1. Vemurafenib acts as an aryl hydrocarbon receptor antagonist: Implications for inflammatory cutaneous adverse events
- Author
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Peter Arne Gerber, Jean Krutmann, Péter Oláh, Heike C Hawerkamp, Afaque Ahmad Imtiyaz Momin, Michael S. Denison, Katharina M. Rolfes, Stefan T. Arold, Stephan Meller, Angeliki Datsi, Stephan Alexander Braun, Anatoly A. Soshilov, Andreas Kislat, Mario E. Lacouture, Marius Pollet, Bernhard Homey, and Thomas Haarmann-Stemmann
- Subjects
Models, Molecular ,0301 basic medicine ,Chemokine ,Protein Conformation ,Biopsy ,Guinea Pigs ,Immunology ,Antineoplastic Agents ,Dermatitis ,Inflammation ,Article ,Proinflammatory cytokine ,Structure-Activity Relationship ,03 medical and health sciences ,0302 clinical medicine ,Downregulation and upregulation ,T-Lymphocyte Subsets ,Basic Helix-Loop-Helix Transcription Factors ,Cytochrome P-450 CYP1A1 ,medicine ,Animals ,Humans ,Immunology and Allergy ,Vemurafenib ,Protein Kinase Inhibitors ,Aged ,biology ,business.industry ,Melanoma ,Th1 Cells ,Aryl hydrocarbon receptor ,medicine.disease ,Disease Models, Animal ,030104 developmental biology ,Receptors, Aryl Hydrocarbon ,030228 respiratory system ,Case-Control Studies ,biology.protein ,Cancer research ,Tumor necrosis factor alpha ,medicine.symptom ,business ,Biomarkers ,medicine.drug - Abstract
Background In recent years, the BRAF inhibitor vemurafenib has been successfully established in the therapy of advanced melanoma. Despite its superior efficacy, the use of vemurafenib is limited by frequent inflammatory cutaneous adverse events that affect patients' quality of life and may lead to dose reduction or even cessation of anti-tumor therapy. To date, the molecular and cellular mechanisms of vemurafenib-induced rashes have remained largely elusive. Methods In this study, we deployed immunohistochemistry, RT-qPCR, flow cytometry, lymphocyte activation tests, and different cell-free protein-interaction assays. Results We here demonstrate that vemurafenib inhibits the downstream signaling of the canonical pathway of aryl hydrocarbon receptor (AhR) in vitro, thereby inducing the expression of proinflammatory cytokines (eg, TNF) and chemokines (eg, CCL5). In line with these results, we observed an impaired expression of AhR-regulated genes (eg, CYP1A1) and an upregulation of the corresponding proinflammatory genes in vivo. Moreover, results of lymphocyte activation tests showed the absence of drug-specific T cells in respective patients. Conclusion Taken together, we obtained no hint of an underlying sensitization against vemurafenib but found evidence suggesting that vemurafenib enhances proinflammatory responses by inhibition of canonical AhR signaling. Our findings contribute to our understanding of the central role of the AhR in skin inflammation and may point toward a potential role for topical AhR agonists in supportive cancer care.
- Published
- 2019
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