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Targeting acetylcholine signaling modulates persistent drug tolerance in EGFR-mutant lung cancer and impedes tumor relapse

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机构: [1]School of Pharmaceutical Sciences, Tsinghua-Peking Center for Life Sciences, Beijing Frontier Research Center for Biological Structure, Tsinghua University, Beijing, 100084, China [2]Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University of Medicine, Shanghai, 200433, China [3]Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China [4]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China [5]Children’s Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA [6]Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
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Although first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) therapy is effective for treating EGFR-mutant non-small cell lung cancer (NSCLC), it is now understood that drug-tolerant persister (DTP) cells escaping from initial treatment eventually drives drug resistance. Here, through integration of metabolomics and transcriptomics, we found that the neurotransmitter acetylcholine (ACh) was specifically accumulated in DTP cells, and illustrated that treatment with EGFR-TKI heightens the expression of the rate-limiting enzyme choline acetyltransferase (ChAT) in ACh biosynthesis via YAP mediation. Genetic and pharmacological manipulation of ACh biosynthesis or ACh signaling could predictably regulate the extent of DTP formation in vitro and in vivo. Strikingly, pharmacologically targeting ACh/M3R signaling with an FDA-approved drug, Darifenacin, retarded tumor relapse in vivo. Mechanistically, upregulated ACh metabolism mediated drug tolerance in part through activating WNT signaling via ACh muscarinic receptor-3 (M3R). Importantly, aberrant ACh metabolism in NSCLC patients represented a potential role in predicting EGFR-TKI response rate and progression-free survival. Our study therefore defines a new therapeutic strategy-targeting ACh-M3R-WNT axis-for manipulating EGFR TKI drug tolerance in the treatment of NSCLC.

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出版当年[2022]版:
大类 | 1 区 医学
小类 | 1 区 医学:研究与实验
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 医学:研究与实验
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第一作者机构: [1]School of Pharmaceutical Sciences, Tsinghua-Peking Center for Life Sciences, Beijing Frontier Research Center for Biological Structure, Tsinghua University, Beijing, 100084, China
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通讯机构: [1]School of Pharmaceutical Sciences, Tsinghua-Peking Center for Life Sciences, Beijing Frontier Research Center for Biological Structure, Tsinghua University, Beijing, 100084, China [*1]School of Pharmaceutical Sciences, Tsinghua University, 30 Shuangqing Rd, Haidian District, Beijing, China, 100084.
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