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Vincristine and bortezomib use distinct upstream mechanisms to activate a common SARM1-dependent axon degeneration program
Stefanie Geisler, … , Jeffrey Milbrandt, Aaron DiAntonio
Stefanie Geisler, … , Jeffrey Milbrandt, Aaron DiAntonio
Published September 5, 2019
Citation Information: JCI Insight. 2019;4(17):e129920. https://doi.org/10.1172/jci.insight.129920.
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Research Article Cell biology Neuroscience

Vincristine and bortezomib use distinct upstream mechanisms to activate a common SARM1-dependent axon degeneration program

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Abstract

Chemotherapy-induced peripheral neuropathy is one of the most prevalent dose-limiting toxicities of anticancer therapy. Development of effective therapies to prevent chemotherapy-induced neuropathies could be enabled by a mechanistic understanding of axonal breakdown following exposure to neuropathy-causing agents. Here, we reveal the molecular mechanisms underlying axon degeneration induced by 2 widely used chemotherapeutic agents with distinct mechanisms of action: vincristine and bortezomib. We showed previously that genetic deletion of SARM1 blocks vincristine-induced neuropathy and demonstrate here that it also prevents axon destruction following administration of bortezomib in vitro and in vivo. Using cultured neurons, we found that vincristine and bortezomib converge on a core axon degeneration program consisting of nicotinamide mononucleotide NMNAT2, SARM1, and loss of NAD+ but engage different upstream mechanisms that closely resemble Wallerian degeneration after vincristine and apoptosis after bortezomib. We could inhibit the final common axon destruction pathway by preserving axonal NAD+ levels or expressing a candidate gene therapeutic that inhibits SARM1 in vitro. We suggest that these approaches may lead to therapies for vincristine- and bortezomib-induced neuropathies and possibly other forms of peripheral neuropathy.

Authors

Stefanie Geisler, Ryan A. Doan, Galen C. Cheng, Aysel Cetinkaya-Fisgin, Shay X. Huang, Ahmet Höke, Jeffrey Milbrandt, Aaron DiAntonio

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Figure 4

Axonal NMNAT2 levels decrease after vincristine and BTZ administration.

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Axonal NMNAT2 levels decrease after vincristine and BTZ administration.
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(A) Axon-only extracts were derived from DRG neurons at indicated time points after adding vincristine and immunoblotted for endogenous NMNAT2 or actin (loading control). Quantification of endogenous NMNAT2 protein levels normalized to actin and baseline showed a decrease of axonal NMNAT2 over time. One-way ANOVA F (4, 15), P = 0.0002; post hoc Tukey’s *P < 0.05, ***P < 0.001; n = 4. (B) Axon extracts derived from DRG neurons at indicated time points after adding BTZ were immunoblotted for endogenous NMNAT2 and actin. Quantification of NMNAT2 levels as in A showed a decrease of axonal NMNAT2 4 and 8 hours after BTZ. One-way ANOVA F (4, 14) = 4.839; P = 0.0116. Post hoc Tukey’s *P < 0.05, **P < 0.01; n = 4. (C) DRG neurons expressing cytoplasmic NMNAT1 (cytNMNAT1) were treated with vincristine or BTZ, and axon degeneration was determined at indicated time points using the degeneration index. Expression of cytNMNAT1 prevented vincristine- and BTZ-induced axon degeneration. Two-way ANOVA showed significant main effects of group F (4, 10) = 21.44, P < 0.0001; time F (3, 30) = 148.5, P < 0.0001; and interaction F (12, 30) = 26.14. Post-hoc analysis with Tukey’s multiple-comparisons test, **P < 0.01, ****P < 0.0001 (n = 3). (D) Representative phase-contrast microphotographs of axons expressing cytNMNAT1 showing intact axons 72 hours after adding vincristine or BTZ. Original magnification 200×.

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