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Autophagy, meaning “self-eating”, is an important cellular waste disposal mechanism. Thereby, damaged proteins, lipids and organelles are enclosed by autophagosomes and subsequently transported to the lysosomes for degradation into basic, cellular building blocks. Under basal conditions autophagy prevents the accumulation of defective and harmful material and generally promotes cell survival. However, several studies reported that hyperactivated autophagy, e.g. during developmental processes in lower eukaryotes, or during chemotherapeutic treatment of cancer cells, can also trigger cell death.
In recent years, autophagic cell death (ACD) has been considered as an alternative cell death pathway for tumor therapy, especially for solid tumors with high apoptosis resistance such as glioblastoma. Glioblastoma (GBM) is a very aggressive, malignant primary brain tumor with a median survival of ~ 15 months despite surgery and chemoradiotherapy. Accordingly, there is a great interest in improving GBM therapy through alternative cell death mechanisms. Interestingly, it has been shown that various substances, e.g. AT 101, cannabinoids and the combination of imipramine and ticlopidine (IM+TIC), induce ACD in GBM cells.
The aim of this project was to identify the underlying mechanisms of stress- and drug-induced ACD and its therapeutic potential for glioblastoma treatment. For detailed investigation of ACD, a CRISPR/Cas9-based approach was used to generate ATG5 and ATG7 knockouts as genetic models of autophagy deficiency. In a previous study of our lab it was demonstrated that administration of AT 101 triggers ACD in glioblastoma cells, which was associated with early mitochondrial fragmentation but no signs of apoptosis. Since mitochondrial fragmentation often precedes mitophagy, the first part of this thesis explored the potential role of mitophagy in AT 101-induced cell death.
ATG5-depleted cells confirmed that AT 101 induces ACD. In addition, treatment with AT 101 resulted in a pronounced mitochondrial depolarization, which was at least partly caused by the opening of the mitochondrial permeability pore. Global proteome analysis of AT 101-treated GBM cells revealed a robust decrease in mitochondrial protein clusters as well as a strong increase in the enzyme heme oxygenase-1 (HMOX1). Subsequent experiments for detailed investigation of mitophagy following AT 101 treatment (western blot, flow cytometric MTG and mt-mKeima, qRT-PCR of mitochondrial vs nuclear DNA) consistently indicated strong mitophagy induction by AT 101, which could be reduced by genetic or pharmacological inhibition of autophagy. Furthermore, siRNA-mediated knockdown experiments revealed that the selective mitophagy receptors BNIP3 and BNIP3L and the HMOX1 enzyme play an essential role in AT 101-induced mitophagy and subsequent cell death. Taken together, these data demonstrate that AT 101-induced mitochondrial dysfunction and HMOX1 induction synergize to promote excessive mitophagy with a lethal outcome in glioma cells.
The second part of this thesis focused on the identification of new substances that cause ACD and the investigation of the underlying cell death pathways. Using a cell death screen of the ENZO Screen-Well™ autophagy library in MZ-54 wild-type vs ATG5 and ATG7-depleted cells, loperamide, pimozide, and STF-62247 were identified as ACD-inducing agents. The increase of the autophagic flux and the induction of ACD by these substances was confirmed by using different ATG5 and ATG7 knockout cell lines and the already established positive control IM+TIC.
In contrast to AT 101, IM+TIC, STF-62247, loperamide and pimozide produced neither mitochondrial dysfunction nor mitophagy. Interestingly, it has been described that imipramine, loperamide and pimozide inhibit the lysosomal enzyme acid sphingomyelinase, which is associated with impaired lipid transport. Global proteome analysis and cholesterol staining confirmed that all four substances, but especially loperamide and pimozide, inhibit cellular lipid transport, leading to massive lipid accumulation in the lysosomes. In the further course of the experiments, the connection between defective lipid transport and autophagy was investigated in more detail. On the one hand, the defective lipid transport contributed to the induction of autophagy, on the other hand the massive accumulation of lipids led to lysosomal membrane damage, inhibition of lysosomal degradation at later time points and finally to a lysosomal cell death. Remarkably, it has been shown that hyperactivated autophagy by IM+TIC, loperamide and pimozide massively promotes lysosomal membrane damage. This result highlights the difficulties of a clear distinction between autophagic and lysosomal cell death.
In summary, two new signaling pathways that induce autophagic cell death in GBM cells and may be relevant for glioblastoma therapy were investigated in this study.
Loperamide, pimozide, and STF-62247 trigger autophagy-dependent cell death in glioblastoma cells
(2018)
Autophagy is a well-described degradation mechanism that promotes cell survival upon nutrient starvation and other forms of cellular stresses. In addition, there is growing evidence showing that autophagy can exert a lethal function via autophagic cell death (ACD). As ACD has been implicated in apoptosis-resistant glioblastoma (GBM), there is a high medical need for identifying novel ACD-inducing drugs. Therefore, we screened a library containing 70 autophagy-inducing compounds to induce ATG5-dependent cell death in human MZ-54 GBM cells. Here, we identified three compounds, i.e. loperamide, pimozide, and STF-62247 that significantly induce cell death in several GBM cell lines compared to CRISPR/Cas9-generated ATG5- or ATG7-deficient cells, pointing to a death-promoting role of autophagy. Further cell death analyses conducted using pharmacological inhibitors revealed that apoptosis, ferroptosis, and necroptosis only play minor roles in loperamide-, pimozide- or STF-62247-induced cell death. Intriguingly, these three compounds induce massive lipidation of the autophagy marker protein LC3B as well as the formation of LC3B puncta, which are characteristic of autophagy. Furthermore, loperamide, pimozide, and STF-62247 enhance the autophagic flux in parental MZ-54 cells, but not in ATG5 or ATG7 knockout (KO) MZ-54 cells. In addition, loperamide- and pimozide-treated cells display a massive formation of autophagosomes and autolysosomes at the ultrastructural level. Finally, stimulation of autophagy by all three compounds is accompanied by dephosphorylation of mammalian target of rapamycin complex 1 (mTORC1), a well-known negative regulator of autophagy. In summary, our results indicate that loperamide, pimozide, and STF-62247 induce ATG5- and ATG7-dependent cell death in GBM cells, which is preceded by a massive induction of autophagy. These findings emphasize the lethal function and potential clinical relevance of hyperactivated autophagy in GBM.
STF-62247 and pimozide induce autophagy and autophagic cell death in mouse embryonic fibroblasts
(2020)
Induction of autophagy can have beneficial effects in several human diseases, e.g. cancer and neurodegenerative diseases (ND). Here, we therefore evaluated the potential of two novel autophagy-inducing compounds, i.e. STF-62247 and pimozide, to stimulate autophagy as well as autophagic cell death (ACD) using mouse embryonic fibroblasts (MEFs) as a cellular model. Importantly, both STF-62247 and pimozide triggered several hallmarks of autophagy in MEFs, i.e. enhanced levels of LC3B-II protein, its accumulation at distinct cytosolic sites and increase of the autophagic flux. Intriguingly, autophagy induction by STF-62247 and pimozide resulted in cell death that was significantly reduced in ATG5- or ATG7-deficient MEFs. Consistent with ACD induction, pharmacological inhibitors of apoptosis, necroptosis or ferroptosis failed to protect MEFs from STF-62247- or pimozide-triggered cell death. Interestingly, at subtoxic concentrations, pimozide stimulated fragmentation of the mitochondrial network, degradation of mitochondrial proteins (i.e. mitofusin-2 and cytochrome c oxidase IV (COXIV)) as well as a decrease of the mitochondrial mass, indicative of autophagic degradation of mitochondria by pimozide. In conclusion, this study provides novel insights into the induction of selective autophagy as well as ACD by STF-62247 and pimozide in MEFs.