Abstract

The treatment for hepatocellular carcinoma (HCC) is promising in recent years, but still facing critical challenges. The first targeted therapy, sorafenib, prolonged the overall survival by months. However, resistance often occurs, largely limits its efficacy. Sorafenib was found to target the electron transport chain complexes, which results in the generation of reactive oxygen species (ROS). To maintain sorafenib resistance and further facilitate tumor progression, cancer cells develop strategies to overcome excessive ROS production and obtain resistance to oxidative stress-induced cell death. In the present study, we investigated the roles of ROS in sorafenib resistance, and found suppressed ROS levels and reductive redox states in sorafenib-resistant HCC cells. Mitochondria in sorafenib-resistant cells maintained greater functional and morphological integrity under the treatment of sorafenib. However, cellular oxygen consumption rate and mitochondria DNA content analyses revealed fewer numbers of mitochondria in sorafenib-resistant cells. Further investigation attributed this finding to decreased mitochondrial biogenesis, likely caused by the accelerated degradation of peroxisome proliferator-activated receptor γ coactivator 1β (PGC1β). Mechanistic dissection showed that upregulated UBQLN1 induced PGC1β degradation in a ubiquitination-independent manner to attenuate mitochondrial biogenesis and ROS production in sorafenib-resistant cells under sorafenib treatment. Furthermore, clinical investigations further indicated that the patients with higher UBQLN1 levels experienced worse recurrence-free survival. In conclusion, we propose a novel mechanism involving mitochondrial biogenesis and ROS homeostasis in sorafenib resistance, which may offer new therapeutic targets and strategies for HCC patients.

Highlights

  • Liver cancer is the fourth leading cause of cancer-related death globally,[1] and with a 5-year survival rate of 18%, liver cancer is the second most lethal tumor.[2]

  • Decreased reactive oxygen species (ROS) levels in sorafenib-resistant hepatocellular carcinoma (HCC) cells To mimic the biological process of sorafenib resistance in HCC patients, an in vitro model was established in this study, as described previously.[24,25]

  • Sorafenib and other emerging novel tyrosine kinase inhibitor (TKI) have been clinically effective for controlling HCC progression; drug resistance curtails their efficacy

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Summary

Introduction

Liver cancer is the fourth leading cause of cancer-related death globally,[1] and with a 5-year survival rate of 18%, liver cancer is the second most lethal tumor.[2]. Because reactive oxygen species (ROS) is intimately associated with metabolic processes, ROS likely plays a significant role in HCC development, those HCC progressed from NAFLD.[7]

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