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Updated: Dec 26, 2025

Author Spotlight: Tracing the Ferroptotic Signatures and Cell Death Dynamics in Medulloblastoma for Advanced Therapeutics
Published on: March 15, 2024
Mitochondrial DNA stress triggers autophagy-dependent ferroptotic death
Changfeng Li1, Ying Zhang1, Jiao Liu2
1Department of Endoscopy Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
Abstract:
Pancreatic cancer tends to be highly resistant to current therapy and remains one of the great challenges in biomedicine with very low 5-year survival rates. Here, we report that zalcitabine, an antiviral drug for human immunodeficiency virus infection, can suppress the growth of primary and immortalized human pancreatic cancer cells through the induction of ferroptosis, an iron-dependent form of regulated cell death. Mechanically, this effect relies on zalcitabine-induced mitochondrial DNA stress, which activates the STING1/TMEM173-mediated DNA sensing pathway, leading to macroautophagy/autophagy-dependent ferroptotic cell death via lipid peroxidation, but not a type I interferon response. Consequently, the genetic and pharmacological inactivation of the autophagy-dependent ferroptosis pathway diminishes the anticancer effects of zalcitabine in cell culture and animal models. Together, these findings not only provide a new approach for pancreatic cancer therapy but also increase our understanding of the interplay between autophagy and DNA damage response in shaping cell death.Abbreviations: ALOX: arachidonate lipoxygenase; ARNTL/BMAL1: aryl hydrocarbon receptor nuclear translocator-like; ATM: ATM serine/threonine kinase; ATG: autophagy-related; cGAMP: cyclic GMP-AMP; CGAS: cyclic GMP-AMP synthase; ER: endoplasmic reticulum; FANCD2: FA complementation group D2; GPX4: glutathione peroxidase 4; IFNA1/IFNα: interferon alpha 1; IFNB1/IFNβ: interferon beta 1; MAP1LC3B/LC3: microtubule-associated protein 1 light chain 3 beta; MDA: malondialdehyde; mtDNA: mitochondrial DNA; NCOA4: nuclear receptor coactivator 4; PDAC: pancreatic ductal adenocarcinoma; POLG: DNA polymerase gamma, catalytic subunit; qRT-PCR: quantitative polymerase chain reaction; RCD: regulated cell death; ROS: reactive oxygen species; SLC7A11: solute carrier family 7 member 11; STING1/TMEM173: stimulator of interferon response cGAMP interactor 1; TFAM: transcription factor A, mitochondrial.
Insights
Zalcitabine, an HIV drug, shows promise in treating pancreatic cancer by triggering ferroptosis, a cell death pathway. This occurs through mitochondrial DNA stress and autophagy, offering a new therapeutic strategy.
Area of Science:
- Oncology
- Cell Death Mechanisms
- Drug Repurposing
Background:
- Pancreatic cancer exhibits high therapeutic resistance and poor survival rates.
- Current treatments for pancreatic cancer are limited.
- Understanding novel cell death pathways is crucial for developing new therapies.
Purpose of the Study:
- To investigate the potential of zalcitabine, an antiviral medication, as a pancreatic cancer therapeutic.
- To elucidate the mechanism by which zalcitabine affects pancreatic cancer cell growth.
- To explore the role of ferroptosis and autophagy in zalcitabine's anticancer effects.
Main Methods:
- Treatment of primary and immortalized human pancreatic cancer cells with zalcitabine.
- Assessment of cell growth inhibition and induction of ferroptosis.
- Analysis of mitochondrial DNA (mtDNA) stress and the STING1/TMEM173 pathway.
- Investigation of macroautophagy/autophagy-dependent cell death and lipid peroxidation.
- Genetic and pharmacological inactivation of the autophagy-dependent ferroptosis pathway in cell culture and animal models.
Main Results:
- Zalcitabine suppressed the growth of human pancreatic cancer cells.
- The drug induced ferroptosis, an iron-dependent form of regulated cell death.
- This effect was mediated by zalcitabine-induced mitochondrial DNA stress activating the STING1/TMEM173 pathway.
- Autophagy-dependent ferroptosis occurred via lipid peroxidation, independent of a type I interferon response.
- Inactivation of the autophagy-dependent ferroptosis pathway abrogated zalcitabine's anticancer effects.
Conclusions:
- Zalcitabine demonstrates potential as a novel therapeutic agent for pancreatic cancer.
- The study highlights the critical role of autophagy-dependent ferroptosis in zalcitabine's mechanism of action.
- Findings advance the understanding of the interplay between DNA damage response and autophagy in regulating cell death for cancer therapy.
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