Bedaquiline, an FDA-approved drug, inhibits mitochondrial ATP production and metastasis in vivo, by targeting the gamma subunit (ATP5F1C) of the ATP synthase

Fiorillo, M; Scatena, C; Naccarato, AG; Sotgia, F; Lisanti, MP

Abstract

Here, we provide evidence that high ATP production by the mitochondrial ATP-synthase is a new therapeutic target for anticancer therapy, especially for preventing tumor progression. More specifically, we isolated a subpopulation of ATP-high cancer cells which are phenotypically aggressive and demonstrate increases in proliferation, stemness, anchorage-independence, cell migration, invasion and multi-drug resistance, as well as high antioxidant capacity. Clinically, these findings have important implications for understanding treatment failure and cancer cell dormancy. Using bioinformatic analysis of patient samples, we defined a mitochondrial-related gene signature for metastasis, which features the gamma-subunit of the mitochondrial ATP-synthase (ATP5F1C). The relationship between ATP5F1C protein expression and metastasis was indeed confirmed by immunohistochemistry. Next, we used MDA-MB-231 cells as a model system to functionally validate these findings. Importantly, ATP-high MDA-MB-231 cells showed a nearly fivefold increase in metastatic capacity in vivo. Consistent with these observations, ATP-high cells overexpressed (i) components of mitochondrial complexes I-V, including ATP5F1C, and (ii) markers associated with circulating tumor cells (CTCs) and metastasis, such as EpCAM and VCAM1. Knockdown of ATP5F1C expression significantly reduced ATP-production, anchorage-independent growth, and cell migration, as predicted. Similarly, therapeutic administration of the FDA-approved drug, Bedaquiline, downregulated ATP5F1C expression in vitro and prevented spontaneous metastasis in vivo. In contrast, Bedaquiline had no effect on the growth of non-tumorigenic mammary epithelial cells (MCF10A) or primary tumors in vivo. Taken together, our results suggest that mitochondrial ATP depletion is a new therapeutic strategy for metastasis prophylaxis, to avoid treatment failure. In summary, we conclude that mitochondrial ATP5F1C is a promising new biomarker and molecular target for future drug development, for the prevention of metastatic disease progression.

Citation

Fiorillo, M., Scatena, C., Naccarato, A., Sotgia, F., & Lisanti, M. (2021). Bedaquiline, an FDA-approved drug, inhibits mitochondrial ATP production and metastasis in vivo, by targeting the gamma subunit (ATP5F1C) of the ATP synthase. Cell Death and Differentiation, 28(9), 2797-2817. https://doi.org/10.1038/s41418-021-00788-x

• Journal Article Type: Article
• Acceptance Date: Apr 15, 2021
• Online Publication Date: May 13, 2021
• Publication Date: Sep 1, 2021
• Deposit Date: May 28, 2021
• Publicly Available Date: May 28, 2021
• Journal: Cell Death and Differentiation
• Print ISSN: 1350-9047
• Electronic ISSN: 1476-5403
• Publisher: Nature Publishing Group
• Volume: 28
• Issue: 9
• Pages: 2797-2817
• DOI: https://doi.org/10.1038/s41418-021-00788-x
• Publisher URL: https://doi.org/10.1038/s41418-021-00788-x
• Related Public URLs: http://www.nature.com/cdd/
• Additional Information: Additional Information : ** From PubMed via Jisc Publications Router **Journal IDs: eissn 1476-5403 **Article IDs: pubmed: 33986463; pii: 10.1038/s41418-021-00788-x **History: accepted 15-04-2021; revised 09-04-2021; submitted 23-10-2020