Anti-cancer effect of doxorubicin is mediated by downregulation of HMG-Co A reductase via inhibition of EGFR/Src pathway

Un Jung Yun, Ji Hye Lee, Jaegal Shim, Kyungsil Yoon, Sung Ho Goh, Eun Hee Yi, Sang Kyu Ye, Jae Seon Lee, Hyunji Lee, Jongsun Park, In Hye Lee, Yong Nyun Kim

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Doxorubicin is a widely used DNA damage-inducing anti-cancer drug. However, its use is limited by its dose-dependent side effects, such as cardiac toxicity. Cholesterol-lowering statin drugs increase the efficacy of some anti-cancer drugs. Cholesterol is important for cell growth and a critical component of lipid rafts, which are plasma membrane microdomains important for cell signaling. 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (HMG-CR) is a critical enzyme in cholesterol synthesis. Here, we show that doxorubicin downregulated HMG-CR protein levels and thus reduced levels of cholesterol and lipid rafts. Cholesterol addition attenuated doxorubicin-induced cell death, and cholesterol depletion enhanced it. Reduction of HMG-CR activity by simvastatin, a statin that acts as an HMG-CR inhibitor, or by siRNA-mediated HMG-CR knockdown enhanced doxorubicin cytotoxicity. Doxorubicin-induced HMG-CR downregulation was associated with inactivation of the EGFR-Src pathway. Furthermore, a high-cholesterol-diet attenuated the anti-cancer activity of doxorubicin in a tumor xenograft mouse model. In a multivulva model of Caenorhabditis elegans expressing an active-EGFR mutant, doxorubicin decreased hyperplasia more efficiently in the absence than in the presence of cholesterol. These data indicate that EGFR/Src/HMG-CR is a new pathway mediating doxorubicin-induced cell death and that cholesterol control could be combined with doxorubicin treatment to enhance efficacy and thus reduce side effects.

Original languageEnglish
Pages (from-to)1157-1172
Number of pages16
JournalLaboratory Investigation
Issue number8
StatePublished - 1 Jul 2019

Bibliographical note

Funding Information:
Acknowledgements This work was supported by a research grant from the National Cancer Center, Republic of Korea (NCC-1510090) and National Research Foundation (NRF) grant funded by Korea government (NRF-2011–0016025).

Publisher Copyright:
© 2019, United States & Canadian Academy of Pathology.


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