Resistance to chemotherapy represents a major obstacle to the successful 35 treatment of non-small cell lung cancer (NSCLC). The goal of this study was to determine 36 how PIM kinases impact mitochondrial dynamics, ROS production, and response to 37 chemotherapy in lung cancer. Live cell imaging and microscopy were used to determine 38 the effect of PIM loss or inhibition on mitochondrial phenotype and ROS. Inhibition of PIM 39 kinases caused excessive mitochondrial fission and significant upregulation of 40 mitochondrial superoxide, increasing intercellular ROS. Mechanistically, we define a 41 signaling axis linking PIM1 to Drp1 and mitochondrial fission in lung cancer. PIM inhibition 42 significantly increased the protein levels and mitochondrial localization of Drp1, causing 43 marked fragmentation of mitochondria. An inverse correlation between PIM1 and Drp1 44 was confirmed in NSCLC patient samples. Inhibition of PIM sensitized NSCLC to 45 chemotherapy and produced a synergistic anti-tumor response in vitro and in vivo.46 Immunohistochemistry and transmission electron microscopy verified that PIM inhibitors 47 promote mitochondrial fission and apoptosis in vivo. These data improve our knowledge 48 about how PIM1 regulates mitochondria and provide justification for combining PIM 49 inhibition with chemotherapy in NSCLC. 50 51 52 species 53 54 55Introduction: Lung cancer is the second most commonly diagnosed type of cancer and 56 the leading cause of cancer-related mortality worldwide. More than two-thirds of lung 57 cancer patients are diagnosed at an advance stage (III-IV), and intrinsic and/or acquired 58 resistance to treatment represent major obstacles to the successful treatment of patients 59 with advanced disease (1,2). As compared to other types of lung cancer, non-small cell 60 lung carcinomas (NSCLC) is less prone to undergo spontaneous and treatment-induced 61 apoptosis (3), suggesting that deficiencies in the apoptotic process may be responsible 62 for their and/or acquired resistance to chemotherapy (4).
63Cumulative evidence has demonstrated that an imbalance of mitochondrial fission 64 and fusion is common in cancer (5). Mitochondria exist as a dynamic network that is 65 constantly undergoing fusion (elongation) and fission (fragmentation). Mitochondrial 66 fusion results in a tubular mitochondrial network that serves to counteract metabolic 67 insults, maintain cellular integrity, and provide protection against cell death (6,7). In 68 contrast, mitochondrial fission creates small and fragmented mitochondria, which can 69 have both pro-and anti-tumor effects depending on the cellular context (8). Mitochondrial 70 fission is required for cell division and has been shown to positively regulate cell 71 proliferation in cancer cells (9). However, in response to apoptotic stimuli and cellular 72 stress, too much fission generates excessive reactive oxygen species (ROS) and is a 73 necessary event for the initiation of apoptosis (10). Mitochondrial fusion is associated with 74 chemoresistance in seve...