Glutaredoxin‐1 promotes lymphangioleiomyomatosis progression through inhibiting Bim‐mediated apoptosis via COX2/PGE2/ERK pathway

Abstract Background Lymphangioleiomyomatosis (LAM) is a female‐predominant interstitial lung disease, characterized by progressive cyst formation and respiratory failure. Clinical treatment with the mTORC1 inhibitor rapamycin could relieve partially the respiratory symptoms, but not curative. It is urgent to illustrate the fundamental mechanisms of TSC2 deficiency to the development of LAM, especially mTORC1‐independent mechanisms. Glutaredoxin‐1 (Glrx), an essential glutathione (GSH)‐dependent thiol‐oxidoreductase, maintains redox homeostasis and participates in various processes via controlling protein GSH adducts. Redox signalling through protein GSH adducts in LAM remains largely elusive. Here, we demonstrate the underlying mechanism of Glrx in the pathogenesis of LAM. Methods 1. Abnormal Glrx expression in various kinds of human malignancies was identified by the GEPIA tumour database, and the expression of Glrx in LAM‐derived cells was detected by real‐time quantitative reverse transcription (RT‐qPCR) and immunoblot. 2. Stable Glrx knockdown cell line was established to evaluate cellular impact. 3. Cell viability was determined by CCK8 assay. 4. Apoptotic cell number and intracellular reactive oxygen species (ROS) level were quantified by flow cytometry. 5. Cox2 expression and PGE2 production were detected to clarify the mechanism of Bim expression modulated by Glrx. 6. S‐glutathionylated p65 was enriched and detected by immunoprecipitation and the direct regulation of Glrx on p65 was determined. 7. The xenograft animal model was established and photon flux was analyzed using IVIS Spectrum. Results In LAM, TSC2 negatively regulated abnormal Glrx expression and activation in a mTORC1‐independent manner. Knockdown of Glrx increased the expression of Bim and the accumulation of ROS, together with elevated S‐glutathionylated proteins, contributing to the induction of apoptotic cell death and inhibited cell proliferation. Knockdown of Glrx in TSC2‐deficient LAM cells increased GSH adducts on nuclear factor‐kappa B p65, which contributed to a decrease in the expression of Cox2 and the biosynthesis of PGE2. Inhibition of PGE2 metabolism attenuated phosphorylation of ERK, which led to the accumulation of Bim, due to the imbalance of its phosphorylation and proteasome degradation. In xenograft tumour models, knockdown of Glrx in TSC2‐deficient LAM cells inhibited tumour growth and increased tumour cell apoptosis. Conclusions Collectively, we provide a novel redox‐dependent mechanism in the pathogenesis of LAM and propose that Glrx may be a beneficial strategy for the treatment of LAM or other TSC‐related diseases.