Zoledronic acid overcomes chemoresistance and immunosuppression of malignant mesothelioma

Oncotarget. 2015 Jan 20;6(2):1128-42. doi: 10.18632/oncotarget.2731.

Abstract

The human malignant mesothelioma (HMM) is characterized by a chemoresistant and immunosuppressive phenotype. An effective strategy to restore chemosensitivity and immune reactivity against HMM is lacking. We investigated whether the use of zoledronic acid is an effective chemo-immunosensitizing strategy. We compared primary HMM samples with non-transformed mesothelial cells. HMM cells had higher rate of cholesterol and isoprenoid synthesis, constitutive activation of Ras/extracellular signal-regulated kinase1/2 (ERK1/2)/hypoxia inducible factor-1α (HIF-1α) pathway and up-regulation of the drug efflux transporter P-glycoprotein (Pgp). By decreasing the isoprenoid supply, zoledronic acid down-regulated the Ras/ERK1/2/HIF-1α/Pgp axis and chemosensitized the HMM cells to Pgp substrates. The HMM cells also produced higher amounts of kynurenine, decreased the proliferation of T-lymphocytes and expanded the number of T-regulatory (Treg) cells. Kynurenine synthesis was due to the transcription of the indoleamine 1,2 dioxygenase (IDO) enzyme, consequent to the activation of the signal transducer and activator of transcription-3 (STAT3). By reducing the activity of the Ras/ERK1/2/STAT3/IDO axis, zoledronic acid lowered the kyurenine synthesis and the expansion of Treg cells, and increased the proliferation of T-lymphocytes. Thanks to its ability to decrease Ras/ERK1/2 activity, which is responsible for both Pgp-mediated chemoresistance and IDO-mediated immunosuppression, zoledronic acid is an effective chemo-immunosensitizing agent in HMM cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B / genetics
  • ATP Binding Cassette Transporter, Subfamily B / metabolism
  • Aged
  • Aged, 80 and over
  • Blotting, Western
  • Cell Proliferation / drug effects
  • Cells, Cultured
  • Cholesterol / metabolism
  • Diphosphonates / pharmacology*
  • Drug Resistance, Neoplasm / drug effects*
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Female
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism
  • Imidazoles / pharmacology*
  • Indoleamine-Pyrrole 2,3,-Dioxygenase / genetics
  • Indoleamine-Pyrrole 2,3,-Dioxygenase / metabolism
  • Kynurenine / metabolism
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / metabolism
  • Male
  • Mesothelioma / drug therapy*
  • Mesothelioma / genetics
  • Mesothelioma / metabolism
  • Mesothelioma, Malignant
  • Middle Aged
  • Reverse Transcriptase Polymerase Chain Reaction
  • STAT3 Transcription Factor / genetics
  • STAT3 Transcription Factor / metabolism
  • Signal Transduction / drug effects
  • T-Lymphocytes / drug effects*
  • T-Lymphocytes / pathology
  • Terpenes / metabolism
  • Tumor Cells, Cultured
  • Zoledronic Acid
  • ras Proteins / metabolism

Substances

  • ATP Binding Cassette Transporter, Subfamily B
  • Diphosphonates
  • HIF1A protein, human
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • Imidazoles
  • Indoleamine-Pyrrole 2,3,-Dioxygenase
  • STAT3 Transcription Factor
  • Terpenes
  • Kynurenine
  • Zoledronic Acid
  • Cholesterol
  • Extracellular Signal-Regulated MAP Kinases
  • ras Proteins