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Cell cycle inhibitors activate the hypoxia-induced DDX41/STING pathway to mediate antitumor immune response in liver cancer
Po Yee Wong, … , Yan Zhang, Carmen Chak Lui Wong
Po Yee Wong, … , Yan Zhang, Carmen Chak Lui Wong
Published October 10, 2024
Citation Information: JCI Insight. 2024;9(22):e170532. https://doi.org/10.1172/jci.insight.170532.
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Research Article Hepatology Oncology

Cell cycle inhibitors activate the hypoxia-induced DDX41/STING pathway to mediate antitumor immune response in liver cancer

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Abstract

Cell cycle inhibitors have a long history as cancer treatment. Here, we report that these inhibitors combated cancer partially via the stimulator of IFN genes (STING) signaling pathway. We demonstrated that paclitaxel (microtubule stabilizer), palbociclib (cyclin-dependent kinase 4/6 inhibitor), and AZD1152 and GSK1070916 (aurora kinase B inhibitors) have anticancer functions beyond arresting the cell cycle. They consistently caused cytosolic DNA accumulation and DNA damage, which inadvertently triggered the cytosolic DNA sensor DEAD-box helicase 41 (DDX41) and activated STING to secrete pro-inflammatory senescence-associated secretory phenotype factors (SASPs). Interestingly, we found that DDX41 was a transcriptional target of HIF. Hypoxia induced expression of DDX41 through HIF-1, making hypoxic hepatocellular carcinoma (HCC) cells more sensitive to the antimitotic agents in STING activation and SASP production. The SASPs triggered immune cell infiltration in tumors for cancer clearance. The treatment with cell cycle inhibitors, especially paclitaxel, extended survival by perturbing mouse HCC growth when used in combination with anti–PD-1. We observed a trend that paclitaxel suppressed Sting wild-type HCC more effectively than Sting-KO HCC, suggesting that STING might contribute to the antitumor effects of paclitaxel. Our study revealed the immune-mediated tumor-suppressing properties of cell cycle inhibitors and suggested combined treatment with immunotherapy as a potential therapeutic approach.

Authors

Po Yee Wong, Cerise Yuen Ki Chan, Helen Do Gai Xue, Chi Ching Goh, Jacinth Wing Sum Cheu, Aki Pui Wah Tse, Misty Shuo Zhang, Yan Zhang, Carmen Chak Lui Wong

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Figure 1

Cell cycle inhibitors lead to genome instability, DNA damage, and cytosolic DNA accumulation in cell cycle regulator–high HCC cells.

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Cell cycle inhibitors lead to genome instability, DNA damage, and cytoso...
(A) TCGA data showing the upregulated gene expression level (RNA-Seq by expectation maximization normalized count) of tubulin (TUBB), aurora kinase B (AURKB), CDK4, and CDK6 in HCC tissues compared to corresponding nontumorous liver tissues (NT) in patients with HCC (n = 50/group). Scatter dot plot: mean with SD. Student’s t test. (B) TCGA data showing the correlation between HCC patients with normal or high expression level of TUBB, AURKB, and CDK4 and the percentage of survival in OS and disease-free survival model (Z > 0). (n > 300/plot.) Log-rank (Mantel-Cox) test. (C) MHCC97L cells were synchronized using double thymidine method. The cell cycle inhibitors with the indicated concentration were applied to the cells. The DNA content was detected using propidium iodide (PI). Number of cells analyzed in each treatment (N) ≥ 10,000. (D and E) MHCC97L cells were treated with cell cycle inhibitors for 48 hours. (D) DNA damage was detected using γ-H2A.X in immunofluorescence (IF) staining. Number of cells analyzed in each treatment (N) ≥ 85. Box and whiskers: min to max. Student’s t test. (E) After histone extraction, Western blot was used to show the expression level of γ-H2A.X. (F) MHCC97L cells were treated with cell cycle inhibitors alone or ZVF alone or cotreated with both cell cycle inhibitors and ZVF for 72 hours. The cells were extracted for cytosolic DNA and total DNA. The gDNA was detected using qPCR. The cytosolic gDNA was determined by normalizing the relative expression of gDNA in the cytoplasmic portion to that in the total portion (n = 3/group). Scatter dot plot: mean with SD. (A–D) Student’s t test. (F) One-way ANOVA with Bonferroni’s correction. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001.

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