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Cunningham A, Oudejans LL, Geugien M, Pereira-Martins DA, Wierenga ATJ, Erdem A, Sternadt D, Huls G, Schuringa JJ. The nonessential amino acid cysteine is required to prevent ferroptosis in acute myeloid leukemia. Blood Adv 2024; 8:56-69. [PMID: 37906522 PMCID: PMC10784682 DOI: 10.1182/bloodadvances.2023010786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023] Open
Abstract
ABSTRACT Cysteine is a nonessential amino acid required for protein synthesis, the generation of the antioxidant glutathione, and for synthesizing the nonproteinogenic amino acid taurine. Here, we highlight the broad sensitivity of leukemic stem and progenitor cells to cysteine depletion. By CRISPR/CRISPR-associated protein 9-mediated knockout of cystathionine-γ-lyase, the cystathionine-to-cysteine converting enzyme, and by metabolite supplementation studies upstream of cysteine, we functionally prove that cysteine is not synthesized from methionine in acute myeloid leukemia (AML) cells. Therefore, although perhaps nutritionally nonessential, cysteine must be imported for survival of these specific cell types. Depletion of cyst(e)ine increased reactive oxygen species (ROS) levels, and cell death was induced predominantly as a consequence of glutathione deprivation. nicotinamide adenine dinucleotide phosphate hydrogen oxidase inhibition strongly rescued viability after cysteine depletion, highlighting this as an important source of ROS in AML. ROS-induced cell death was mediated via ferroptosis, and inhibition of glutathione peroxidase 4 (GPX4), which functions in reducing lipid peroxides, was also highly toxic. We therefore propose that GPX4 is likely key in mediating the antioxidant activity of glutathione. In line, inhibition of the ROS scavenger thioredoxin reductase with auranofin also impaired cell viability, whereby we find that oxidative phosphorylation-driven AML subtypes, in particular, are highly dependent on thioredoxin-mediated protection against ferroptosis. Although inhibition of the cystine-glutamine antiporter by sulfasalazine was ineffective as a monotherapy, its combination with L-buthionine-sulfoximine (BSO) further improved AML ferroptosis induction. We propose the combination of either sulfasalazine or antioxidant machinery inhibitors along with ROS inducers such as BSO or chemotherapy for further preclinical testing.
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Affiliation(s)
- Alan Cunningham
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lieve L. Oudejans
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marjan Geugien
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Diego Antonio Pereira-Martins
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Albertus T. J. Wierenga
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ayşegül Erdem
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Dominique Sternadt
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerwin Huls
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan Jacob Schuringa
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Erdem A, Marin S, Pereira-Martins DA, Geugien M, Cunningham A, Pruis MG, Weinhäuser I, Gerding A, Bakker BM, Wierenga ATJ, Rego EM, Huls G, Cascante M, Schuringa JJ. Inhibition of the succinyl dehydrogenase complex in acute myeloid leukemia leads to a lactate-fuelled respiratory metabolic vulnerability. Nat Commun 2022; 13:2013. [PMID: 35440568 PMCID: PMC9018882 DOI: 10.1038/s41467-022-29639-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 03/24/2022] [Indexed: 12/03/2022] Open
Abstract
Metabolic programs can differ substantially across genetically distinct subtypes of acute myeloid leukemia (AML). These programs are not static entities but can change swiftly as a consequence of extracellular changes or in response to pathway-inhibiting drugs. Here, we uncover that AML patients with FLT3 internal tandem duplications (FLT3-ITD+) are characterized by a high expression of succinate-CoA ligases and high activity of mitochondrial electron transport chain (ETC) complex II, thereby driving high mitochondrial respiration activity linked to the Krebs cycle. While inhibition of ETC complex II enhances apoptosis in FLT3-ITD+ AML, cells also quickly adapt by importing lactate from the extracellular microenvironment. 13C3-labelled lactate metabolic flux analyses reveal that AML cells use lactate as a fuel for mitochondrial respiration. Inhibition of lactate transport by blocking Monocarboxylic Acid Transporter 1 (MCT1) strongly enhances sensitivity to ETC complex II inhibition in vitro as well as in vivo. Our study highlights a metabolic adaptability of cancer cells that can be exploited therapeutically. Inhibition of specific metabolic pathways often drives metabolic adaptation. Here, the authors show that FLT3-ITD + acute myeloid leukemia cells are OXPHOS-driven, and inhibition of complex II activity results in increased lactate influx to drive respiration, which creates a targetable vulnerability.
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Affiliation(s)
- Ayşegül Erdem
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.,Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Avda. Diagonal 643, Barcelona, 08028, Spain
| | - Silvia Marin
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Avda. Diagonal 643, Barcelona, 08028, Spain.,CIBER of Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III, 28029, Madrid, Spain.,Institute of Biomedicine of University of Barcelona, 08028, Barcelona, Spain
| | - Diego A Pereira-Martins
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.,Hematology Division, LIM31, Faculdade de Medicina, University of São Paulo, São Paulo, SP, Brazil
| | - Marjan Geugien
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Alan Cunningham
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Maurien G Pruis
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Isabel Weinhäuser
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.,Hematology Division, LIM31, Faculdade de Medicina, University of São Paulo, São Paulo, SP, Brazil
| | - Albert Gerding
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.,Laboratory of Pediatrics, Section Systems Medicine of Metabolism and Signaling, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara M Bakker
- Laboratory of Pediatrics, Section Systems Medicine of Metabolism and Signaling, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Albertus T J Wierenga
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.,Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Eduardo M Rego
- Hematology Division, LIM31, Faculdade de Medicina, University of São Paulo, São Paulo, SP, Brazil
| | - Gerwin Huls
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Marta Cascante
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Avda. Diagonal 643, Barcelona, 08028, Spain.,CIBER of Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III, 28029, Madrid, Spain.,Institute of Biomedicine of University of Barcelona, 08028, Barcelona, Spain
| | - Jan Jacob Schuringa
- Department of Experimental Hematology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
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Wagner A, Barrows A, Wijnen JT, van der Klift H, Franken PF, Verkuijlen P, Nakagawa H, Geugien M, Jaghmohan-Changur S, Breukel C, Meijers-Heijboer H, Morreau H, van Puijenbroek M, Burn J, Coronel S, Kinarski Y, Okimoto R, Watson P, Lynch JF, de la Chapelle A, Lynch HT, Fodde R. Molecular analysis of hereditary nonpolyposis colorectal cancer in the United States: high mutation detection rate among clinically selected families and characterization of an American founder genomic deletion of the MSH2 gene. Am J Hum Genet 2003; 72:1088-100. [PMID: 12658575 PMCID: PMC1180263 DOI: 10.1086/373963] [Citation(s) in RCA: 160] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2002] [Accepted: 12/30/2002] [Indexed: 12/14/2022] Open
Abstract
The identification of germline mutations in families with HNPCC is hampered by genetic heterogeneity and clinical variability. In previous studies, MSH2 and MLH1 mutations were found in approximately two-thirds of the Amsterdam-criteria-positive families and in much lower percentages of the Amsterdam-criteria-negative families. Therefore, a considerable proportion of HNPCC seems not to be accounted for by the major mismatch repair (MMR) genes. Does the latter result from a lack of sensitivity of mutation detection techniques, or do additional genes underlie the remaining cases? In this study we address these questions by thoroughly investigating a cohort of clinically selected North American families with HNPCC. We analyzed 59 clinically well-defined U.S. families with HNPCC for MSH2, MLH1, and MSH6 mutations. To maximize mutation detection, different techniques were employed, including denaturing gradient gel electrophoresis, Southern analysis, microsatellite instability, immunohistochemistry, and monoallelic expression analysis. In 45 (92%) of the 49 Amsterdam-criteria-positive families and in 7 (70%) of the 10 Amsterdam-criteria-negative families, a mutation was detected in one of the three analyzed MMR genes. Forty-nine mutations were in MSH2 or MLH1, and only three were in MSH6. A considerable proportion (27%) of the mutations were genomic rearrangements (12 in MSH2 and 2 in MLH1). Notably, a deletion encompassing exons 1-6 of MSH2 was detected in seven apparently unrelated families (12% of the total cohort) and was subsequently proven to be a founder. Screening of a second U.S. cohort with HNPCC from Ohio allowed the identification of two additional kindreds with the identical founder deletion. In the present study, we show that optimal mutation detection in HNPCC is achieved by combining accurate and expert clinical selection with an extensive mutation detection strategy. Notably, we identified a common North American deletion in MSH2, accounting for approximately 10% of our cohort. Genealogical, molecular, and haplotype studies showed that this deletion represents a North American founder mutation that could be traced back to the 19th century.
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Affiliation(s)
- Anja Wagner
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Alicia Barrows
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Juul Th. Wijnen
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Heleen van der Klift
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Patrick F. Franken
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Paul Verkuijlen
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Hidewaki Nakagawa
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Marjan Geugien
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Shantie Jaghmohan-Changur
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Cor Breukel
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Hanne Meijers-Heijboer
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Hans Morreau
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Marjo van Puijenbroek
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - John Burn
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Stephany Coronel
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Yulia Kinarski
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Ross Okimoto
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Patrice Watson
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Jane F. Lynch
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Albert de la Chapelle
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Henry T. Lynch
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - Riccardo Fodde
- Center for Human and Clinical Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Creighton University, Omaha, NE; Human Cancer Genetics Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; and Department of Clinical Genetics, University of Newcastle, Newcastle upon Tyne, United Kingdom
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