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Abstract
Ovarian
cancer is a leading cause of cancer death in women in the United
States. While the majority of ovarian cancers are serous, some rarer
subtypes (i.e. clear cell) are often associated with endometriosis, a
benign gynecological disease. Iron is rich in the cyst fluid of
endometriosis-associated ovarian cancers and induces persistent
oxidative stress. The role of iron, an essential nutrient involved in
multiple cellular functions, in normal ovarian cell survival and ovarian
cancer remains unclear. Iron, presented as ferric ammonium citrate
(FAC), dramatically inhibits cell survival in ovarian cancer cell types
associated with Ras mutations, while it is without effect in
immortalized normal ovarian surface epithelial (T80) and endometriotic
epithelial cells (lacking Ras mutations). Interestingly, FAC induced
changes in cytoplasmic vacuolation concurrently with increases in LC3-II
levels (an autophagy marker); these changes occurred in an
ATG5/ATG7-dependent, beclin-1/hVps34-independent, and Ras-independent
manner. Knockdown of autophagy mediators in HEY ovarian cancer cells
reversed FAC-induced LC3-II levels, but there was little effect on
reversing the cell death response. Intriguingly, transmission electron
microscopy of FAC-treated T80 cells demonstrated abundant lysosomes
(confirmed using Lysotracker) rich in iron particles, which occurred in a
Ras-independent manner. Although the mitogen-activated protein kinase
(MAPK) inhibitor, U0126, reversed FAC-induced LC3-II/autophagic punctae
and lysosomes in a Ras-independent manner, it was remarkable that U0126
reversed cell death in malignant ovarian cells associated with Ras
mutations. Moreover, FAC increased heme oxygenase-1 expression in
H-Ras-overexpressing T80 cells, which was associated with increased cell
death when overexpressed in T80 cells. Disruption of intracellular iron
levels, via chelation of intracellular iron (deferoxamine), was also
detrimental to malignant ovarian cell survival; thus, homeostatic
intracellular iron levels are essential for cell survival. Collectively,
our results implicate iron in modulating cell death in a Ras- and
MAPK-dependent manner in ovarian cancer cells.
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