From bed to bench and back to bed: Mimicking how HPV-positive cancer responds to treatment

September 07, 2017

Patients with head and neck squamous cell carcinoma who are positive for human papilloma virus (HPV-positive) have been observed to respond significantly better to chemo-radiotherapy than HPV-negative patients. This observation is surprising because HPV infection leads to an increased risk of developing oropharyngeal cancer. To date, the reason for this dichotomy has not been well understood.

In an article in the August 2017 issue of EMBO: Molecular Medicine, researchers and clinicians at the Medical University of South Carolina (MUSC) Hollings Cancer Center report having identified one of the underlying mechanisms -- expression of the viral protein E7 leads to cell death through mitophagy, a process that destroys the mitochondria. They went on to develop a novel peptide that mimics this pathway and improves therapeutic intervention in HPV-negative head and neck cancers.

"This study looked at both the clinical aspects as well as the mechanistic and therapeutic aspects of oral cancer. We are very excited about these findings because they represent what is happening in the clinic," says Besim Ogretmen, Ph.D., senior author for this study, director of the Lipidomics Shared Resource Center and professor of Biochemistry and Molecular Biology at MUSC.

Ogretmen's laboratory has a history of studying mitochondria as well as a specific lipid, ceramide. Association of ceramide with mitochondria elicits a decrease in energy production as well as an increase in the production of toxic molecules called reactive oxygen species. The findings described in their recent work bridges these two areas of study and describes a mechanism of cell death termed ceramide-induced mitophagy, which plays an important role in killing oral cancer cells.

Ceramide-induced mitophagy is a two-pronged approach to killing cancer cells. The first prong involves treating cancer cells with cisplatin, a chemotherapeutic agent that mimics ceramide. The treated cells accumulate ceramide at the mitochondria. The second prong involves the viral protein E7. The E7 protein liberates the cellular protein E2F5, which is then capable of binding another cellular protein called dynamin related protein 1 (DRP1). This complex is then targeted to the mitochondria. Importantly, it is the combined presence of ceramide and DRP1 at mitochondria that prompts mitochondrial degradation and ultimately cell death.

Having described the mechanism by which HPV-positive cancer cells succumb to chemotherapy, the Ogretmen lab next wanted to determine if they could apply these findings to HPV- cancers, since patients with these cancers are much more likely to succumb to their disease relative to patients with HPV-related cancer.

"Based on these mechanistic findings, we developed a peptide that can mimic the HPV effects without the HPV infection," says Ogretmen.

In order to accomplish this, they developed a peptide that mimics the interaction of the cellular proteins E2F5 and DRP1. Treatment of HPV- oral cancer cells with cisplatin and this novel peptide led to increased cell death in a manner that was similar to treatment of HPV-positive cancer cells with cisplatin. Further experiments showed that this peptide was effective at killing HPV cancer cells in a mouse model.

Future studies are aimed at better understanding the mechanism by which ceramide is incorporated into mitochondria. How does ceramide enter the cell? How is ceramide transported to the mitochondria? Better understanding of this pathway may provide further avenues for improved treatment with cisplatin or other ceramide-like compounds.

Overall, these results demonstrate that chemotherapy is much more effective in HPV-positive cancer cells and that this improved efficacy can be achieved in HPV-negative cancer cells through co-treatment with an E2F5 peptide.

"We are very excited about the potential therapeutic aspects of this peptide; however, developing a drug and taking that drug to the clinic takes a lot of effort and a lot of funding," says Ogretmen.

There are many hurdles that have to be overcome before this novel treatment becomes available in the clinic. One of the first hurdles is manufacturing large quantities of the peptide using good laboratory practices, which is a requirement of the Food and Drug Administration. Once these protocols have been established, clinical trials testing the safety and efficacy of this combinatorial therapy can begin.

This work was achieved through the coordinated collaboration of clinicians and basic science researchers and exemplifies the "bed to bench to bed" mantra that scientific research strives to achieve. Patients were asked to donate the leftover cancer tissue from their surgery. Then the tissues were tested in the lab and in animal models. Now, the results of these tests are to be taken back into the clinic (bedside) in an attempt to treat patients with HPV-negative head and neck cancers.

"Given the profound impact of HPV status on survival, it has become clear that understanding the mechanisms driving the sensitivity of HPV-related disease to cytotoxic therapies could provide the foundation for novel therapies in HPV-negative head and neck cancer," says David Neskey, M.D., a surgeon at MUSC Hollings Cancer Center specializing in the treatment of head and neck cancers.
-end-
About MUSC

Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 13,000 employees, including approximately 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $2.2 billion. MUSC operates a 750-bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (a National Cancer Institute designated center) Level I Trauma Center, and Institute of Psychiatry. For more information on academic information or clinical services, visit musc.edu. For more information on hospital patient services, visit muschealth.org.

About MUSC Hollings Cancer Center

The Hollings Cancer Center at the Medical University of South Carolina is a National Cancer Institute-designated cancer center and the largest academic-based cancer research program in South Carolina. The cancer center comprises more than 120 faculty cancer scientists with an annual research funding portfolio of $44 million and a dedication to reducing the cancer burden in South Carolina. Hollings offers state-of-the-art diagnostic capabilities, therapies and surgical techniques within multidisciplinary clinics that include surgeons, medical oncologists, radiation therapists, radiologists, pathologists, psychologists and other specialists equipped for the full range of cancer care, including more than 200 clinical trials. For more information, visit http://www.hollingscancercenter.org

Medical University of South Carolina

Related Mitochondria Articles from Brightsurf:

Researchers improve neuronal reprogramming by manipulating mitochondria
Researchers at Helmholtz Zentrum M√ľnchen and Ludwig Maximilians University Munich (LMU) have identified a hurdle towards an efficient conversion: the cell metabolism.

Inside mitochondria and their fascinating genome
EPFL scientists have observed -- for the first time in living cells -- the way mitochondria distribute their transcriptome throughout the cell, and it involves RNA granules that turn out to be highly fluid.

'Cheater mitochondria' may profit from cellular stress coping mechanisms
Cheating mitochondria may take advantage of cellular mechanisms for coping with food scarcity in a simple worm to persist, even though this can reduce the worm's wellbeing.

A ribosome odyssey in mitochondria
The ciliate mitoribosome structure provides new insights into the diversity of translation and its evolution.

Fireflies shed light on the function of mitochondria
By making mice bioluminescent, EPFL scientists have found a way to monitor the activity of mitochondria in living organisms.

First successful delivery of mitochondria to liver cells in animals
This experiment marks the first time researchers have ever successfully introduced mitochondria into specific cells in living animals.

Lack of mitochondria causes severe disease in children
Researchers at Karolinska Institutet in Sweden have discovered that excessive degradation of the power plants of our cells plays an important role in the onset of mitochondrial disease in children.

Unexpected insights into the dynamic structure of mitochondria
As power plants and energy stores, mitochondria are essential components of almost all cells in plants, fungi and animals.

Mitochondria are the 'canary in the coal mine' for cellular stress
Mitochondria, tiny structures present in most cells, are known for their energy-generating machinery.

Master regulator in mitochondria is critical for muscle function and repair
New study identifies how loss of mitochondrial protein MICU1 disrupts calcium balance and causes muscle atrophy and weakness.

Read More: Mitochondria News and Mitochondria Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.