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Kanellis DC, Zisi A, Skrott Z, Lemmens B, Espinoza JA, Kosar M, Björkman A, Li X, Arampatzis S, Bartkova J, Andújar-Sánchez M, Fernandez-Capetillo O, Mistrik M, Lindström MS, Bartek J. Actionable cancer vulnerability due to translational arrest, p53 aggregation and ribosome biogenesis stress evoked by the disulfiram metabolite CuET. Cell Death Differ 2023:10.1038/s41418-023-01167-4. [PMID: 37142656 DOI: 10.1038/s41418-023-01167-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
Drug repurposing is a versatile strategy to improve current therapies. Disulfiram has long been used in the treatment of alcohol dependency and multiple clinical trials to evaluate its clinical value in oncology are ongoing. We have recently reported that the disulfiram metabolite diethyldithiocarbamate, when combined with copper (CuET), targets the NPL4 adapter of the p97VCP segregase to suppress the growth of a spectrum of cancer cell lines and xenograft models in vivo. CuET induces proteotoxic stress and genotoxic effects, however important issues concerning the full range of the CuET-evoked tumor cell phenotypes, their temporal order, and mechanistic basis have remained largely unexplored. Here, we have addressed these outstanding questions and show that in diverse human cancer cell models, CuET causes a very early translational arrest through the integrated stress response (ISR), later followed by features of nucleolar stress. Furthermore, we report that CuET entraps p53 in NPL4-rich aggregates leading to elevated p53 protein and its functional inhibition, consistent with the possibility of CuET-triggered cell death being p53-independent. Our transcriptomics profiling revealed activation of pro-survival adaptive pathways of ribosomal biogenesis (RiBi) and autophagy upon prolonged exposure to CuET, indicating potential feedback responses to CuET treatment. The latter concept was validated here by simultaneous pharmacological inhibition of RiBi and/or autophagy that further enhanced CuET's tumor cytotoxicity, using both cell culture and zebrafish in vivo preclinical models. Overall, these findings expand the mechanistic repertoire of CuET's anti-cancer activity, inform about the temporal order of responses and identify an unorthodox new mechanism of targeting p53. Our results are discussed in light of cancer-associated endogenous stresses as exploitable tumor vulnerabilities and may inspire future clinical applications of CuET in oncology, including combinatorial treatments and focus on potential advantages of using certain validated drug metabolites, rather than old, approved drugs with their, often complex, metabolic profiles.
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Affiliation(s)
- Dimitris C Kanellis
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden.
| | - Asimina Zisi
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
| | - Zdenek Skrott
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Bennie Lemmens
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
| | - Jaime A Espinoza
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
| | - Martin Kosar
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
| | - Andrea Björkman
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
| | - Xuexin Li
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
| | | | - Jirina Bartkova
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
- Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark
| | - Miguel Andújar-Sánchez
- Pathology Department, Complejo Hospitalario Universitario Insular, Las Palmas, Gran Canaria, Spain
| | - Oscar Fernandez-Capetillo
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
- Genomic Instability Group, Spanish National Cancer Research Centre (CNIO), Madrid, 28029, Spain
| | - Martin Mistrik
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Mikael S Lindström
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden
| | - Jiri Bartek
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 21, Stockholm, Sweden.
- Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark.
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Buchtova T, Skrott Z, Chroma K, Rehulka J, Dzubak P, Hajduch M, Lukac D, Arampatzis S, Bartek J, Mistrik M. Cannabidiol-induced activation of the metallothionein pathway impedes anticancer effects of disulfiram and its metabolite CuET. Mol Oncol 2021; 16:1541-1554. [PMID: 34632694 PMCID: PMC8978514 DOI: 10.1002/1878-0261.13114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/21/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022] Open
Abstract
Disulfiram (DSF), an established alcohol‐aversion drug, is a candidate for repurposing in cancer treatment. DSF’s antitumor activity is supported by preclinical studies, case reports, and small clinical trials; however, ongoing clinical trials of advanced‐stage cancer patients encounter variable results. Here, we show that one reason for the inconsistent clinical effects of DSF may reflect interference by other drugs. Using a high‐throughput screening and automated microscopy, we identify cannabidiol, an abundant component of the marijuana plant used by cancer patients to mitigate side effects of chemotherapy, as a likely cause of resistance to DSF. Mechanistically, in cancer cells, cannabidiol triggers the expression of metallothioneins providing protective effects by binding heavy metal‐based substances including the bis‐diethyldithiocarbamate‐copper complex (CuET). CuET is the documented anticancer metabolite of DSF, and we show here that the CuET’s anticancer toxicity is effectively neutralized by metallothioneins. Overall, this work highlights an example of undesirable interference between cancer therapy and the concomitant usage of marijuana products. In contrast, we report that insufficiency of metallothioneins sensitizes cancer cells toward CuET, suggesting a potential predictive biomarker for DSF repurposing in oncology.
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Affiliation(s)
- Tereza Buchtova
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
| | - Zdenek Skrott
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
| | - Katarina Chroma
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
| | - Jiri Rehulka
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
| | - Petr Dzubak
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
| | - Marian Hajduch
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
| | - David Lukac
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
| | | | - Jiri Bartek
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic.,Danish Cancer Society Research Center, Copenhagen, Denmark.,Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
| | - Martin Mistrik
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech Republic
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Lindner G, Funk GC, Leichtle AB, Fiedler GM, Schwarz C, Eleftheriadis T, Pasch A, Mohaupt MG, Exadaktylos AK, Arampatzis S. Impact of proton pump inhibitor use on magnesium homoeostasis: a cross-sectional study in a tertiary emergency department. Int J Clin Pract 2014; 68:1352-7. [PMID: 24898571 DOI: 10.1111/ijcp.12469] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 05/01/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To date, the use of proton pump inhibitors (PPIs) has been associated with a low risk of hypomagnesaemia and associated adverse outcomes. We hypothesised that a better risk estimate could be derived from a large cohort of outpatients admitted to a tertiary emergency department (ED). METHODS A cross-sectional study was performed in 5118 patients who had measurements of serum magnesium taken on admission to a large tertiary care ED between January 2009 and December 2010. Hypomagnesaemia was defined as a serum magnesium concentration < 0.75 mmol/l. Demographical data, serum electrolyte values, data on medication, comorbidities and outcome with regard to length of hospital stay and mortality were analysed. RESULTS Serum magnesium was normally distributed where upon 1246 patients (24%) were hypomagnesaemic. These patients had a higher prevalence of out-of-hospital PPI use and diuretic use when compared with patients with magnesium levels > 0.75 mmol/l (both p < 0.0001). In multivariable regression analyses adjusted for PPIs, diuretics, renal function and the Charlson comorbidity index score, the association between use of PPIs and risk for hypomagnesaemia remained significant (OR = 2.1; 95% CI: 1.54-2.85). While mortality was not directly related to low magnesium levels (p = 0.67), the length of hospitalisation was prolonged in these patients even after adjustment for underlying comorbid conditions (p < 0.0001). CONCLUSION Use of PPIs predisposes patients to hypomagnesaemia and such to prolonged hospitalisation irrespective of the underlying morbidity, posing a critical concern.
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Affiliation(s)
- G Lindner
- Department of Emergency Medicine, Inselspital University of Bern, Bern, Switzerland
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Kenward RE, Whittingham MJ, Arampatzis S, Manos BD, Hahn T, Terry A, Simoncini R, Alcorn J, Bastian O, Donlan M, Elowe K, Franzén F, Karacsonyi Z, Larsson M, Manou D, Navodaru I, Papadopoulou O, Papathanasiou J, von Raggamby A, Sharp RJA, Söderqvist T, Soutukorva Å, Vavrova L, Aebischer NJ, Leader-Williams N, Rutz C. Identifying governance strategies that effectively support ecosystem services, resource sustainability, and biodiversity. Proc Natl Acad Sci U S A 2011; 108:5308-12. [PMID: 21402916 PMCID: PMC3069166 DOI: 10.1073/pnas.1007933108] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [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] [Indexed: 11/18/2022] Open
Abstract
Conservation scientists, national governments, and international conservation groups seek to devise, and implement, governance strategies that mitigate human impact on the environment. However, few studies to date have systematically investigated the performance of different systems of governance in achieving successful conservation outcomes. Here, we use a newly-developed analytic framework to conduct analyses of a suite of case studies, linking different governance strategies to standardized scores for delivering ecosystem services, achieving sustainable use of natural resources, and conserving biodiversity, at both local and international levels. Our results: (i) confirm the benefits of adaptive management; and (ii) reveal strong associations for the role of leadership. Our work provides a critical step toward implementing empirically justified governance strategies that are capable of improving the management of human-altered environments, with benefits for both biodiversity and people.
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Affiliation(s)
- R. E. Kenward
- Natural Environment Research Council Centre for Ecology and Hydrology, Crowmarsh Gifford, Wallingford OX10 8BB, United Kingdom
| | - M. J. Whittingham
- School of Biology, University of Newcastle, Newcastle-Upon-Tyne NE1 7RU, United Kingdom
| | | | - B. D. Manos
- Faculty of Agriculture, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - T. Hahn
- Stockholm Resilience Centre, Stockholm University, 10691 Stockholm, Sweden
| | - A. Terry
- Durrell Wildlife Conservation Trust, Trinity, Jersey JE3 5BP, United Kingdom
| | - R. Simoncini
- International Union for Conservation of Nature, Economic Sciences Department, University of Florence, 50127 Florence, Italy
| | - J. Alcorn
- Fundacion Yangareko, Santa Cruz, Bolivia
| | | | - M. Donlan
- Industrial Economics, Cambridge, MA 02140
| | - K. Elowe
- Maine Department of Inland Fisheries and Wildlife, Augusta, ME 04333
| | | | - Z. Karacsonyi
- Centre for Environmental Management and Policy, University of Debrecen, 4032, Debrecen, Hungary
| | - M. Larsson
- Stockholm Resilience Centre, Stockholm University, 10691 Stockholm, Sweden
| | - D. Manou
- Faculty of Agriculture, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - I. Navodaru
- Danube Delta National Institute, 820112 Tulcea, Romania
| | | | - J. Papathanasiou
- Faculty of Agriculture, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - R. J. A. Sharp
- International Union for Conservation of Nature, London NW6 6LN, United Kingdom
| | | | | | - L. Vavrova
- International Union for Conservation of Nature, 11070 Belgrade, Serbia
| | - N. J. Aebischer
- Game and Wildlife Conservation Trust, Fordingbridge SP6 1EF, United Kingdom
| | - N. Leader-Williams
- Department of Geography, University of Cambridge, Cambridge CB2 3EN, United Kingdom; and
| | - C. Rutz
- Department of Zoology, University of Oxford, Oxford OX1 3PS, United Kingdom
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Liakopoulos V, Arampatzis S, Kourti P, Tsolkas T, Zarogiannis S, Eleftheriadis T, Giannopoulou M, Stefanidis I. Aeromonas hydrophila as a causative organism in peritoneal dialysis-related peritonitis: case report and review of the literature. Clin Nephrol 2011; 75 Suppl 1:65-68. [PMID: 21269597] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Most episodes of peritoneal dialysis (PD)-related peritonitis could be attributed to a single organism, but in almost 10% of peritonitis episodes multiple organisms are identified. Polymicrobial peritonitis is often related to intra-abdominal pathology, and the prognosis may be poor. Aeromonas spp. have rarely been identified as the causative pathogen in PD-related peritonitis, and a very small number of cases has been reported in the literature. These rod-shaped, gram-negative microorganisms have been isolated from wastewater drainage systems, food, vegetables, and soil. Herein we report a case of polymicrobial peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) patient with systemic lupus erythematosus (SLE), due to a combination of Streptococcus viridans and Aeromonas hydrophila infection. The patient was involved in gardening and was not compliant with her technique protocol. She did not wear a mask and omitted thorough hand washing. The patient was treated with i.p. vancomycin and ceftazidime and peritonitis was resolved. The patient's technique was reassessed, and she was retrained by our PD nurses.
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Affiliation(s)
- V Liakopoulos
- Department of Nephrology, School of Medicine, University of Thessaly, Larissa, Greece
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