Somatic Epigenetic Silencing of RIPK3 Inactivates Necroptosis and Contributes to Chemoresistance in Malignant Mesothelioma

Clinical Cancer Research 2020 November 17 [Link]

Yinfei Tan, Eleonora Sementino, Mitchell Cheung, Suraj Peri, Craig W Menges, Anna-Mariya Kukuyan, Ting Zhang, Vladimir Khazak, Lauren A Fox, Eric A Ross, Suresh Ramanathan, Suresh C Jhanwar, Raja M Flores, Siddharth Balachandran, Joseph R Testa


Purpose: Receptor-interacting protein kinase RIPK3 phosphorylates effector molecule MLKL to trigger necroptosis. Although RIPK3 loss is seen in several human cancers, its role in malignant mesothelioma (MM) is unknown. This study aimed to determine if RIPK3 functions as a potential tumor suppressor to limit development of MM.

Experimental design: RIPK3 expression was examined in 66 MM tumors and cell lines. Promoter methylation and DNMT1 siRNAstudies were performed to assess the mode of RIPK3 silencing in RIPK3-deficient MM cells. Restoration of RIPK3 expression in RIPK3-negative MM cells, either by treatment with 5-aza-2′-deoxycytidine or lentiviral expression of cDNA, was performed to assess effects on cell viability, necrosis, and chemosensitization.

Results: Loss of RIPK3 expression was observed in 42/66 (63%) primary MMs and MM cell lines, and RT-PCR analysis demonstrated that downregulation occurs at the transcriptional level, consistent with epigenetic silencing. RIPK3-negative MM cells treated with 5-aza-2′-deoxycytidine resulted in re-expression of RIPK3 and chemosensitization. Ectopic expression of RIPK3 also resulted in chemosensitization and led to necroptosis, the latter demonstrated by phosphorylation of downstream target MLKL and confirmed by rescue experiments. Mining of RIPK3 expression and survival outcomes among MM patients available from The Cancer Genome Atlas repository revealed that promoter methylation of RIPK3 is associated with reduced RIPK3 expression and poor prognosis.

Conclusions: These data suggest that RIPK3 acts as a tumor suppressor in MM by triggering necroptosis and that epigenetic silencing of RIPK3 by DNA methylation impairs necroptosis and contributes to chemoresistance and poor survival in this incurable disease.