Macrolide antibiotics block autophagy flux and sensitize to bortezomib via endoplasmic reticulum stress-mediated CHOP induction in myeloma cells

Moriya,Shota; Che,Xiao-Fang; Komatsu,Seiichiro; Abe,Akihisa; Kawaguchi,Tomohiro; Gotoh,Akihiko; Inazu,Masato; Tomoda,Akio; Miyazawa,Keisuke

doi:10.3892/ijo.2013.1870

Macrolide antibiotics block autophagy flux and sensitize to bortezomib via endoplasmic reticulum stress-mediated CHOP induction in myeloma cells

Authors:
- Shota Moriya
- Xiao-Fang Che
- Seiichiro Komatsu
- Akihisa Abe
- Tomohiro Kawaguchi
- Akihiko Gotoh
- Masato Inazu
- Akio Tomoda
- Keisuke Miyazawa
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Affiliations: Department of Biochemistry, Tokyo Medical University, Tokyo, Japan, Department of Breast Oncology, Tokyo Medical University, Tokyo, Japan, Department of Hematology, Tokyo Medical University, Tokyo, Japan, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
Published online on: March 28, 2013 https://doi.org/10.3892/ijo.2013.1870
Pages: 1541-1550
Copyright: © Moriya et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].

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Abstract

The specific 26S proteasome inhibitor bortezomib (BZ) potently induces autophagy, endoplasmic reticulum (ER) stress and apoptosis in multiple myeloma (MM) cell lines (U266, IM-9 and RPMI8226). The macrolide antibiotics including concanamycin A, erythromycin (EM), clarithromycin (CAM) and azithromycin (AZM) all blocked autophagy flux, as assessed by intracellular accumulation of LC3B-II and p62. Combined treatment of BZ and CAM or AZM enhanced cytotoxicity in MM cell lines, although treatment with either CAM or AZM alone exhibited almost no cytotoxicity. This combination also substantially enhanced aggresome formation, intracellular ubiquitinated proteins and induced the proapoptotic transcription factor CHOP (CADD153). Expression levels of the proapoptotic genes transcriptionally regulated by CHOP (BIM, BAX, DR5 and TRB3) were all enhanced by combined treatment with BZ plus CAM, compared with treatment with each reagent alone. Like the MM cell lines, the CHOP+/+ murine embryonic fibroblast (MEF) cell line exhibited enhanced cytotoxicity and upregulation of CHOP and its transcriptional targets with a combination of BZ and one of the macrolides. In contrast, CHOP-/- MEF cells exhibited resistance against BZ and almost completely canceled enhanced cytotoxicity with a combination of BZ and a macrolide. These data suggest that ER stress-mediated CHOP induction is involved in pronounced cytotoxicity. Simultaneously targeting two major intracellular protein degradation systems such as the ubiquitin-proteasome system by BZ and the autophagy-lysosome system by a macrolide antibiotic enhances ER stress-mediated apoptosis in MM cells. This result suggests the therapeutic possibility of using a macrolide antibiotic with a proteasome inhibitor for MM therapy.

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