Enhancement of Cancer-Specific Protoporphyrin IX Fluorescence by Targeting Oncogenic Ras/MEK Pathway

Abstract

Protoporphyrin IX (PpIX) is an endogenous fluorescent molecule that selectively accumulates in cancer cells treated with the heme precursor 5-aminolevulinic acid (5-ALA). This cancer-specific accumulation of PpIX is used to distinguish tumor from normal tissues in fluorescence-guided surgery (FGS) and to destroy cancer cells by photodynamic therapy (PDT). In this study, we demonstrate that oncogenic Ras/mitogen-activated protein kinase kinase (MEK) pathway can modulate PpIX accumulation in cancer cells.Methods: To identify Ras downstream elements involved in PpIX accumulation, chemical inhibitors were used. To demonstrate the increase of PpIX accumulation by MEK inhibition, different human normal and cancer cell lines, BALB/c mice bearing mammary 4T1 tumors and athymic nude mice bearing human tumors were used. To identify the mechanisms of PpIX regulation by MEK, biochemical and molecular biological experiments were conducted.Results: Inhibition of one of the Ras downstream elements, MEK, promoted PpIX accumulation in cancer cells treated with 5-ALA, while inhibitors against other Ras downstream elements did not. Increased PpIX accumulation with MEK inhibition was observed in different types of human cancer cell lines, but not in normal cell lines. We identified two independent cellular mechanisms that underlie this effect in cancer cells. MEK inhibition reduced PpIX efflux from cancer cells by decreasing the expression level of ATP binding cassette subfamily B member 1 (ABCB1) transporter. In addition, the activity of ferrochelatase (FECH), the enzyme responsible for converting PpIX to heme, was reduced by MEK inhibition. Finally, we found that in vivo treatment with MEK inhibitors increased PpIX accumulation (2.2- to 2.4-fold) within mammary 4T1 tumors in BALB/c mice injected with 5-ALA without any change in normal organs. Similar results were also observed in a human tumor xenograft model.Conclusion: Our study demonstrates that inhibition of oncogenic Ras/MEK significantly enhances PpIX accumulation in vitro and in vivo in a cancer-specific manner. Thus, suppressing the Ras/MEK pathway may be a viable strategy to selectively intensify PpIX fluorescence in cancer cells and improve its clinical applications in FGS.

MEK reduces cancer-specific PpIX accumulation through the RSK-ABCB1 and HIF-1α-FECH axes

“…In our previous studies, we used human cancer cell lines to demonstrate the regulation of PpIX accumulation via the Ras/MEK pathway (14, 17). As most human cancer cell lines have mutations that activate multiple oncogenic signaling pathways, it is often difficult to interpret the specific roles of a single activated pathway.…”

“…In contrast, we identified that the activation of MEK, a downstream element of Ras, reduces 5-ALA-induced PpIX accumulation through two independent pathways – increased expression of ATP-binding cassette sub-family B member 1 (ABCB1), one of the PpIX efflux pumps, and increased activity of ferrochelatase (FECH), the enzyme that catalyzes the conversion of PpIX to heme (Fig. 1) (14). Furthermore, treatment with a MEK inhibitor significantly increased the efficacy of tumor diagnosis (5-ALA-PDD) and treatment (5-ALA-PDT) in animal models (14, 17).…”

“…1) (14). Furthermore, treatment with a MEK inhibitor significantly increased the efficacy of tumor diagnosis (5-ALA-PDD) and treatment (5-ALA-PDT) in animal models (14, 17). Importantly, the promotion of PpIX accumulation by MEK inhibition was cancer-specific, as it was not observed in normal cells in vitro and healthy organs in vivo .…”

Advanced Nanotechnology Leading the Way to Multimodal Imaging‐Guided Precision Surgical Therapy

“…[183,[303][304][305] PSs and photothermal materials can also provide optical signals for ablation guidance and IGS. [310][311][312][313][314] Nanotechnology is an effective method to develop ideal PSs with additional functions. [176,274,309] www.advmat.de www.advancedsciencenews.com was repeatable without significant complications compared with adjuvant radiotherapy and chemotherapy.…”

Order from Chaos: Self‐Assembly of Nanoprism from a Mixture of Tetratopic Terpyridine‐Porphyrin Conformers

“…In the field of synthetic chemistry, substitution and modification have been used to elicit specific functions of porphyrins. Free base porphyrins have been extensively studied in the biomedical fields, e.g ., clinical phototherapy and cancer imaging . Metallo‐porphyrins have been applied in sensors, molecular electronics, photovoltaic devices, ionophores and catalysts …”