Reversible p53 inhibition prevents cisplatin ototoxicity without blocking chemotherapeutic efficacy.

Reversible p53 inhibition prevents cisplatin ototoxicity without blocking chemotherapeutic efficacy.
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DOI:
10.15252/emmm.201606230
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发表时间:
2017-01
影响因子:
11.1
通讯作者:
Wang J
Wang J
中科院分区:
医学1区
文献类型:
--
作者:
Benkafadar N;Menardo J;Bourien J;Nouvian R;François F;Decaudin D;Maiorano D;Puel JL;Wang J

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顺铂是一种广泛使用的化疗药物,尽管其显著的耳毒性副作用。迄今为止,顺铂诱导耳毒性的机制尚不清楚,患者在顺铂化疗期间缺乏听力保护。我们发现ATM - Chk2 - p53通路的激活是顺铂耳毒性的主要决定因素。然而,ATM激活对感觉毛细胞的相反作用阻碍了顺铂诱导耳毒性的预防:促进外毛细胞死亡和内毛细胞存活。然而,令人鼓舞的是,基因或药物消融p53可显著减少耳蜗细胞凋亡,从而保持听力。重要的是,在患有患者源性三阴性乳腺癌的小鼠中,系统给予p53抑制剂可以保护听觉功能,而不会影响顺铂的抗肿瘤功效。总之,这些发现强调了一种新的、有效的顺铂化疗听力保护策略。
Cisplatin is a widely used chemotherapy drug, despite its significant ototoxic side effects. To date, the mechanism of cisplatin‐induced ototoxicity remains unclear, and hearing preservation during cisplatin‐based chemotherapy in patients is lacking. We found activation of the ATM‐Chk2‐p53 pathway to be a major determinant of cisplatin ototoxicity. However, prevention of cisplatin‐induced ototoxicity is hampered by opposite effects of ATM activation upon sensory hair cells: promoting both outer hair cell death and inner hair cell survival. Encouragingly, however, genetic or pharmacological ablation of p53 substantially attenuated cochlear cell apoptosis, thus preserving hearing. Importantly, systemic administration of a p53 inhibitor in mice bearing patient‐derived triple‐negative breast cancer protected auditory function, without compromising the anti‐tumor efficacy of cisplatin. Altogether, these findings highlight a novel and effective strategy for hearing protection in cisplatin‐based chemotherapy.
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