Repurposing of the Antipsychotic Trifluoperazine Induces SLC7A11/GPX4- Mediated Ferroptosis of Oral Cancer via the ROS/Autophagy Pathway

Int J Biol Sci. 2024 Nov 11;20(15):6090-6113. doi: 10.7150/ijbs.99859. eCollection 2024.

Abstract

Ferroptosis, a mode of cell death characterized by iron-dependent phospholipid peroxidation, has a substantial therapeutic potential for the treatment of various cancers. This study investigated the effects of trifluoperazine (TFP), an FDA-approved drug traditionally utilized for mental health disorder, on oral cancer cells, with a particular focus on the mechanisms involved in its potential anti-tumor properties. Our findings indicate that TFP significantly elevates the levels of lipid-derived reactive oxygen species (ROS) and induces ferroptotic cell death in oral cancer cells through pathways involving autophagy, the SLC7A11/GPX4 axis, and mitochondrial damage. Additionally, molecular docking analyses revealed that TFP acts as an inhibitor of GPX4. The elevated expression level of GPX4 in oral cancer biopsies was also found to correlate with a poor prognosis. Together, these results provide evidence that TFP selectively induces GPX4-mediated, autophagy-dependent ferroptosis, thereby exerting anti-cancer effects against oral cancer and preventable death.

Keywords: Autophagy; Ferroptosis; Oral Cancer; ROS; Trifluoperazine; mental disorder; preventable death.

MeSH terms

  • Amino Acid Transport System y+* / metabolism
  • Antipsychotic Agents* / pharmacology
  • Antipsychotic Agents* / therapeutic use
  • Autophagy* / drug effects
  • Cell Line, Tumor
  • Drug Repositioning*
  • Ferroptosis* / drug effects
  • Humans
  • Molecular Docking Simulation
  • Mouth Neoplasms* / drug therapy
  • Mouth Neoplasms* / metabolism
  • Mouth Neoplasms* / pathology
  • Phospholipid Hydroperoxide Glutathione Peroxidase* / metabolism
  • Reactive Oxygen Species* / metabolism
  • Trifluoperazine* / pharmacology
  • Trifluoperazine* / therapeutic use

Substances

  • Trifluoperazine
  • Reactive Oxygen Species
  • Phospholipid Hydroperoxide Glutathione Peroxidase
  • Antipsychotic Agents
  • SLC7A11 protein, human
  • Amino Acid Transport System y+