Argininosuccinate Synthase

精氨酸琥珀酸合酶
  • 文章类型: Journal Article
    对阿尔茨海默病(AD)和额颞叶痴呆(FTD)的遗传基础进行了全面研究,对于未分类为这些诊断的非典型病例,情况并非如此。在本研究中,我们的目标是有助于对由尿素循环基因突变引起的高氨血症导致的非AD和非FTD痴呆的发展的分子理解.通过对90例患者进行合并的全外显子组测序(WES),并通过在常染色体基因中寻找尿素循环途径的酶或转运蛋白的罕见致病变异来进行分析。该调查返回了导致I型瓜氨酸血症的两种罕见致病性编码突变:rs148918985,p.Arg265Cys,C>T;rs121908641,p.Gly390Arg,精氨酸琥珀酸合酶1(ASS1)基因中的G>A。p.Arg265Cys变体导致酶缺乏,而p.Gly390Arg使酶失活。在简单或复合杂合性中发现的这些变体可导致I型瓜氨酸血症的迟发性形式,与高氨含量有关,这可能导致大脑功能障碍,从而导致痴呆症的发展。引起尿素循环障碍的突变的存在可用于早期开始抗高氨血症治疗,以防止神经毒性作用。
    The genetic bases of Alzheimer\'s disease (AD) and frontotemporal dementia (FTD) have been comprehensively studied, which is not the case for atypical cases not classified into these diagnoses. In the present study, we aim to contribute to the molecular understanding of the development of non-AD and non-FTD dementia due to hyperammonemia caused by mutations in urea cycle genes. The analysis was performed by pooled whole-exome sequencing (WES) of 90 patients and by searching for rare pathogenic variants in autosomal genes for enzymes or transporters of the urea cycle pathway. The survey returned two rare pathogenic coding mutations leading to citrullinemia type I: rs148918985, p.Arg265Cys, C>T; and rs121908641, p.Gly390Arg, G>A in the argininosuccinate synthase 1 (ASS1) gene. The p.Arg265Cys variant leads to enzyme deficiency, whereas p.Gly390Arg renders the enzyme inactive. These variants found in simple or compound heterozygosity can lead to the late-onset form of citrullinemia type I, associated with high ammonia levels, which can lead to cerebral dysfunction and thus to the development of dementia. The presence of urea cycle disorder-causing mutations can be used for the early initiation of antihyperammonemia therapy in order to prevent the neurotoxic effects.
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  • 文章类型: Journal Article
    许多类型的人类癌症抑制精氨酸琥珀酸合酶1(ASS1)的表达,精氨酸生产的限速酶。尽管精氨酸剥夺疗法可以利用对外源性精氨酸的依赖性,ASS1抑制对肿瘤蛋白质组质量的影响尚不清楚.因此,我们询问了癌症患者的蛋白质组的精氨酸密码子重新分配(替代),并且令人惊讶地在肺肿瘤中特异性地鉴定了半胱氨酸的强富集(R>C)。大多数R>C事件与遗传编码的R>C突变不一致,但可能是tRNA未对齐的产物。R>C取代子的表达与致癌海带样表氯醇(ECH)相关蛋白1(KEAP1)途径突变高度相关,并在KEAP1突变的癌细胞中被完整的KEAP1抑制。最后,功能询问表明R>C替代物在顺铂的细胞存活中起关键作用,这表明,调节密码子的重新分配赋予癌细胞更多的抗应激能力。因此,我们提出了一种富含半胱氨酸的肺癌蛋白质组可能影响治疗决策的机制.
    Many types of human cancers suppress the expression of argininosuccinate synthase 1 (ASS1), a rate-limiting enzyme for arginine production. Although dependency on exogenous arginine can be harnessed by arginine-deprivation therapies, the impact of ASS1 suppression on the quality of the tumor proteome is unknown. We therefore interrogated proteomes of cancer patients for arginine codon reassignments (substitutants) and surprisingly identified a strong enrichment for cysteine (R>C) in lung tumors specifically. Most R>C events did not coincide with genetically encoded R>C mutations but were likely products of tRNA misalignments. The expression of R>C substitutants was highly associated with oncogenic kelch-like epichlorohydrin (ECH)-associated protein 1 (KEAP1)-pathway mutations and suppressed by intact-KEAP1 in KEAP1-mutated cancer cells. Finally, functional interrogation indicated a key role for R>C substitutants in cell survival to cisplatin, suggesting that regulatory codon reassignments endow cancer cells with more resilience to stress. Thus, we present a mechanism for enriching lung cancer proteomes with cysteines that may affect therapeutic decisions.
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  • 文章类型: Journal Article
    精氨酸琥珀酸合酶(ASS1),尿素循环中的关键酶,在许多癌症中充当肿瘤抑制因子。迄今为止,ASS1的抗癌机制尚未完全阐明。这里,我们发现磷酸甘油酸脱氢酶(PHGDH),丝氨酸合成中的关键限速酶,是与ASS1相互作用的关键蛋白。我们的结果表明ASS1直接与PHGDH结合并促进其泛素化介导的降解以抑制丝氨酸合成,从而抑制肿瘤发生。重要的是,ASS1的肿瘤抑制作用被PHGDH基因敲除强烈取消.此外,当丝氨酸和甘氨酸耗尽时,ASS1敲除和敲除部分挽救了细胞增殖,通过添加丝氨酸和甘氨酸恢复ASS1过表达对细胞增殖的抑制作用。这些发现揭示了ASS1的新作用,并表明ASS1/PHGDH丝氨酸合成途径是癌症治疗的有希望的靶标。
    Argininosuccinate synthase (ASS1), a critical enzyme in the urea cycle, acts as a tumor suppressor in many cancers. To date, the anticancer mechanism of ASS1 has not been fully elucidated. Here, we found that phosphoglycerate dehydrogenase (PHGDH), a key rate-limiting enzyme in serine synthesis, is a pivotal protein that interacts with ASS1. Our results showed that ASS1 directly binds to PHGDH and promotes its ubiquitination-mediated degradation to inhibit serine synthesis, consequently suppressing tumorigenesis. Importantly, the tumor suppressive effects of ASS1 were strongly abrogated by PHGDH knockout. In addition, ASS1 knockout and knockdown partially rescued cell proliferation when serine and glycine were depleted, while the inhibitory effect of ASS1 overexpression on cell proliferation was restored by the addition of serine and glycine. These findings unveil a novel role of ASS1 and suggest that the ASS1/PHGDH serine synthesis pathway is a promising target for cancer therapy.
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  • 文章类型: Journal Article
    尿素循环经常在癌细胞中重新连接以满足癌症的代谢需求。阐明致癌信号介导尿素循环重编程的潜在机制可以帮助识别可靶向的代谢脆弱性。在这项研究中,我们发现KRAS在非小细胞肺癌(NSCLC)中的致癌激活沉默了精氨酸琥珀酸合酶1(ASS1)的表达,一种尿素循环酶,催化天冬氨酸和瓜氨酸产生精氨酸,从而将天冬氨酸的利用转向嘧啶合成,以满足对DNA复制的高需求。具体来说,KRAS信号以组蛋白去乙酰化酶3依赖性方式促进ASS1基因启动子区域的低乙酰化状态,这反过来又阻碍了ASS1转录中c-MYC的募集。KRAS突变型NSCLC细胞中的ASS1抑制损害了精氨酸的生物合成,并依赖精氨酸跨膜转运蛋白SLC7A1输入细胞外精氨酸。在患者来源的类器官和异种移植模型中SLC7A1的耗尽抑制了KRAS驱动的NSCLC生长。一起,这些发现揭示了致癌KRAS在重新连接尿素循环代谢中的作用,并确定了SLC7A1介导的精氨酸摄取是治疗KRAS突变型NSCLC的治疗脆弱性.
    ASS1缺陷是由突变KRAS在NSCLC中诱导的,以促进DNA合成,并产生对SLC7A1的依赖性,这表明饮食精氨酸限制和SLC7A1抑制是潜在的治疗策略。
    The urea cycle is frequently rewired in cancer cells to meet the metabolic demands of cancer. Elucidation of the underlying mechanism by which oncogenic signaling mediates urea cycle reprogramming could help identify targetable metabolic vulnerabilities. In this study, we discovered that oncogenic activation of KRAS in non-small cell lung cancer (NSCLC) silenced the expression of argininosuccinate synthase 1 (ASS1), a urea cycle enzyme that catalyzes the production of arginine from aspartate and citrulline, and thereby diverted the utilization of aspartate to pyrimidine synthesis to meet the high demand for DNA replication. Specifically, KRAS signaling facilitated a hypoacetylated state in the promoter region of the ASS1 gene in a histone deacetylase 3-dependent manner, which in turn impeded the recruitment of c-MYC for ASS1 transcription. ASS1 suppression in KRAS-mutant NSCLC cells impaired the biosynthesis of arginine and rendered a dependency on the arginine transmembrane transporter SLC7A1 to import extracellular arginine. Depletion of SLC7A1 in both patient-derived organoid and xenograft models inhibited KRAS-driven NSCLC growth. Together, these findings uncover the role of oncogenic KRAS in rewiring urea cycle metabolism and identify SLC7A1-mediated arginine uptake as a therapeutic vulnerability for treating KRAS-mutant NSCLC.
    UNASSIGNED: ASS1 deficiency is induced by mutant KRAS in NSCLC to facilitate DNA synthesis and creates a dependency on SLC7A1, revealing dietary arginine restriction and SLC7A1 inhibition as potential therapeutic strategies.
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  • 文章类型: Journal Article
    来自天然来源的药物的探索在解决卵巢癌(OC)治疗中的当前局限性方面具有重要的前景。虽然先前的研究强调了天然化合物β-谷甾醇(SIT)在各种肿瘤中的显着抗癌特性,其在OC治疗中的具体作用仍有待探索。本研究旨在利用体外和体内模型研究SIT在OC中的抗肿瘤活性。描绘潜在的机制,并为未来的临床试验建立临床前理论基础,从而促进进一步的研究。利用网络药理学,我们确定SIT是OC治疗的有希望的候选药物,并预测其潜在的靶点和途径.通过一系列的体外和体内实验,我们揭示了SIT通过调节氧化还原状态减轻OC细胞恶性生物学行为的新机制。具体来说,SIT选择性靶向精氨酸琥珀酸合成酶1(ASS1),在OC组织和细胞中明显过表达的蛋白质。抑制ASS1,SIT增强Nrf2和Keap1之间的相互作用,促使Nrf2的泛素依赖性降解,随后减少下游抗氧化基因HO-1和NQO1的转录激活。SIT对抗氧化剂程序的中断导致OC细胞中活性氧(ROS)的大量积累。这个,反过来,上调PTEN,对AKT的磷酸化激活施加负调控。AKT信号的抑制破坏了与细胞周期相关的下游通路,细胞存活,凋亡,迁移,和入侵,最终导致OC细胞死亡。我们的研究发现了SIT对抗OC的新目标和机制,有助于在OC背景下对天然产物抗肿瘤作用的现有知识。此外,这项研究揭示了ASS1在调节Nrf2介导的抗氧化剂程序和控制OC中的氧化还原稳态方面的新作用,提供了对这种复杂疾病的更深入的了解。
    The exploration of drugs derived from natural sources holds significant promise in addressing current limitations in ovarian cancer (OC) treatments. While previous studies have highlighted the remarkable anti-cancer properties of the natural compound β-sitosterol (SIT) across various tumors, its specific role in OC treatment remains unexplored. This study aims to investigate the anti-tumor activity of SIT in OC using in vitro and in vivo models, delineate potential mechanisms, and establish a preclinical theoretical foundation for future clinical trials, thus fostering further research. Utilizing network pharmacology, we pinpoint SIT as a promising candidate for OC treatment and predict its potential targets and pathways. Through a series of in vitro and in vivo experiments, we unveil a novel mechanism through which SIT mitigates the malignant biological behaviors of OC cells by modulating redox status. Specifically, SIT selectively targets argininosuccinate synthetase 1 (ASS1), a protein markedly overexpressed in OC tissues and cells. Inhibiting ASS1, SIT enhances the interaction between Nrf2 and Keap1, instigating the ubiquitin-dependent degradation of Nrf2, subsequently diminishing the transcriptional activation of downstream antioxidant genes HO-1 and NQO1. The interruption of the antioxidant program by SIT results in the substantial accumulation of reactive oxygen species (ROS) in OC cells. This, in turn, upregulates PTEN, exerting negative regulation on the phosphorylation activation of AKT. The suppression of AKT signaling disrupted downstream pathways associated with cell cycle, cell survival, apoptosis, migration, and invasion, ultimately culminating in the death of OC cells. Our research uncovers new targets and mechanisms of SIT against OC, contributing to the existing knowledge on the anti-tumor effects of natural products in the context of OC. Additionally, this research unveils a novel role of ASS1 in regulating the Nrf2-mediated antioxidant program and governing redox homeostasis in OC, providing a deeper understanding of this complex disease.
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  • 文章类型: Journal Article
    动脉粥样硬化起因于高脂血症下的内皮细胞(EC)功能障碍和血管炎症。Sirtuin3(SIRT3)是一种线粒体脱乙酰酶。然而,内皮细胞SIRT3在动脉粥样硬化过程中的具体作用尚不清楚.本研究旨在研究SIRT3在动脉粥样硬化过程中在EC功能中的作用及机制。野生型Sirt3f/f小鼠和内皮选择性SIRT3敲除Sirt3f/f;Cdh5Cre/+(Sirt3EC-KO)小鼠注射腺相关病毒(AAV)以过表达PCSK9,并饲喂高胆固醇饮食(HCD)12周以诱导动脉粥样硬化。Sirt3EC-KO小鼠表现出增加的动脉粥样硬化斑块形成,随着巨噬细胞浸润的增加,血管炎症,和降低循环L-精氨酸水平。在人类ECs中,SIRT3抑制导致血管炎症加剧,减少一氧化氮(NO)的产生,增加活性氧(ROS),和减少L-精氨酸水平。SIRT3的沉默会导致精氨酸琥珀酸合酶1(ASS1)的高乙酰化和失活,一种参与L-精氨酸生物合成的限速酶,这种效应在突变型ASS1中消失。此外,在Sirt3EC-KO小鼠中,L-精氨酸补充减弱增强的斑块形成和血管炎症。这项研究提供了令人信服的证据支持内皮SIRT3在动脉粥样硬化中的保护作用,并且还表明SIRT3诱导的ECs对ASS1的去乙酰化对精氨酸合成的关键作用。
    Atherosclerosis is initiated with endothelial cell (EC) dysfunction and vascular inflammation under hyperlipidemia. Sirtuin 3 (SIRT3) is a mitochondrial deacetylase. However, the specific role of endothelial SIRT3 during atherosclerosis remains poorly understood. The present study aims to study the role and mechanism of SIRT3 in EC function during atherosclerosis. Wild-type Sirt3f/f mice and endothelium-selective SIRT3 knockout Sirt3f/f; Cdh5Cre/+ (Sirt3EC-KO) mice are injected with adeno-associated virus (AAV) to overexpress PCSK9 and fed with high-cholesterol diet (HCD) for 12 weeks to induce atherosclerosis. Sirt3EC-KO mice exhibit increased atherosclerotic plaque formation, along with elevated macrophage infiltration, vascular inflammation, and reduced circulating L-arginine levels. In human ECs, SIRT3 inhibition resulted in heightened vascular inflammation, reduced nitric oxide (NO) production, increased reactive oxygen species (ROS), and diminished L-arginine levels. Silencing of SIRT3 results in hyperacetylation and deactivation of Argininosuccinate Synthase 1 (ASS1), a rate-limiting enzyme involved in L-arginine biosynthesis, and this effect is abolished in mutant ASS1. Furthermore, L-arginine supplementation attenuates enhanced plaque formation and vascular inflammation in Sirt3EC-KO mice. This study provides compelling evidence supporting the protective role of endothelial SIRT3 in atherosclerosis and also suggests a critical role of SIRT3-induced deacetylation of ASS1 by ECs for arginine synthesis.
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  • 文章类型: Journal Article
    1型瓜氨酸血症(CTLN1)是一种罕见的常染色体隐性遗传尿素循环障碍,由胞质酶精氨酸琥珀酸合成酶1(ASS1)的缺乏引起,这是由于位于9q34.11号染色体上的ASS1基因的致病性变异。尽管子宫肌瘤亢进被认为是神经功能缺损和认知功能障碍的主要病理机制因素,在没有高氨代偿的情况下,相关的个体子集表现为神经退行性过程。在这里我们展示,反义介导的斑马鱼ASS1同源基因敲低诱导的ASS1缺陷与神经元分化缺陷有关,最终导致斑马鱼幼虫体内神经元细胞丢失和大脑大小连续减小。而缺乏ASS1的斑马鱼幼虫的特征是瓜氨酸的浓度显著升高-CTLN1的生化标志,L-瓜氨酸的积累,高氨血症或与之相关的继发性代谢改变没有解释观察到的表型.有趣的是,人ASS1mRNA的共同注射不仅使瓜氨酸浓度正常化,而且逆转了脑形态表型和恢复了脑大小,确认跨物种ASS1的保守功能特性。本研究的结果暗示了一种新颖的,ASS1蛋白在神经发育中的潜在非酶(月光)功能。
    Citrullinemia type 1 (CTLN1) is a rare autosomal recessive urea cycle disorder caused by deficiency of the cytosolic enzyme argininosuccinate synthetase 1 (ASS1) due to pathogenic variants in the ASS1 gene located on chromosome 9q34.11. Even though hyperammenomia is considered the major pathomechanistic factor for neurological impairment and cognitive dysfunction, a relevant subset of individuals presents with a neurodegenerative course in the absence of hyperammonemic decompensations. Here we show, that ASS1 deficiency induced by antisense-mediated knockdown of the zebrafish ASS1 homologue is associated with defective neuronal differentiation ultimately causing neuronal cell loss and consecutively decreased brain size in zebrafish larvae in vivo. Whereas ASS1-deficient zebrafish larvae are characterized by markedly elevated concentrations of citrulline - the biochemical hallmark of CTLN1, accumulation of L-citrulline, hyperammonemia or therewith associated secondary metabolic alterations did not account for the observed phenotype. Intriguingly, coinjection of the human ASS1 mRNA not only normalized citrulline concentration but also reversed the morphological cerebral phenotype and restored brain size, confirming conserved functional properties of ASS1 across species. The results of the present study imply a novel, potentially non-enzymatic (moonlighting) function of the ASS1 protein in neurodevelopment.
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  • 文章类型: Journal Article
    食管鳞状细胞癌(ESCC)是一种常见的恶性肿瘤,由于缺乏早期检测,预后较差。的确,ESCC进展的潜在机制仍不清楚.这里,我们发现精氨酸代谢异常有助于ESCC进展。基于转录组学和代谢组学分析,我们发现精氨酰琥珀酸合成酶1(ASS1)和精氨酰琥珀酸裂解酶(ASL)水平在原发肿瘤组织中升高,但在淋巴转移肿瘤组织中降低.有趣的是,FOXO3a在原发和转移肿瘤组织中与ASS1和ASL呈负相关。这表明FOXO3a在ESCC的不同阶段对ASS1和ASL的调控不同。沉默ASS1/ASL抑制原发肿瘤生长,促进转移。相反,ASS1/ASL过表达或精氨酸供应增加可促进肿瘤增殖但抑制转移。此外,FOXO3a激活通过抑制ASS1和ASL转录抑制原发性肿瘤生长,而FOXO3a的失活通过释放ASS1和ASL转录来阻碍转移。一起,这一发现揭示了ESCC中的转移重编程。
    Esophageal squamous cell carcinoma (ESCC) is a common malignant tumor with a poor prognosis due to a lack of early detection. Indeed, the mechanisms underlying ESCC progression remain unclear. Here, we discovered that abnormal arginine metabolism contributes to ESCC progression. Based on transcriptomic and metabolomic analyses, we found that argininosuccinate synthetase 1 (ASS1) and argininosuccinate lyase (ASL) levels were increased in primary tumor tissues but decreased in lymph-metastatic tumor tissues. Intriguingly, FOXO3a was inversely correlated with ASS1 and ASL in primary and metastatic tumor tissues, suggesting that FOXO3a dissimilarly regulates ASS1 and ASL at different stages of ESCC. Silencing ASS1/ASL inhibited primary tumor growth and promoted metastasis. Conversely, overexpression of ASS1/ASL or increased arginine supply promoted tumor proliferation but suppressed metastasis. In addition, FOXO3a activation inhibited primary tumor growth by repressing ASS1 and ASL transcription, whereas inactivation of FOXO3a impeded metastasis by releasing ASS1 and ASL transcription. Together, the finding sheds light on metastatic reprogramming in ESCC.
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  • 文章类型: English Abstract
    目的:分析3个瓜氨酸血症Ⅰ型(CTLN1)中国家系的临床和遗传特点。
    方法:选取2017-2020年山东大学附属儿童医院确诊的3例儿童作为研究对象。从先证者及其父母的外周血样品中提取基因组DNA。进行下一代测序(NGS)以检测先证者的病理变体。Sanger测序用于验证谱系中的候选变体。
    结果:先证者分别携带了c.207_209delGGA和c.1168G>A的复合杂合变体,c.349G>A和c.364-1G>A,ASS1基因的c.470G>A和c.970G>A,分别从父母那里继承。
    结论:新发现的c.207_209delGGA和c.364-1G>A变体丰富了ASS1基因的突变谱。中国CTLN1患者的突变谱具有异质性。
    OBJECTIVE: To analyze the clinical and genetic characteristics of three Chinese pedigrees affected with Citrullinemia type I (CTLN1).
    METHODS: Three children diagnosed at the Children\'s Hospital Affiliated to Shandong University from 2017 to 2020 were selected as the study subjects. Genomic DNA was extracted from peripheral blood samples of the probands and their parents. Next generation sequencing (NGS) was carried out to detect pathological variants of the probands. Sanger sequencing was used for validating the candidate variant among the pedigrees.
    RESULTS: The probands have respectively carried compound heterozygous variants of c.207_209delGGA and c.1168G>A, c.349G>A and c.364-1G>A, c.470G>A and c.970G>A of the ASS1 gene, which were respectively inherited from their parents.
    CONCLUSIONS: The newly discovered c.207_209delGGA and c.364-1G>A variants have enriched the mutational spectrum of the ASS1 gene. And the mutation spectrum of Chinese CTLN1 patients is heterogeneous.
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  • 文章类型: Journal Article
    癌症是一个全球性的公共卫生问题。神经母细胞瘤(NB)起源于交感神经系统的任何组织,受影响最大的部位是腹部。肾上腺是38%病例的主要部位。大约50%的患者在诊断时患有转移性疾病,骨髓经常受到影响。转移性疾病的特征是经常对化学疗法和放射疗法具有抗性的癌细胞从原发性肿瘤扩散到身体的其他特定部位,并导致90%的癌症相关死亡。越来越多的证据表明,一氧化氮(NO)信号与许多类型的癌症的病理生理学有关。特别是在肿瘤发生和癌症进展中。然而,NO对转移的影响不能轻易分类为前转移或抗转移。在分子水平上了解NO在癌症中的作用将对疾病的诊断和治疗具有深远的治疗意义。这里,从Bothropsjararaca毒液(Bj-PRO-10c)中分离出的富含脯氨酸的十肽可增强和维持NO的产生,用于阐明代谢NO在转移步骤中的作用。Bj-PRO-10c显示出抗转移作用,主要通过干扰肌动蛋白细胞骨架重排,控制细胞增殖,并降低NB在转移生态位中的播种效率。因此,我们提出用正确的分子策略控制NO诱导的方法有望抑制NB患者的转移并延长其寿命.
    Cancer is a global public health issue. Neuroblastoma (NB) originates from any tissue of the sympathetic nervous system, and the most affected site is the abdomen. The adrenal gland is the primary site in 38% of cases. Approximately 50% of patients have metastatic disease at diagnosis, and bone marrow is often affected. Metastatic disease is characterized by the spreading of cancer cells that are frequently resistant to chemotherapy and radiotherapy from the primary tumor to other specific parts of the body and is responsible for 90% of cancer-related deaths. Increasing evidence has indicated that nitric oxide (NO) signaling is implicated in the pathophysiology of many types of cancer, particularly in tumorigenesis and cancer progression. However, the effect of NO on metastasis cannot be easily classified as prometastatic or antimetastatic. An understanding at the molecular level of the role of NO in cancer will have profound therapeutic implications for the diagnosis and treatment of disease. Here, the proline-rich decapeptide isolated from Bothrops jararaca venom (Bj-PRO-10c) that enhances and sustains the generation of NO was used to unravel the role of metabolic NO in steps of metastasis. Bj-PRO-10c showed an antimetastatic effect, mainly by interfering with actin cytoskeleton rearrangement, controlling cell proliferation, and decreasing the seeding efficiency of NB in metastatic niches. Therefore, we proposed that an approach for controlled NO induction with the right molecular strategies can hopefully inhibit metastasis and increase the lifespan of NB patients.
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