic lesions in patients can resist ferroptosis caused by iron overload, which can promote cystine/glutamate transporter hyperexpression by highly expressing activating transcription factor 4 (ATF4). In summary, local iron overload in ovarian EM can activate autophagy-related ferroptosis in ESCs, and ectopic lesions grow in a high-iron environment via ATF4-xCT while resisting ferroptosis. The effects of iron overload on other cells in the EM environment require further study. This study deepens our understanding of the role of ferroptosis in ovarian EM.
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Affiliation(s)
- Xiaoyu Dong
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Le Xu
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Shuang Wang
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Xue Jiao
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Shumin Yan
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Yufei Huang
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Ming Yuan
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Guoyun Wang
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
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