TY - JOUR A1 - Houben, Roland A1 - Alimova, Pamela A1 - Sarma, Bhavishya A1 - Hesbacher, Sonja A1 - Schulte, Carolin A1 - Sarosi, Eva-Maria A1 - Adam, Christian A1 - Kervarrec, Thibault A1 - Schrama, David T1 - 4-[(5-methyl-1H-pyrazol-3-yl)amino]-2H-phenyl-1-phthalazinone inhibits MCPyV T antigen expression in Merkel cell carcinoma independent of Aurora kinase A JF - Cancers N2 - Merkel cell carcinoma (MCC) is frequently caused by the Merkel cell polyomavirus (MCPyV), and MCPyV-positive tumor cells depend on expression of the virus-encoded T antigens (TA). Here, we identify 4-[(5-methyl-1H-pyrazol-3-yl)amino]-2H-phenyl-1-phthalazinone (PHT) — a reported inhibitor of Aurora kinase A — as a compound inhibiting growth of MCC cells by repressing noncoding control region (NCCR)-controlled TA transcription. Surprisingly, we find that TA repression is not caused by inhibition of Aurora kinase A. However, we demonstrate that β-catenin — a transcription factor repressed by active glycogen synthase kinase 3 (GSK3) — is activated by PHT, suggesting that PHT bears a hitherto unreported inhibitory activity against GSK3, a kinase known to function in promoting TA transcription. Indeed, applying an in vitro kinase assay, we demonstrate that PHT directly targets GSK3. Finally, we demonstrate that PHT exhibits in vivo antitumor activity in an MCC xenograft mouse model, suggesting a potential use in future therapeutic settings for MCC. KW - Merkel cell carcinoma KW - polyomavirus KW - large T antigen KW - phthalazinone pyrazole KW - glycogen synthase kinase 3 KW - GSK3 Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-313547 SN - 2072-6694 VL - 15 IS - 9 ER - TY - THES A1 - Sarma, Bhavishya T1 - Merkel Cell Carcinoma: Investigations on its carcinogenesis and new therapeutic approaches T1 - Merkelzellkarzinom: Untersuchungen zur Karzinogenese und neue Therapieansätze N2 - Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with an increasing incidence. The majority of MCC cases (approximately 80%) are associated with the Merkel cell polyomavirus (MCPyV). This virus encodes for the MCPyV T antigens (small T (sT) and large T (LT)), which are oncoproteins that drive MCC carcinogenesis. However, the precise cells of the skin that are transformed by the T antigens are not known i.e., the cells of origin of MCC are yet to be discovered. Therefore, the first part of this study involved the generation and evaluation of a vector system that could be used to study MCC oncogenesis. To this end, a set of lentiviral vectors was cloned that allows independent, inducible expression of potential key factors in MCC oncogenesis. In addition, a CRISPR/Cas9 knock in was established that allows the coding sequence for a fluorescent protein to be placed under the control of the promoter of KRT20, one of the most crucial markers of MCC. The functionality of this KRT20 reporter was proven in the MCPyV-positive MCC cell line, WaGa. The different inducible vector systems (doxycycline-inducible MCPyV T antigens or MCPyV sT, RheoSwitch-inducible ATOH1 and IPTG-inducible dnMAML1 and GLI1) were found to have different efficacies in various cellular systems and in particular, a considerable reduction in efficiency was observed at times upon the interaction of several vectors in one cell. In the second and more important part of this study, the role of the well-established anti-malarial drug, artesunate, which possesses additional anti-tumor and anti-viral activity, in the treatment of MCPyV-positive MCC was analyzed. In our study, artesunate was found to be cytotoxic towards MCPyV-positive MCC cell lines in vitro and repressed tumor growth in vivo in a mouse model. Artesunate was also found to downregulate T antigen expression, which is critical for the proliferation of MCPyV-positive MCC cells. The repression of T antigen expression, however, was not the sole mechanism of artesunate’s cytotoxic action; instead, the MCPyV-positive MCC cell line, WaGa, was found to be even less sensitive to artesunate after shRNA knockdown of the T antigens. Since loss of membrane integrity occurred more rapidly than degradation/loss of genomic DNA under the influence of artesunate in four of five MCPyV-positive MCC cell lines examined, apoptosis, although widely described as a modus operandi for artesunate, did not appear to be a determinant of the cytotoxicity of artesunate against MCPyV-positive MCC cells. Instead, we were able to demonstrate that artesunate induced the recently described iron-dependent and lipid peroxide-associated form of cell death known as "ferroptosis". This was achieved primarily through the use of inhibitors that can suppress specific individual steps of the ferroptotic process. Thus, artesunate-induced cell death of MCPyV-positive MCC cells could be suppressed by iron chelators and by the inhibition of lipid peroxidation and lysosomal transport. Surprising results were obtained from the analysis of two proteins associated with the ferroptotic process, namely, ferroptosis suppressor protein 1 (FSP1) and tumor suppressor protein p53. Here, we showed that ectopically- 2 expressed FSP1 cannot suppress artesunate-induced ferroptosis in MCPyV-positive MCC cells and that p53 does not play a pro-ferroptotic role in artesunate-induced cell death of MCPyV-positive MCCs. Since artesunate did not suppress the interferon-γ-induced expression of immune-related molecules such as HLA and PD-L1 on the surface of MCPyV-positive MCCs, our study also provided the first positive evidence for its use in combinatorial immunotherapy. Overall, this study showed that artesunate appears to be an effective drug for the treatment of MCPyV-positive MCC and might also be considered for its use in combinatorial MCC immunotherapy in the future. N2 - Das Merkelzellkarzinom (MCC) ist ein seltener und aggressiver Hautkrebs mit einer steigenden Inzidenz. Die Mehrzahl der MCC-Fälle (ca. 80%) sind mit dem Merkelzell-Polyomavirus (MCPyV) assoziiert. Dieses Virus kodiert für die MCPyV T Antigene (small T (sT) und Large T (LT)), die als Onkoproteine die MCC Karzinogenese vorantreiben. Unbekannt ist jedoch welche Zellen der Haut durch die T Antigene transformiert werden, was also die Ursprungszellen des MCC sind. Der erste Teil dieser Arbeit befasste sich daher mit der Generierung und Evaluierung eines Vektorsystems, das zur Untersuchung der MCC-Onkogenese genutzt werden könnte. Dazu wurde ein Set von lentiviralen Vektoren kloniert, das die voneinander unabhängige, induzierbare Expression von potentiellen Schlüsselfaktoren der MCC-Onkogenese erlaubt. Außerdem wurde ein CRISPR/Cas9 knock in etabliert, der es erlaubt die kodierende Sequenz für ein fluoreszierendes Protein unter die Kontrolle des Promoters von KRT20, dessen Expression eines der wichtigsten MCC Marker ist, zu bringen. Die Funktionalität dieses KRT20 Reporters konnte in einer MCPyV-positive MCC Linie, WaGa, nachgewiesen werden. Die verschiedenen induzierbaren Vektorsysteme (Doxycyclin-induzierbare MCPyV T Antigene bzw. MCPyV sT, RheoSwitch-induzierbare ATOH1, IPTG-induzierbares dnMAML1 und GLI1) zeigten sich unterschiedlich effektiv in unterschiedlichen Zellsystemen und insbesondere im Zusammenspiel mehrerer Vektoren in einer Zelle war die Induzierbarkeit teilweise erheblich reduziert. Im zweiten, und wichtigeren Teil dieser Arbeit, habe ich mich mit der Frage auseinandergesetzt, ob ein etabliertes Anti-Malaria-Medikament, dem zusätzlich anti-tumorale und anti-virale Aktivität zugeschrieben werden, sich für die Behandlung des MCPyV-positiven MCC anbieten könnte. In unserer Studie wurde festgestellt, dass Artesunat in vitro zytotoxisch auf MCPyV-positive MCC Zelllinien wirkt und in vivo im Mausmodell das Tumorwachstum verlangsamen kann. Es wurde zudem beobachtet, dass Artesunat die T Antigen Expression unterdrückt, das für die Proliferation von MCPyV-positiven MCC-Zellen entscheidend ist. Allerdings spielt die Repression der T Antigen Expression keine Rolle für den zytotoxischen Effekt von Artesunat, sondern es zeigte sich, dass die MCC-Zelllinie WaGa nach shRNA knockdown der T Antigene sogar weniger sensitiv gegenüber Artesunat war. Da unter dem Einfluss von Artesunat in vier von fünf untersuchten MCC Zelllinien der Verlust der Membranintegrität schneller eintrat als eine Degradation/Verlust der genomischen DNA scheint Apoptose, obwohl vielfach als Modus Operandi für Artesunat beschrieben, nicht bestimmend für die Zytotoxität von Artesunat gegenüber MCPyV-positiven MCC Zellen zu sein. Stattdessen konnten wir die kürzlich beschriebene eisenabhängige und Lipidperoxid-assoziierte Form des Zelltods, die sogenannte "Ferroptose", nachweisen. Dies gelang vor allem durch den Einsatz von Inhibitoren, die spezifische Einzelschritte des ferroptotischen Prozesses unterdrücken können. So ließ sich der durch Artesunat induzierte Zelltod von MCPyV-positiven Zellen durch Eisenchelatbildner und Inhibition der Lipidperoxidation und des lysosomalen Transports unterdrücken. Überraschende Ergebnisse lieferte die Analyze von zwei Proteinen, die mit dem ferroptotischen Prozess in Verbindung gebracht werden, nämlich dem Ferroptose-Suppressor-Protein 1 (FSP1) und dem Tumorsuppressor-Protein p53. Hier zeigte sich, dass ektopisch-exprimiertes FSP1 die Artesunat-induzierte Ferroptose in MCC Zellen nicht unterdrücken kann und dass p53 keine pro-ferroptotische Rolle beim Artesunat-induzierten Zelltod von MCPyV-positiven MCCs spielt. Da Artesunat die Interferon-γ induzierte Expression von immunrelevanten Molekülen wie HLA und PD-L1 auf der Oberfläche von MCPyV-positiven MCCs nicht unterdrückte, ergaben sich auch erste positive Hinweise auf seinen Einsatz in der kombinatorischen Immuntherapie. Insgesamt zeigte diese Studie, dass Artesunat ein wirksames Medikament für die Behandlung von MCPyV-positivem MCC zu sein scheint und in Zukunft auch für den Einsatz in der kombinatorischen MCC-Immuntherapie in Frage kommen könnte. KW - Merkel cell carcinoma KW - Merkel cell polyomavirus KW - Ferroptosis KW - Artesunate Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-247402 ER - TY - JOUR A1 - Sarma, Bhavishya A1 - Willmes, Christoph A1 - Angerer, Laura A1 - Adam, Christian A1 - Becker, Jürgen C. A1 - Kervarrec, Thibault A1 - Schrama, David A1 - Houben, Roland T1 - Artesunate affects T antigen expression and survival of virus-positive Merkel cell carcinoma JF - Cancers N2 - Merkel cell carcinoma (MCC) is a rare and highly aggressive skin cancer with frequent viral etiology. Indeed, in about 80% of cases, there is an association with Merkel cell polyomavirus (MCPyV); the expression of viral T antigens is crucial for growth of virus-positive tumor cells. Since artesunate — a drug used to treat malaria — has been reported to possess additional anti-tumor as well as anti-viral activity, we sought to evaluate pre-clinically the effect of artesunate on MCC. We found that artesunate repressed growth and survival of MCPyV-positive MCC cells in vitro. This effect was accompanied by reduced large T antigen (LT) expression. Notably, however, it was even more efficient than shRNA-mediated downregulation of LT expression. Interestingly, in one MCC cell line (WaGa), T antigen knockdown rendered cells less sensitive to artesunate, while for two other MCC cell lines, we could not substantiate such a relation. Mechanistically, artesunate predominantly induces ferroptosis in MCPyV-positive MCC cells since known ferroptosis-inhibitors like DFO, BAF-A1, Fer-1 and β-mercaptoethanol reduced artesunate-induced death. Finally, application of artesunate in xenotransplanted mice demonstrated that growth of established MCC tumors can be significantly suppressed in vivo. In conclusion, our results revealed a highly anti-proliferative effect of the approved and generally well-tolerated anti-malaria compound artesunate on MCPyV-positive MCC cells, suggesting its potential usage for MCC therapy. KW - artesunate KW - Merkel cell carcinoma KW - MCC KW - polyomavirus KW - ferroptosis Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-203851 SN - 2072-6694 VL - 12 IS - 4 ER -