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Integrative analysis reveals therapeutic potential of pyrvinium pamoate in Merkel cell carcinoma
Jiawen Yang, … , James A. DeCaprio, Megha Padi
Jiawen Yang, … , James A. DeCaprio, Megha Padi
Published February 11, 2025
Citation Information: J Clin Invest. 2025;135(7):e177724. https://doi.org/10.1172/JCI177724.
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Research Article Dermatology Oncology Virology

Integrative analysis reveals therapeutic potential of pyrvinium pamoate in Merkel cell carcinoma

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Abstract

Merkel Cell Carcinoma (MCC) is an aggressive neuroendocrine cutaneous malignancy arising from either ultraviolet-induced mutagenesis or Merkel cell polyomavirus (MCPyV) integration. Despite extensive research, our understanding of the molecular mechanisms driving the transition from normal cells to MCC remains limited. To address this knowledge gap, we assessed the impact of inducible MCPyV T antigens on normal human fibroblasts by performing RNA-seq. Our data uncovered changes in expression and regulation of Wnt signaling pathway members. Building on this observation, we bioinformatically evaluated various Wnt pathway perturbagens for their ability to reverse the MCC gene expression signature and identified pyrvinium pamoate, an FDA-approved anthelminthic drug known for its antitumor activity in other cancers. Leveraging transcriptomic, network, and molecular analyses, we found that pyrvinium targets multiple MCC vulnerabilities. Pyrvinium not only reverses the neuroendocrine features of MCC by modulating canonical and noncanonical Wnt signaling but also inhibits cancer cell growth by activating p53-mediated apoptosis, disrupting mitochondrial function, and inducing endoplasmic reticulum stress. Finally, we demonstrated that pyrvinium reduces tumor growth in an MCC mouse xenograft model. These findings offer a deeper understanding of the role of Wnt signaling in MCC and highlight the utility of pyrvinium as a potential treatment for MCC.

Authors

Jiawen Yang, James T. Lim, Paul Victor Santiago Raj, Marcelo G. Corona, Chen Chen, Hunain Khawaja, Qiong Pan, Gillian D. Paine-Murrieta, Rick G. Schnellmann, Denise J. Roe, Prafulla C. Gokhale, James A. DeCaprio, Megha Padi

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Figure 5

Pyrvinium pamoate reverses neuroendocrine and Wnt signaling signature in MCC cells.

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Pyrvinium pamoate reverses neuroendocrine and Wnt signaling signature in...
(A) Volcano plot of DEGs in WaGa cells treated with pyrvinium compared with DMSO for 24 hours. DEGs with Padj ≤ 0.05 and |log2 fold change|≥ 1 that show a reversed expression trend relative to MCC versus normal skin are highlighted in red (upregulated in MCC) or blue (downregulated in MCC). Known MCC marker genes are labeled in red text. (B) Scatter plot of predicted master regulator activity levels in pyrvinium-treated MCC versus DMSO-treated MCC cells. Blue (or red) indicates regulators with decreased (or increased) activity. (C) Relative mRNA levels of TCF7 and TCF3 in WaGa TopGFP cells treated with siRNA control, siTCF7, and siTCF3, as measured by RT-qPCR. Statistical significance determined by unpaired 2-sample t-test. (D) Protein levels of ATOH1, SOX2, and GFP, in untreated WaGa TopGFP cells and the cells treated with siRNA negative control, siTCF7, and siTCF3. (E) Protein levels of WNT5A/B following pyrvinium treatment for 24 hours in MCC cell lines. (F) Relative mRNA levels of AXIN2, ATOH1, and SOX2 in WaGa cells treated with recombinant hWNT5B protein for 6 hours, as measured by RT-qPCR. Statistical significance determined by unpaired 2-sample, 2-tailed t test. (G) Protein levels of total β-catenin, WNT5B, ATOH1, SOX2, and GFP following 6 hours of treatment with recombinant hWNT5B in WaGa TopGFP cells. (H) WNT5B, ATOH1, and SOX2 protein levels at 0, 12, 24, and 48 hours after 1 μg/mL doxycycline induction in WaGa WNT5B OE cells. (I and J) Cell viability in WaGa WNT5B OE cells and GFP control cells with or without 1 μg/mL doxycycline. Statistical significance between dox+ and dox– conditions on the same day was assessed by unpaired 2-sample, 2-tailed t test. (****P < 0.0001; ***P < 0.001; **P < 0.01; *P < 0.05).

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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