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ZNF207-driven PRDX1 lactylation and NRF2 activation in regorafenib resistance and ferroptosis evasion
Tianfeng Yang1, Suyu Zhang1, Kun Nie1
1School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, PR China; State Key Laboratory of Shaanxi for Natural Medicines Research and Engineering, Xi'an 710061, PR China.
Abstract:
Regorafenib (RGF) is a critical second-line therapy for advanced hepatocellular carcinoma (HCC) following disease progression on sorafenib; however, the rapid onset of RGF resistance poses a significant barrier to enhancing patient outcomes. In this study, CRISPR/Cas9 screening in RGF-treated HCC cells identified Zinc Finger Protein 207 (ZNF207) as a primary driver of resistance. Further analysis revealed that ZNF207 promotes resistance by inducing antioxidant responses that inhibit ferroptosis, a form of iron-dependent cell death. Mechanistically, ZNF207 facilitates the lactylation of peroxiredoxin 1 (PRDX1) at lysine 67, enhancing nuclear translocation and activation of nuclear factor erythroid 2-related factor 2 (NRF2), a master regulator of antioxidant pathways. This ZNF207-PRDX1-NRF2 pathway creates a ferroptosis-resistant, pro-survival environment under RGF treatment, enabling HCC cells to evade cell death. Functional assays demonstrated that ZNF207 knockdown significantly enhances RGF sensitivity by restoring ferroptosis, with additional findings showing that disrupting PRDX1 lactylation or NRF2 activity similarly reverses resistance. Together, these findings establish a critical link between protein lactylation and RGF resistance, positioning the ZNF207-PRDX1-NRF2 axis as a promising therapeutic target to enhance treatment efficacy in HCC. The implications of this research extend beyond HCC, indicating that targeting ferroptosis-suppressive pathways may offer a broader approach to overcoming resistance in various cancers.
Insights
Zinc Finger Protein 207 (ZNF207) drives resistance to Regorafenib (RGF) in liver cancer by inhibiting ferroptosis. Targeting the ZNF207-PRDX1-NRF2 pathway restores RGF sensitivity and offers new therapeutic strategies.
Area of Science:
- Oncology
- Molecular Biology
- Biochemistry
Background:
- Regorafenib (RGF) is a key second-line treatment for advanced hepatocellular carcinoma (HCC).
- Drug resistance, particularly to RGF, significantly limits treatment efficacy and patient outcomes in HCC.
- Understanding the molecular mechanisms of RGF resistance is crucial for developing effective therapeutic strategies.
Purpose of the Study:
- To identify key molecular drivers of RGF resistance in HCC.
- To elucidate the mechanism by which ZNF207 confers RGF resistance.
- To explore the therapeutic potential of targeting the identified resistance pathway.
Main Methods:
- CRISPR/Cas9 screening was employed in RGF-treated HCC cells to identify resistance-associated genes.
- Western blotting and immunoprecipitation were used to analyze protein modifications and interactions.
- Cell viability assays, ferroptosis assays, and knockdown/inhibition experiments were performed to assess functional roles.
Main Results:
- CRISPR/Cas9 screening identified Zinc Finger Protein 207 (ZNF207) as a critical mediator of RGF resistance.
- ZNF207 promotes RGF resistance by enhancing the lactylation of peroxiredoxin 1 (PRDX1), leading to NRF2 activation and suppressed ferroptosis.
- Knockdown of ZNF207 or disruption of the ZNF207-PRDX1-NRF2 pathway restored RGF sensitivity by reactivating ferroptosis.
Conclusions:
- The ZNF207-PRDX1-NRF2 signaling axis is a novel mechanism driving RGF resistance in HCC.
- Targeting protein lactylation and ferroptosis suppression presents a promising strategy to overcome RGF resistance.
- This pathway may represent a broader therapeutic target for overcoming drug resistance in other cancers.
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