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Liu X, Bi Y, Wei C, Zhang Y, Liu X, Guo X, Zhao L, Zhang J, Wang C, Gao H. Engineered Neutrophil Nanovesicles for Inhibiting Corneal Neovascularization by Synergistic Anti-Inflammatory, Anti-VEGF, and Chemoexcited Photodynamic Therapy. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2025; 37:e2411030. [PMID: 39838757 DOI: 10.1002/adma.202411030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 12/17/2024] [Indexed: 01/23/2025]
Abstract
Corneal neovascularization (CorNV) develops under various pathological conditions and is one of the main causes of blindness. Due to that CorNV progression involves multiple steps, anti-vascular endothelial growth factor (VEGF) drugs alone could not sufficiently suppress this process, highlighting an urgent need for an efficient delivery system for the multi-step management of CorNV. In this study, a neutrophil nanovesicle-based eye drop (NCCR) is developed for CorNV therapy that simultaneously inhibits angiogenesis and inflammation, while eliminating pathological cells through chemoexcited photodynamic therapy (PDT). NCCR targets inflammatory lesions by leveraging the expression of chemokine receptors from the source cells. Then, NCCR exerts inhibitory effects on the sequential steps of neovascularization. First, it acts as a decoy and exerts an anti-inflammatory effect by neutralizing cytokines via its receptors on the surface of nanovesicles. Second, thioketals bond-linked ranibizumab is released in the high reactive oxygen species microenvironment of CorNV sites to bind VEGF, inhibiting vascular endothelial cell activation and proliferation. Finally, chemoexcited PDT eliminates preformed corneal blood vessels, disrupting tube formation and pericyte recruitment. The synergistic effects of NCCR on angiogenesis and inflammation, combined with the induction of apoptosis in neovessels via chemoexcited PDT, offer a novel and efficient strategy for CorNV treatment.
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Affiliation(s)
- Xiaoxue Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Yingxuan Bi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Chaoqun Wei
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Ye Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Xiaoyu Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Xinghan Guo
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Longfei Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Jingjing Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
| | - Changlong Wang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- School of Life Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Hua Gao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, 266071, China
- Eye Hospital of Shandong First Medical University, Jinan, 250021, China
- School of Ophthalmology, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, 250000, China
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Dai X, Yang X, Feng Y, Wu X, Ju Y, Zou R, Yuan F. The role of vitamin K and its antagonist in the process of ferroptosis-damaged RPE-mediated CNV. Cell Death Dis 2025; 16:190. [PMID: 40108164 PMCID: PMC11923134 DOI: 10.1038/s41419-025-07497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 02/08/2025] [Accepted: 03/03/2025] [Indexed: 03/22/2025]
Abstract
Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in people over the age of 55. AMD currently affects approximately 8% of the world's population, and the number is growing as the global population ages. Growing evidence suggests that pathological choroidal neovascularization (CNV) is often related to more severe and rapid vision loss and blindness associated with AMD. The typical clinical treatment is intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents. However, some patients do not respond well to this therapy, and the potential risks of long-term repeated injections cannot be ignored. Therefore, there is an urgent need to explore the specific mechanisms of CNV development and find new, safe, and effective treatments. In this study, our data indicate that ferroptotic damage of retinal pigment epithelium (RPE) and its induced VEGFA overexpression are critical promoting factors in the development of CNV. Vitamin K can mediate the protection of RPE cells from ferroptotic damage and regulate the expression of eIF2α-ATF4-VEGFA in a VKOR/FSP1-dependent manner, inhibiting new angiogenesis to alleviate CNV. On the contrary, vitamin K antagonists (VKA) represented by warfarin, can promote RPE ferroptotic damage and related vascular proliferation in mice and eventually aggravate CNV lesions. However, vitamin K still showed significant protective effects even in the presence of VKA. Due to its significant anti-ferroptosis and anti-neovascular effects, as well as its relative safety and convenience of use, vitamin K has excellent potential in the treatment of CNV and is expected to become a clinically effective and safe new CNV treatment strategy.
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Affiliation(s)
- Xiaochan Dai
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, PR China
| | - Xi Yang
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, PR China
| | - Yifan Feng
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, PR China
| | - Xinyuan Wu
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, PR China
| | - Yahan Ju
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, PR China
| | - Rong Zou
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, PR China
| | - Fei Yuan
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, PR China.
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Liu J, Lyu Q, Wu M, Zhou Y, Wang T, Zhang Y, Fan N, Yang C, Wang W. Integrating mTOR Inhibition and Photodynamic Therapy Based on Carrier-Free Nanodrugs for Breast Cancer Immunotherapy. Adv Healthc Mater 2024; 13:e2402357. [PMID: 39235716 PMCID: PMC11650419 DOI: 10.1002/adhm.202402357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/07/2024] [Indexed: 09/06/2024]
Abstract
Conventional photodynamic therapy (PDT) in cancer treatment needs to utilize oxygen to produce reactive oxygen species to eliminate malignant tissues. However, oxygen consumption in tumor microenvironment exacerbates cancer cell hypoxia and may promote vasculature angiogenesis. Since the mammalian target of rapamycin (mTOR) signaling pathway plays a vital role in endothelial cell proliferation and fibrosis, mTOR inhibitor drugs hold the potential to reverse hypoxia-evoked angiogenesis for improved PDT effect. In this study, a carrier-free nanodrug formulation composed of Torin 1 as mTORC1/C2 dual inhibitor and Verteporfin as a photosensitizer and Yes-associated protein inhibitor is developed. These two drug molecules can self-assemble into stable nanoparticles through π-π stacking and hydrophobic interactions with good long-term stability. The nanodrugs can prompt synergistic apoptosis, combinational anti-angiogenesis, and strong immunogenic cell death effects upon near-infrared light irradiation in vitro. Furthermore, the nanosystem also exhibits improved antitumor effect, anti-cancer immune response, and distant tumor inhibition through tumor microenvironment remodeling in vivo. In this way, the nanodrugs can reverse PDT-elicited angiogenesis and promote cancer immunotherapy to eliminate tumor tissues and prevent metastasis. This nanosystem provides insights into integrating mTOR inhibitors and photosensitizers for safe and effective breast cancer treatment in clinical settings.
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Affiliation(s)
- Jinzhao Liu
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Qingyang Lyu
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Meicen Wu
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Yang Zhou
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Tianyi Wang
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Yichi Zhang
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Ni Fan
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Chang Yang
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
| | - Weiping Wang
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong999077China
- Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong Kong999077China
- Dr. Li Dak‐Sum Research CentreThe University of Hong KongHong Kong999077China
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Chen K, Liu Y, Liu X, Guo Y, Liu J, Ding J, Zhang Z, Ni X, Chen Y. Hyaluronic acid-modified and verteporfin-loaded polylactic acid nanogels promote scarless wound healing by accelerating wound re-epithelialization and controlling scar formation. J Nanobiotechnology 2023; 21:241. [PMID: 37496007 PMCID: PMC10369727 DOI: 10.1186/s12951-023-02014-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
Wound healing is a common occurrence. However, delayed healing and aberrant scarring result in pathological wound healing. Accordingly, a scarless wound healing remains a significant clinical challenge. In this study, we constructed hyaluronic acid (HA)-modified and verteporfin (VP)-loaded polylactic acid (PLA) nanogels (HA/VP-PLA) to promote scarless wound healing by accelerating wound re-epithelialization and controlling scar formation. Owing to the unique structure of HA incorporating and coating in VP-loaded PLA nanoparticles, HA/VP-PLA could be topically applied on wound to achieve targeted delivery to fibroblasts. Then, HA/VP-PLA released HA and lactic acid (LA) to stimulate the proliferation and migration of fibroblasts, as well as VP to inhibit Yes-associated protein (YAP) expression and nuclear localization to suppress fibrosis. In vitro (skin fibroblasts) and in vivo (rat and rabbit models) experiments strongly suggested that HA/VP-PLA promoted scarless wound healing by accelerating wound re-epithelialization and controlling scar formation. Therefore, our work provides a feasible strategy for scarless wound healing, and the sophisticated HA/VP-PLA exhibit a great potential for clinical applications.
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Affiliation(s)
- Kun Chen
- Department of Burn and Plastic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yuanhu Liu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children' s Hospital, Capital Medical University, National Center for Children' s Health, Beijing, 100045, China
- Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Xiaohui Liu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children' s Hospital, Capital Medical University, National Center for Children' s Health, Beijing, 100045, China
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jing Liu
- Department of Burn and Plastic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jiaojiao Ding
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children' s Hospital, Capital Medical University, National Center for Children' s Health, Beijing, 100045, China
| | - Zheng Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Xin Ni
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children' s Hospital, Capital Medical University, National Center for Children' s Health, Beijing, 100045, China.
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Yunsheng Chen
- Department of Burn, Shanghai Burn Institute, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
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Luo G, Sun Z, Liu H, Yuan Z, Wang W, Tu B, Li J, Fan C. Verteporfin attenuates trauma-induced heterotopic ossification of Achilles tendon by inhibiting osteogenesis and angiogenesis involving YAP/β-catenin signaling. FASEB J 2023; 37:e23057. [PMID: 37367700 DOI: 10.1096/fj.202300568r] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023]
Abstract
Heterotopic ossification occurs as a pathological ossification condition characterized by ectopic bone formation within soft tissues following trauma. Vascularization has long been established to fuel skeletal ossification during tissue development and regeneration. However, the feasibility of vascularization as a target of heterotopic ossification prevention remained to be further clarified. Here, we aimed to identify whether verteporfin as a widely used FDA-approved anti-vascularization drug could effectively inhibit trauma-induced heterotopic ossification formation. In the current study, we found that verteporfin not only dose dependently inhibited the angiogenic activity of human umbilical vein endothelial cells (HUVECs) but also the osteogenic differentiation of tendon stem cells (TDSCs). Moreover, YAP/β-catenin signaling axis was downregulated by the verteporfin. Application of lithium chloride, an agonist of β-catenin, recovered TDSCs osteogenesis and HUVECs angiogenesis that was inhibited by verteporfin. In vivo, verteporfin attenuated heterotopic ossification formation by decelerating osteogenesis and the vessels densely associated with osteoprogenitors formation, which could also be readily reversed by lithium chloride, as revealed by histological analysis and Micro-CT scan in a murine burn/tenotomy model. Collectively, this study confirmed the therapeutic effect of verteporfin on angiogenesis and osteogenesis in trauma-induced heterotopic ossification. Our study sheds light on the anti-vascularization strategy with verteporfin as a candidate treatment for heterotopic ossification prevention.
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Affiliation(s)
- Gang Luo
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Ziyang Sun
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Hang Liu
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhengqiang Yuan
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wei Wang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Bing Tu
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Juehong Li
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Cunyi Fan
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, PR China
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Wang C, Pang Y. Nano-based eye drop: Topical and noninvasive therapy for ocular diseases. Adv Drug Deliv Rev 2023; 194:114721. [PMID: 36773886 DOI: 10.1016/j.addr.2023.114721] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 02/11/2023]
Abstract
Eye drops are the most accessible therapy for ocular diseases, while inevitably suffering from their lower bioavailability which highly restricts the treatment efficacy. The introduction of nanotechnology has attracted considerable interest as it has advantages over conventional ones such as prolonged ocular surface retention time and enhanced ocular barrier penetrating properties, and achieving higher bioavailability and improved treatment efficacy. This review describes various ocular diseases treated with eye drops as well as the physiological and anatomical ocular barriers faced with through drug administration. It also summarizes the recent advances regarding the utilization of nanotechnology in developing eye drops, and how to optimize the nanocarrier-based ocular drug delivery systems. The prospective future research directions for nano-based eye drops are also discussed here.
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Affiliation(s)
- Chuhan Wang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yan Pang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Cerivastatin Synergizes with Trametinib and Enhances Its Efficacy in the Therapy of Uveal Melanoma. Cancers (Basel) 2023; 15:cancers15030886. [PMID: 36765842 PMCID: PMC9913575 DOI: 10.3390/cancers15030886] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Metastatic uveal melanoma (MUM) is a highly aggressive, therapy-resistant disease. Driver mutations in Gα-proteins GNAQ and GNA11 activate MAP-kinase and YAP/TAZ pathways of oncogenic signalling. MAP-kinase and MEK-inhibitors do not significantly block MUM progression, likely due to persisting YAP/TAZ signalling. Statins inhibit YAP/TAZ activation by blocking the mevalonate pathway, geranyl-geranylation, and subcellular localisation of the Rho-GTPase. We investigated drugs that affect the YAP/TAZ pathway, valproic acid, verteporfin and statins, in combination with MEK-inhibitor trametinib. METHODS We established IC50 values of the individual drugs and monitored the effects of their combinations in terms of proliferation. We selected trametinib and cerivastatin for evaluation of cell cycle and apoptosis. Synergism was detected using isobologram and Chou-Talalay analyses. The most synergistic combination was tested in vivo. RESULTS Synergistic concentrations of trametinib and cerivastatin induced a massive arrest of proliferation and cell cycle and enhanced apoptosis, particularly in the monosomic, BAP1-mutated UPMM3 cell line. The combined treatment reduced ERK and AKT phosphorylation, increased the inactive, cytoplasmatic form of YAP and significantly impaired the growth of UM cells with monosomy of chromosome 3 in NSG mice. CONCLUSION Statins can potentiate the efficacy of MEK inhibitors in the therapy of UM.
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