title: Cyclosporine A suppresses keratinocyte cell death through MPTP inhibition in a model for skin cancer in organ transplant recipients.
abstract: Transplant recipients have an elevated risk of skin cancer, with a 65- to 250-fold increase in squamous cell carcinoma. Usage of the immunosuppressant cyclosporine A (CsA) is associated with the development of skin cancer. We hypothesized that the increased incidence of skin cancer was due to the action of CsA within keratinocyte mitochondria where it can inhibit mitochondrial permeability transition pore (MPTP) opening. Normally, MPTP opening is induced by oxidative stress such as that caused by UV light and leads to cell death, thereby eliminating a cell that has been exposed to genotoxic insult. However, in the presence of CsA, damaged cells may survive and consequently form tumors. To test this hypothesis, we treated keratinocytes with levels of CsA used therapeutically in transplant patients and assessed their viability following UVA-irradiation. CsA prevented cell death by inhibiting MPTP opening, even though the levels of oxidative stress were increased markedly. Nim811, a non-immunosuppressive drug that can block the MPTP had a similar effect while the immunosuppressive drug tacrolimus that does not interact with the mitochondria had no effect. These findings suggest that CsA may promote skin cancer in transplant patients by allowing keratinocyte survival under conditions of increased genotoxic stress.
authors.affiliation: Department of Medicine, Division of Dermatology, VA Tennessee Valley Healthcare System and Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Norman
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Canter
authors.forename: Mingjian
authors.initials: M
authors.lastname: Shi
authors.forename: Ginger L
authors.initials: GL
authors.lastname: Milne
authors.forename: Jason D
authors.initials: JD
authors.lastname: Morrow
authors.forename: James E
authors.initials: JE
authors.lastname: Sligh
mesh_terms: D016923:Cell Death; D002460:Cell Line; D002470:Cell Survival / Q000187:drug effects / Q000528:radiation effects; D016572:Cyclosporine / Q000494:pharmacology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D015603:Keratinocytes / Q000187:drug effects*; D033681:Mitochondrial Membrane Transport Proteins / Q000037:antagonists & inhibitors*; D000083162:Mitochondrial Permeability Transition Pore; D016377:Organ Transplantation / Q000009:adverse effects; D012878:Skin Neoplasms; D014466:Ultraviolet Rays
chemical_list: D007166:Immunosuppressive Agents; D033681:Mitochondrial Membrane Transport Proteins; D000083162:Mitochondrial Permeability Transition Pore; D016572:Cyclosporine