Therapeutic targeting of thioredoxin reductase 1 causes ferroptosis while potentiating anti-PD-1 efficacy in head and neck cancer

Ming-Shou Hsieh; Hang Huong Ling; Syahru Agung Setiawan; Mardiah Suci Hardianti; Iat-Hang Fong; Chi-Tai Yeh; Jia-Hong Chen

doi:10.1016/j.cbi.2024.111004

Therapeutic targeting of thioredoxin reductase 1 causes ferroptosis while potentiating anti-PD-1 efficacy in head and neck cancer

Chem Biol Interact. 2024 Apr 16:395:111004. doi: 10.1016/j.cbi.2024.111004. Online ahead of print.

Authors

Ming-Shou Hsieh¹, Hang Huong Ling², Syahru Agung Setiawan³, Mardiah Suci Hardianti³, Iat-Hang Fong⁴, Chi-Tai Yeh⁴, Jia-Hong Chen⁵

Affiliations

¹ Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, 11031, Taiwan; Department of Otolaryngology-Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan.
² Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung, 204, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.
³ Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
⁴ Department of Medical Research & Education, Taipei Medical University-Shuang Ho Hospital, New Taipei City, 23561, Taiwan.
⁵ Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, 11490, Taiwan. Electronic address: wen17140@mail.ndmctsgh.edu.tw.

PMID: 38636790
DOI: 10.1016/j.cbi.2024.111004

Abstract

Head and neck squamous cell carcinoma (HNSCC) faces low response rates to anti-PD-1 immunotherapies, highlighting the need for enhanced treatment strategies. Auranofin, which inhibits thioredoxin reductase (TrxR) through its gold-based composition, has shown potential in cancer treatment. It targets the TrxR system, essential for safeguarding cells from oxidative stress. The overproduction of TrxR in cancerous cells supports their proliferation. However, auranofin's interference with this system can upset the cellular redox equilibrium, boost levels of reactive oxygen species, and trigger the death of cancer cells. This study is the first to highlight TXNRD1 as a crucial factor contributing to resistance to anti-PD-1 treatment in HNSCC. In this study, we identified targetable regulators of resistance to immunotherapy-induced ferroptosis in HNSCC. We observed a link of thioredoxin reductase 1 (TXNRD1) with tumoral PD-L1 expression and ferroptosis suppression in HNSCC. Moreover, HNSCC tumors with aberrant TXNRD1 expression exhibited a lack of PD-1 response, NRF2 overexpression, and PD-L1 upregulation. TXNRD1 inhibition promoted ferroptosis in HNSCC cells with NRF2 activation and in organoid tumors derived from patients lacking a PD-1 response. Mechanistically, TXNRD1 regulated PD-L1 transcription and maintained the redox balance by binding to ribonucleotide reductase regulatory subunit M2 (RRM2). TXNRD1 expression disruption sensitized HNSCC cells to anti-PD-1-mediated Jurkat T-cell activation, promoting tumor killing through ferroptosis. Moreover, TXNRD1 inhibition through auranofin cotreatment synergized with anti-PD-1 therapy to potentiate immunotherapy-mediated ferroptosis by mediating CD8⁺ T-cell infiltration and downregulating PD-L1 expression. Our findings indicate that targeting TXNRD1 is a promising therapeutic strategy for improving immunotherapy outcomes in patients with HNSCC.

Keywords: Ferroptosis; HNSCC; Immunotherapy; NRF2; Pembrolizumab; TXNRD1.