Cell Death Dis:类固醇激素合成介导肾上腺皮质细胞铁死亡

2020-04-03 MedSci原创 MedSci原创

目前对于肾上腺皮质细胞死亡反应的了解甚少,但其极具临床意义。在Addison病中,肾上腺皮质细胞的破坏导致肾上腺类固醇匮乏,如果不加以治疗则可能会致命。

目前对于肾上腺皮质细胞死亡反应的了解甚少,但其极具临床意义。在Addison病中,肾上腺皮质细胞的破坏导致肾上腺类固醇匮乏,如果不加以治疗则可能会致命。虽然已有研究表明参与自身免疫调控的基因多态性会增加Addison病的发病风险,但目前尚不清楚垂死的肾上腺皮质细胞如何引发抗原暴露,并最终导致肾上腺皮质破坏。相反,肾上腺皮质细胞不受控制的增殖时,则会导致肿瘤,如肾上腺皮质癌(ACC)这种非常罕见的恶性肿瘤,总体预后较差。所以进一步了解肾上腺细胞死亡的病理生理过程迫在眉睫。

铁死亡是一种铁依赖性的细胞死亡形式,与脂质过氧化反应增强相关。

研究人员发现GPX4(谷胱甘肽过氧化物酶4)和ACSL4(长链脂肪酸CoA连接酶4)这两个引起铁死亡的关键基因在肾上腺皮质中具有高表达水平。采用MALDI质谱成像分析正常及肿瘤肾上腺皮质组织,研究人员检测到高水平的花生四烯酸及肾上腺酸,这两种长链多不饱和脂肪酸在铁死亡的治疗过程中发生了过氧化反应。研究人员发现在三种肾上腺皮质细胞系(H295R,CU-ACC1及CU-ACC-2)中,RSL3对GPX4抑制作用具有高度敏感性,EC50值分别是5.7×10-8、8.1×10-7 和2.1×10-8;而在所有非类固醇生成细胞中该敏感性均显著降低。

通过RSL3完全阻断GPX4的活性可导致铁死亡的发生,在肾上腺皮质细胞中使用酮康唑抑制类固醇的生成可以完全逆转该作用,但使用美替拉酮阻断皮质醇合成的最终步骤不能逆转该反应。尽管会诱导ACC细胞脂质过氧化反应,米托坦是批准用于ACC治疗中唯一不会引起铁死亡的药物。

总而言之,该研究首次证明了肾上腺皮质细胞对铁死亡反应的高敏感性是通过活性类固醇合成途径介导的。在ACC治疗中,密妥坦不会诱导这种形式的细胞死亡。

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    2021-01-11 docwu2019
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    2020-04-05 cy0328

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