Abstract Sonic hedgehog (Shh) signaling is closely coupled with the bioenergetics of medulloblastoma, the most common malignant pediatric solid tumor. We have previously reported that Shh causes deregulation of mitochondrial biogenesis by suppressing mitofusins. This led to fragmented mitochondria in vitro in primary cultures of mouse cerebellar progenitor cells, putative cells-of-origin of the SHH molecular subclass of medulloblastoma. This phenomenon was also observed in electron micrographs of SmoA1 mouse medulloblastomas in vivo. Ectopic expression of mitofusins in both proliferating progenitor cells and primary mouse medulloblastoma cell cultures restored mitochondrial fusion and led to a non-proliferative phenotype (1). We have observed high levels of Reactive Oxygen Species (ROS) in SmoA1 mouse medulloblastoma cells in vitro. When total ROS in primary cultures of mouse medulloblastoma cells was scavenged by N-Acetyl Cytosine (NAC) treatment, the mitochondria regained their fused morphology, leading to a reduction in cell proliferation. NAC treatment of organotypic cerebellar slice cultures implanted with SmoA1 neurospheres also resulted in a reduction in proliferation as well as impaired spread of tumor cells within normal cerebellar tissue. Medulloblastoma tumor repopulating cells, which are responsible for radiation resistance and tumor recurrence, are primarily located in the perivascular niche (PVN) of Medulloblastoma (2). We therefore focused our attention on the role played by ROS in regulating mitochondrial structure of tumor repopulating cells, to decipher if this affects the survival of these cells. Indeed we have observed that NAC treatment combined with irradiation restores mitochondrial morphology, leading to enhanced cell death within the PVN of Medulloblastoma. We further carried out gene expression analysis of ROS-regulating genes in the Shh subgroup of Medulloblastoma. NADPH Oxidase 4 (NOX4), which is a known producer of cytoplasmic ROS in cells (3), was found to be upregulated as compared to NOX1 and 3. This elevation was observed across all subgroups of medulloblastoma, but was most evident in the Shh subgroup. We have also found that NOX4 co-localizes in the PVN of medulloblastoma. Treatment with Apocynin, a NOX2/4 inhibitor, led to enhanced cell death in the PVN, similar to what we observed after NAC treatment. Taken together, our results show that anti-oxidant treatment restores the fused morphology of mitochondria in the PVN and leads the cells to apoptosis, thereby preventing tumor recurrence post-irradiation, and they implicate Nox4 as a potential therapeutic target. 1. Malhotra A, Dey A, Prasad N, Kenney AM. 2015. Mol Cancer Res 2. Hambardzumyan D, Becher OJ, Rosenblum MK, Pandolfi PP, Manova-Todorova K, Holland EC. 2008. Genes Dev 22: 436-48 3. Bedard K, Krause KH. 2007. Physiol Rev 87: 245-313 Citation Format: Anshu Malhotra, Abhinav Dey, Anna M. Kenney. Reactive Oxygen Species regulates tumor stem cell survival in medulloblastoma via mitochondrial biogenesis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2411.
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