Abstract

Thoracic radiotherapy causes damage of normal lung tissue, which limits the cumulative radiation dose and, hence, confines the anticancer efficacy of radiotherapy and impacts the quality of life of tumor patients. Ras-homologous (Rho) small GTPases regulate multiple stress responses and cell death. Therefore, we investigated whether pharmacological targeting of Rho signaling by the HMG-CoA-reductase inhibitor lovastatin influences ionizing radiation (IR)-induced toxicity in primary human lung fibroblasts, lung epithelial and lung microvascular endothelial cells in vitro and subchronic mouse lung tissue damage following hypo-fractionated irradiation (4x4 Gy). The statin improved the repair of radiation-induced DNA double-strand breaks (DSBs) in all cell types and, moreover, protected lung endothelial cells from IR-induced caspase-dependent apoptosis, likely involving p53-regulated mechanisms. Under the in vivo situation, treatment with lovastatin or the Rac1-specific small molecule inhibitor EHT1864 attenuated the IR-induced increase in breathing frequency and reduced the percentage of γH2AX and 53BP1-positive cells. This indicates that inhibition of Rac1 signaling lowers IR-induced residual DNA damage by promoting DNA repair. Moreover, lovastatin and EHT1864 protected lung tissue from IR-triggered apoptosis and mitigated the IR-stimulated increase in regenerative proliferation. Our data document beneficial anti-apoptotic and genoprotective effects of pharmacological targeting of Rho signaling following hypo-fractionated irradiation of lung cells in vitro and in vivo. Rac1-targeting drugs might be particular useful for supportive care in radiation oncology and, moreover, applicable to improve the anticancer efficacy of radiotherapy by widening the therapeutic window of thoracic radiation exposure.

Highlights

  • Radiation therapy (RT) is a frequently used treatment modality for thoracic malignancies

  • Fractionated irradiation-induced apoptosis of HMVEC-L was accompanied by slightly increased mRNA expression of Bax and substantial increase in Fas receptor

  • Inhibition of Rho signaling by statins is radioprotective in umbilical vein endothelial cells in vitro[13] and in an acute rat model of radiation enteritis,[15,16] with Rho-associated kinase (ROCK) being involved

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Summary

Introduction

Radiation therapy (RT) is a frequently used treatment modality for thoracic malignancies. Its therapeutic efficacy is limited because of adverse effects on normal lung tissue, resulting in radiation-induced lung injury (RILI). The influence of statins on adverse late responses resulting from fractionated irradiation of the lung is unknown It is unclear which cell type of the lung is sensitive to fractionated irradiation and, might be of major relevance for the pathophysiology of RILI and, correspondingly, could be targeted for radioprotection. Received 16.3.17; revised 22.6.17; accepted 02.7.17; Edited by A Stephanou primary human lung cells following fractionated irradiation in vitro and (ii) the impact of lovastatin and the Rac1-specific small molecule inhibitor EHT1864 on RILI analyzed four weeks after fractionated lung irradiation in vivo. EHT1864 was included to figure out the specific relevance of Rac1-regulated signaling mechanisms for statin-mediated effects

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