Abstract

Gefitinib and erlotinib are anticancer agents, which inhibit epidermal growth factor receptor (EGFR) tyrosine kinase. Interstitial lung disease (ILD) occurs in patients with non-small cell lung cancer receiving EGFR inhibitors. In the present study, we examined whether gefitinib- and erlotinib-induced lung injury related to ILD through endoplasmic reticulum (ER) stress, which is a causative intracellular mechanism in cytotoxicity caused by various chemicals in adenocarcinomic human alveolar basal epithelial cells. These two EGFR inhibitors increased Parkinson juvenile disease protein 2 and C/EBP homologous protein mRNA expressions, and activated the eukaryotic initiation factor (eIF) 2α/activating transcription factor 4 pathway without protein kinase R-like ER kinase activation in A549 cells. Gefitinib and erlotinib caused neither ER stress nor cell death; however, these agents inhibited cell growth via the reduction of cyclin-D1 expression. Tauroursodeoxycholic acid, which is known to suppress eIF2α phosphorylation, cancelled the effects of EGFR inhibitors on cyclin-D1 expression and cell proliferation in a concentration-dependent manner. The results of an EGFR-silencing study using siRNA showed that gefitinib and erlotinib affected eIF2α phosphorylation and cyclin-D1 expression independent of EGFR inhibition. Therefore, the inhibition of cell growth by these EGFR inhibitors might equate to impairment of the alveolar epithelial cell repair system via eIF2α phosphorylation and reduced cyclin-D1 expression.

Highlights

  • Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, such as gefitinib and erlotinib, are oral molecule-targeted drugs for non-small cell lung cancer

  • Gefitinib and Erlotinib Induced the Up-Regulation of PARK2 and C/EBP homologous protein (CHOP) mRNA in A549 Cells

  • We investigated if unfolded protein response (UPR)-related molecules were influenced by EGFR inhibitors in A549 cells

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Summary

Introduction

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, such as gefitinib and erlotinib, are oral molecule-targeted drugs for non-small cell lung cancer. These drugs occasionally induce interstitial lung disease (ILD), especially interstitial pneumonia, as a critical adverse reaction [1, 2]. Type-II cells proliferate and differentiate into type-I cells, leading to alveolus repair [4]. Deterioration of this repair pathway in alveoli can be interpreted as a possible mechanism for the promotion of ILD in EGFR inhibitor therapy

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