Activation of Chaperon-Mediated Autophagy Via Modulation of Hsp90 Activity Inhibits Tumor Growth Under Hypoxia

Background: Chaperon-mediated autophagy (CMA) is a target specific degradation pathway among autophagic processes. Although CMA plays critical roles in tumor progression in general, the role of CMA in tumor progression under hypoxia is poorly understood. We investigated the role of CMA in hypoxic tumor using a novel Hsp90-mediated modulator of CMA.Methods: We examined whether manassantin A (ManA), known as a potent inhibitor of HIF-1α, is a CMA modulator using biochemical, molecular, and cell biology approaches. We analyzed the effects of ManA on Hsp90 chaperone function by using Significant Analysis of Microarray, luciferase refolding assay, HS-10 resin binding assay, NMR spectroscopy, and SPR assay. We investigated tumor growth in response to monotherapy and combination therapy with ManA and anti-programmed death-1 (PD-1) antibody in vivo. To assess the clinical efficacy of CMA-related genes, we analyzed the gene expressions of HIF-1α, HSP90AA1, and transcription factor EB (TFEB) using TCGA datasets. Finally, we assessed in vivo/in vitro absorption, distribution, metabolism, and excretion properties of ManA.Results: ManA inhibits Hsp90 chaperone function through disruption of the Hsp90/F1F0-ATP synthase (chaperone/co-chaperone) complex. The inhibition of Hsp90 enhances the interaction of CMA substrates and LAMP-2A as well as TFEB nuclear localization, thus leading to CMA activation. Importantly, CMA activation not only retards tumor growth in vitro and in vivo, but also displays cooperative antitumor activity with anti-PD-1 antibody in vivo. An in-depth analysis of TCGA datasets shows that combined expression of HSP90AA1High/HIF1AHigh or TFEBLow/HIF1AHigh is strongly correlated with poor prognosis in lung cancer patients. Conclusions: ManA-induced inhibition of Hsp90 promotes CMA activity and decreases the stability of CMA substrates such as HIF-1α protein, leading to a marked reduction of hypoxic tumor growth. Therefore, targeting CMA activity via Hsp90 may present a promising therapeutic strategy for hypoxic tumor.