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Updated: Jun 20, 2026

Visualizing and Quantifying Endonuclease-Based Site-Specific DNA Damage
Published on: August 21, 2021
Essential role of DNA base excision repair on survival in an acidic tumor microenvironment
1Department of Radiation Oncology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA.
Abstract:
The base excision repair (BER) pathway is required to repair endogenous and exogenous oxidative DNA damage. Multiple DNA repair pathways have been shown to be down-regulated in the tumor microenvironment, whereas APE1/Ref1, a central protein in BER, is overexpressed in many types of solid tumors. APE1/Ref1 has dual functions, participating both in BER and redox regulation of oxidized transcription factors. Here, we show that inhibition of the BER pathway in an acidic tumor microenvironment increases oxidative DNA damage temporally related to increased intracellular reactive oxygen species. Unrepaired oxidative DNA damage results in cell cycle arrests and increased DNA double-strand breaks, leading to cell death. Therefore, up-regulation of BER in solid cancers may represent an adaptive survival response. Consequently, BER inhibition may confer tumor microenvironment targeted cytotoxicity in human cancers. Our data suggest that BER inhibition is a rational basis for cancer therapy with or without other cytotoxic therapy. Additionally, our results offer insight as to why APE1/Ref1 retains its unique dual functionality, both of which counteract environmental oxidative stress.
Insights
Inhibition of base excision repair (BER) in acidic tumors increases DNA damage and cell death. Upregulating BER is a cancer survival response, suggesting BER inhibition as a targeted cancer therapy.
Area of Science:
- Molecular Biology
- Cancer Biology
- Biochemistry
Background:
- The base excision repair (BER) pathway is crucial for repairing oxidative DNA damage.
- Many DNA repair pathways are downregulated in the tumor microenvironment, but APE1/Ref1, key in BER, is often overexpressed in solid tumors.
- APE1/Ref1 possesses dual roles in DNA repair and redox regulation.
Purpose of the Study:
- To investigate the impact of inhibiting the BER pathway in an acidic tumor microenvironment.
- To explore the potential of BER inhibition as a cancer therapy strategy.
Main Methods:
- Inhibition of the base excision repair (BER) pathway.
- Analysis of oxidative DNA damage and reactive oxygen species levels.
- Assessment of cell cycle arrest, DNA double-strand breaks, and cell death.
Main Results:
- BER inhibition in an acidic tumor microenvironment leads to increased oxidative DNA damage and reactive oxygen species.
- Unrepaired DNA damage causes cell cycle arrest, DNA double-strand breaks, and subsequent cell death.
- Upregulation of BER in solid cancers appears to be an adaptive survival mechanism.
Conclusions:
- BER inhibition can induce targeted cytotoxicity in the tumor microenvironment of human cancers.
- BER inhibition represents a rational approach for cancer therapy, potentially in combination with other treatments.
- The dual functionality of APE1/Ref1 likely serves to counteract oxidative stress in the cellular environment.
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