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Blockade of EGFR Activation Promotes TNF-Induced Lung Epithelial Cell Apoptosis and Pulmonary Injury
Toshimitsu Yamaoka1,2, Satoru Arata3, Mayumi Homma4
1Advanced Cancer Translational Research Institute, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan. yamaoka.t@med.showa-u.ac.jp.
Abstract:
Pneumonitis is the leading cause of death associated with the use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) against non-small cell lung cancer (NSCLC). However, the risk factors and the mechanism underlying this toxicity have not been elucidated. Tumor necrosis factor (TNF) has been reported to transactivate EGFR in pulmonary epithelial cells. Hence, we aimed to test the hypothesis that EGFR tyrosine kinase activity regulates TNF-mediated bronchial epithelial cell survival, and that inhibition of EGFR activity increases TNF-induced lung epithelial cell apoptosis. We used surfactant protein C (SPC)-TNF transgenic (tg) mice which overexpress TNF in the lungs. In this model, gefitinib, an EGFR-TKI, enhanced lung epithelial cell apoptosis and lymphocytic inflammation, indicating that EGFR tyrosine kinase prevents TNF-induced lung injury. Furthermore, IL-17A was significantly upregulated by gefitinib in SPC-TNF tg mice and p38MAPK activation was observed, indicative of a pathway involved in lung epithelial cell apoptosis. Moreover, in lung epithelial cells, BEAS-2B, TNF stimulated EGFR transactivation via the TNF-α-converting enzyme in a manner that requires heparin binding (HB)-EGF and transforming growth factor (TGF)-α. These novel findings have significant implications in understanding the role of EGFR in maintaining human bronchial epithelial cell homeostasis and in NSCLC treatment.
Insights
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) can cause lung inflammation. This study reveals EGFR inhibition increases lung cell death, suggesting EGFR protects against lung injury during cancer treatment.
Area of Science:
- Pulmonary Medicine
- Oncology
- Cell Biology
Background:
- Pneumonitis is a major cause of death in non-small cell lung cancer (NSCLC) patients treated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).
- The precise mechanisms and risk factors for TKI-induced pneumonitis remain unclear.
- Tumor necrosis factor (TNF) is known to activate EGFR in lung cells.
Purpose of the Study:
- To investigate the role of EGFR tyrosine kinase activity in regulating TNF-mediated bronchial epithelial cell survival.
- To determine if inhibiting EGFR activity exacerbates TNF-induced lung epithelial cell apoptosis.
Main Methods:
- Utilized surfactant protein C (SPC)-TNF transgenic mice overexpressing TNF in the lungs.
- Administered gefitinib, an EGFR-TKI, to the transgenic mice.
- Examined lung epithelial cells (BEAS-2B) stimulated with TNF in vitro.
Main Results:
- Gefitinib treatment in SPC-TNF tg mice led to increased lung epithelial cell apoptosis and lymphocytic inflammation.
- EGFR inhibition by gefitinib upregulated IL-17A and activated p38MAPK in the mouse model.
- In lung epithelial cells, TNF induced EGFR transactivation via TNF-α-converting enzyme, dependent on heparin binding (HB)-EGF and transforming growth factor (TGF)-α.
Conclusions:
- EGFR tyrosine kinase activity plays a protective role against TNF-induced lung injury.
- EGFR inhibition may increase susceptibility to lung epithelial cell apoptosis.
- Findings provide insights into EGFR's role in maintaining lung epithelial homeostasis and NSCLC treatment strategies.
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