1. Targeting the mevalonate pathway enhances the efficacy of 5-fluorouracil by regulating pyroptosis.
- Author
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Xing Z, Ma Y, Jiang X, Qing H, Wu Y, Che S, Gao Z, Wang K, Wang T, He Q, Li Z, Zhao B, Liu W, Sun H, and Yu Z
- Subjects
- Animals, Mice, Humans, Simvastatin pharmacology, Cell Line, Tumor, Drug Synergism, Hydroxymethylglutaryl CoA Reductases metabolism, Drug Resistance, Neoplasm drug effects, Polyisoprenyl Phosphates metabolism, Polyisoprenyl Phosphates pharmacology, Antimetabolites, Antineoplastic pharmacology, Antineoplastic Combined Chemotherapy Protocols pharmacology, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology, Female, Male, Fluorouracil pharmacology, Mevalonic Acid metabolism, Pyroptosis drug effects, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms metabolism, Pancreatic Neoplasms pathology
- Abstract
The 5-fluorouracil (5-FU)-based chemotherapy regimen is a primary strategy for treating pancreatic cancer (PC). However, challenges related to 5-FU resistance persist. Investigating the mechanisms of 5-FU resistance and identifying a clinically viable therapeutic strategy are crucial for improving the prognosis of PC. Here, through clinical samples analysis, we found that the expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), the rate-limiting enzyme in mevalonate metabolism, is negatively correlated with the efficacy of 5-FU treatment. There is a significant correlation between HMGCR and the pyroptosis marker gasdermin D (GSDMD), and the HMGCR inhibitor simvastatin can significantly inhibit the activation of pyroptosis signaling. The exogenous addition of geranylgeranyl pyrophosphate (GGPP), a key metabolite of the mevalonate pathway, can significantly reduce sensitivity to 5-FU, and simvastatin combined with 5-FU demonstrates a strong synergistic effect. Furthermore, in organoid models and genetically engineered mice with spontaneous PC, the combination of simvastatin and 5-FU significantly inhibits tumor growth. In conclusion, our study reveals the critical role of the mevalonate pathway in 5-FU resistance and proposes a clinically feasible combination therapy strategy., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no competing interests. Ethical approval: This research was conducted in accordance with the ethical standards and approved by the Human Research Ethics Committee of Lanzhou University Second Hospital (Permit No. 2023A-173). The animal research was reviewed and approved by the Animal Experiment Ethics Committee of Lanzhou University Second Hospital (Permit No. D2023–M2). Consent for Publication: Not applicable., (© 2024. The Author(s).)
- Published
- 2024
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