Br J Pharmacol. 2022 Jul 19.
BACKGROUND AND PURPOSE: Endoplasmic reticulum (ER) stress triggers an adaptive response in tumors which fosters their cell survival and resilience to stress. Activation of the ER stress response, through its PERK branch, promotes phosphorylation of the α-subunit of the translation initiation factor eIF2alpha, repressing general protein translation and selectively augmenting the translation of ATF4 with the downstream CHOP transcription factor and the protein disulfide oxidase ERO1.
EXPERIMENTAL APPROACH: Here we show that ISRIB, a small molecule that inhibits the action of the phosphorylated α-subunit of eIF2, activating protein translation, synergistically interacts with the genetic deficiency of protein disulfide oxidase ERO1, enfeebling breast tumor growth and spread.
KEY RESULTS: ISRIB represses the CHOP signal but, surprisingly, it does not inhibit ERO1. Mechanistically ISRIB increases the ER protein load with a marked perturbing effect on ERO1-deficient triple-negative breast cancer cells, which display impaired proteostasis and have adapted to living with a low client protein load in hypoxia, while ERO1 deficiency also impairs VEGF-dependent angiogenesis. ERO1-deficient triple-negative breast cancer xenografts have an augmented ER stress response and its PERK branch. ISRIB acts synergistically with ERO1 deficiency, inhibiting the growth of triple-negative breast cancer xenografts by impairing proliferation and angiogenesis, while it is not so effective on the xenograft counterparts with ERO1.
CONCLUSIONS AND IMPLICATIONS: These results demonstrate that ISRIB together with ERO1 deficiency synergistically shatter the PERK-dependent adaptive ER stress response by restarting protein synthesis in the setting of impaired proteostasis, finally promoting tumor cytotoxicity. Therefore, our findings suggest two surprising features in breast tumors: ERO1 is not regulated via CHOP under hypoxic conditions, and ISRIB offers a therapeutic option to efficiently inhibit tumor progression in those tumors with limited ERO1 and high PERK, and thus impaired proteostasis.
Keywords: ERO1 alpha; Endoplasmic reticulum Stress; ISRIB (Integrated Stress Response Inhibitor); PERK pathway; UPR (unfolded protein response); breast cancer