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HO-1 impairs the efficacy of radiotherapy by redistributing cGAS and STING in tumors
Chuqing Zhang, … , Cheng Xu, Xiaoyu Liang
Chuqing Zhang, … , Cheng Xu, Xiaoyu Liang
Published December 2, 2024
Citation Information: J Clin Invest. 2024;134(23):e181044. https://doi.org/10.1172/JCI181044.
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Research Article Immunology Oncology

HO-1 impairs the efficacy of radiotherapy by redistributing cGAS and STING in tumors

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Abstract

Type I IFNs (IFN-Is) induced by radiotherapy (RT) are critical for its efficacy, while the mechanism by which tumor cells inhibit IFN-I production remains largely unsolved. By an unbiased CRISPR screen, we identified hemeoxygenase 1 (HO-1) as an RT-related regulator of IFN-I production. Mechanistically, the ER-anchored, full-length HO-1 disrupted stimulator of IFN genes (STING) polymerization and subsequent coat protein complex II–mediated (COPII-mediated) ER-Golgi transportation, leading to hampered activation of downstream signaling. This process was exacerbated by the upregulation of HO-1 expression under RT. Importantly, RT also induced HO-1 cleavage. Cleaved HO-1 underwent nuclear translocation, interacted with cyclic GMP-AMP synthase (cGAS), and inhibited its nuclear export upon irradiation, leading to suppressed 2′3′-cyclic GMP-AMP (cGAMP) production. Furthermore, we revealed that HO-1 inhibitors could enhance local and distant tumor control of RT in vivo. Clinically, higher HO-1 expression was associated with a poorer prognosis and earlier tumor relapse after RT in multiple types of patient tumors. Collectively, through comprehensive inhibition of the cGAS/STING pathway, HO-1 strongly inhibited RT-induced IFN-I production, and targeting HO-1 was shown to be a promising RT-sensitizing therapeutic strategy.

Authors

Chuqing Zhang, Zhenji Deng, Jiawei Wu, Cong Ding, Zhe Li, Zhimin Xu, Weipeng Chen, Kaibin Yang, Hanmiao Wei, Tingxiang He, Liufen Long, Jun Ma, Cheng Xu, Xiaoyu Liang

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Figure 10

High expression of HO-1 correlates with unfavorable RT prognosis.

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High expression of HO-1 correlates with unfavorable RT prognosis.
(A) Re...
(A) Representative images of immunohistochemical staining for HO-1 protein expression, which is graded according to the staining intensity in 220 NPC tissues. Scale bars: 100 μm. (B) Correlations of the locoregional recurrence status with HO-1 expression detected by IHC. P value was determined by 2-tailed χ2 test. (C and D) Kaplan-Meier analysis of OS (C) and DFS (D) according to HO-1 expression. (E) Kaplan-Meier analysis of DFS based on HO-1 expression in the published bulk RNA-Seq dataset. (C–E) P values were determined using the log-rank test. (F) Proposed working model of HO-1. By an unbiased CRISPR screen, we identified HO-1 as an irradiation-related regulator of IFN-I production. Mechanistically, irradiation induced HO-1 expression and promoted its cleavage. Cleaved HO-1 underwent nuclear translocation, interacted with cGAS, inhibited its nuclear export upon radiation, and suppressed its enzymatic activity. ER-anchored full-length HO-1 disturbed STING polymerization and subsequent COPII-mediated ER-Golgi transportation, leading to impaired activation of downstream signaling.

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

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